Matenda a shuga a Adrenal

Nthenda yamunthu yomwe imayamba chifukwa cha kuchuluka kwa kuchuluka kwa madzi am'magazi opangidwa ndi adrenal cortex imatchedwa steroid shuga mellitus. Mankhwala, matendawa amatchedwanso sekondaleti yodwala matenda a shuga.

Mtunduwu wa shuga ndi mtundu waukulu wamatenda omwe amadalira insulin.

Zomwe zimayambitsa matendawa komanso zomwe zimayambitsa ngozi

Shuga ya Steroid koyambirira ndi matenda omwe samalumikizana ndi mavuto pakugwira ntchito kwa kapamba.

Anthu omwe ali ndi kagayidwe kakang'ono kachulukidwe ka metabolism amadwala matenda amtunduwu mu mawonekedwe oyamba ngati mankhwala osokoneza bongo a glucocorticosteroids apezeka m'thupi. Pambuyo pogwirizanitsa kuchuluka kwa mahomoni m'thupi, momwe limagwirira ntchito limafanana ndipo zizindikiro za nthendizo zimazimiririka.

Kudya kwa mitundu yina yamankhwala kumakhala ndi vuto pa mapuloteni ndi mapuloteni a carbohydrate, chifukwa cha zovuta, kusokonezeka kumachitika mu njira yawo yokhazikika, yomwe imatsogolera kuchuluka kwa nayitrogeni m'madzi a m'magazi.

Endocrinologists amazindikira matenda ashuga momwe mayesowo akuwonetsa kupezeka kwa shuga mthupi la 11.5 mmol / L ndipo kuwonjezera apo, kupezeka kwa glucose kumapezeka mkodzo.

Pathology imayenda pang'onopang'ono. Pazifukwa izi, gawo loyambirira, lomwe ndi gawo la matenda ashuga, pomwe kulolerana kwa glucose, ndizovuta kuzindikira.

Zomwe zimayambitsa ngozi zomwe zingayambitse kukula kwa matenda a shuga m'thupi la wodwala ndi izi:

• kumwa kwa nthawi yayitali mankhwala ozikidwa pa corticosteroids,
• gwiritsani ntchito popanga njira zochiritsira zamankhwala a steroid mu mulingo wowonjezereka,
• kupezeka kwa thupi la wodwalayo kulumpha mu shuga, komwe kumachitika chifukwa chosadziwika,
• Kukula kwa wodwala kunenepa kwambiri mulingo uliwonse.

Kupezeka kwa chilichonse mwa zinthu izi wodwala kumawonjezera mwayi wokhala ndi matenda a shuga m'thupi la wodwalayo.

Zizindikiro zakukula kwa matenda a shuga a steroid

Chithandizo cha matenda a shuga a steroid chimakhala chovuta kwambiri chifukwa chakuti matendawa samawoneka mthupi la munthu mwachangu ndi zizindikiro zotchulidwa.

Nthawi zambiri, chomwe chimayambitsa kukula kwa matenda amtunduwu ndi kuphwanya magwiridwe antchito a adrenal, omwe amawonekera chifukwa cha kupezeka kwa matenda ena omwe amakhudza kugwira ntchito kwa ma tezi.

Nthawi zina, matenda a shuga a steroid amayamba chifukwa cha kuwoneka kwa mahomoni azinthu zotere za endocrine mumitsempha yaumunthu.

Zizindikiro zodziwika bwino zomwe zimayambitsa kupezeka kwa matenda am'mimba komanso kukula kwa matenda a shuga a m'magazi ndi awa:

1. Kukula kwa ludzu losatha komanso losagonjetseka ndi chilakolako chofuna kumeza madzi ambiri momwe tingathere.
2. Kuwonjezeka kwa kuchuluka kwa nthawi yomwe mumayendera chimbudzi komanso kumachitika pokodza kwambiri.
3. Kukula kwa glycemic kusagwirizana m'thupi.
4. Maonekedwe ofooka thupi lonse.
5. Maonekedwe akumva kutopa kwachangu.
6. Kuzindikira kwa zomwe zimachitika mthupi komanso thanzi la munthu.

Chovuta pakuzindikira matenda chagona poti zizindikirozi zimawonekera pakukonzekera mthupi la munthu matenda ambiri okhudzana ndi dongosolo la endocrine.Chifukwa, mwachitsanzo, zizindikirozi ndizodziwika pakachitika zolakwika m'thupi, zomwe zimagwirizanitsidwa ndi kuphwanya kwazonse kwa ntchito ya adrenal cortex.

