Kodi thupi lanu lili ndi asidi wambiri? Tiyeni tiphunzire za lactic acidosis!

Kodi munayamba mwamvapo kutopa, kupweteka, kapena kupuma movutikira mukatopa pang'ono? Izi zitha kukhala chifukwa cha zifukwa zingapo. Komabe, lero tikambirana za vuto lomwe lingachitike pamene mankhwala otchedwa lactic acid akuchuluka m'thupi lathu. Izi ndi zomwe madokotala amatcha lactic acidosis . Musadandaule, tiyeni tikambirane za izi mosavuta.

Kodi Lactic Acidosis ndi chiyani?

Mwachidule, lactic acidosis ndi vuto lomwe limakhala ndi lactic acid yambiri m'magazi mwanu. Izi zitha kuchitika pamene thupi lanu limapanga lactic acid yambiri, kapena pamene thupi lanu silingathe kuchotsa bwino lactic acid yomwe limapanga.

Kawirikawiri, chiwindi ndi impso zathu ndi zomwe zimachotsa lactic acid yochulukirapo m'thupi lathu. Komabe, ngati kuchuluka kwa lactic acid kuli kokwera kwambiri, kapena ngati pali kufooka kwina m'ziwalo izi monga chiwindi ndi impso, sizingathe kuchita bwino ntchitoyi. Pamenepo ndi pomwe lactic acid imayamba kudziunjikira m'magazi.

Ngati mulingo wa lactic acid m'magazi mwanu wakwera pang'ono, timautcha hyperlactatemia . Komabe, ngati izi zikuwonjezeka kwambiri ndipo pH ya thupi (monga acid-base balance) ikakhala acidic kwambiri, ndiye kuti lactic acidosis .

Chifukwa chiyani lactic acid imapezeka m'thupi lathu?

Lactic acid, yomwe nthawi zina imatchedwa lactate , ndi chinthu chachilengedwe chomwe chimachokera ku kagayidwe ka maselo. Maselo athu amagwiritsa ntchito shuga (shuga) kuti apange mphamvu. Njira imeneyi imatchedwa anaerobic glycolysis . Izi zimachitika pamene maselo amafunikira mphamvu mwachangu, koma alibe mpweya wokwanira kuti achite zimenezo.

Kawirikawiri, timapeza mphamvu kudzera mu njira yomwe imagwiritsa ntchito mpweya. Izi zimatchedwa aerobic metabolism . Komabe, anaerobic glycolysis ndi ngati gwero la mphamvu lomwe timagwiritsa ntchito pazidzidzidzi. Tangoganizirani, pamene mwadzidzidzi mukuthamanga kwambiri kapena kunyamula katundu wolemera, minofu yanu imasowa mpweya mwadzidzidzi. Pamenepo ndi pamene njira iyi imagwiritsidwa ntchito. Mofananamo, pamene minofu yathu silandira mpweya chifukwa cha matenda ena, lactic acid imapangidwanso motere.

Kodi chimachitika ndi chiyani ngati lactic acidosis ichitika?

Zomwe zimachitika mukakhala ndi lactic acidosis zimadalira kuopsa kwake. Anthu ena angakumane ndi vutoli kwakanthawi, makamaka mukachita masewera olimbitsa thupi kwambiri. Lingapangitse thupi lanu kupweteka kwa masiku angapo. Koma ngati chiwindi ndi impso zanu zili bwino, lactic acid imatha pakatha masiku ochepa.

Komabe, ngati thupi lanu likupitiriza kupanga lactic acid yochuluka, kapena ngati chiwindi ndi impso zanu sizingathe kuikonza bwino, vutoli likhoza kukhala lalikulu kwambiri. Izi nthawi zambiri zimachitika ndi matenda enaake. Pamene kuchuluka kwa lactate m'magazi anu kukupitirira kukwera, kuchuluka kwa pH kumachepa, ndipo kutulutsa kwa mtima kumachepa pang'onopang'ono. Izi zingayambitse kulephera kwa ziwalo zina komanso imfa. Chifukwa chake ndikofunikira kudziwa izi.

Kodi zizindikiro za Lactic Acidosis ndi ziti?

