Chirwere cheshuga uye kuwedzerwa kweropa zvakakonzera zvirwere zvakabatana zvinodyidzana uye zvinowedzera kuwedzera pamwe nenguva. Muzvinyorwa zvehupenyu, hukama huri pakati pehuga nehuwandu hwemhepo inokonzerwa nehuwandu hwehupenyu hunopikisa, apo imwe nhanho inokonzera danho rechipiri uye yechipiri chigadziro "kunodzosera" kunokonzera zvimwe zvekutanga.
The Feedback Loop
Muenzaniso wakanyatsodzidza zvakanyanya wehukama hwekusimbisa hukama pakati pehutachiwana uye huwandu hwehutano hwemarangariro hunowanikwa muitsvo.
Iyo itsvo ndiyo inonyanya kukosha yomuviri kwenguva refu yeropa rinoronga. Nokuenzanisa chiyero chemunyu uye potassium mumuviri, itsvo dzizopedzisira dzichitonga kuti mvura yakadini inenge yakasvibiswa semuguta. Izvi zvinoshandiswa zvinoshandiswa zvinoshandiswa zvinobatsira kutora nguva refu yeropa rega nekugadzirisa kuti mvura yakawanda iripo mumidziyo yeropa. Kuita basa iri kunobva pakuramba kweropa nguva dzose pamadziro makadzika edzimbadziro anonzi glomeruli (pamwe chete: glomerulus). I-glomeruli ndiyo inosvibisa mairi epiyo.
Mazinga ehuga akakwirira anokonzerwa nechirwere cheshuga chekudzivirira makumbo, kusanganisira izvo zvinosanganisira glomeruli. Nenzira yakakomba yezvikwiriso, shuga yakawedzerwa yeropa zvirokwazvo inokonzera masvingo eti capillaries kuvhara uye, pane dzimwe nguva, anonyadzisa zvachose. Kunyange zvazvo nzira dzakanyatsogadziriswa izvi zvakanyanya kuoma kuti dzikurukure zvakadzama, mugumisiro wekupedzisira ndeyekuti glomeruli inowedzera, uye inonyengerwa mukufunga kuti haisi kuwana ropa rakakwana.
Somugumisiro, itsvo dzinopindura kuburikidza nekusimudza ropa kwekudzorera "ropa" rinotenderera kuburikidza ne glomeruli. Nemhaka yokuti dzakakanganiswa, iyo glomeruli inonyanya kuwedzera kukura kwechigarire muropa rega kuitira kuti ienderere mberi kuchenesa ropa. Sezvenguva inopfuurira mberi, kuramba ichienderera kune shuga yakakwirira kunokanganisa glomeruli yakawanda, zvichikonzera kuwedzera kuwedzera kwezvinokonzerwa neropa sezvo itsvo dzinoedza kugadzirisa mamiriro acho ezvinhu.
Migumisiro Yaro Kune Dzimwe Mamwe
Iyi miedzo yepamusoro yeropa yakawandisa zvakanyanya kune dzimwe nhengo dzomuviri dzomuviri, kusanganisira masumbu uye insulin-secreting nzvimbo dze pancreas. Mumuviri, kukwirira kwakanyanya kunokonzera mitsipa yeropa kubvumirana. Somugumisiro, ropa shoma rinopfuurira kuburikidza nenzvimbo dzakakura dzemasumbu emuviri.
Izvi zvinotungamirira kukuderera kwehukuru hwemasero masero uye kuderera kwehuwandu hwehuga hunoshandiswa nemasero aya kubva muropa. Sezvo shuga shomanana iri kuwedzerwa kubva muropa, muzinga we shuga wakasununguka muropa rinomuka. Ichi shuga yakasununguka pakupedzisira inoita nzira yayo kune itsvo, iyo inobatsira kuti uwedzere kupera kwema glomerular. Ropa rakashandura rinoyerera kuburikidza nepascreas, semugumisiro wekudzivirira, inogonawo kutungamirira pakuderera kwekugadzirwa kwe insulin, kusimudzira shuga yeropa kunyange yakakwirira.
Kudzivirira
Nokuti chirwere cheshuga uye kukwirira kweropa zvakanyanya zvakasimba kuzvisimbisa, zvakakosha zvikuru kuchengetedza zvakasimba kutarisa kwega shuga yeropa neropa. Kunyange kukwirira kwakanyanyisa kwevamwe varwere vane zvirwere zvose izvi zvinogona kukurumidza kuendesa kune chiwedzere chekuwedzerwa (chi "chimiro" chakanyanya) chekukuvara. Ichi ndicho chikonzero chikuru chekurapa kwehuga yeropa zvakanyanya zvakanyanya mukugadzirisa kwehupfumi hweropa uye zvinangwa zvekurapa kweropa zvinowedzera zvakanyanya mukugadzirisa chirwere cheshuga.
Sources:
Tight blood pressure control uye ngozi ye macrovascular uye microvascular complications mu chirwere chechirwere cheshuga: UKPDS 38. UK Inotarisira Diabetes Study Group. BMJ 1998; 317: 703.
K / DOQI Mirayiridzo yeChipatara Chekuita uye Maitiro ekurapa mazano anokurudzira chirwere cheshuga uye chirwere chisingaperi chepfungwa. Am J Kidney Dis 2007; 49 (Suppl 2): S17.
Jafar, TH, Stark, PC, Schmid, CH, et al. Kuwedzera kwezvirwere zvesingaperi zvepfungwa: iyo yeropa rekudzivirira ropa, proteinuria, uye angiotensin-kushandura enzyme kubvisa: chirwere chepamusoro-meta-analysis. Ann Intern Med 2003; 139: 244.
Buse, JB, Ginsberg, HN, Bakris, GL, uye al. Kunyanya kudzivirira zvirwere zvepfungwa muvanhu vane chirwere cheshuga mellitus: chirevo chesayenzi chinobva kuAmerican Heart Association uye American Diabetes Association. Circulation 2007; 115: 114.