Ndi chitukuko cha mtundu wa matenda ashuga m'thupi, kukula kwa ketoacidosis nthawi zambiri sikuchitika.

Mwapadera, matendawa akapita patsogolo m'thupi la munthu kwa nthawi yayitali, wodwala yemwe ali ndi matenda amtunduwu amatha kumva fungo la acetone kuchokera mkamwa, ndipo pofufuza kapangidwe ka mkodzo, kupezeka kwa ma ketones kumapezeka.

Ziwerengero zachipatala zimawonetsa kuti pafupifupi 60% ya omwe ali ndi matenda a shuga a 2 amayamba kusinthana ndi gulu la odwala omwe amadalira insulin pamene mawonekedwe a steroid atayamba mthupi.

Nthawi zambiri, anti-insulin mankhwala samabweretsa zotsatira zabwino. Zikatero, odwala matenda ashuga amafunika kugwiritsa ntchito zakudya zowonjezera zomwe zimakhala zochepa mu chakudya chamagulu.

Kuphatikiza apo, kupumula kowonjezera komwe kumagwira ntchito komanso kuchita masewera olimbitsa thupi apadera kumalimbikitsidwa kwa wodwala yemwe ali ndi matenda osokoneza bongo.

Chithandizo ndi kupewa matenda a shuga ku zovuta za adrenal gland

Kusankhidwa kwa ndalama zochizira mtundu wa matenda amtundu wa shuga kumafanana ndi kusankha kwa mankhwala othandizira odwala matenda ashuga, omwe amadalira insulin.

Kusankhidwa kwa njira kumatengera mtundu wa matendawa komanso momwe thupi la munthu likuvutikira matendawa.

Dokotala wokhayo ndi amene ali ndi ufulu wofotokoza zovuta ndi mankhwalawo.

Chithandizo cha matenda a shuga a steroid chimaphatikizanso kugwiritsa ntchito njira zotsatirazi:

• kukhazikitsa jakisoni wa kukonzekera komwe kuli ndi insulin, majekeseni oterowo amathandizira ntchito ya kapamba,
• Kusintha kwa munthu yemwe akudwala mtundu wina wa shuga wodwala matenda ashuga kupita ku chakudya chapadera, zomwe zimagwiritsidwa ntchito pazakudya ziyenera kukhala ndi mafuta ochepa,
• kugwiritsa ntchito mankhwala a hypoglycemic kuti thupi lizisintha mthupi la wodwalayo,
• pakukula kwa matendawa m'njira zovuta, opaleshoni imachitidwa kuti ichotse minyewa yowonjezera ya adrenal, yomwe imachepetsa zovuta zoyipa m'thupi la wodwalayo mahomoni a adrenal, omwe amapangidwa kwakukulu.
• kusiya kumwa mankhwala omwe amachititsa kuti pakhale zovuta za metabolic m'thupi la wodwala.

Akatswiri ambiri azachipatala omwe ali ndi gawo la endocrinology amakhulupirira kuti kugwiritsa ntchito njira zophatikiza zamankhwala kumatha kukwaniritsa zabwino zomwe mukufuna.

Ndiye chifukwa chake, pakukonzekera bwino komanso kupeza zotsatira zabwino za mankhwala, limodzi ndi mankhwala amkamwa, jakisoni wamankhwala omwe ali ndi insulin adalembedwa nthawi yomweyo.

Jekeseni wa mankhwala okhala ndi insulini amaperekedwa pokhapokha ngati mankhwala osokoneza bongo a hypoglycemic sakupatsani zotsatira zabwino.

Tiyenera kukumbukira kuti jakisoni wa mankhwala okhala ndi insulini sindiwo njira yokhayo yomwe imathandizira kukula kwa shuga m'thupi la wodwalayo.

Kuchita opaleshoni yochotsa gawo la minofu ya adrenal ndiwowonjezera kwambiri ndipo kumachitika pokhapokha pokhapokha. Kugwiritsa ntchito njira zina zamankhwala sizinabweretse zotsatira zabwino.

Kuchita maopaleshoni othandizira m'thupi, momwe mumachotsa minyewa ya adrenal, kumalumikizidwa ndi kuwoneka kwangozi zambiri pa thanzi la munthu, chifukwa chake kugwiritsa ntchito njirayi ndiosafunikira.

