Hoʻokomo ʻia nā antiododies i ka insulin i kā lākou iho i ka insulin ponoʻī. I ka insulin, ʻo ia ka hōʻailona kikoʻī loa maʻamau no ka maʻi maʻi 1 ka maʻi. Pono ke kuhikuhi ʻana i nā haʻawina e ʻike i ka maʻi.
Pahu aku ka maʻi diabetes mellitus ma ke ʻano o ka hōʻino ʻana o ka pulima o nā mokupuni o Langerhans. ʻO ke ʻanoʻo ia e alakaʻi ai i ka nele o ka insulin i ke kino kanaka.
Pēlā, ke kū'ē nei i ka maʻi type 1 i ka diabetes type 2, ʻaʻole e hoʻopili ka mea i ka nui o nā maʻi o ka maʻi immunological. Me ke kōkua o ka maʻi ʻokoʻa ʻana o nā ʻano maʻi o ka maʻi maʻi, hiki ke mālama ʻia i ka hoʻomaʻamaʻa ʻana me ka mea kūpono a hiki ke kuhikuhi ʻia ka hoʻolālā kūpono kūpono.
Ka hoʻoholoʻana i nā antibodies i ka insulin
He hōʻailona ia no nā lesi autoimmune o nā pā poli pancreatic e hana ai i ka insulin.
ʻO Autoantibodies i ka intrinsic insulin he mau antibodies i hiki ke ʻike i ka serum o ke koko o ka maʻi maʻi maʻi type 1 ma mua o ka insulin therapy.
Ke hōʻike nei i ka hoʻohana ʻana:
- ka maʻi ʻaʻai o ka maʻi diabetes
- hoʻoponopono 'ana o ka inema insulin,
- ka hoʻomaka ʻana o nā hana mua o ka maʻi diabetes,
- ka maʻi ʻana o ka maʻi prediabetes.
ʻO ke ʻano o kēia mau antibodies e hoʻoponopono me kahi makahiki. Kuhi ʻia nā ʻano antibodies i nā hihia āpau inā ʻike ʻia ka maʻi maʻi i nā keiki ma lalo oʻelima mau makahiki o ka makahiki. Ma 20% o nā hihia, ʻike ʻia nā antibodies i nā poʻe me ka maʻi diabetes.
Inā ʻaʻohe hyperglycemia, akā aia he mau antibodies, a laila ʻaʻole i hōʻoia ʻia ka maʻi ʻa ka maʻi type o ka maʻi type 1. I ka wā e hele ai ka maʻi, ua emi ka nui o nā antibodies i ka insulin, a hiki i ko lākou nalowale āpau.
ʻO ka hapa nui o nā maʻi maʻi maʻi o ka maʻi HLA-DR3 a me HLA-DR4. Inā loaʻa i ka ʻohana nona ka maʻi diabetes type 1, ʻo ka nui o ka maʻi o ka maʻi e piʻi ana e 15. Kuhi ka lōʻihi o nā autoantibodies i ka insulin i mua o nā mākaʻi mua ma ke ʻano o ka maʻi maʻi.
No nā hōʻailona, hoʻopau ʻia ka 85% o nā cell beta. E nānā i kahi loiloi o kēia mau antibodies i ka hopena o ka maʻi diabetes i ka wā e hiki mai ana i ka poʻe me kahi predisposition.
Inā he keiki kekahi me ka predisposition genetic he antibodies i ka insulin, ʻo ka make o ka hoʻomohala ʻana i ke ʻano type type 1 i nā makahiki he 10 e hiki mai ana e 20%.
Inā loaʻa a ʻelua a oi paha nā antibodies e kūikawā no ka maʻi mellitus type 1, ʻo ka hopena o ka maʻi o ka maʻi e piʻi aʻe i ka 90%. Inā loaʻa he kanaka i ka hoʻomākaukau ʻana o ka insulin (exogenous, recombinant) i ka ʻōnaehana maʻi diabetes, a laila maʻa ka manawa e hoʻomaka ke kino e hana i ka antibodies ma ia.
E kūpono ke nānā ʻana i kēia hihia. Eia naʻe, ʻaʻole hiki i ka nānā ʻana ke hoʻomaopopo inā ua ʻae ʻia nā antibodies i ka insulin a i ʻole a i waho.
