Ese umubiri wawe ufite aside nyinshi? Reka twige ku bijyanye na aside metabolike!

Ese wigeze wumva unaniwe, ushonje, cyangwa uzumva umeze nk'ufite isereri? Cyangwa wenda guhumeka kwawe kwariyongereye gato, cyangwa igituza cyawe kirimo gutera? Ibi rimwe na rimwe bishobora guterwa n'impinduka nto mu mubiri wawe. Uyu munsi tugiye kuvuga ku ndwara isaba kwitabwaho gato, ariko niba uyimenye, ishobora gufashwa kuyigenzura. Ibyo byitwa aside metabolic . Izina rishobora kumvikana nk'aho riteye ubwoba gato, ariko reka tubiganireho mu buryo bworoshye.

Asidiyoze y'umubiri ni iki? Mu magambo make...

Muri make, aside metabolic ni igihe amazi yo mu mubiri wawe, cyane cyane mu maraso yawe, aba aside cyane cyangwa aside . Tekereza ku mibiri yacu nk'imashini zoroshye. Ibintu byose biri muri yo, cyane cyane imiti, bigomba kuba biri mu rugero rwiza. Iyo bitabaye ibyo, ibibazo bitangira kuvuka.

Imibiri yacu ifite ikinyabutabire cyitwa bicarbonate . Iki ni cyo kintu nyamukuru kigenzura cyangwa kigabanya ubushyuhe bw'umubiri. Rero, hari uburyo bubiri bw'ingenzi butuma aside metabolike itera.

1. Ingano ya aside mu mubiri yiyongera birenze uko bikenewe kandi ikarenga ingano ya bicarbonate (ibi byitwa 'High Anion Gap Metabolic Acidosis' ).

2. Bitabaye ibyo, bicarbonate nyinshi isohoka mu mubiri binyuze mu mpyiko cyangwa mu bundi buryo (ibi byitwa 'Normal Anion Gap Metabolic Acidosis') .

Ariko, ingaruka zabyo ni uko umubiri urushaho kugira aside nyinshi. Ushobora kuba warumvise abaganga bavuga ikintu cyitwa 'Anion Gap' . Iri ni itandukaniro riri hagati y'uduce twa electrolyte (electrolyte) dufite amashanyarazi meza n'ayifite amashanyarazi mabi mu maraso yacu. Ibi bituma abaganga babona ishusho y'ingano ya aside n'ishingiro.

Ni nde ushobora kugira ingaruka kuri iki kibazo? Ese twese twagombye kwitonda?

Mu by’ukuri, umuntu wese ashobora kurwara indwara yitwa aside metabolic. Ariko, iyi ngaruka ni nyinshi cyane cyane ku bantu impyiko zabo zidakora neza (Impyiko zinanirwa gukora neza / Impyiko zinanirwa gukora neza) cyangwa abafite indwara zidakira z’impyiko . Ibi biterwa nuko impyiko zacu zigira uruhare runini mu gutuma umubiri uhorana neza binyuze mu gukuraho aside nyinshi ikorerwa mu mubiri wacu binyuze mu nkari. Rero iyo impyiko zidafite imbaraga, iyi mikorere ntikora neza.

Ni iki kiba mu mubiri iyo ubu busharire bwiyongera? Inkuru ivuga ku gaciro ka pH yacu

Kugira ngo sisitemu zose z'umubiri wacu zikore neza, amaraso yacu agomba kuba ari mu rugero runaka rwitwa pH balance . Iyi pH ni igipimo cy'ingano ya aside na alkali mu maraso yacu. Ni igipimo kuva kuri 0 kugeza kuri 14. 0 ni aside cyane, naho 14 ni alkali cyane. pH y'amaraso y'umuntu muzima ubusanzwe iba iri hagati ya 7.35 na 7.45.Uko ni ko bikwiye kumera. Iyi ni uburinganire bugoye cyane.

Impyiko zacu n'ibihaha ni byo bice by'ingenzi bifasha mu kubungabunga ubu buringanire. Impyiko zisohora aside nyinshi n'ibice by'inkari. Ibihaha bigenzura ingano ya dioxyde de carbone mu maraso iyo duhumeka. Dioxyde de carbone kandi igira ingaruka ku rugero rwa aside mu mubiri.

Rero, muri aside metabolize, inzira za metabolize mu mubiri zikora aside nyinshi cyane, cyangwa impyiko ntizishobora gusohora iyi aside neza. Hanyuma pH twavuze igabanuka riri munsi ya 7.35, bivuze ko amaraso arushaho kuba aside.

Ni ibihe bimenyetso by'ibi? Ni ngombwa cyane kubimenya!

