Muviri wako une acid yakawanda here? Ngatidzidzei nezve lactic acidosis!

Wakambonzwa kuneta, kurwadziwa, kana kushaya mweya paunenge waneta zvishoma here? Izvi zvinogona kunge zvichikonzerwa nezvikonzero zvakasiyana-siyana. Zvisinei, nhasi tichataura nezvechirwere chinogona kuitika kana kemikari inonzi lactic acid yaungana mumiviri yedu. Izvi ndizvo zvinonzi navanachiremba lactic acidosis . Usazvidya moyo, ngatitaurei nezvazvo zviri nyore.

Chii chinonzi Lactic Acidosis?

Zvichitaurwa zviri nyore, lactic acidosis chirwere chinokonzerwa ne lactic acid yakawandisa muropa rako. Izvi zvinogona kuitika kana muviri wako uchigadzira lactic acid yakawandisa, kana kuti kana muviri wako usingakwanise kubvisa lactic acid yaunogadzira nemazvo.

Kazhinji, chiropa neitsvo dzedu ndizvo zvinobvisa lactic acid yakawandisa mumiviri yedu. Zvisinei, kana huwandu hwelactic acid hwakawandisa, kana paine kusasimba munhengo idzi dzakadai sechiropa neitsvo, hadzigone kuita basa iri nemazvo. Ndipo panotanga kuungana lactic acid muropa.

Kana huwandu hwe lactic acid muropa rako hwakwira zvishoma, tinohudaidza kuti hyperlactatemia . Zvisinei, kana izvi zvikawedzera uye pH yemuviri (kureva acid-base balance) ikava acidic yakawandisa, izvo zvinonzi lactic acidosis .

Sei lactic acid ichiumbwa mumuviri wedu?

Lactic acid, dzimwe nguva inonzi lactate , chinhu chinobva mukugadzirwa kwemasero. Masero edu anoshandisa glucose (shuga) kugadzira simba. Maitiro aya anonzi anaerobic glycolysis . Izvi zvinoitika kana masero achida simba nekukurumidza, asi asina oxygen yakakwana kuti aite izvozvo.

Kazhinji, tinowana simba kuburikidza nemaitiro anoshandisa okisijeni. Izvi zvinonzi aerobic metabolism . Zvisinei, anaerobic glycolysis yakafanana nesosi yesimba yatinoshandisa munguva dzenjodzi. Fungidzira, paunongoerekana wamhanya nesimba kana kusimudza mutoro unorema, tsandanyama dzako dzinongoerekana dzashaya okisijeni. Ndipo panoshandiswa nzira iyi. Saizvozvowo, kana nyama dzedu dzikasagamuchira okisijeni nekuda kwezvimwe zvirwere, lactic acid inogadzirwawo nenzira iyi.

Chii chinoitika kana lactic acidosis ikaitika?

Zvinoitika kana uine lactic acidosis zvinoenderana nekuoma kwayo. Vamwe vanhu vanogona kusangana nechirwere ichi kwenguva pfupi, kunyanya mushure mekurovedza muviri zvakanyanya. Chinogona kuita kuti muviri wako urwadziwe kwemazuva mashoma. Asi kana chiropa chako neitsvo zviri muhutano hwakanaka, lactic acid ichapera mumazuva mashoma.

Zvisinei, kana muviri wako ukaramba uchigadzira lactic acid yakawandisa, kana chiropa chako neitsvo zvikasakwanisa kuigadzirisa nemazvo, mamiriro acho anogona kutowedzera kuipa. Izvi zvinowanzoitika kana paine chirwere. Sezvo huwandu hwe lactate muropa rako huchiramba huchikwira, huwandu hwe pH hunoderera, uye kubuda kwemoyo kunoderera zvishoma nezvishoma. Izvi zvinogona kutungamira kune dzimwe nhengo dzemuviri uye kunyange kufa. Saka zvakakosha kuziva izvi.

Ndezvipi zviratidzo zveLactic Acidosis?

