Matenda a shuga

Matenda a shuga ndi matenda amtundu wa endocrine omwe amayamba chifukwa cha kuperewera kwa thupi la antidiuretic mahomoni (vasopressin). Matendawa amayamba chifukwa chophwanya magazi kagayidwe ka madzi ndi kapangidwe ka zosmotic zamadzimadzi amthupi, ndiye kuti zizindikiro zazikulu za matenda a shuga a insipidus ndi ludzu losalekeza (polydipsia) ndi polyuria (excretion ya malita 6 mpaka 15 a mkodzo patsiku).

Nthendayi imakonda kupezeka mwa achinyamata azaka za pakati pa 18 ndi 25 (omwe amakhala ndi akazi pafupipafupi), komabe, milandu yokhudzana ndi matenda osokoneza bongo a ana mu chaka choyamba cha moyo imadziwika mu zamankhwala. Matendawa amatha kukhala obadwa nawo kapena kutengedwa. Mitundu yovomerezeka imayamba makamaka munthawi ya kusintha kwa mahomoni m'thupi: kutha msambo ndi kusamba, komanso nthawi yapakati.

Zomwe zimayambitsa matendawa

Matenda a shuga a shuga nthawi zambiri amakhala matenda omwe amapezeka. Njira zotsatirazi zomwe zimayambitsa matenda zimatha kubweretsa chitukuko:

• kuphwanya kapangidwe ka vasopressin ndi hypothalamus,
• kuyanʻanila mwachizolowezi vasopressin m'magazi, kudziwa izo mu impso,
• matenda a hypothalamic-pituitary system,
• sarcoidosis
• zotupa zoyipa za chapakati mantha dongosolo,
• metastases ya ubongo yomwe imakhudza kugwira ntchito kwa hypothalamus ndi gitu pituitary,
• meningitis
• encephalitis
• chindapusa
• matenda a autoimmune
• matenda a mtima
• craniopharyngioma,
• mitsempha yamatumbo
• kuvulala kwamtundu wamatumbo
• ntchito pa ubongo (nthawi zambiri chitukuko cha matenda a shuga insipidus kumabweretsa kuchotsedwa kwa pituitary adenoma).

Matenda a shuga angayambitsenso matenda obadwa nawo. Matendawa amatengera zonse mthupi zomwe zimachitika pang'onopang'ono, ndipo nthawi zambiri zimayendera limodzi ndi vuto lina la mahomoni m'thupi (mwachitsanzo, kuchepetsedwa kukula kwa ziwalo zogonana, kusokonekera kwamafuta kagayidwe, kusokonezeka kwa thupi, ndi zina zotere).

Gulu la shuga insipidus

Shuga insipidus ndi gulu la matenda amtundu wa endocrine omwe amadziwika ndi kukhalapo kwa chizindikiro chimodzi chodziwika - kutulutsidwa kwa mkodzo wothinitsidwa zochuluka. Gululi limaphatikizapo matenda a shuga a mitundu zotsatirazi:

• chapakati
• nephrogenic
• mitsempha polydipsia.

Matenda ashuga apakati amakula pomwe machulukitsidwe ochulukitsa amadzi a antidiuretic amakhala ochepera 75% ya momwe amakhala. Pankhaniyi, matendawa amatha kubereka kapena kutengedwa. Matenda a shuga a m'magazi amaperekedwa ndi mfundo yofunika kwambiri. Mawonekedwe omwe apezeka ndi matendawa ndi zotsatira za kuvulala kwamtundu wamatumbo, zotupa, autoimmune kapena matenda opatsirana omwe amayambitsa kuwonongeka kwa hypothalamus kapena neurohypophysis, kuvulala kwa opaleshoni.

Nephrogenic shuga insipidus amayamba chifukwa cha kusagwirizana kwa aimpso epithelium receptors ku antidiuretic mahomoni. Mtundu wobadwa nawo wa matendawa umayamba chifukwa cha masinthidwe amtundu wa receptor. Nthawi yomweyo, hypotonic polyuria, yomwe ndi chizindikiro chachikulu cha matendawa, imayamba ndi mtundu wa matenda a shuga wodwala ana osakhanda. Kukula kwa matenda omwe amapezeka ndi shuga kumayambitsa hypokalemia, hypercalcemia, sickle cell anemia, komanso kutsekeka kwamitsempha. Chofunikira kusiyanitsa ndi matenda a shuga a mtundu wa nephrogenic (onse obadwa nawo komanso otenga) ndikulimbana kwake kwakukulu ndi mankhwalawa okonzekera ma antidiuretic.