Igitangaje ni uko rimwe na rimwe abantu barwaye aside metabolic bashobora kutagaragaza ibimenyetso byihariye mu ntangiriro . Ariko, hari ibimenyetso bimwe na bimwe bishobora kugaragara uko indwara ikomeza. Ni ngombwa ko wowe n'umuryango wawe mumenya ibi bikurikira:

• Umutima utera cyane (tachycardia). Ushobora kumva nk'aho igituza cyawe kirimo gutera cyane, cyangwa se nk'aho ufite ubwoba bwinshi.
• Kumva umeze nk'uzunguza cyangwa ufite umutwe urembye. Hari igihe bishobora kubaho no mu gihe uhagaze.
• Kumva unaniwe cyane, ukumva nta buzima ufite kandi unaniwe igihe cyose. Uko ibitotsi byawe byaba bingana kose, uracyakumva unaniwe.
• Kubura amaraso, kumva ubabaye ndetse no kubona ibiryo.
• Kubabara umutwe bidashira.
• Guhumeka biba vuba, cyangwa bigafata umwuka muremure kandi wimbitse. Mu by'ukuri, umubiri uba ugerageza kugabanya aside usohora umwuka mwinshi wa dioxyde de carbone (ubwoko bwa aside).
• Isesemi no kuruka.
• Kumva ufite intege nke n'intege nke muri rusange.
• Impumuro nziza kandi y'imbuto mu mwuka. Iki ni ikimenyetso cy'uburwayi bwa diyabete buterwa na ketoacidosis.

Icy'ingenzi cyane: Iyo iki kibazo kibaye gikomeye cyane, ni ukuvuga ko iyo urugero rw'aside mu mubiri rwiyongereye cyane, hashobora kubaho ingorane zikomeye nko kunanirwa kw'impyiko, kwangirika kw'izindi ngingo, gutakaza ubwenge, ndetse no gupfa . Bityo rero, niba ufite kimwe cyangwa byinshi muri ibi bimenyetso, ni byiza gushaka inama kwa muganga vuba.

Kuki ibi bibaho? Ni izihe mpamvu nyamukuru zitera aside metabolike?

Hari ibyiciro bine by'ingenzi by'impamvu zishobora gutera aside metabolike. Reka turebere hamwe izo ari zo:

1. Aside iterwa na diyabete / Ketoacidosis ya diyabete (DKA):Abantu benshi babyumvise. Bishobora kugaragara ku bantu barwaye diyabete idacunzwe neza, cyane cyane abafite diyabete yo mu bwoko bwa 1. Iyo uturemangingo tw'umubiri tubuze insuline ikenewe kugira ngo ikore ingufu, cyangwa iyo insuline ifite idakora neza, uturemangingo ntidushobora gufata glucose mu maraso. Hanyuma umubiri utangira gutwika ibinure kugira ngo ubone ingufu. Nk'umusaruro w'iyi nzira, ubwoko bwa aside yitwa 'ketone bodies' buriyongereye mu mubiri. Iyi ni indwara iteje akaga cyane isaba kuvurwa vuba.

2. Aside yo mu bwoko bwa Hyperchloremic: Ibi biterwa no gutakaza umunyu ngugu mwinshi wa sodium bicarbonate. Tekereza, urwaye impiswi ikomeye mu gihe cy'iminsi myinshi , kugeza aho utakaza amazi. Muri icyo gihe, bicarbonate nyinshi ishobora gusohoka mu mara. Ibi bishobora no kubaho iyo ukoresheje imiti imwe n'imwe yo mu bwoko bwa laxatives ( imiti yo mu bwoko bwa laxatives ) cyane, utabanje kugisha inama muganga.

3. Lactic acidosis: Iyi ndwara ibaho iyo umubiri wacu ufite ubwoko bwinshi bwa aside yitwa lactic acid. Tekereza kuri ibi, iyo dukora siporo cyane, cyangwa iyo uturemangingo tw'umubiri wacu tutabona ogisijeni ihagije (urugero: indwara y'umutima, ubwandu bukomeye), aside lactic ikorwa nk'umusaruro wo gukora ingufu. Ubusanzwe, umubiri urabigenzura. Ariko rimwe na rimwe, urugero, ku muntu ufite ikibazo cy'umwijima , cyangwa iyo isukari mu maraso igabanutse mu buryo butunguranye (Hypoglycemia cyangwa isukari nke mu maraso) , cyangwa iyo bamwe bakoresha inzoga cyane (indwara yo kunywa inzoga) , mu ndwara zimwe na zimwe za kanseri , cyangwa iyo bakoze siporo cyane (siporo ikomeye) , ingano ya aside lactic ishobora kwiyongera kandi umubiri ntushobore kubyihanganira.

