Somogyi lub syndrome los yog mob syndrome ntawm insulin overdose (SKHPI): cov tsos mob, mob, kev kho mob ntawm

Somogyi lub syndrome - ib tug tsawg tab sis insidious kab mob, tshwj xeeb tshaj yog neeg nto moo kev txom nyem los ntawm cov ntshav qab zib. Yuav ua li cas yuav paub txog nws thiab seb koj muaj peev xwm yuav kho?

Lub tswvyim syndrome Somogyi

Nyob rau hauv cov ntshav qab zib yuav tsum tau qhov tseeb muab xam los ntawm cov koob tshuaj insulin, tiam sis feem ntau nws yuav ua tau yooj yim ua, uas yog fraught nrog teeb meem. Cov yuav qhov tshuaj overdose Somogyi syndrome. Nyob rau hauv lwm yam lus, nws yog ib tug mob syndrome ntawm insulin overdose. American paub txog Michael Somogyi kawm no phenomenon nyob rau hauv 1959 thiab xaus lus tias tus kom tsawg ntawm ntau zaug tshuaj provokes hypoglycemia - ib tug txo nyob rau hauv cov ntshav qab zib theem. Qhov no ua rau cov stimulation ntawm cov tshuaj hormones thiab kontrinsulinovyh teb - hyperglycemia thaws (nce nyob rau hauv cov ntshav qab zib theem).

Nws hloov tawm hais tias nyob rau hauv txhua lub sij hawm nyob rau hauv cov ntshav insulin theem siab tshaj yam, uas nyob rau hauv ib tug cov ntaub ntawv ua rau hypoglycemia, thiab nyob rau hauv lwm - rau overeating. Ib tug tso tawm ntawm cov tshuaj hormones ua tas mus li kontrinsulinovyh ua viav vias nyob rau hauv cov ntshav qab zib theem, ua rau ib tug tsis ruaj tsis khov txaus ntawm cov ntshav qab zib, thiab yuav ua tau kom ketonuria (acetone nyob rau hauv cov zis) thiab ketoacidosis (mob ntshav qab zib).

keeb kwm tseeb

Insulin yog thawj siv tau ntse nyob rau hauv 1922, tom qab uas pib ib tug kev tshawb no ntawm nws cov teebmeem rau lub cev, nqa tawm thwmsim rau tej tsiaj txhu thiab tib neeg. Zaum tau pom tias siab koob tshuaj ntawm cov tshuaj nyob rau hauv cov tsiaj ua hypoglycemic poob siab, feem ntau ua rau txoj kev tuag. Nws twb pom tias ib tug loj tus naj npawb ntawm tshuaj lom los ntawm cov hormone rau lub cev. Nyob rau hauv cov thaum ntxov xyoo, cov tshuaj siv los kho cov neeg mob uas anorexia nyob rau hauv thiaj li yuav ua rau kom lawv lub cev muaj ceeb thawj. Qhov no coj mus rau qhov kev hloov nyob rau hauv cov ntshav qab zib ntau ntau, variations ntawm hypoglycemia rau hyperglycemia. Thaum kawm tiav ntawm lub chav kawm ntawm kev kho mob rau tus neeg mob tsom tej yam tshwm sim ntawm cov ntshav qab zib. Ib tug zoo xws li cov nyhuv tshwm sim nyob rau hauv Psychiatry rau cov kev kho mob ntawm cov neeg mob nrog schizophrenia "insulin shocks". Txawv ntawm kev nce rau hauv ntau npaum thiab ua rau kom insulin tsom glycemia thiab kev kho mob ntawm cov ntshav qab zib. Qhov no tshwm sim tau ua lub npe hu nyob rau hauv lub neej yav tom ntej raws li lub Somogyi syndrome.

cov tsos mob

Raws li ib tug self-to taub hais tias lub cev yog raug mob overdose ntawm insulin? Somogyi syndrome yog manifested los ntawm cov tsos mob:

