Ngaba umzimba wakho une-asidi eninzi? Masifunde nge-lactic acidosis!

Ngaba wakha waziva udiniwe, uqaqanjelwa, okanye uphelelwa ngumphefumlo xa udiniwe kancinci? Oku kusenokuba ngenxa yezizathu ezahlukeneyo. Nangona kunjalo, namhlanje siza kuthetha ngemeko enokwenzeka xa ikhemikhali ebizwa ngokuba yi-lactic acid iqokelelana emizimbeni yethu. Oku kubizwa ngoogqirha ngokuba yi-lactic acidosis . Ungakhathazeki, masithethe ngale nto ngokulula.

Yintoni iLactic Acidosis?

Ngamafutshane, i-lactic acidosis yimeko apho kukho i-lactic acid eninzi egazini lakho. Oku kunokwenzeka xa umzimba wakho uvelisa i-lactic acid eninzi, okanye xa umzimba wakho ungakwazi ukususa i-lactic acid eyivelisayo ngokufanelekileyo.

Ngokwesiqhelo, isibindi kunye nezintso zethu zezona zisusa i-lactic acid egqithisileyo emizimbeni yethu. Nangona kunjalo, ukuba ubungakanani be-lactic acid buphezulu kakhulu, okanye ukuba kukho ubuthathaka obuthile kula malungu anjengesibindi kunye nezintso, azikwazi ukwenza lo msebenzi ngokufanelekileyo. Kulapho ke i-lactic acid iqala ukuqokelelana egazini.

Xa inqanaba le-lactic acid egazini lakho liphezulu kancinci, silibiza ngokuba yi -hyperlactatemia . Nangona kunjalo, ukuba oku kuyanda ngakumbi kwaye i-pH yomzimba (oko kukuthi, ibhalansi ye-acid-base) iba ne-acid eninzi, oko kubizwa ngokuba yi- lactic acidosis .

Kutheni i-lactic acid ifumaneka emizimbeni yethu?

I-lactic acid, ngamanye amaxesha ebizwa ngokuba yi-lactate , yimveliso yendalo ye-metabolism yeeseli. Iiseli zethu zisebenzisa i-glucose (iswekile) ukuvelisa amandla. Le nkqubo ibizwa ngokuba yi-anaerobic glycolysis . Oku kwenzeka xa iiseli zifuna amandla ngokukhawuleza, kodwa zingenawo umoya-mpilo owaneleyo wokwenza oko.

Ngokwesiqhelo, sifumana amandla ngenkqubo esebenzisa ioksijini. Oku kubizwa ngokuba yi -aerobic metabolism . Nangona kunjalo, i-anaerobic glycolysis ifana nomthombo wamandla esiwusebenzisa kwiimeko ezingxamisekileyo. Khawuthelekelele, xa ubaleka ngamandla ngequbuliso okanye uphakamisa ubunzima obunzima, izihlunu zakho ziphelelwa yioksijini ngequbuliso. Kulapho ke le ndlela isetyenziswa khona. Ngokufanayo, xa izicubu zethu zingafumani oksijini ngenxa yezifo ezithile, i-lactic acid nayo iveliswa ngale ndlela.

Kwenzeka ntoni xa kukho i-lactic acidosis?

Okwenzekayo xa une -lactic acidosis kuxhomekeke kubukhali bayo. Abanye abantu banokuhlangabezana nale meko okwethutyana, ingakumbi emva kokuzilolonga kakhulu. Ingenza umzimba wakho ube buhlungu kangangeentsuku ezimbalwa. Kodwa ukuba isibindi sakho kunye nezintso zisempilweni entle, i-lactic acid iya kuphela kwiintsuku ezimbalwa.

Nangona kunjalo, ukuba umzimba wakho uqhubeka nokuvelisa i-lactic acid eninzi, okanye ukuba isibindi sakho kunye nezintso azikwazi ukuyicubungula kakuhle, imeko inokuba mandundu ngakumbi. Oku kudla ngokubangelwa kukugula okuthile. Njengoko inqanaba le-lactate egazini lakho liqhubeka linyuka, inqanaba le-pH liyehla, kwaye ukuphuma kwentliziyo kuyehla kancinci kancinci. Oku kunokukhokelela ekusileleni kwezinye izitho zomzimba kwanokufa. Ngoko ke kubalulekile ukuqaphela oku.