Mitsempha yotupa ya m'mitsempha (polydipsia, pulseogenic shuga insipidus) imachitika chifukwa cha kuwonongeka kwa organic kapena ntchito kwa malo amodzi a chapakati amitsempha yama cell omwe amayang'anira kupanga vasopressin komanso kuthetsa ludzu. Izi zimaphatikizidwa ndi kuchepa kwa plasma osmolarity wothandizirana ndi msinkhu wofunikira kuchititsa kuphatikiza kwapadera kwa mahomoni a antidiuretic. Mkhalidwe wa odwala, monga momwe zimakhalira ndi mitundu ina iwiri ya shuga yomwe tafotokozera pamwambapa, imadziwika ndi ludzu lalikulu komanso mkodzo wowonjezera womwe umachotsedwa masana.

Payokha, azimayi oyembekezera amakhalanso ndi matenda a shuga. Matendawa amakhala osachedwa kubadwa, mawonekedwe ake amawonekeranso atabadwa mwana.

Zizindikiro za matenda a shuga insipidus

Matendawa nthawi zambiri amadziwonekera mwadzidzidzi. M'magawo oyamba a chitukuko, chizindikiro chake choyamba ndi kuwonjezeka kwamkodzo tsiku lililonse mpaka malita 5-15, limodzi ndi ludzu lamphamvu. Pankhaniyi, mkodzo umakhala ndi mtundu wowala kwambiri ndipo mulibe zoipitsa zina. Kukakamira pafupipafupi kukodza kumachitika, kuphatikizapo usiku. Chifukwa cha izi, kugona kumasokonezeka, kusowa tulo kumayamba. Matenda a wodwalayo akuipiraipira pang'onopang'ono. Matendawa akamakula, zizindikiro zotsatirazi za matenda a shuga insipidus zimatha kuchitika:

• mutu
• khungu lowuma,
• kuwonda
• kupweteketsa malovu
• kuzindikira kwamimba, limodzi ndi kufalikira kwake,
• kuphwanya ntchito ya m'mimba,
• chikhodzodzo kutulutsa
• kugunda kwa mtima
• kutsitsa magazi.

Matenda a shuga a insipidus mwa ana a chaka choyamba cha moyo komanso akhanda, monga lamulo, amayamba mwamphamvu. Zizindikiro zake ndi:

• kusanza kwa etiology yosadziwika,
• malungo
• zovuta zamitsempha.

Ana akamakula, amakhala ndi ma enisis.

Matenda a shuga insipidus

Kuzindikira matenda a shuga insipidus, monga lamulo, si kovuta, chifukwa mawonetseredwe azachipatala amatchulidwa. Kuzindikira kumadalira zotsatirazi:

• zotchedwa polyuria,
• polydipsia
• kuchuluka kwa plmma osmolarity,
• sodium wamkulu
• kuchuluka mkodzo osmolarity,
• utachepa mkodzo mkodzo.

Kuphatikiza pa mayeso a labotale kuti apezeke matenda a shuga insipidus, wodwalayo ayenera kukakumana ndi mayeso a x-ray, ophthalmological and neuropsychiatric. Izi zimakuthandizani kuti mudziwe zomwe zimayambitsa matendawa. Kuganiza mofatsa zaubongo kumatithandizanso kudziwa bwino matenda athu.

Chithandizo cha matenda a shuga insipidus

Chithandizo cha matenda a shuga a insipidus chimakhazikitsidwa pakubwezeretsa mankhwala pogwiritsa ntchito ma analogue opanga ma antidiuretic mahomoni (nthawi zambiri amakhala amoyo wamtundu wonse) komanso mankhwala othandizira. Kuphatikiza apo, odwala amalangizidwa kuti azitsatira zakudya zokhala ndi mapuloteni ochepa kuti muchepetse nkhawa pa impso. Kutsindika kwakukulu kuyenera kuyikidwa pazakudya zopangidwa kuchokera ku zipatso ndi ndiwo zamasamba zokhala ndi mafuta okwanira ndi chakudya. Chokwanira ndi chakudya chamafuta.

Mankhwala a wodwala matenda ashuga omwe ali munthawiyo amapereka chiyembekezo cha moyo wa wodwalayo.