Zakudya zochepa za carb

Cholinga chachikulu cha njira zochizira mankhwalawa matenda a shuga ndikupangitsa matenda a shuga m'thupi la wodwala. Cholinga china cha chithandizo cha matenda ashuga ndikuchedwa kuchedwetsa mavuto omwe angachitike mthupi motsutsana ndi matenda ashuga kwa nthawi yayitali.

Kusintha kwa zakudya ndi njira yophweka yotetezera kuyambika ndi kuchiritsa kwa mtundu wa matenda a shuga. Njirayi, ngakhale ndiyopepuka, imagwira ntchito kwambiri ndipo siyapamwamba pakuchita bwino kwa jakisoni wa insulin.

Zotsatira zabwino za chakudya chamafuta ochepa paminyewa ya adrenal komanso thupi lonse limadziwika ndi zizindikiro zingapo.

Zizindikiro zazikulu zokomera thupi la chakudya chamafuta ochepa ndi izi:

1. Kuchepetsa kufunikira kwa mankhwala a insulin kapena mankhwala a hypoglycemic.
2. Matenda a shuga atatha kudya kwa nthawi yayitali.
3. Kupititsa patsogolo thanzi la wodwalayo komanso kutha kwa zizindikiro zomwe zili ndi matenda a shuga.
4. Chiwopsezo cha kupezeka ndi kupitilira kwa zovuta zina za matenda ashuga kumachepetsedwa kwambiri.
5. Kuchepetsa kwambiri mafuta m'thupi la wodwalayo.

Chakudya chopatsa thanzi pang'ono ndizakudya zapadera zomwe zimachokera ku masamba, zipatso ndi zitsamba zatsopano. Mukamagwiritsa ntchito zakudya izi, nyama ndi mkaka zimadyedwa zochepa.

Ngati munthu ali ndi vuto la kunenepa kwambiri komanso kuchuluka kwa shuga wa plasma wopitilira katatu, odwala amalangizidwa kuti azitsatira pophika zakudya zopanda chakudya mu chakudya - nambala 8.

Malangizo Pazakudya

Zakudya zapadera zapangidwa ngati njira yoletsa kukula kwa matenda a shuga.

Kukula kwa zakudya zomwe amadya kumadalira mwachindunji mtundu wa mankhwala a hypoglycemic omwe amatengedwa ndi wodwala.

Mukamagwiritsa ntchito zakudya zapadera, muyenera kutsatira malamulo ndi zofunika zina.

Malamulo oyenera kutsatiridwa mukamagwiritsa ntchito zakudya zamafuta ndi awa:

• malinga ndi zakudya za tsiku ndi tsiku ziyenera kukhala zakudya zomwe zimakhala ndi fiber,
• Njira zazikuluzikulu zothetsera kutentha pamoto potsatira chakudya muyenera kupatsa mphamvu, kuwiritsa kapena kuwotcha nkhumba pazinthu,
• nyama yofiira yomwe ili pachakudya iyenera kusinthidwa ndi nsomba kapena kudya nyama zopanda mafuta monga, mwachitsanzo, nkhuku kapena kalulu,
• kumwa pafupifupi malita 1.5 amadzi oyera tsiku lililonse,
• Kuletsa kugwiritsa ntchito zinthu monga pasitala, makeke, shuga, confectionery, mpunga, ophika buledi.

Monga mankhwala ena owonjezera, wodwalayo amapatsidwa mahomoni omwe ali ndi mphamvu ya analgesic. Ntchito yogwiritsira ntchito mankhwalawa ndikuwongolera kuchuluka kwa mahomoni a glucocorticoid.

Munthawi yamankhwala, muyenera kuyang'anira kuchuluka kwa shuga m'thupi ndi kutsatira moyo wabwino komanso wakhama. Mankhwala olimbitsa thupi opangidwa moyenera a shuga sangasokoneze.

Zambiri zokhudzana ndi matenda a shuga a steroid zimaperekedwa mu kanema munkhaniyi.

Zoyambitsa ndi Zoopsa

Poyamba, matendawa samagwirizanitsidwa mwachindunji ndi matenda opha pancreatic. Mwa anthu omwe ali ndi kagayidwe kazakudya, mtundu wa matenda amtunduwu umatha kupezeka mwa njira yayikulu makamaka ngati glucocorticoids wambiri.Pambuyo pakuchotsa m'thupi, zizindikirizo zimazimiririka. Mankhwala amakhudza kwambiri kagayidwe kazakudya zomanga thupi ndi zomanga thupi m'thupi, zomwe zimapangitsa kuphwanya kagayidwe kazachilengedwe, ndiye kuti munthu amadzuka ndi nayitrogeni m'magazi.