Ziziphi iimpawu zeLactic Acidosis?

Iimpawu zale meko zinokwahluka kwizigaba zokuqala naxa imeko iba mandundu.

Iimpawu zokuqala

Ekuqaleni, unokuziva izinto ezinje:

• Isicaphucaphu nokuhlanza.
• Ukudinwa kakhulu nokudinwa.
• Ukuphefumla okukhawulezayo nokunzulu (oku kubizwa ngokuba yi -respiratory compensation , ukuzama ukunciphisa i-asidi yomzimba ngokuphefumla).
• Ukuqhaqhazela kwemisipha kunye nentlungu yomzimba.

Iimpawu xa imeko iba mandundu

Njengoko imeko isiya isiba mandundu, ezi mpawu zilandelayo zinokuvela:

• Ubuthathaka kunye nokozela okwandileyo.
• Ukuphambana kwengqondo kunye nokudideka.
• Ubunzima bokulawula iintshukumo, njengaxa uhamba ( ataxia ).
• Ukwehla kokuphuma komchamo ( i-Oliguria ).

Ezinye iimpawu

Usenokuba neempawu zesifo esithile esibangela i-lactic acidosis . Umzekelo, iimeko ezifana ne -sepsis ( usulelo lwegazi), ukothuka ( istroke), okanye ukungasebenzi kakuhle kwesibindi . Iimpawu zoku zingabandakanya:

• Ubushushu bomzimba obuphantsi.
• Uxinzelelo lwegazi oluphantsi.
• Ifiva.
• I-Jaundice (ukutyheli kolusu kunye namhlophe emehlweni).

Yintoni eyona nto ibangela i-lactic acidosis?

Zininzi izizathu zoku. Eyona nto ixhaphakileyo kukuba amanqanaba e-oksijini aphantsi egazini lakho (i-hypoxemia) okanye ukunqongophala kwe-oksijini kwizicubu zakho (i-hypoxia). Oku kudla ngokubangelwa yimeko yempilo.

Oogqirha bahlukanise le meko ye-lactic acidosis kwiintlobo ezahlukeneyo ngokusekwe kwizizathu zayo:

Uhlobo A

I-Type A lactic acidosis yenzeka xa izicubu zakho zingafumani ioksijini eyaneleyo. Ihlala ibonakala kwiimeko ezinzima zempilo. Isenokuba yesikhashana, ebangelwa kukuzilolonga kakhulu.

Ezinye iimeko ezinokubangela ukuveliswa kwe-lactate eninzi ziquka:

• Iingxaki zemiphunga zibangela ukuba igazi lingafumani ioksijini eyaneleyo.
• Iingxaki zokujikeleza kwegazi zibangela ukuhamba kwegazi okucothayo kunye nokunqongophala kweoksijini kwizicubu.
• Iingxaki ze-hemoglobin zichaphazela amandla eeseli ezibomvu zegazi okuthwala ioksijini.
• Iimeko zomothuko ezifana nomothuko we-septic , umothuko we-hypovolemic, okanye umothuko we-cardiogenic .
• Isifo se-ischemic samathumbu .
• Ukuxhuzula nokuxhuzula ixesha elide.
• Ityhefu ye-carbon monoxide .

Uhlobo B

I-Type B lactic acidosis yenzeka ngaphandle koxinzelelo lwegazi oluphantsi okanye uxinzelelo oluphantsi . Kukho iintlobo ezintathu ezahlukeneyo.

Uhlobo B1

Oku kubangelwa zizifo ezingaphantsi eziphazamisana nokukwazi ukucola i-lactate.

Zingaba:

• Isifo sesibindi .
• Isifo sezintso.
• Ukunqongophala kwe -thiamine (i-vitamin B1) .
• Umhlaza.
• imeko ye-HIV/AIDS .
• Izifo zeMitochondrial .
• I-ketoacidosis enxulumene nesifo seswekile .
• Ingxaki yokusebenzisa utywala .