Zviratidzo zvechirwere ichi zvinogona kusiyana pakutanga uye kana chirwere chacho chakanyanya kuipa.

Zviratidzo zvepakutanga

Pakutanga, unogona kunzwa zvinhu zvakaita seizvi:

• Kusvotwa nekurutsa.
• Kuneta zvakanyanya uye kuneta.
• Kufema nekukurumidza uye kwakadzika (izvi zvinonzi kudzoreredza mweya , kuedza kuderedza acidity yemuviri kuburikidza nekufema).
• Kugwinha kwetsandanyama uye kurwadziwa kwemuviri.

Zviratidzo kana chirwere chacho chikanyanya kuipa

Sezvo mamiriro acho achiipa, zviratidzo zvinotevera zvinogonawo kuoneka:

• Kushaya simba uye kuwedzera hope.
• Kuvhiringidzika mupfungwa nekuvhiringidzika .
• Kuoma kudzora mafambiro, senge pakufamba ( ataxia ).
• Kuderera kwehuwandu hweweti ( Oliguria ).

Zvimwe zviratidzo

Unogonawo kuva nezviratidzo zvechirwere chiri kukonzera lactic acidosis . Semuenzaniso, mamiriro akadai se sepsis ( utachiona hweropa), shock ( stroke), kana kutadza kwechiropa . Zviratidzo zveizvi zvinogona kusanganisira:

• Kupisa muviri kwakaderera.
• Kuderera kweropa.
• Kupindwa nechando.
• Jaundice (kutsvuka kweganda uye machena emaziso).

Chii chinonyanya kukonzera lactic acidosis?

Pane zvikonzero zvakawanda zveizvi. Chikonzero chikuru ndechekushaya okisijeni muropa (hypoxemia) kana kushomeka kweokisijeni munyama yako (hypoxia). Izvi zvinowanzokonzerwa nechirwere.

Vanachiremba vakapatsanura chirwere ichi che lactic acidosis mumhando dzakasiyana-siyana zvichienderana nezvikonzero zvacho:

Rudzi A

Rudzi rweA lactic acidosis runoitika kana nyama dzako dzikasawana okisijeni yakakwana. Runowanzoonekwa muzvirwere zvakakomba. Runogonawo kuva rwenguva pfupi, runokonzerwa nekurovedza muviri zvakanyanya.

Zvimwe zvirwere zvinogona kukonzera kugadzirwa kwe lactate yakawandisa zvinosanganisira:

• Zvirwere zvemapapu zvinokonzera kuti ropa risawane okisijeni yakakwana.
• Matambudziko ekutenderera kweropa anokonzera kunonoka kweropa uye kushomeka kweokisijeni munyama.
• Matambudziko ehemoglobin anokanganisa kugona kwemasero matsvuku eropa kutakura okisijeni.
• Zvirwere zvekuvhunduka zvakaita sekuvhunduka kweropa , kuvhunduka kweropa, kana kuvhunduka kwemwoyo .
• Chirwere cheIschemic mudumbu .
• Kubatwa nepfari kwenguva refu uye kugwinha.
• Kuchetura kwecarbon monoxide .

Rudzi B

Rudzi rweB lactic acidosis runoitika pasina hypoxemia kana hypoxia . Kune marudzi matatu akasiyana.

Rudzi B1

Izvi zvinokonzerwa nezvirwere zviri pasi peganda zvinokanganisa kugona kwekugaya lactate.

Vanogona kuva:

• Chirwere chechiropa .
• Chirwere cheitsvo.
• Kushaikwa kweThiamine (vitamini B1) .
• Kenza.
• Mamiriro eHIV/AIDS .
• Zvirwere zveMitochondria .
• Ketoacidosis inokonzerwa nechirwere cheshuga .
• Dambudziko rekushandisa doro .