• muaj yog ib tug general deterioration ntawm kev noj qab nyob, muaj ib tug tsis muaj zog,
• cia li mob taub hau, kiv taub hau, uas yuav dramatically mus tom qab noj haus kom tsawg ntawm cov carbohydrates,
• disturbed pw tsaug zog, yuav txhawj xeeb thiab ces, feem ntau npau suav phem,
• muaj yog ib qhov kev xav ntawm nkees, tsaug zog,
• sawv nyob rau hauv thaum sawv ntxov tsis yooj yim, cov neeg xav tias ntxhov siab heev,
• yuav tshwm sim qhov muag plooj tsis pom kev nyob rau hauv daim ntawv ntawm ib tug pos huab ua ntej nws lub qhov muag, daim ntaub thaiv los flashing kaj me ntsis,
• mus ob peb vas swings, feem ntau nyob rau hauv ib tug tsis zoo coj,
• nce qab los noj mov, koj qhov hnyav nce.

Tej tsos mob yog alarming tswb, tab sis tej zaum yuav tsis ua cuab vim li cas rau mob, raws li cov cim qhia ntawm cov kab mob ntau. Ib tug ua tiav daim duab ntawm lub dab tshwm sim nyob rau hauv lub cev yuav tsum havzoov nrog kev pab los ntawm kev ntsuam xyuas.

diagnostics

Mob "Somogyi syndrome" pab cov tsos mob no yog:

• tsos ntawm ketone lub cev (acetone) nyob rau hauv cov zis,
• ntse thiab ceev ceev hloov mus hloov los glucose theem indicators los ntawm tsis rau siab thiab rov qab mus rau txhua hnub,
• qhia tau meej heev los yog implicit hypoglycemia,
• zoo glucose rau mob khaub thuas,
• rau cov ntshav qab zib worsens nrog ua koob tshuaj insulin thiab pab txoj kev nrog txo.

Somogyi syndrome mob nyob rau hauv feem ntau tus neeg mob yog ib qhov nyuaj txawm rau cov kws txawj, tsis tas ib tug endocrinologist kev sib tham yuav muab tseeb tau tam sim ntawd. Qhov no yog vim lub fact tias tus neeg mob tus mob mob uas tshwm sim nyob rau hauv nws lub cev, yuav teeb liab li ib tug overabundance ntawm insulin, thiab nws cov nyiaj tsawg. Cov soj ntsuam daim duab nyob rau hauv cov txheej txheem yog zoo tib yam, mob overdose yuav yuav ntes tau nkaus xwb nyob rau hauv qhov kev saib xyuas thiab cov neeg txawj ceev faj txoj kev tshawb no ntsuam. Kuaj raws li yam li cov raug soj ntsuam kev nthuav qhia, heev hypoglycemic lub xeev, ib tug ntshav qab zib hloov mus hloov los.

differential mob

Somogyi nyob rau hauv qhov mob ntawm lub syndrome yog yooj yim meej pem nrog tus paub txog tus phenomenon ntawm "kaj ntug", raws li cov tsos mob ntawm ob pathologies yog zoo tib yam. Txawm li cas los, muaj qhov sib txawv. Cov tshwm sim ntawm "kaj ntug" yog pom tau tias muaj nyob rau hauv cov neeg mob uas mob ntshav qab zib, tab sis kuj nyob rau hauv cov neeg noj qab, nws manifested qhov kaj ntug hyperglycemia. Qhov no yog vim ib tug tsis muaj basal insulin ntau vim sai puas tsuaj ntawm nws lub siab los yog kho kom zoo tso tawm contrainsular lawm nyob rau hauv thaum sawv ntxov. Tsis zoo li Somogyi syndrome, manifestation ntawm no phenomenon yog tsis preceded by hypoglycemia. Yuav kom muab tso ib tug muaj tseeb mob yog tsim nyog los paub qhov ntshav qab zib theem ntawm ob mus rau plaub nyob rau hauv thaum sawv ntxov, nyob rau hauv cov neeg mob uas mob overdose syndrome nws yog nws txo qis, thiab nyob rau hauv ib tug neeg mob nrog hyperglycemia kaj ntug nws tsis hloov. Kev kho mob ntawm cov kab mob yog qhov opposite: nyob rau hauv thawj cov ntaub ntawv, cov insulin koob tshuaj yog txo, ces tus thib ob - mus nce.