Kumwa mankhwala osokoneza bongo waukulu kumasokoneza kagayidwe kazakudya zomanga thupi ndi chakudya.

Endocrinologists imakhazikitsa mwapadera matenda pamene mayeso akuwonetsa kuti kupezeka kwa shuga m'magazi kumakhala 11.5 mmol ndi glucose mumkodzo kumatsimikiziridwa. Pathology imayenda pang'onopang'ono, kotero gawo loyambirira ndilo gawo la shuga usanachitike, pakakhala kuphwanya kulekerera kwa shuga. Ndipokhapo pomwe adotolo amadzazindikira.

Zowopsa zomwe zingayambitse matenda a shuga a steroid:

• Kutenga nthawi yayitali kwambiri
• kumwa mankhwala a steroid mu kuchuluka,
• amathira shuga m'magazi pazifukwa zosadziwika,
• kunenepa kwa digiri iliyonse.

Kukonzekera kwa Glucocorticoid

Zimachitika kuti kugwiritsidwa ntchito kwa glucocorticoids kumapangitsa kuti pakhale shuga, zomwe sizinkadziwika kale chifukwa cha kufooka kwa zizindikiro za matendawa. Zikatere, pamakhala mwayi woti wodwalayo athe kuwonongeka mosaganizira bwino mpaka kufika pakukomoka. Chifukwa chake, madokotala amalimbikitsa kuti mupite kukaonana ndi dokotala komanso kukayezetsa matenda ashuga musanatenge ma steroid (mwachitsanzo, njira zolerera kapena diuretics). Malangizowa ndiofunika makamaka kwa okalamba, komanso anthu omwe ali ndi mafuta ochulukirapo amthupi.

Mankhwala, kugwiritsa ntchito komwe kumayambitsa matenda a shuga a steroid:

• glucocorticoid mankhwala omwe amalembedwa chifukwa cha kutupa kapena mphumu (mwachitsanzo, "Dexamethasone", "Prednisolone"),
• mapiritsi a diuretic ("Hypothiazide", "Navidrex", "Dichlothiazide"),
• njira zakulera za mahomoni.

Mankhwalawa ndi owopsa makamaka kwa anthu onenepa omwe ali pachiwopsezo cha matenda ashuga.

Glucocorticoids ndi mtundu wapadera wa mahomoni omwe ma adrenal gland amatulutsa nthawi ya ntchito. Monga lamulo, Mlingo wambiri wa mankhwalawa umaperekedwa kwa wodwala amene akuchira ku vuto la impso. Kukhazikitsidwa kwa mankhwala a glucocorticoid kumachitikanso pamene wodwala ali ndi mavuto:

• Mphumu ya bronchial,
• nyamakazi
• matenda osiyanasiyana autoimmune
• multiple sclerosis.

Matenda a Itsenko-Cushing

Dzina lina la matendawa ndi hypercorticism, lomwe limakhudza azimayi azaka 25 mpaka 40. Amakhala amodzi mwa odwala kwambiri pagulu la matenda a neuroendocrine. Kulephera kwa magwiridwe antchito a gwero la adrenal, gland pituitary ndi hypothalamus ndiye maziko. Chizindikiro chachikulu ndicho kunenepa kwambiri, ndipo kunenepa kwambiri kumakhazikika m'mimba, kumbuyo, khosi komanso kumaso. Zizindikiro zowonjezera:

• minofu yolakwika komanso kusakhala ndi chidwi chochita masewera olimbitsa thupi,
• zotupa za pakhungu, epithelium ya nkhope imatha kukhala ndi khunyu lodana,
• anagwetsa kugunda kwa mtima
• matenda amanjenje - kukhumudwa, kupsinjika kwa nthawi yayitali, kusinthasintha kwadzidzidzi.

Mavuto amtunduwu mthupi la munthu sabwezeka. Malinga ndi ziwerengero, pafupifupi 30-50% ya milandu imapha, motero kudziwitsidwa kwakanthawi ndi chithandizo choyenera ndikofunikira kuti moyo wa wodwalayo ukhale wabwino. Mankhwalawa amachitidwa kudzera mu chithandizo cha radiation kapena kudzera mu opareshoni. Kupambana kuchira kwathunthu kumatsimikiziridwa ndi magawo apadera a postoperative.

