Ingabe umzimba wakho une-asidi eningi kakhulu? Ake sifunde nge-lactic acidosis!

Wake wazizwa ukhathele, uphatheke kabi, noma uphelelwa umoya uma ukhathele kancane? Lokhu kungaba ngenxa yezizathu eziningana. Kodwa-ke, namuhla sizokhuluma ngesimo esingase senzeke lapho ikhemikhali ebizwa ngokuthi i-lactic acid inqwabelana emizimbeni yethu. Yilokhu odokotela abakubiza ngokuthi i-lactic acidosis . Ungakhathazeki, ake sixoxe ngalokhu kalula.

Kuyini i-Lactic Acidosis?

Kalula nje, i-lactic acidosis yisimo lapho kukhona i-lactic acid eningi egazini lakho. Lokhu kungenzeka uma umzimba wakho ukhiqiza i-lactic acid eningi kakhulu, noma lapho umzimba wakho ungakwazi ukususa i-lactic acid oyikhiqizayo ngendlela efanele.

Ngokuvamile, isibindi nezinso zethu yizo ezisusa i-lactic acid eningi emizimbeni yethu. Kodwa-ke, uma inani le-lactic acid liphezulu kakhulu, noma uma kukhona ubuthakathaka obuthile kulezi zitho ezifana nesibindi nezinso, azikwazi ukwenza lo msebenzi kahle. Yilapho i-lactic acid iqala ukuqongelela egazini.

Uma izinga le-lactic acid egazini lakho liphakeme kancane, sikubiza ngokuthi i-hyperlactatemia . Kodwa-ke, uma lokhu kukhuphuka kakhulu futhi i-pH yomzimba (okungukuthi ibhalansi ye-acid-base) iba ne-acid kakhulu, lokho kubizwa ngokuthi i-lactic acidosis .

Kungani i-lactic acid yakheka emizimbeni yethu?

I-lactic acid, ngezinye izikhathi ebizwa ngokuthi i-lactate , ingumkhiqizo wemvelo we-metabolism yamaseli. Amaseli ethu asebenzisa i-glucose (ushukela) ukukhiqiza amandla. Le nqubo ibizwa ngokuthi i-anaerobic glycolysis . Lokhu kwenzeka lapho amaseli edinga amandla ngokushesha, kodwa engenawo umoya-mpilo owanele ukwenza kanjalo.

Ngokuvamile, sithola amandla ngenqubo esebenzisa umoya-mpilo. Lokhu kubizwa ngokuthi i-aerobic metabolism . Kodwa-ke, i-anaerobic glycolysis ifana nomthombo wamandla esiwusebenzisa ezimweni eziphuthumayo. Cabanga nje, lapho ugijima kanzima ngokuzumayo noma uphakamisa isisindo esinzima, imisipha yakho intula umoya-mpilo ngokuzumayo. Yilapho le ndlela isetshenziswa khona. Ngokufanayo, lapho izicubu zethu zingawutholi umoya-mpilo ngenxa yezifo ezithile, i-lactic acid nayo ikhiqizwa ngale ndlela.

Kwenzekani uma kwenzeka i-lactic acidosis?

Okwenzekayo uma une -lactic acidosis kuncike ebunzimeni bayo. Abanye abantu bangase babhekane nalesi simo okwesikhashana, ikakhulukazi ngemva kokuzivocavoca okunzima. Kungenza umzimba wakho ube buhlungu izinsuku ezimbalwa. Kodwa uma isibindi sakho nezinso zakho ziphilile, i-lactic acid izophela ezinsukwini ezimbalwa.

Kodwa-ke, uma umzimba wakho uqhubeka nokukhiqiza i-lactic acid eningi kakhulu, noma uma isibindi sakho nezinso zakho zingakwazi ukuyicubungula kahle, isimo singaba sibi kakhulu. Lokhu kuvame ukwenzeka ngohlobo oluthile lokugula. Njengoba izinga le-lactate egazini lakho liqhubeka likhuphuka, izinga le-pH liyehla, futhi ukuphuma kwenhliziyo kuyehla kancane kancane. Lokhu kungaholela ekuhlulekeni kwezinye izitho zomzimba ngisho nokufa. Ngakho-ke kubalulekile ukuqaphela lokhu.