Nta ntawm cov ntshav qab zib nyob rau hauv lub syndrome Somogyi

Lub ua ke ntawm cov ntshav qab zib nrog lub syndrome mob overdose ntawm insulin (SKHPI) muab nyhuv dejnum, tus kab mob no yog tshwj xeeb yog nyuaj. Tawm tsam tom qab ntawm lossi tau txais ntev li koob tshuaj hypoglycemia yuav latent daim ntawv. Somogyi syndrome nyob rau hauv cov ntshav qab zib yog reflected nyob rau hauv cov kev mob ntawm tus neeg mob, thiab nws tus cwj pwm.

Ceev cov kev hloov ntawm mus ob peb vas tsis muaj yog vim li cas - ib tug heev tshwm sim nrog xws li kev mob nkeeg. Thaum uas koj nyiam ua zaj lus qhia tej lag luam los yog kev ua si tom qab ib tug thaum tus txiv neej mam li nco dheev poob kev txaus siab nyob rau hauv txhua yam yuav mus nyob rau, nws yuav sluggish thiab apathetic, tsis muaj ab tsi mus rau sab nraud yam. Tej zaum unmotivated resentment los yog aggression yuav tshwm sim. Heev feem ntau, muaj ib tug muaj zog qab los noj mov nyob rau hauv ib tug neeg mob, tab sis, dua li no, tej zaum kuj yog ib tug tsis zoo tus cwj pwm rau cov zaub mov, tus txiv neej tsis kam noj mov. Cov tsos mob tshwm sim nyob rau hauv 35% ntawm cov neeg mob. Ntau ntau tsis txaus siab muaj xws li tsis muaj zog tawm tsam, kiv taub hau, mob taub hau, pw tsaug zog ntxaug. Ib txhia nco ntsoov ib tug cia li thiab luv luv-lived nrig txog kev pom kev tsis taus (nyob rau hauv daim ntawv ntawm ib daim ntaub thaiv ua ntej lub ob lub qhov muag los yog kaj "yoov").

kev kho mob

Kev kho mob ntawm lub syndrome yuav Somogyi tseeb muab xam los ntawm cov kua dej los koob tshuaj. Rau lub hom phiaj no, tus nqi xeem yuav tsum tau tom, nws yog txo los ntawm 10-20% nyob rau hauv nruj kev soj xyuas tus neeg mob. Yuav ua li cas ntev yog kho Somogyi syndrome? Nyob ntawm seb tus neeg indications txawv kho hom kev kawm uas siv - ceev thiab qeeb. Thawj ua tshaj yav dhau los ob lub lim piam, lub thib ob yuav siv sij hawm 2-3 lub hlis.

Thaum xub thawj siab ib muag, ib tug tej zaum xav hais tias ib tug yuav txo tau nyob rau hauv insulin koob tshuaj yuav ua rau lub disappearance ntawm lub syndrome, tab sis nws tsis yog. Mere yuav txo tau nyob rau hauv tus nqi ntawm cov muab tshuaj tsis zoo rau thaum kawg ntawm cov ntshav qab zib, cov kev kho mob yuav tsum yog complex. Nws muaj feem xyuam rau cov zaub mov (rau normalize tus nqi ntawm cov carbohydrates noj nrog zaub mov), lub cev ua si. Insulin yog muab ua ntej noj mov. Tsuas yog ib tug kev mus kom ze yuav paib zoo tau nyob rau hauv sib ntaus tawm tsam tus syndrome Somogyi.

outlook

Raws sij hawm kom paub tias mob syndrome ntawm insulin overdose muaj zoo forecasts. Nws yog ib qho tseem ceeb rau saib xyuas ntawm koj tus kheej, tus ntsais teeb ntawm lub cev, tej txheej xwm kev hloov thiab deterioration ntawm kev noj qab nyob tam sim ntawd sab laj ib tug kws kho mob, rau piv txwv, nyob rau hauv lub Center ntawm endocrinology nyob rau Academic (Moscow). Lub paaj sij hawm ntawm qhov kev kho mob ntawm cov yooj yim lub luag hauj lwm ua si los ntawm cov professionalism thiab kev tus kws kho mob. Thaum undiagnosed syndrome unfavorable forecasts: tu ncua overdose ntawm insulin yuav tsuas paug tus mob ntawm tus neeg mob, mob ntshav qab zib yog tsis zoo heev tshaj.

kev tiv thaiv

Main SKHPI tiv thaiv destinations xws li ib tug txheej ntawm kev ntsuas.