Zizindikiro za Steroid Diabetes

Chithandizo cha matenda a shuga a steroid chimakhala chowonjezereka chifukwa chakuti sichidziwonetsa ndi zizindikiro zotchulidwa. Monga lamulo, chachikulu chomwe chimayambitsa kupezeka kwa matendawa ndikuphwanya misempha ya adrenal. Nthawi zina matendawa amayambitsidwa ndi kuwonjezeka kwa kuchuluka kwa mahomoni a adrenal m'mimba.

Zizindikiro zodziwika zomwe zimayambitsa kukula kwa matenda a shuga a steroid:

• kufunitsitsa kumwa ndi kumwa zamadzi zambiri,
• maulendo ochulukirapo kupita kuchimbudzi ndi kukodzetsa kwambiri,
• glycemic kusowa bwino
• kufooka
• kutopa,
• kuwonongeka kwa thanzi lonse.

Chovuta ndikuti izi ndi zizindikiro zomwe zimadziwika ndi matenda omwe amadziwika kwambiri. Mwachitsanzo, zolephera zotere zitha kuwonetsa kuphwanya kwa magwiridwe antchito a adrenal cortex. Ndi mtundu wa steroid wa matenda ashuga, ketoacidosis sikuwonetsedwa kwambiri. Mwapadera, pamene matendawa akhala akukulira kwa nthawi yayitali, wodwalayo amatha kukhala ndi fungo labwino la acetone kuchokera mkamwa. Nthawi zina mayeso a mkodzo amawonetsa ma ketones.

Malinga ndi ziwerengero, pafupifupi 60% ya anthu omwe ali ndi matenda ashuga a 2 amakonda kupita m'gulu la odwala omwe amadalira insulin omwe ali ndi mtundu wa matendawa. Nthawi zambiri, mankhwala a anti-insulin samabweretsa zotsatira zomwe amafunikira, motero odwala amakupatsani zakudya zofunikira zomwe zimakhala ndi chakudya chamagulu, zochitika zakunja ndi masewera olimbitsa thupi.

Chithandizo ndi kupewa matenda a shuga ku zovuta za adrenal gland

Kusankhidwa kwa njira zochizira matenda am'madzi a shuga zimafanana ndi chithandizo cha matenda a shuga omwe amadalira insulin. Njira imatengera mtundu wa matendawa komanso machitidwe a thupi la wodwalayo. Njira zoyenera ndi mankhwala kuti muchepetse zitha kutumizidwa ndi dokotala wodziwa zambiri.

Zomwe zikufunika zikuphatikizapo zinthu izi:

• jakisoni wa insulin kuti matendawa agwire ntchito,
• Sinthani ku zakudya zapadera zamafuta,
• kugwiritsa ntchito mankhwala ochepetsa shuga,
• pamavuto, kulowererapo kwa opaleshoni ndikofunikira kuti tichotse minyewa yambiri m'magazi a adrenal ndikuchepetsa mavuto owopsa a mahomoni,
• kuleka kwa mankhwala omwe amachititsa kusokonezeka kwa metabolic m'thupi.

Madokotala ambiri amakhulupirira kuti ndi kuphatikiza kwa njira zamankhwala zomwe zingakwaniritse zomwe mukufuna. Chifukwa chake, kuphatikiza pa mankhwala a pakamwa, jakisoni wa insulin ndi mankhwala.

Kukhazikitsidwa kwa insulin kumayikidwa pamlandu pamene mankhwala ochepetsa shuga sagwirizana ndi ntchitoyo. Tiyenera kudziwa kuti kasamalidwe ka insulin si njira yokhayo yomwe ilipo yokwaniritsira shuga m'magazi. Kuchotsa gawo limodzi mwa tiziwalo ta adrenal ndikuwonjezera kwambiri ndipo kumachitika ngati njira zina sizikuthandizira. Opaleshoni yochotsa minofu ya chiwalochi imalumikizidwa ndi ziwopsezo zambiri ku thanzi la munthu.