Uhlobo B2

Oku kwenzeka njengesiphumo esingesihle seminye imithi kunye neetyhefu. Imizekelo:

• Ityhefu ye-cyanide .
• Ityhefu ye-carbon monoxide .
• Ukutyhefwa butywala .
• Ukusetyenziswa kwecocaine .
• Amanye amayeza e-HIV ( Nucleoside reverse transcriptase inhibitors (unyango lwe-antiretroviral) ).
• Ezinye iintlobo zee-inhaler ezisetyenziselwa izifo ezifana ne-asthma ( ii-inhaler ze-Beta-adrenergic agonist ).
• Inaliti ye -epinephrine xa kukho i-allergies ezinzima.
• I-antibiotic linezolid .
• I-Propofol ye-anesthesia.
• I-Metformin, iyeza elisetyenziselwa isifo seswekile (eli lisetyenziswa kakhulu eSri Lanka, ngoko ke kufuneka uqaphele ngakumbi oku).

Uhlobo B3

Oku kubangelwa kukungabikho kwee-enzymes ezithile ezifunekayo ekugayweni kwe-lactate. Ezi azifumaneki lula. Imizekelo:

• Isifo sokugcina i-glycogen .
• Ukunqongophala kwe-Fructose-1,6-diphosphatase .
• Ukunqongophala kwe-pyruvate carboxylase .
• Ukunqongophala kwe-pyruvate dehydrogenase .
• Ukunqongophala kwe-oxidative phosphorylation .
• I-Methylmalonic aciduria .

I-D-lactic acidosis

Iintlobo u-A no-B esithethe ngazo ngaphambili zinxulumene nokuqokelelana kwe-L-lactate egazini lakho. Le L-lactate luhlobo lwe-lactic acid edla ngokuveliswa kwaye inyibilikiswe emzimbeni womntu.

Nangona kunjalo, kukho olunye uhlobo olungaqhelekanga lwe-lactic acidosis, olubangelwa kukuqokelelana kwe-D-lactate . Olu hlobo lwe-lactic acid luveliswa luhlobo lwebhaktheriya emathunjini akho amakhulu. I-D-lactate iveliswa njengemveliso elandelayo xa ezi bhaktheriya zicola iicarbohydrate ngexesha lokugaya.

I-D-lactic acidosis yenzeka xa ezi bhaktheriya zikhula kakhulu. I- D-lactate engaphezulu ifunxwa emathunjini iye egazini. I-D-lactate ayinakugaywa zizintso okanye isibindi sethu. Ngoko ke iyaqhubeka nokuqokelelana egazini. Oku kudla ngokubonwa njengengxaki yemeko ebizwa ngokuba yi -short gut syndrome .

Ifunyanwa njani iLactic Acidosis?

Oogqirha bagqiba ukuba unayo na i-lactic acidosis ngokusekelwe kwezi zinto zilandelayo:

• Amanqanaba e-lactate egazini angaphezu kwe-4 mmol/L (ii-millimoles ngelitha).
• I-pH yegazi ingaphantsi kwe-7.35.

La maxabiso alinganiswa ngokuthatha isampuli yegazi kuwe uze ulivavanye.

Zeziphi iimvavanyo ezenziwayo koku?

Ezi zilingo zilandelayo zenziwa ukuze kufunyaniswe i-lactic acidosis :

• Iphaneli epheleleyo ye-metabolic (CMP) : Olu luvavanyo lwegazi olulula olulinganisa izinto ezahlukeneyo egazini lakho ukuze ufumane ulwazi olusisiseko malunga nempilo yakho.
• Uvavanyo lwe-lactate egazini : Ukongeza koko kulinganiswa kwi-CMP, inqanaba le-lactate egazini lakho lilinganiswa ngokukodwa.
• Uvavanyo lwegazi lwe-anion gap : Olu vavanyo lulinganisa ibhalansi ye-pH kunye ne-electrolyte egazini lakho.
• Uvavanyo lwegesi yegazi lwe-arterial : Olu vavanyo lulinganisa ukugcwala kweoksijini kwimithambo yakho, kunye nebhalansi ye-pH kunye ne-electrolyte.

Inyangwa njani iLactic Acidosis?

Ukuba une -lactic acidosis ngenxa yesizathu sexeshana, njengokuzilolonga kakhulu, ukungcangcazela, okanye ukuxhuzula, idla ngokuphela ngokuhamba kwexesha. Ungafumana isiqabu ngokuhlala ekhaya kwaye uhlale unamanzi emzimbeni.