Ziyini izimpawu ze-Lactic Acidosis?

Izimpawu zalesi simo zingase zihluke ezigabeni zokuqala nalapho isimo siba sibi kakhulu.

Izimpawu zokuqala

Ekuqaleni, ungase uzizwe izinto ezinjengalezi:

• Isicanucanu nokuhlanza.
• Ukukhathala okukhulu nokukhathala.
• Ukuphefumula okusheshayo nokujulile (lokhu kubizwa ngokuthi isinxephezelo sokuphefumula , umzamo wokunciphisa i-asidi yomzimba ngokuphefumula).
• Ukuqhaqhazela kwemisipha kanye nobuhlungu bomzimba.

Izimpawu lapho isimo siba sibi kakhulu

Njengoba isimo siba sibi kakhulu, kungase kuvele izimpawu ezilandelayo:

• Ubuthakathaka kanye nokozela okwandisiwe.
• Ukuphambana kwengqondo nokudideka .
• Ubunzima bokulawula ukunyakaza, njengalapho uhamba ( ataxia ).
• Ukwehla kokukhishwa komchamo ( i-Oliguria ).

Ezinye izimpawu

Ungase ube nezimpawu zesimo sezokwelapha esiyisisekelo esibangela i-lactic acidosis . Isibonelo, izimo ezifana ne -sepsis ( ukutheleleka kwegazi), ukushaqeka ( uhlangothi), noma ukwehluleka kwesibindi . Izimpawu zalokhu zingafaka:

• Ukushisa komzimba okuphansi.
• Umfutho wegazi ophansi.
• Imfiva.
• I-jaundice (ukuphuzi kwesikhumba kanye nokumhlophe kwamehlo).

Iyini imbangela eyinhloko ye-lactic acidosis?

Kungaba nezizathu eziningi zalokhu. Imbangela evame kakhulu amazinga aphansi omoya-mpilo egazini lakho (i-hypoxemia) noma ukuntuleka komoya-mpilo ezicutshini zakho (i-hypoxia). Lokhu kuvame ukubangelwa yisimo sezokwelapha.

Odokotela bahlukanise lesi simo se-lactic acidosis ngezinhlobo eziningana ngokusekelwe ezimbangela zaso:

Uhlobo A

I-Type A lactic acidosis yenzeka lapho izicubu zakho zingatholi umoya-mpilo owanele. Ivame ukubonakala ezimweni ezinzima zezokwelapha. Kungaba futhi okwesikhashana, okubangelwa ukuvivinya umzimba ngokweqile.

Ezinye izimo ezingabangela ukukhiqizwa ngokweqile kwe-lactate zifaka:

• Izinkinga zamaphaphu zibangela ukuthi igazi lingatholi umoya-mpilo owanele.
• Ukuphazamiseka kokujikeleza kwegazi kubangela ukuhamba kwegazi okuhamba kancane kanye nokuntuleka komoya-mpilo ezicutshini.
• Izinkinga ze-hemoglobin zithinta ikhono lamaseli abomvu egazi lokuthwala umoya-mpilo.
• Izimo zokushaqeka ezifana nokushaqeka kwe-septic , ukushaqeka kwe-hypovolemic, noma ukushaqeka kwe-cardiogenic .
• I-intestinal ischemic syndrome .
• Ukuxhuzula nokuxhuzula isikhathi eside.
• Ubuthi be-carbon monoxide .

Uhlobo B

I-lactic acidosis yohlobo B yenzeka ngaphandle kokuntuleka koshukela wegazi noma ukuntuleka koshukela wegazi . Kunezinhlobo ezintathu zezinhlobo.

Uhlobo B1

Lokhu kubangelwa yizifo eziyisisekelo eziphazamisa ikhono lokugaya i-lactate.

Kungaba:

• Isifo sesibindi .
• Isifo sezinso.
• Ukuntuleka kwe-Thiamine (i-vitamin B1) .
• Umdlavuza.
• Isimo se- HIV/AIDS .
• Izifo ze-Mitochondria .
• I-ketoacidosis ehlobene nesifo sikashukela .
• Inkinga yokusebenzisa utshwala .