• Nyob rau hauv cov ntshav qab zib yuav tsum tau nruj me ntsis adhered noj cov khoom noj kom zoo sib phim rau tus neeg mob thiab saib kuas cov nyiaj ntawm carbohydrate metabolism. Ib tug neeg yuav tsum npaj rau koj noj mov, yuav tau mus xam tus nqi ntawm ib tug carbohydrate zaub mov noj, ua ib tug txaus hloov ntawm cov khoom yog tias tsim nyog.
• Insulin yog cov kev ua nyob rau hauv lub koob yuav tsum tau rau ib tug neeg mob. ua hauj lwm ntawm tus kws kho mob - yog hais tias tsim nyog los ua ib tug kho lus, tus neeg mob - saib xyuas cov xwm txheej ntawm cov kab mob.
• Qhov ce yog tsim nyog rau cov neeg mob uas mob ntshav qab zib, tshwj xeeb tshaj yog yog hais tias tus neeg mob yog sedentary los yog muaj ib tug sit-down txoj hauj lwm.
• Qhov xyuas ntawm tus kab mob, ib tug endocrinologist sab laj nyob rau ib tug neeg lub sij hawm thiab raws li xav tau.
• Zoo Tsim Nyog kev ntsuam xyuas ntawm lub zwj ceeb ntawm lub cev, noj qab haus huv, ceev ceev nrhiav kom tau ntawm tej yam txawv cov tsos mob.
• Creation ntawm tej yam kev mob rau nws tus kheej-tswj nyob rau hauv lawv lub neej, txoj kev tshawb ntawm cov neeg mob thiab tsev neeg lub hauv paus ntsiab lus ntawm nws tus kheej-kev tswj.

Somogyi syndrome nyob rau hauv cov me nyuam

Cov me nyuam txom nyem los ntawm cov ntshav qab zib, yuav tsis yeej ib txwm kom khiav ntawm kev hloov nyob rau hauv lub xeev ntawm tus kab mob, feem ntau qhov no yog tsis tau, yog li ntawd, kom tswj tau tus chav kawm ntawm lub mob - tu cov niam txiv. Ua tib zoo saib rau tsaug zog tus me nyuam, raws li qhov kev txiav txim ntawm insulin yog tsuas yog nyob rau yav hmo ntuj, thiab tus me nyuam tus cwj pwm coj yuav qhia rau ib tug ntau. Thaum lub manifestation ntawm cov syndrome pw nws tau muaj num ntau thiab ces, nrog los ntawm ua pa nrov ua tsis taus pa. Tus me nyuam tej zaum yuav quaj qw los yog quaj nyob rau hauv nws pw tsaug zog vim npau suav phem. Awakening hnyav, tam sim ntawd tom qab nws tshwm sim tsis meej pem.

Tag nrho cov ces - ib tug kos npe rau ntawm ib tug hypoglycemic mob. Tag nrho cov hnub tus me nyuam tseem nyob rau hauv lub flaccid lub xeev, nws yog capricious, chim siab, muaj tsis muaj kev txaus siab nyob rau hauv kev ua si los yog kev tshawb fawb. Apathy zaum yuav tshwm sim mam li nco dheev, tsis muaj yog vim li cas, nyob rau hauv lub chav kawm ntawm ib tug kev sib kho. Nquag kab mob ntawm unmotivated aggression, mus ob peb vas swings yog unpredictable. Feem ntau, cov me nyuam nrog rau cov syndrome raug kev txom nyem los ntawm kev nyuaj siab. Kev kho mob yog nqa tawm nyob rau hauv tib lub hauv paus ntsiab lus li hais tias ntawm cov neeg laus. Endocrinology Center nyob rau Academic, piv txwv li, pab cov me nyuam tiv nrog lub syndrome Somogyi.