Zakudya zochepa za carb

Cholinga chachikulu chomwe amathandizira odwala matenda ashuga ndi kuthandizira wodwalayo ndi kuchedwetsa zovuta zomwe zingachitike kwa nthawi yayitali. Kusintha kwa zakudya zopatsa thanzi ndi njira yosavuta kwambiri yothandizira kupewa ndi kuchiza matenda a shuga a steroid, koma izi sizothandiza kwenikweni kuposa insulin kapena opaleshoni. Zotsatira zabwino za chakudya chamafuta ochepa paminyewa ya adrenal ndipo thupi lonse lathunthu limadziwika ndi zizindikiro zotere:

• kusowa kwa mankhwala a insulin kapena kuchepetsa shuga;
• matenda a shuga kwa nthawi yayitali atatha kudya,
• Kukhala bwino komanso kusowa kwa zizindikiro za matenda ashuga,
• chiwopsezo cha zovuta zina chikucheperachepera,
• kuchuluka kwa mafuta m'thupi amatsika.

Zakudya zama carb ochepa ndi zakudya zapadera zomwe zimadalira kudya masamba ambiri, zipatso, ndi zitsamba zatsopano. Zopangira mkaka ndi nyama zimatha kudyedwa pang'ono. Ndi mawonekedwe ochulukirapo a kunenepa kwambiri komanso kuchuluka kwa shuga kowonjezera katatu, odwala amalangizidwa kuti azitsatira zakudya zopanda chakudya (8).

Malangizo pazakudya

Chakudya chapadera chidapangidwa ngati njira yolepheretsa matenda a shuga a steroid. Malamulo oyambira:

• maziko azakudya za tsiku ndi tsiku ndizakudya zambiri
• njira zosinthira zinthu - kutumiza, kuphika kapena kuwotcha,
• nyama yofiira isinthidwe ndi nsomba kapena nyama yotsamira ya nkhuku, kalulu,
• osachepera malita 1.5 amadzi oyera,
• kuletsa kwa "chopanda" chakudya - pasitala, makeke, shuga, confectionery, mpunga, masikono ndi mkate.

Pafupipafupi zakudya zimadalira mtundu wa mankhwala ochepetsa shuga omwe wodwala amatenga.

Monga chida chowonjezera, wodwalayo amapatsidwa mahomoni a anabolic, ntchito yake ndikuwongolera mahomoni a glucocorticoid. Steroid shuga mellitus samawonetsedwa ndi zizindikiritso zowoneka bwino ngati matenda ashuga okhazikika, koma izi sizitanthauza kuti ziyenera kunyalanyazidwa ndipo palibe njira zomwe zikuyenera kuchitidwa kuti achire. Kupatula apo, mitundu yonse ya matenda a shuga iyenera kuthandizidwa kuti mukhale ndi thanzi labwino la wodwalayo. Ndikofunikira kutsatira njira zopewera, kuwunika kuchuluka kwa shuga, kuchita masewera olimbitsa thupi komanso kusamalira thanzi lanu.

Matenda a shuga a Adrenal

Shuga ya Steroid - mawonekedwe a shuga omwe amadalira shuga.

Matendawa amakula chifukwa chogwira ntchito bwino kwa tiziwalo timene timatulutsa timadzi tambiri komanso kutalika kwa nthawi yayitali ya kuchuluka kwa mahomoni omwe amatulutsidwa ndi adrenal cortex.

Matenda a shuga amtunduwu amakwiya chifukwa cha zomwe zimachitika m'thupi kapena kumwa mankhwala ena ake. Zizindikiro za matenda ashuga zimayamba pang'onopang'ono ndipo alibe mawu.

Pachimake adrenal kuchepa

Acute adrenal insufficiency (vuto la Addison) ndi vuto lalikulu chifukwa chakuchepa kwambiri kapena kuchepa kwa kupanga kwa mahomoni ndi adrenal cortex.

Pachimake adrenal kusowa nthawi zambiri kumachitika mu odwala matenda adrenal kuchepa.

Mwachitsanzo, ngati atasiya kumwa mahomoni a corticosteroid kuti apange kuperewera kwawo.

Zomwezi zimatha kuchitika motsutsana ndi maziko a kuvulala, maopareshoni, matenda opatsirana pachimake, ndikusintha kwa nyengo, kuvutikira kwambiri kwa thupi, kupsinjika kwakukulu kwa psychoemotional.

Kuphatikiza apo, vuto lazowonjezera limachitika:

• Mu hemorrhage pachimake mu adrenal tiziwalo kapena ndi vuto la mtima mwa iwo (minofu necrosis),
• Ndi meningitis, sepsis, kuchepa magazi kwambiri (mabala, kubala), matenda oyaka.