Uhlobo B2

Lokhu kwenzeka njengomphumela ongemuhle wemithi ethile kanye nobuthi. Izibonelo:

• Ubuthi be -cyanide .
• Ubuthi be-carbon monoxide .
• Ubuthi botshwala .
• Ukusetshenziswa kwe-cocaine .
• Eminye imithi ye-HIV ( i-Nucleoside reverse transcriptase inhibitors (ukwelashwa nge-antiretroviral) ).
• Ezinye izinhlobo ze-inhaler ezisetshenziselwa izifo ezifana ne-asthma ( i-Beta-adrenergic agonist inhaler ).
• Umjovo we-Epinephrine we-allergies enzima.
• I-antibiotic i-linezolid .
• I-Propofol yokubulala izinzwa.
• I-Metformin, umuthi osetshenziselwa isifo sikashukela (lokhu kusetshenziswa kabanzi eSri Lanka, ngakho-ke kufanele uqaphele kakhulu ngalokhu).

Uhlobo B3

Lokhu kubangelwa ukuntuleka kwama-enzyme athile azalwa nawo adingekayo ukuze kugaywe i-lactate. Lokhu akuvamile kakhulu. Izibonelo:

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

I-D-lactic acidosis

Izinhlobo A kanye no-B esikhulume ngazo ngaphambilini zihlobene nokuqongelela kwe-L-lactate egazini lakho. Le L-lactate uhlobo lwe-lactic acid oluvame ukukhiqizwa futhi lugaywe emzimbeni womuntu.

Kodwa-ke, kukhona olunye uhlobo olungavamile kakhulu lwe-lactic acidosis, olubangelwa ukuqongelela kwe-D-lactate . Lolu hlobo lwe-lactic acid lukhiqizwa uhlobo lwebhaktheriya emathunjini akho amakhulu. I-D-lactate ikhiqizwa njengomkhiqizo olandelayo lapho la mabhaktheriya egaya ama-carbohydrate ngesikhathi sokugaya ukudla.

I-D-lactic acidosis yenzeka lapho la magciwane ekhula kakhulu. I -D-lactate eningi iyamuncwa isuka emathunjini iye egazini. I-D-lactate ayikwazi ukugaywa yizinso noma isibindi sethu. Ngakho-ke iyaqhubeka nokuqongelela egazini. Lokhu kuvame ukubhekwa njengenkinga yesimo esibizwa ngokuthi i-short gut syndrome .

Itholakala kanjani i-Lactic Acidosis?

Odokotela banquma ukuthi une -lactic acidosis yini ngokusekelwe kulezi zici ezilandelayo:

• Amazinga e-lactate egazini angaphezu kuka-4 mmol/L (ama-millimole ngelitha).
• I-pH yegazi ingaphansi kuka-7.35.

Lezi zindinganiso zilinganiswa ngokuthatha isampula yegazi kuwe bese ulihlola.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Ukuhlolwa okulandelayo kwenziwa ukuze kutholakale i-lactic acidosis :

• Iphaneli ephelele ye-metabolic (CMP) : Lokhu ukuhlolwa kwegazi okulula okulinganisa izinto ezahlukahlukene egazini lakho ukuze kutholakale ulwazi oluyisisekelo mayelana nempilo yakho.
• Ukuhlolwa kwe-lactate yegazi : Ngaphezu kwezinto ezilinganiswa ku-CMP, izinga le-lactate egazini lakho lilinganiswa ngokuqondile.
• Ukuhlolwa kwegazi le-anion gap : Lokhu kuhlolwa kulinganisa ibhalansi ye-pH kanye ne-electrolyte egazini lakho.
• Ukuhlolwa kwegesi yegazi lemithambo yegazi : Lokhu kulinganisa ukugcwala komoya-mpilo emithanjeni yakho, kanye nebhalansi ye-pH kanye ne-electrolyte.

Iphathwa kanjani i-Lactic Acidosis?

Uma une -lactic acidosis ngenxa yesizathu sesikhashana, njengokuzivocavoca ngokweqile, ukuthuthumela, noma ukuxhuzula, ngokuvamile kuzophela ngokuhamba kwesikhathi. Ungathola impumuzo ngokuhlala ekhaya futhi uhlale unamanzi.