I ka hopena o ka insulin insulin i ka maʻi maʻi maʻi, i ka nui o nā antibodies e kū i waho i ka insulin i ka nui o ke koko, e hiki ai i ka pale ʻana i ka insulin a hoʻopilikia i ka mālama ʻia.
Pono e noʻonoʻo i ka kūleʻa ʻana o ka insulin e hele mai ana i ka wā o ka maʻi me ka hoʻomākaukau ʻana i nā hoʻomaʻamaʻa ʻana o ka insulin.
ʻO ka ho'ākāka o ke ʻano o ka maʻi maʻi
Ua aʻo ʻia ʻo Autoantibodies e kūʻē i nā ʻōlapa beta o islet e hoʻoholo ai i ke ʻano o ka maʻi maʻi. ʻO nā meaola o ka hapanui o nā kānaka e loaʻa i kahi maʻi o nā maʻi maʻi type 1 e hana i nā antibodies i nā mea o kā lākou iho pancreas. ʻAʻole ʻano mau ʻano neʻe i ka ʻano o nā maʻi maʻi type 2.
I ke ʻano maʻi diabetes type 1, he ʻāhane hoʻi ka insulin. No ka pancreas, ʻo ka insulin ka mea nui o ka autoantigen kikoʻī. ʻOkoʻa ka hormone a me kekahi mau autoantigens i loaʻa i kēia maʻi.
Loaʻa ka Autoantibodies i ka insulin i ke koko o nā mea ma mua o 50% o ka poʻe me ka maʻi maʻi. I ka maʻi o ka maʻi pālahalaha 1, aia kekahi mau antibodies i loko o ke kahe e pili ana me nā pupu beta o ka pancreas, no ka laʻana, nā antibodies i ka glutamate decarboxylase.
E hōʻike ʻia:
- ma kahi o 70% o nā mea maʻi he ʻekolu a ʻoi paha nā ʻano o nā antibodies,
- emi ma lalo o 10% i hoʻokahi mau ʻano,
- ʻaʻohe mea pono autoantibodies ma 2-4% o nā mea maʻi.
He mea koʻikoʻi ia e hōʻike ana i nā antibodies i ka hormone insulin i ka diabetes mellitus, ʻaʻole ia he mea hoʻonāukiuki o ka maʻi. Hōʻike wale ʻia kēlā mau antibodies i ka luku ʻana o nā pihi pancreatic. ʻO nā antibiotibies i ka insulin i nā keiki me nā maʻi type 1 e ʻike ʻia i nā nui aʻe ma mua o nā pākeke.
He mea nui ia e kiaʻi i ka ʻoiaʻiʻo o ia, ma ke ʻano he lula, i nā keiki me ka maʻi type type 1, hele mai nā ʻano antibodies i mua a me ke kūlana kiʻekiʻe. Hōʻike pinepine ʻia kēia ʻano i nā keiki i lalo o nā makahiki ʻekolu.
Ka hoʻomaopopo ʻana i kēia mau hiʻohiʻona, ʻike ʻia kahi hana like ʻole i kēia lā ke ʻano ʻoi loa ʻo ka ʻike noi lāʻau no ka hoʻopaʻa ʻana i ka maʻi mellitus no ka wā kamaliʻi.
E loaʻa i ka ʻike piha loa e pili ana i ka hoʻomohala ʻana i ka maʻi diabetes, ʻaʻole wale nō kahi hōʻike ʻenepili i kuhikuhi ʻia, akā he ʻano ʻano hoʻi no ke ʻano o nā autoantibodies.
Inā ʻaʻohe keiki ka hyperglycemia, akā he mea hōʻailona o nā loiloi autoimmune o nā pūna o nā moku ʻo Langerhans, ʻaʻole kēia he manaʻo aia he ʻano 1 ka maʻi mellitus.
Ke hoʻomau nei ka maʻi diabetes, hoʻemi ka pae o ka autoantibodies a hiki i ka undetectable.