ZITI ZILI ZONSE?

Tizilombo ta adrenal pafupifupi titha kutulutsa mahomoni, zomwe zimayambitsa kuphwanya mitundu yonse ya kagayidwe. Choyamba, kuchepa kwamphamvu kwa thupi kumachitika ndipo kuchuluka kwa magazi omwe amayendayenda kumachepa.

Kuphwanya kwa potaziyamu kumabweretsa kuti minofu yamtima iyambe kudwala. Nthawi yomweyo, kagayidwe kazakudya kamene kamachepetsa: kuchuluka kwa shuga m'magazi kumachepa, chidwi cha maselo kuti insulin iwonjezeke.

Ntchito ya impso imasokonekera.

Mkhalidwe wa munthu mwadzidzidzi komanso mofulumira kwambiri:

Mavuto a adrenal amakula kuyambira maola ochepa mpaka masiku angapo. Munthawi yammbuyo yovuta, kufooka kwa minofu kumawonjezeka, kusowa chakudya kumatha, kupweteka kwa minofu kumawonekera.

Zizindikiro za pachimake adrenal kusakwanira (vuto):

• Kupsinjika kwa magazi kumatsika kwambiri, komwe kumawonetsedwa ndi thukuta lalikulu, manja ndi mapazi ozizira, kufooka mwadzidzidzi,
• Ntchito yamtima isokoneza, arrhasmia imayamba,
• Kusanza ndi kusanza, kupweteka kwambiri pamimba, kutsekula m'mimba,
• Kutulutsa mkodzo kumachepa kwambiri (oligoanuria),
• Chikumbumtima chasokonekera. Poyamba, wodwalayo anali wopanda mphamvu, movutikira kuyankhula, mawu ake anali chete, osakhazikika. Kenako kuyerekezera zinthu zina, kukomoka, kukomoka kumachitika

Ngati zizindikiro zotere zikuwoneka, kuthandizidwa kuchipatala ndikofunikira.

DIAGNOSIS NDI KULIMA

Pa matenda a pachimake adrenal kusakwanira anaika:

• Kuyesedwa kwa magazi konse.Pali kuchuluka kwa maselo ofiira am'magazi (erythrocytosis) ndi hemoglobin (chifukwa cha magazi amathamanga), kuchuluka kwa leukocytes ndi ESR,
• Kuyesedwa kwa magazi kwa shuga: hypoglycemia (kutsika kwa shuga),
• Kusanthula kwamwazi m'mwazi: pali kuchuluka kwa potaziyamu ndi creatinine, kutsika kwa sodium, chloride,
• Urinalysis: mapuloteni otsimikiza, maselo ofiira, nthawi zina acetone,
• Kuphunzira kuchuluka kwa mahomoni a adrenal mkodzo ndi magazi: kuchepa kwakukulu kwa chiwerengero cha corticosteroids (cortisol, aldosterone, ndi zina).
• ECG: zizindikiro za hyperkalemia.

Chithandizo chimachitidwa muchipinda chothandizira kwambiri kapena chothandizira kwambiri. Maziko a chithandizo ndi ma droport omwe ali ndi corticosteroids ndi njira zapadera. Njira zimatengedwanso kuti munthu amuchotsere wodwala nkhawa.

Ngati chithandizo chikuyambira pa nthawi yake, mwayi wopangitsa wodwalayo mavuto awonjezeke.

Pambuyo kuchira, odwala amawonetseranso chizindikiro cha kukomoka kwa adrenal, motero amafunikira chithandizo chamankhwala obwezeretsanso kwina ndi ma hormone opangira adrenal cortex.

KULAMBIRA

Popewa vuto la adrenal, ndikofunikira kuchita chithandiziro chokwanira cha mahomoni chifukwa chodwala matenda a adrenal cortex osakwanira ndi matenda ena omwe amafunika kugwiritsa ntchito corticosteroids nthawi zonse.

Palibe chifukwa chomwe muyenera kusiya kusiya kutenga corticosteroids kapena kuchepetsa kumwa.

M'pofunika kuti muzilumikizana ndi endocrinologist, yemwe amasintha mlingo wa mankhwalawa kutengera mphamvu ya wodwala.

Mutha kuwerenga nkhaniyi pa tsamba la Medportal.ru

Funso la gawo la adrenal glands mu minyewa yamatenda a shuga

Chokondweretsa ndi funso la gawo la adrenal glands mu minyewa yamatenda a shuga.