Zizindikiro za vutoli zimatha kusiyana pachiyambi komanso pamene vutoli lakula kwambiri.

Zizindikiro zoyambirira

Poyamba, mungamve zinthu ngati izi:

• Kusanza ndi kusanza.
• Kutopa kwambiri komanso kutopa kwambiri.
• Kupuma mofulumira komanso mozama (izi zimatchedwa kupuma bwino , kuyesa kuchepetsa acidity m'thupi kudzera mu kupuma).
• Kugwedezeka kwa minofu ndi kupweteka kwa thupi.

Zizindikiro pamene vutoli lafika poipa kwambiri

Pamene vutoli likuipiraipira, zizindikiro zotsatirazi zingawonekerenso:

• Kufooka ndi kugona kwambiri.
• Kusokonezeka maganizo ndi chisokonezo.
• Kuvuta kulamulira mayendedwe, monga poyenda ( ataxia ).
• Kuchepa kwa mkodzo wotuluka ( Oliguria ).

Zizindikiro zina

Mungakhalenso ndi zizindikiro za matenda ena omwe amayambitsa lactic acidosis . Mwachitsanzo, matenda monga sepsis ( matenda a m'magazi), shock ( sitiroko), kapena kulephera kwa chiwindi . Zizindikiro za izi zingaphatikizepo:

• Kutentha kochepa kwa thupi.
• Kuthamanga kwa magazi pang'ono.
• Malungo.
• Jaundice (kutuluka kwachikasu pakhungu ndi maso oyera).

Kodi chifukwa chachikulu cha lactic acidosis ndi chiyani?

Pakhoza kukhala zifukwa zambiri za izi. Chomwe chimayambitsa izi nthawi zambiri ndi kuchepa kwa mpweya m'magazi mwanu (hypoxemia) kapena kusowa kwa mpweya m'maselo anu (hypoxia). Izi nthawi zambiri zimachitika chifukwa cha matenda.

Madokotala agawa vutoli la lactic acidosis m'mitundu ingapo kutengera zomwe zimayambitsa:

Mtundu A

Mtundu wa A lactic acidosis umachitika pamene minofu yanu silandira mpweya wokwanira. Nthawi zambiri imapezeka m'matenda oopsa. Imathanso kukhala kwakanthawi, chifukwa chochita masewera olimbitsa thupi mopitirira muyeso.

Zina mwa zinthu zomwe zingayambitse kupanga lactate yambiri ndi izi:

• Matenda a m'mapapo amachititsa kuti magazi asalandire mpweya wokwanira.
• Matenda a magazi m'thupi amachititsa kuti magazi aziyenda pang'onopang'ono komanso kuti minofu isapeze mpweya wokwanira.
• Matenda a hemoglobin amakhudza kuthekera kwa maselo ofiira a magazi kunyamula mpweya.
• Matenda odzidzimutsa monga kugwedezeka kwa magazi , kugwedezeka kwa magazi, kapena kugwedezeka kwa mtima .
• Matenda a ischemic m'mimba .
• Kugwidwa ndi khunyu ndi kugwedezeka kwa nthawi yayitali.
• Kuopsa kwa carbon monoxide .

Mtundu B

Mtundu wa B lactic acidosis umachitika popanda hypoxemia kapena hypoxia . Pali mitundu itatu ya mankhwala.

Mtundu B1

Izi zimachitika chifukwa cha matenda omwe amalepheretsa kagayidwe ka lactate m'thupi.

Zitha kukhala:

• Matenda a chiwindi .
• Matenda a impso.
• Kusowa kwa Thiamine (vitamini B1) .
• Khansa.
• Mkhalidwe wa HIV/AIDS .
• Matenda a Mitochondria .
• Ketoacidosis yokhudzana ndi matenda a shuga .
• Vuto la kugwiritsa ntchito mowa .