Ke hoʻokau ʻia kahi aʻo
Pono e nānā ʻia ka loiloi inā ua loaʻa ka maʻi maʻi i nā hōʻailona lapaʻau o ka hyperglycemia, ʻo ia hoʻi:
- makewai nui
- ka nui o ka nui o ka urine
- Kaumaha kaumaha
- ikaika ikaika
- ka haʻahaʻa haʻahaʻa o nā haʻahaʻa haʻahaʻa,
- ka emi ʻana o ke ʻano ʻike,
- trophic, maʻi maʻi ʻeha maʻi,
- nā hōʻeha ʻaʻole nā lahu e lōʻihi.
No ka hana i nā hoʻokolohua no ka antibodies i ka insulin, pono ʻoe e ʻimi i ka immunologist a i ʻole ʻimi aku i ka rheumatologist.
Hoʻomākaukau hoʻomākaukau i ke koko
ʻO ka mea mua, wehewehe ke kauka i ka mea maʻi i ka pono o ia ʻano aʻo ʻana. Pono e hoʻomanaʻo ʻia e pili ana i nā kūlana o ka olakino a me nā ʻano kūlohelohe, ʻoiai ua ulu kēlā me kēia kanaka i ka kū hoʻokahi.
ʻO kahi koho maikaʻi loa he lilo ia i mea hoʻohālikelike koko e kekahi ʻenehana loea a kauka paha. Pono e hoʻākāka i ka mea maʻi e hana ʻia kahi ʻano hoʻohālike e like me ka maʻi o ka maʻi maʻi. Pono e wehewehe he nui a make ka maʻi, a inā e hahai ʻoe i nā lula, hiki iā ʻoe ke alakaʻi i ke ʻano holoʻokoʻa.
Hāʻawi ʻia ke koko i ke kakahiaka ma ka ʻōpū ʻole, ʻaʻole hiki iā ʻoe ke inu i ke kofe a iʻa paha. Hiki iā ʻoe ke inu i ka wai wale. ʻAʻole hiki iā ʻoe ke ʻai i nā hola 8 ma mua o ka hoʻokolohua. ʻO ka lā ma mua o ka pāpā ʻia ʻana:
- inu waiʻona
- ʻai i nā meaʻai iʻa ʻia
- e pāʻani i nā haʻuki.
Hoʻopuka ʻia ka hoʻonaninani koko ke ʻano he ʻano penei:
- hōʻiliʻili ʻia ke koko i loko o kahi pākī hoʻokolokolo hoʻomākaukau ʻia (hiki iā ia ke kīpoka hoʻokaʻawale a kīnā ʻole).
- ma hope o ke kahe ʻana, e hoʻopili ʻia ka pae puncture me ka uala o ka ʻōpala,
Inā hele mai kahi hematoma ma ke ʻano o ka puncture, ke kauka nei ke kauka i nā mea hoʻomehana i ka wela.
He aha nā hopena e ʻōlelo ai?
Inā kūleʻa ke kaulike, hōʻike kēia:
- maʻi diabetes type 1
- ʻO ka maʻi ʻo Hirat
- polyendocrine autoimmune syndrome,
- ka heleʻana o nā antibodies e nānā i ka insulin a exogenous.
Hōʻike ʻia kahi hopena hōʻike maikaʻi ʻole.
ʻO nā maʻi pili
Ma kahi e ʻike ai i kahi mākaʻi o ka autoimmune beta-cell pathologies a me ka hōʻoia o ke ʻano maʻi type 1, pono e kau ʻia nā haʻawina hou. Pono lākou e hoʻokaʻawale i kēia mau maʻi.
I ka hapa nui o nā maʻi maʻi 1, ua nānā ʻia hoʻokahi o nā ala ʻokoʻa autoimmune.
ʻO ka maʻamau, ʻo ia kēia:
- nā pathologies autoimmune o ka nui o ka lāʻau thyroid, no ka laʻana, ka maʻi thyroiditis Hashimoto a me nā maʻi Graves,
- kaluhi o ka adrenal maʻamau (maʻi o Addison),
- maʻi celiac, i.e. gluten enteropathy a pernicious anemia.
He mea nui hoʻi ia e hana i nā noi i nā maʻi ʻelua. Eia kekahi, pono ʻoe e ʻike i ka pono o ka maʻi i ka poʻe i loaʻa ka mōʻī līlio a kaumaha hoʻi, ʻoi aku hoʻi i nā keiki. ʻO ke wikiō ma kēia ʻatikala e haʻi aku pehea e ʻike ai ke kino i ka antibodies.