Kodwa-ke, esibhedlela, i-lactic acidosis yelashwa ngokushesha ngoketshezi olufakwa emthanjeni ( uketshezi lwe-IV , yilokho esikubiza ngokuthi i-saline) kanye nezinye izindlela zokuvuselela umzimba, njengokwelashwa nge-oxygen, uma kudingeka.

Ukwelashwa kuzonqunywa ngokusekelwe kumbangela. Kuye ngezimpawu zakho, ithimba lakho lezokwelapha lizosebenza ukwelapha isimo sezokwelapha esiyisisekelo noma ubuthi obubangela i-lactic acidosis .

Uma ubonisa izimpawu zamazinga aphansi omoya-mpilo, ithimba lezokwelapha lizosola izimbangela zohlobo A - njengokwehluleka kwenhliziyo noma ukuphefumula, i-sepsis , noma ukushaqeka - bese lelapha lezo zimo eziphuthumayo kuqala.

Ezimweni lapho amazinga aphansi omoya-mpilo engaboniswa khona, bacabangela izimbangela ezahlukahlukene zohlobo B bese bezelapha ngokuqondile.

Hlobo luni lwemiphumela umuntu one-lactic acidosis angalulindela?

Imiphumela incike embangela kanye nobunzima besimo. I-Type A lactic acidosis – ehlotshaniswa ne -sepsis , ukushaqeka, kanye/noma ukwehla kokulethwa komoya-mpilo egazini – iyingozi kakhulu. Ezinye izinhlobo ze -lactic acidosis zingaba mnene futhi zikhule kancane, zivumele isikhathi esengeziwe nethuba lokwelashwa.

Ngokuvamile, njengoba amazinga e-lactate egazini ekhuphuka, amazinga okufa anganda. Kodwa-ke, ukululama okuphelele kungenzeka ngokwelashwa okusheshayo nokuphumelelayo.

I-Lactic acidosis ingenye yezimo eziningana ezibizwa ngokuthi i-metabolic acidosis, lapho i-asidi inqwabelana khona egazini lakho. Ku- metabolic acidosis , izinqubo zomzimba ezijwayelekile ze-metabolic ezikhiqiza futhi zilawule i-asidi ziyaphazamiseka ngandlela thile. Ngokuvamile, isibindi sakho nezinso zakho zingahlunga i-asidi eningi. Kodwa uma lezo zitho zingasebenzi kahle, azikwazi ukulawula i-asidi. Ngakho-ke, ukunakekela isibindi sakho nezinso ngokuphuza amanzi amaningi, ukunciphisa utshwala kanye nokuthatha imithi eyingozi kungasiza kakhulu ekugcineni impilo yakho yesikhathi eside.

Amaphuzu amafushane okufanele uwakhumbule

Kulungile, ake sikukhumbuze ezinye zezinto ezibaluleke kakhulu esikhulume ngazo namuhla:

• I-Lactic acidosis ukwanda kwe-lactic acid egazini.
• Kungaba nezizathu eziningi zalokhu. Isizathu esiyinhloko ukuthi umzimba awutholi umoya-mpilo owanele.
• Izimpawu zokuqala zingase zihlanganise ukukhathala okukhulu, ukuhlanza, nokuphefumula ngokushesha.
• Ukuhlolwa kwegazi kwenziwa ukuze kutholakale lesi simo.
• Ukwelashwa kuncike embangela. Ngezinye izikhathi ukuphumula noketshezi kwanele, ngezinye izikhathi kudingeka ukulaliswa esibhedlela.
• Uma kutholakale futhi kwelashwa kusenesikhathi, kungalapheka.
• Ukugcina isibindi nezinso ziphilile kusiza ekuvikeleni ezimweni ezinjengalezi.

Ngakho-ke, uma unezinye zalezi zimpawu, noma uma ufuna ukwazi okwengeziwe ngalokhu, ungakhohlwa ukubonana nodokotela. Hlala uphilile!

I- Lactic acidosis, i-lactic acidosis, i-lactate, i-asidi egazini, ibhalansi ye-asidi yomzimba, ukuzivocavoca, impilo