Lactate: chii uye nei zvingave zvakakwirira

Zvemukati

• Nguva yekutora iyo lactate bvunzo
• Chii chinonzi high lactate chinorevei

Lactate chigadzirwa cheglucose metabolism, ndiko kuti, imhedzisiro yekushandura glucose kuita simba remasero kana pasina oxygen yakakwana, maitiro anonzi anaerobic glycolysis. Zvisinei, kunyange mumamiriro ezvinhu eerobic, umo mune okisijeni, lactate inogadzirwa, asi mune zvishoma zvishoma.

Lactate chinhu chakakosha, sezvo ichionekwa sechiratidzo kuCentral Nervous System, biomarker yemitsipa shanduko uye tishu hypoperfusion, umo mune oxygen shoma inosvika kumatumbu, uye nehukuru hwekuita kwemuviri uye kuneta kwemhasuru, kubvira zvakanyanya zvakanyanya sei chiitiko ichi, iko kudiwa kukuru kweoksijeni nesimba, izvo zvinotungamira mukugadzirwa kwakanyanya kwea lactate.

Nguva yekutora iyo lactate bvunzo

Iyo lactate bvunzo inoshandiswa zvakanyanya mukiriniki yekuita muzvipatara varwere uye sechiratidzo chekusimba kwechiitiko chemuviri uye kuneta kwemhasuru. Muzvipatara, muyero we lactate wakakosha kuti uongorore mamiriro emurwere uye uone mhinduro kurapwa. Kazhinji muyero unoitwa muzvipatara varwere vanofungidzirwa kana vakawanikwa vaine sepsis kana septic kuvhunduka, ayo mamiriro ezvinhu anoonekwa ne lactate pamusoro pe2 mmol / L mukuwedzera kwekudzikira kweropa, kufema nekukurumidza, kuderera kwekugadzira weti uye kuvhiringidzika kwepfungwa.

Nekudaro, kana uchiita lactate dosing, zvinokwanisika kutarisa kana murwere ari kupindura kurapwa kana zvichidikanwa kuchinja chirongwa chekurapa uye kuwedzera kuchengetwa zvinoenderana nekuderera kana kuwedzera mumazinga eactate.

Mumitambo, muyero wea lactate unobvumidza kuona mwero wekuita kwemumhanyi uye kusimba kwechiitwa. Mukuita kwakasimba kwazvo kana kwenguva refu, kuwanda kweiyo okisijeni inowanikwa hakuwanzo kukwana, kunoda kugadzirwa kwe lactate kuchengetedza mashandiro emaseru. Nekudaro, kuyera huwandu hwe lactate mushure mekurovedza muviri kuno bvumidza iye mudzidzisi wepanyama kuti aratidze chirongwa chekudzidzisa chinonyanya kukodzera kumutambi.

Iko kukosha kweiyo lactate kunoonekwa sekujairika kana iri shoma kana yakaenzana ne2 mmol / L. Iyo yakakwira iyo lactate yevasungwa, inowedzera kukura kwechirwere. Panyaya ye sepsis, semuenzaniso, kuwanda kwe4.0 mmol / L kana yepamusoro kunogona kuwanikwa, izvo zvinoratidza kuti kurapwa kunofanira kutanga nekukurumidza kudzivisa kunetseka.

Kuita muyedzo we lactate, hazvidiwe kuti utsanye, zvisinei zvinokurudzirwa kuti munhu azorore, nekuti kurovedza muviri kunogona kuchinja mazinga eactate uye, nekudaro, kukanganisa mhedzisiro yekuyedzwa.

Chii chinonzi high lactate chinorevei

Kuwedzera kwekutenderedza kwekutenderedza lactate, kunodaidzwa kuti hyperlactemia, kunogona kuitika nekuda kwekuwedzera kugadzirwa kweiyo lactate, shanduko mukupa okisijeni kumatukisi kana kushomeka mukubviswa kwechinhu ichi kubva mumuviri, zvichikonzera kuwanda kwazvo muropa. Nekudaro, yakakwira lactate inogona kuitika nekuda kwe:

• Sepsis uye septic kuvhunduka, umo, nekuda kwekugadzirwa kwehupfu nema microorganisms, pane kuderera kwehuwandu hweokisijeni inosvika kumatukisi, nekuwedzera mukugadzirwa kweactate;
• Kunyanya kuita muviri, nekuti mune mamwe mamiriro huwandu hweoksijeni yekuita kurovedza muviri hauna kukwana, pamwe nekuwedzera mukugadzira lactate;
• Kuneta kwetsandanyama, nekuda kwehuwandu hwakawanda hwe lactate yakaunganidzwa mumhasuru;
• Systemic kuzvimba mhinduro syndrome (SIRS), sezvo paine shanduko mukuyerera kweropa uye maseru ezvirwere zvemuviri, zvichikonzera kuwedzerwa kugadzirwa kwelactate mukuyedza kuchengetedza zviitwa zvema cell uye kubatsira mukugadzirisa kwekuzvimba. Muyero wea lactate mune ino mamiriro unoshandiswa zvakanyanya kuongorora mhinduro yemurwere uye kuyera njodzi yekukundikana kwemitezo, chiri chiratidzo chekufungidzira;
• Cardiogenic kuvhunduka, umo mune shanduko muropa inopa kune moyo uye, zvichidaro, oxygen;
• Hypovolemic kuvhunduka, umo mune kurasikirwa kukuru kwemvura uye neropa, kuchinja kugoverwa kweropa kumatishu;

Pamusoro pezvo, zvimwe zvidzidzo zvakaratidza kuti kuwanda kwe lactate kunogona kuitika pachinetso chechiropa neitsvo, chirwere cheshuga mellitus, chepfu nemishonga uye chepfu uye metabolic acidosis, semuenzaniso. Nekudaro, zvichibva pakuongororwa kweiyo lactate concentration, zvinokwanisika kuita kuongororwa kwezvirwere, kuongorora shanduko yemurwere uye mhinduro kurapa uye kufanotaura mhedzisiro yekiriniki.