Rudzi B2

Izvi zvinoitika semhedzisiro yemimwe mishonga uye chepfu. Mienzaniso:

• Chepfu yeCyanide .
• Kuchetura kwecarbon monoxide .
• Kunwa doro zvisina kunaka .
• Kushandisa cocaine .
• Mimwe mishonga yeHIV ( Nucleoside reverse transcriptase inhibitors (kurapa nehutachiona hweHIV) ).
• Mamwe marudzi emishonga yekufemesa inoshandiswa pazvirwere zvakaita seasthma ( Beta-adrenergic agonist inhalers ).
• Jekiseni reEpinephrine rekurapa allergies dzakakomba.
• Mishonga inorwisa mabhakitiriya inonzi linezolid .
• Propofol yeanesthesia.
• Metformin, mushonga unoshandiswa pakurapa chirwere cheshuga (izvi zvinoshandiswa zvakanyanya muSri Lanka, saka unofanira kuziva izvi zvakanyanya).

Rudzi B3

Izvi zvinokonzerwa nekusakwana kwema enzymes ekuzvarwa nawo anodiwa kuti lactate igayiwe. Izvi hazviwanzoitiki. Mienzaniso:

• Chirwere chekuchengetedza glycogen .
• Kushaikwa kweFructose-1,6-diphosphatase mumuviri .
• Kushaikwa kwe pyruvate carboxylase .
• Kushaikwa kwe pyruvate dehydrogenase .
• Kushaikwa kwe phosphorylation mu oxidative .
• Methylmalonic aciduria .

D-lactic acidosis

Mhando A neB dzatakataura nezvadzo kare dzine chekuita nekuunganidzwa kweL-lactate muropa rako. Iyi L-lactate imhando yelactic acid inowanzogadzirwa uye kugadzirwa mumuviri wemunhu.

Zvisinei, kune rumwe rudzi rusingawanzoitiki rwe lactic acidosis, iyo inokonzerwa nekuunganidzwa kweD-lactate . Rudzi urwu rwe lactic acid runogadzirwa nerudzi rwebhakitiriya muura hwako hukuru. D-lactate inogadzirwa sechinhu chimwe kana mabhakitiriya aya achichinja makabhohaidhiretsi panguva yekugaya.

D-lactic acidosis inoitika kana mabhakitiriya aya akawandisa. D-lactate yakawandisa inobva yatorwa kubva muura ichipinda muropa. D-lactate haigone kugayiwa neitsvo kana chiropa. Saka inoramba ichiungana muropa. Izvi zvinowanzoonekwa sedambudziko rechirwere chinonzi short gut syndrome .

Lactic Acidosis inoonekwa sei?

Vanachiremba vanosarudza kana uine lactic acidosis zvichibva pazvinhu zvinotevera:

• Mazinga e lactate muropa anopfuura 4 mmol/L (millimoles pa litre).
• pH yeropa iri pasi pe7.35.

Hunhu uhwu hunoyerwa nekutora ropa kubva kwauri woriedza.

Ndedzipi bvunzo dzinoitwa pakuita izvi?

Miedzo inotevera inoitwa kuti uongorore lactic acidosis :

• Comprehensive metabolic panel (CMP) : Iyi iongororo yeropa iri nyore inoyera zvinhu zvakasiyana-siyana muropa rako kuti uwane ruzivo rwekutanga nezvehutano hwako.
• Kuongororwa kweropa re lactate : Kuwedzera pane zvinoyerwa muCMP, huwandu hwe lactate muropa rako hunoyerwa zvakananga.
• Kuongororwa kweropa reAnion gap : Kuongororwa uku kunoyera pH uye electrolyte balance yeropa rako.
• Kuongororwa kwegasi reropa re arterial : Izvi zvinoyera kuwanda kweokisijeni mutsinga dzako, pamwe chete ne pH ne electrolyte balance.

Lactic acidosis inorapwa sei?

Kana uine lactic acidosis nekuda kwechikonzero chenguva pfupi, senge kurovedza muviri zvakanyanya, kudedera, kana pfari, inowanzopera nekufamba kwenguva. Unogona kuwana zororo nekugara kumba uye kugara wakanwa mvura yakawanda.