4. Acidosis ya Renal Tubular (RTA): Ibi bibaho iyo imiyoboro mito (utubyimba) mu mpyiko idashobora gusohora aside ihagije hamwe n'inkari. Cyangwa, bikarubonate ntiyongere kwinjiza neza. Ingaruka zabyo ni uko aside mu maraso yiyongera buhoro buhoro.

Impamvu ebyiri zikunze kugaragara ni impiswi idakira no kunanirwa kw'impyiko.

Ese iyi ni indwara yandura? Ese nzayikwirakwiza ku bandi?

Oya, oya rwose. Indwara ya aside metabolique si indwara yandura . Ntushobora kuyikwirakwiza ku wundi muntu ngo ni uko uyirwaye. Ni ikibazo cy'imikorere y'imbere mu mubiri.

Abaganga bapima iki kibazo gute?

Iyo ugiye kwa muganga, abanza kukubaza ibimenyetso byawe, akakubaza indwara zawe za kera, hanyuma akagusuzuma. Hanyuma azagutegeka ibizamini byinshi kugira ngo yemeze iyo ndwara kandi amenye impamvu.

Hari igihe ushobora koherezwa kwa muganga w’indwara z’imitsi , cyane cyane iyo ukeka ko ufite ikibazo cy’impyiko.

Ibi bizamini ubikora ute?

Ibizamini bishobora gutandukana bitewe n'ibimenyetso byawe n'icyo muganga wawe abona ko ari cyo kibitera. Ibizamini bikunze kugaragara ni ibi bikurikira:

• Ibipimo by'amaraso: Ibi ni ingenzi cyane.
• Ikizamini cy'Icyuho cya Anion: Icyitegererezo gito cy'amaraso gifatwa mu mutsi uri mu kuboko kwawe, maze hapimwa itandukaniro riri hagati y'ibinyabutabire byiza n'ibitari byiza byitwa electrolytes. Niba iki cyuho ari kinini kuruta ibisanzwe, bishobora kuba ikimenyetso gikomeye cy'uko ufite aside metabolike.
• Ikizamini cya Gaz mu Maraso yo mu Mutsi (ABG): Iki ni ikizamini gitandukanye gato. Ibi bikubiyemo gufata amaraso make mu mitsi iri mu kuboko kwawe, mu nkokora, cyangwa mu kibuno (ubusanzwe ni make ugereranyije n'imitsi). Ibi bipima urugero rwa ogisijeni, urugero rwa dioxyde de carbone, kandi ikiruta byose, pH y'amaraso yawe. pH iri munsi ya 7.35 bivuze ko amaraso yawe afite aside nyinshi cyangwa ari make cyane.
• Ibindi bipimo by'amaraso: Isuzuma ry'isukari mu maraso, isuzuma ry'imikorere y'impyiko (urugero: Serum Creatinine, BUN), n'isuzuma ry'amashanyarazi (Electrolyte nka Sodium, Potasiyumu, Chloride) nabyo bishobora gusuzumwa.

• Ibipimo by'inkari:

Iyo urimo kunyara mu icupa ryabigenewe, pH irapimwa. Ibi bishobora kukubwira ibintu nko kumenya niba inkari zawe zifite aside nyinshi, zisanzwe cyane, cyangwa zirimo ketone.

Ibi bivurwa bite? (Ubuvuzi)

Iyo umuganga wawe amaze kumenya impamvu nyayo ya aside metabolic yawe, azaguha gahunda y'ubuvuzi ikubereye. Ubuvuzi buterwa n'impamvu.

• Ikintu cy'ingenzi ni ukuvura icyayiteye . Urugero, mu ndwara ya diyabete yitwa ketoacidosis, isukari yo mu maraso igenzurwa no gutanga insuline n'amazi yo mu mutwe.
• Abantu bafite indwara y'impyiko bashobora guhabwa sodium bicarbonate mu buryo bw'ibinini cyangwa sodium citrate mu buryo bw'umuti wo kugabanya aside mu mubiri.
• Niba hari amazi menshi yavuye mu mubiri (urugero: bitewe no gucibwamo), ni ngombwa gutanga umunyu (IV fluids) binyuze mu mitsi.
• Mu bihe bimwe na bimwe bikomeye, sodium bicarbonate itangwa binyuze mu mutsi (IV Sodium Bicarbonate) kugira ngo ihuze vuba aside mu maraso.
• Iyo ikintu cy’uburozi cyinjiye mu mubiri (urugero, bitewe no gufata aspirine nyinshi cyangwa kunywa imiti nka methanol), ubuvuzi bwihariye (urugero: dialyse) bushobora kuba ngombwa kugira ngo icyo kintu cy’uburozi gikurwe mu maraso.