Mtundu B2

Izi zimachitika ngati zotsatira zina za mankhwala ndi poizoni. Zitsanzo:

• Kupha poizoni wa cyanide .
• Kuopsa kwa carbon monoxide .
• Kumwa mowa mopitirira muyeso.
• Kugwiritsa ntchito mankhwala a cocaine .
• Mankhwala ena a kachilombo ka HIV ( Nucleoside reverse transcriptase inhibitors (mankhwala oletsa mavairasi) ).
• Mitundu ina ya ma inhalers omwe amagwiritsidwa ntchito pa matenda monga mphumu ( Beta-adrenergic agonist inhalers ).
• Jakisoni wa Epinephrine pa matenda oopsa a ziwengo.
• Mankhwala opha tizilombo otchedwa linezolid .
• Propofol ya mankhwala oletsa ululu.
• Metformin, mankhwala ogwiritsidwa ntchito pa matenda a shuga (izi zimagwiritsidwa ntchito kwambiri ku Sri Lanka, kotero muyenera kudziwa bwino izi).

Mtundu B3

Izi zimachitika chifukwa cha kusowa kwa ma enzyme enaake obadwa nawo omwe amafunikira kuti agwiritse ntchito lactate. Izi ndizosowa kwambiri. Zitsanzo:

• Matenda osungira glycogen .
• Kusowa kwa Fructose-1,6-diphosphatase .
• Kusowa kwa pyruvate carboxylase .
• Kusowa kwa pyruvate dehydrogenase .
• Kusowa kwa okosijeni wa phosphorylation .
• Methylmalonic aciduria .

D-lactic acidosis

Mitundu ya A ndi B yomwe tidakambirana kale ikugwirizana ndi kuchuluka kwa L-lactate m'magazi anu. L-lactate iyi ndi mtundu wa lactic acid womwe nthawi zambiri umapangidwa ndi kusinthidwa m'thupi la munthu.

Komabe, palinso mtundu wina wosowa kwambiri wa lactic acidosis, womwe umayamba chifukwa cha kuchulukana kwa D-lactate . Mtundu uwu wa lactic acid umapangidwa ndi mtundu wa mabakiteriya m'matumbo anu akuluakulu. D-lactate imapangidwa ngati chinthu china pamene mabakiteriyawa amasintha chakudya m'mimba mwawo.

D-lactic acidosis imachitika pamene mabakiteriyawa akuchulukirachulukira. D-lactate yochulukirapo imatengedwa kuchokera m'matumbo kupita m'magazi. D-lactate singathe kusinthidwa ndi impso kapena chiwindi chathu. Chifukwa chake imapitilira kusonkhana m'magazi. Izi nthawi zambiri zimawonedwa ngati vuto la matenda otchedwa short gut syndrome .

Kodi Lactic Acidosis imapezeka bwanji?

Madokotala amatsimikiza ngati muli ndi lactic acidosis kutengera zinthu zotsatirazi:

• Kuchuluka kwa lactate m'magazi kopitilira 4 mmol/L (millimoles pa lita).
• pH ya magazi ndi yochepera 7.35.

Mayeso amenewa amayesedwa potengera magazi kuchokera kwa inu ndikuyesa.

Ndi mayeso ati omwe amachitidwa pa izi?

Mayeso otsatirawa amachitika kuti adziwe lactic acidosis :

• Comprehensive metabolic panel (CMP) : Iyi ndi njira yosavuta yoyezera zinthu zosiyanasiyana m'magazi anu kuti mudziwe zambiri zokhudza thanzi lanu.
• Kuyesa kwa lactate m'magazi : Kuwonjezera pa zinthu zomwe zimayesedwa mu CMP, kuchuluka kwa lactate m'magazi anu kumayesedwa mwachindunji.
• Kuyesa magazi a Anion gap : Kuyesa kumeneku kumayesa pH ndi electrolyte balance ya magazi anu.
• Kuyesa mpweya wa m'magazi : Izi zimayesa kuchuluka kwa mpweya m'mitsempha yanu, komanso pH ndi electrolyte balance.

Kodi Lactic Acidosis imachiritsidwa bwanji?

Ngati muli ndi lactic acidosis chifukwa cha chifukwa cha kanthawi kochepa, monga kuchita masewera olimbitsa thupi mopitirira muyeso, kugwedezeka, kapena khunyu, nthawi zambiri zimatha pakapita nthawi. Mutha kupeza mpumulo mwa kukhala panyumba ndikukhala ndi madzi okwanira.