Nangona kunjalo, esibhedlele, i-lactic acidosis inyangwa ngoko nangoko ngolwelo olufakwa kwimithambo ( ii-IV fluids , oko sikubiza ngokuba yi-saline) kunye nezinye iindlela zokuvuselela umzimba, ezifana nonyango lwe-oxygen, ukuba kuyimfuneko.

Unyango luya kugqitywa ngokusekelwe kwisizathu. Ngokuxhomekeke kwiimpawu zakho, iqela lakho lezonyango liya kusebenza ukunyanga imeko yezonyango esisiseko okanye ityhefu ebangela i-lactic acidosis .

Ukuba ubonisa iimpawu zamanqanaba aphantsi eoksijini, iqela lezonyango liza kurhanela izizathu zohlobo A - ezinje ngokusilela kwentliziyo okanye ukuphefumla, i-sepsis , okanye i-shock - kwaye liza kunyanga ezo meko zingxamisekileyo kuqala.

Kwimeko apho amanqanaba aphantsi eoksijini engaboniswanga, baqwalasela izizathu ezahlukeneyo zohlobo B baze bazinyange ngokukodwa.

Luhlobo luni lweziphumo umntu one-lactic acidosis anokulindela?

Iziphumo zixhomekeke kwisizathu kunye nobunzima bemeko. Uhlobo A lwe -lactic acidosis – olunxulunyaniswa ne -sepsis , i-shock, kunye/okanye ukuhanjiswa kweoksijini egazini – lubi kakhulu. Ezinye iintlobo ze- lactic acidosis zinokuba buthathaka kwaye zikhule kancinci, zivumela ixesha elingakumbi kunye nethuba lonyango.

Ngokubanzi, njengoko amanqanaba e-lactate egazini esanda, amazinga okufa anokunyuka. Nangona kunjalo, ukubuyela esimeni ngokupheleleyo kunokwenzeka ngonyango olukhawulezileyo nolusebenzayo.

I-lactic acidosis yenye yeemeko ezininzi ezibizwa ngokuba yi -metabolic acidosis, apho i-asidi iqokelelana egazini lakho. Kwi- metabolic acidosis , iinkqubo eziqhelekileyo zomzimba ezivelisa kwaye zilawula i-asidi ziyaphazamiseka ngandlela thile. Ngokwesiqhelo, isibindi sakho kunye nezintso zinokuhluza i-asidi egqithisileyo. Kodwa xa ezo zitho zingasebenzi kakuhle, azikwazi ukulawula i-asidi. Ngoko ke, ukunyamekela isibindi sakho kunye nezintso ngokusela amanzi amaninzi, ukunciphisa utywala kunye nokuthatha amayeza anobungozi kunokunceda kakhulu ekugcineni impilo yakho yexesha elide.

Amanqaku amafutshane ekufuneka uwakhumbule

Kulungile, masikukhumbuze ezinye zezona zinto zibalulekileyo esithethe ngazo namhlanje:

• I-lactic acidosis kukwanda kwe-lactic acid egazini.
• Zininzi izizathu zoku. Esona sizathu siphambili kukuba umzimba awufumani ioksijini eyaneleyo.
• Iimpawu zokuqala zingabandakanya ukudinwa kakhulu, ukuhlanza, kunye nokuphefumla ngokukhawuleza.
• Uvavanyo lwegazi lwenziwa ukuze kufunyaniswe esi sifo.
• Unyango luxhomekeke kwisizathu. Ngamanye amaxesha ukuphumla kunye nolwelo kwanele, ngamanye amaxesha kufuneka ulaliswe esibhedlele.
• Ukuba ifunyenwe kwaye yanyangwa kwangethuba, inganyangeka.
• Ukugcina isibindi nezintso zisempilweni kunceda ekukhuseleni kwiimeko ezinje.

Ngoko ke, ukuba unayo nayiphi na kwezi mpawu, okanye ukuba ufuna ukwazi okungakumbi ngale nto, ungalibali ukubonana nogqirha. Hlala uphilile!

I- Lactic acidosis, i-lactic acidosis, i-lactate, i-asidi yegazi, ibhalansi ye-asidi yomzimba, umthambo, impilo