Ese ibiryo n'ibinyobwa bigira ingaruka kuri ibi? Ni iki nkwiye kurya kandi ni iki nkwiye kurya bike?

Yego rwose. Bimwe mu biribwa n'ibinyobwa turya byongera aside mu mubiri, mu gihe ibindi byongera alkalinity kandi bigafasha kugabanya aside. Ariko, ibi ni ingenzi cyane: Mbere yo guhindura byinshi mu mirire yawe, ugomba kuvugana na muganga wawe cyangwa inzobere mu mirire. Iyi nama ni ingenzi cyane cyane niba urwaye impyiko.

Ibiribwa bikora aside:

• Inyama (cyane cyane inyama zitukura, inkoko, amafi).
• Amagi.
• Foromaje n'ibindi bikomoka ku mata (bimwe muri byo).
• Ibinyampeke byatunganyijwe.
• Inzoga.

Ibiryo bitanga alkali byongera alkali mu mubiri, ni ukuvuga bifasha kugabanya aside:

• Ubwoko bwinshi bw'imbuto (cyane cyane imbuto z'indimu).
• Imbuto n'amavuta y'imbuto.
• Ibinyamisogwe (urugero: lentils, poisons, ibishyimbo bibisi, soya).
• Imboga nyinshi (cyane cyane imboga z'icyatsi).
• Hari abantu bavuga ku mazi afite alkaline , ariko hari ibitekerezo bitandukanye ku bijyanye n'ishingiro rya siyansi ry'ibi, bityo ni byiza kubaza muganga.

Ni iyihe miti yindi ikoreshwa kuri ibi?

Hari igihe imiti itangwa mu buryo butari ubwa muganga (OTC) nka Sodium Citrate cyangwa Sodium Bicarbonate ishobora gufasha kuringaniza aside mu mubiri. Ariko, ntugakoreshe iyi miti utabanje kugisha inama muganga, kuko ishobora guteza ibindi bibazo.

Mu bihe bimwe na bimwe bikomeye, iyo umutima udakora neza kandi umubiri udafite umwuka uhagije, abaganga bashobora kuguha imiti yitwa inotropes . Iyi miti ituma umutima utera cyane. Ibi bifasha umubiri kubona umwuka mwinshi kandi bikanagabanya aside mu maraso. Iyi miti ikunze gutangwa binyuze mu mitsi (IV) mu bitaro.

Ese hari icyo twakora kugira ngo tugabanye iterambere rya aside metabolike?

Nubwo bidashoboka gukumira burundu iki kibazo, hari ibintu bike twakora kugira ngo tugabanye ibyago:

• Kunywa amazi ahagije n'ibindi binyobwa byiza umunsi wose.
• Niba urwaye diyabete, ni ngombwa kugenzura urugero rw'isukari mu maraso yawe nk'uko muganga wawe yabigutegetse. Ibi birimo imiti, indyo, n'imyitozo ngororamubiri.
• Niba unywa inzoga, gabanya ingano unywa cyangwa ureke burundu. Igipimo ntarengwa cy’inzoga gifatwa nk’ibinyobwa bisanzwe bibiri ku munsi ku bagabo n’ibisanzwe kimwe ku bagore.
• Kurya indyo yuzuye.

Ni iki kizaba mu gihe kizaza muri iki kibazo? Ese ni ikintu cyo gutinya? (Icyizere)

Niba ufite aside metabolize, ahazaza haterwa n'uburemere bw'indwara, icyayiteye, n'uburyo wakira vuba kandi neza ubuvuzi.

• Kenshi na kenshi, iyi ndwara ishobora gusubizwa inyuma iyo umuntu ayisuzumye neza akanayivura.
• Mu bihe byoroheje , ibimenyetso bishobora kuba iby'igihe gito kandi ntibisaba ubuvuzi bwihariye mu gihe icyateye gikemutse ubwacyo.
• Ariko, nk'uko nabivuze mbere, mu bihe bikomeye, iyo bitavuwe, bishobora gutera impyiko cyangwa izindi ngingo kudakora neza, ndetse no gupfa. Niyo mpamvu ibi atari ibintu byoroshye gufata.