Komabe, kuchipatala, lactic acidosis imachiritsidwa nthawi yomweyo ndi madzi a m'mitsempha ( madzi a m'mitsempha , omwe timawatcha kuti saline) ndi njira zina zochiritsira, monga chithandizo cha okosijeni, ngati pakufunika.

Chithandizo chidzatsimikiziridwa kutengera chomwe chikuyambitsa. Kutengera ndi zizindikiro zanu, gulu lanu lachipatala lidzagwira ntchito yochiza matenda omwe amayambitsa lactic acidosis .

Ngati mukuwonetsa zizindikiro za mpweya wochepa, gulu lachipatala lidzakayikira zomwe zimayambitsa Mtundu A - monga kulephera kwa mtima kapena kupuma, sepsis , kapena shock - ndikuchiza zadzidzidzizo kaye.

Ngati mpweya wochepa sunatchulidwe, amaganizira zifukwa zosiyanasiyana za mtundu wa B ndikuwachiza mwachindunji.

Kodi munthu amene ali ndi lactic acidosis angayembekezere zotsatira zotani?

Zotsatira zake zimadalira chifukwa ndi kuopsa kwa vutoli. Mtundu A lactic acidosis - womwe umagwirizanitsidwa ndi sepsis , shock, ndi/kapena kuchepa kwa mpweya woperekedwa m'magazi - ndi woopsa kwambiri. Mitundu ina ya lactic acidosis ingakhale yofatsa ndipo imayamba pang'onopang'ono, zomwe zimapangitsa kuti pakhale nthawi yochulukirapo komanso mwayi wopeza chithandizo.

Kawirikawiri, pamene kuchuluka kwa lactate m'magazi kukukwera, chiwerengero cha anthu omwe amafa chikhoza kuwonjezeka. Komabe, kuchira kwathunthu n'kotheka ndi chithandizo chachangu komanso chogwira mtima.

Lactic acidosis ndi chimodzi mwa matenda angapo otchedwa metabolic acidosis, momwe asidi amaunjikana m'magazi mwanu. Mu metabolic acidosis , njira zachibadwa za kagayidwe kachakudya m'thupi zomwe zimapanga ndikusamalira asidi zimasokonekera mwanjira ina. Nthawi zambiri, chiwindi ndi impso zanu zimatha kusefa asidi wochulukirapo. Koma ziwalozo zikapanda kugwira ntchito bwino, sizimatha kuthana ndi acidosis. Chifukwa chake, kusamalira chiwindi ndi impso zanu mwa kumwa madzi ambiri, kuchepetsa mowa ndi kumwa mankhwala owopsa kungathandize kwambiri kuti mukhale ndi thanzi labwino kwa nthawi yayitali.

Mfundo zazifupi zoti muzikumbukire

Chabwino, tiyeni tikukumbutseni zina mwa zinthu zofunika kwambiri zomwe takambirana lero:

• Lactic acidosis ndi kuwonjezeka kwa lactic acid m'magazi.
• Pakhoza kukhala zifukwa zambiri za izi. Chifukwa chachikulu ndichakuti thupi silikupeza mpweya wokwanira.
• Zizindikiro zoyamba zingakhale kutopa kwambiri, kusanza, komanso kupuma mofulumira.
• Mayeso a magazi amachitidwa kuti adziwe vutoli.
• Chithandizo chimadalira chomwe chimayambitsa vutoli. Nthawi zina kupuma ndi madzi okwanira, nthawi zina kugonekedwa kuchipatala kumafunika.
• Ngati yapezeka ndi kuchiritsidwa msanga, imatha kuchiritsidwa.
• Kusunga chiwindi ndi impso kukhala zathanzi kumathandiza kuteteza matenda ngati amenewa.

Kotero, ngati muli ndi zizindikiro izi, kapena ngati mukufuna kudziwa zambiri za izi, musaiwale kukaonana ndi dokotala. Khalani ndi thanzi labwino!

Lactic acidosis, lactic acidosis, lactate, acidity m'magazi, acidity m'thupi, masewera olimbitsa thupi, thanzi