Zvisinei, muchipatara, lactic acidosis inorapwa nekukasika nemvura inopinzwa mutsinga ( IV fluids , ndizvo zvatinodaidza kuti saline) uye dzimwe nzira dzekurapa nadzo, dzakadai se oxygen therapy , kana zvichidikanwa.

Kurapwa kuchabva kwasarudzwa zvichienderana nechikonzero chacho. Zvichienderana nezviratidzo zvako, timu yako yezvekurapa ichashanda kurapa chirwere chiripo kana chepfu chiri kukonzera lactic acidosis .

Kana uri kuratidza zviratidzo zvekushomeka kweoxygen mumuviri, timu yezvekurapa ichafungidzira zvikonzero zveType A - zvakaita sekushaya simba kwemoyo kana kufema, sepsis , kana shock - votanga varapa emergency idzodzo.

Kana pasina mwero weokisijeni wakaderera, vanoongorora zvikonzero zvakasiyana-siyana zverudzi rweB vozvirapa zvakananga.

Munhu ane lactic acidosis anogona kutarisira mhedzisiro yerudzii?

Mhedzisiro yacho inoenderana nechikonzero uye kuoma kwechirwere ichi. Type A lactic acidosis - iyo inobatanidzwa ne sepsis , shock, uye/kana kudzikira kwekuendeswa kweokisijeni muropa - yakakomba zvikuru. Mamwe marudzi e lactic acidosis anogona kunge asina kusimba uye achikura zvishoma nezvishoma, zvichiita kuti pave nenguva yakawanda nemukana wekurapwa.

Kazhinji, sezvo huwandu hwe lactate muropa huchiwedzera, huwandu hwevanhu vanofa hunogona kuwedzera. Zvisinei, kupora kwakakwana kunogoneka nekurapwa nekukurumidza uye kunoshanda.

Lactic acidosis chimwe chezvirwere zvinonzi metabolic acidosis, umo acid inoungana muropa rako. Mu metabolic acidosis , maitiro emuviri akajairika ekugadzirisa acid anogadzira uye anotonga acid anokanganiswa neimwe nzira. Kazhinji, chiropa chako neitsvo zvinogona kuchenesa acid yakawandisa. Asi kana nhengo idzodzo dzisiri kushanda zvakanaka, hadzikwanisi kudzora acidosis. Saka, kutarisira chiropa chako neitsvo nekunwa mvura yakawanda, kuderedza doro uye kutora mishonga inokuvadza kunogona kubatsira zvikuru kuchengetedza hutano hwako hwenguva refu.

Pfungwa pfupi dzekurangarira

Zvakanaka, ngatikuyeuchidzei zvimwe zvezvinhu zvakakosha zvatataura nezvazvo nhasi:

• Lactic acidosis kuwedzera kwe lactic acid muropa.
• Panogona kuva nezvikonzero zvakawanda zveizvi. Chikonzero chikuru ndechekuti muviri hausi kuwana oxygen yakakwana.
• Zviratidzo zvekutanga zvinogona kusanganisira kuneta zvakanyanya, kurutsa, uye kufema nekukurumidza.
• Kuongororwa kweropa kunoitirwa kuti chirwere ichi chionekwe.
• Kurapwa kunoenderana nechikonzero. Dzimwe nguva kuzorora nemvura zvakakwana, dzimwe nguva kuchipatara kunodiwa.
• Kana chirwere ichi chikaonekwa uye chikarapwa nekukurumidza, chinogona kurapwa.
• Kuchengetedza chiropa neitsvo zvine hutano kunobatsira kudzivirira zvirwere zvakaita seizvi.

Saka, kana uine chimwe chezviratidzo izvi, kana kuti uchida kuziva zvakawanda nezvazvo, usakanganwa kubvunza chiremba. Ramba uine hutano hwakanaka!

Lactic acidosis, lactic acidosis, lactate, acidity muropa, kuenzana kweacid mumuviri, kurovedza muviri, hutano