Nigute nakwiyitaho? Ni iki nakora ubwanjye? (Kwiyitaho)

Muganga wawe azagukorera gahunda y'ubuvuzi ikubereye. Izaba irimo imiti n'impinduka mu mibereho yawe. Gukurikiza izi ntambwe bizagufasha kwihutisha gukira no gukumira ko indwara ishobora kongera kugaruka:

• Suzuma urugero rw'isukari mu maraso yawe buri gihe (niba urwaye diyabete). Kora igenzura ry'isukari mu maraso mu rugo nk'uko muganga yabigutegetse.
• Fata umuti wanditswe na muganga wawe neza neza nkuko wanditswe, mu gihe gikwiye, kandi mu gipimo gikwiye. Ntucikwe na kimwe.
• Niba muganga wawe cyangwa inzobere mu mirire akugira inama, gerageza kurya ibiryo bifite aside nkeya kandi bifite alkaline nyinshi.
• Kugabanya cyangwa guhagarika burundu kunywa inzoga.
• Komeza gahunda zawe zo kwa muganga ku gihe. Muri ubwo buryo, ushobora kubona uko umeze no guhindura ibikenewe byose.

Ni ryari nkwiye kujya kwa muganga? Ese ni ibintu byihutirwa?

Niba ufite ibimenyetso bya aside metabolic (nk'umunaniro twavuze mbere, impinduka mu guhumeka, isesemi), cyangwa niba ufite ibimenyetso bikomeye by'indi ndwara ishobora gutera iyi ndwara (urugero: diyabete idakora, impiswi ikomeye, ibimenyetso by'indwara z'impyiko), shaka ubufasha bwa muganga vuba. Ntugatinde.

Ni irihe tandukaniro riri hagati ya aside metabolike na aside yo mu buhumekero?

Nubwo ibi byombi ari indwara zituma aside mu mubiri yiyongera, uburyo zibaho n'ingingo zikunze kwibasirwa nazo biratandukanye.

Indwara ya aside metabolike ni indwara ikunze kugira ingaruka ku mikorere y'umubiri ndetse n'imikorere y'inkari, cyane cyane impyiko . Ibaho iyo hakozwe aside nyinshi mu mubiri, cyangwa impyiko zidashobora kuyungurura aside neza mu maraso, cyangwa umubiri ugatakaza bicarbonate.

Indwara yo mu myanya y'ubuhumekero ni indwara ifata cyane cyane inzira y'ubuhumekero, cyangwa ibihaha . Ibi bibaho igihe ibihaha bitabasha gukura dioxyde de carbone (CO2) mu maraso vuba bihagije. CO2 yivanga n'amazi kugira ngo ikore aside. Iyo indwara nka asima ibaye mbi, indwara z'ibihaha (nka COPD), kwangirika k'ubwonko bitera kugorwa no guhumeka, cyangwa gukoresha imiti imwe n'imwe cyangwa ibinini bisinziriza bishobora kugira ingaruka ku mikorere y'ibihaha, bigatuma CO2 yiyongera kandi ikongera aside.

Mu magambo make, ikibazo cy’imikorere y’umubiri mu mubiri no mu mpyiko ni ikibazo cy’imikorere y’ibinyabutabire mu mubiri no mu mpyiko. Ikibazo cy’ubuhumekero ni ikibazo cy’imikorere y’ibihaha n’iy’umubiri.

Hanyuma, ibintu by'ingenzi ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Indwara ya aside metabolike ni indwara ugomba kwitaho cyane, kuko igira ingaruka ku buringanire bw'umubiri. Hari igihe ushobora kugerageza kwirengagiza ibimenyetso ukavuga uti "Bizaba nta kibazo." Ariko ibuka ko ari umubiri wawe ukuvugisha uti "Hari ikintu kitagenda neza imbere, mfasha."

Ugomba kwitondera cyane ibi bimenyetso, cyane cyane niba ufite indwara zimara igihe kinini nk'ibibazo by'impyiko cyangwa diyabete.

Ariko ntugire ikibazo. Ntabwo uri wenyine. Hari abaganga b'inzobere, abaforomo, n'abandi bahanga mu by'ubuzima bashobora kugufasha no kukuvana muri iki kibazo. Iyo usuzumye neza kandi ukavurwa vuba kandi neza, iyi ndwara ishobora kugenzurwa ku rugero runini kandi igahinduka burundu. Kubwibyo, niba ufite gushidikanya kuri ibi, ntugatinye cyangwa ngo utinde kubonana na muganga, ubaze ibibazo byawe, kandi ubone inama n'ubuvuzi bikenewe. Kuko, ubuzima bwawe ari cyo kintu cy'agaciro kurusha ibindi kuri iyi si!

Aside itera metabolisme, uburinganire bwa aside-base, pH value, indwara z'impyiko, diyabete, ketoacidosis, lactic acidosis, ibimenyetso, uburyo bwo kuvura