Mwa odwala 6 omwe ali ndi matenda a shuga komanso retinopathy, ma gren adrenal amachotsedwa, zomwe zimapangitsa kuti asinthe matenda a shuga komanso retinopathy.

Zisonyezo za opaleshoni yotere, malinga ndi a Melins, ndizovuta zam'mimba, matenda oopsa, glomerulosulinosis ndi albinuria.

Headstrom ndi Wertham (Headstrem A.

Wortham;

Opaleshoni isanachitike komanso masiku otsatirawo, odwala adapatsidwa cortisone. Olembawo sanawone zodabwitsa za kusakwanira kwa adrenal. Mwa odwala onse, kufunika kwa insulini kunachepa ndipo kuthamanga kwa magazi kunachepa, komanso kutsika kwa potaziyamu ndi mpweya wotsalira m'magazi.

Kuchuluka kwa mapuloteni mumkodzo kunachepa ndipo kutupa kunazimiririka. Odwala ena adathandizanso kupenyerera komanso kukhala bwino. Komabe, monga momwe alembawo amanenera, mwa odwala ena mkhalidwe wa retina sunasinthe ndipo zodabwitsa zakulephera kwa impso zakula.

Kuyesa kwazachipatala kumeneku kwawonetsa kuti kuchotsedwa kwa ndulu za adrenal kumatha kusintha nthawi ya matenda ashuga. Komanso, akuwonetsedwa chifukwa cha kuthamanga kwa adrenal cortex, adrenal syndrome, yomwe imakulitsidwa ndi matenda osokoneza bongo.

Chifukwa chake, pankhani ya Spreg, Priestley ndi Doketi (Spraque, Pristley a.

Dockety) wodwala yemwe ali ndi matenda osokoneza bongo zaka 3 zapitazo, chotupa chowopsa chochokera ku adrenal cortex chidachotsedwa, zomwe zidapangitsa kuti ayambenso kuchira.

Chotupacho chidafikira kukula kwa mpira wamiyendo ndipo chimalemera 1550 g shuga m'magazi asanachitike opaleshoni 252 - 375 mg%, patsiku la 3 atachitidwa opaleshoni adatsikira ku 107 mg%, ndiye - mpaka 88 mg%. Kulekerera kwa chakudya chamthupi kwakhala kwachilendo.

Poganizira za kupezeka kwapadera kwa zotupa za adrenal zomwe zimayambitsa matenda a metabolism, tikuona kuti ndikofunikira kupereka lipoti la odwala omwe timawawona.

Kukayikira kwa hypofunction ya adrenal cortex ndi zizindikiro zoyambirira za matendawa

Kuwonongeka kwa adrenal cortex ndi matenda omwe amachitika chifukwa chophwanya mapangidwe a mahomoni ofunikira, omwe amakhala pamwamba pa impso iliyonse. Kutha kwa adrenal cortex kungakhale:

Zinsinsi izi zimakwaniritsa malingaliro awo m'moyo wonse wamunthu. Ntchito ya adrenal glands mwa akazi siyosiyana ndi kagwiridwe ka ntchito ka ziwalozi mwa amuna. Kuperewera kwa Adrenal cortex kumatha kuchitika pazifukwa zosiyanasiyana. Mwa kutsimikiza kwawo kolondola, diagnostics amachitika mu chipatala.

Zopereka Zambiri

Mu ana, zoyambira zazikulu za adrenal zingathenso kuchitika. Nthawi yomweyo, ntchito za adrenal glands zimachepetsedwa. Kukayikakayika kwa matenda am'mimba kumayambitsa hypercorticism, zomwe zikuwonetsa kuchepa kwamahomoni m'thupi.

Hyperfunction imatha kupezekanso mu makanda. Kupatuka kuzinthu zomwe zimachitika nthawi ya kukula kwa fetal kumabweretsa kuphwanya. Chizindikiro chingakhale kuperewera kwa mahomoni, zomwe zimakhudza ntchito ya kagayidwe kachakudya mu mwana.

Izi zingayambitse kuchepa kwa VCD. Pankhaniyi, gren adrenal amasiya kugwira ntchito yawo moyenera. Zizindikiro zakuchepa kwa adrenal kungakhale kosiyana.

Amachitanso njira zingapo zodziwira matenda kuti adziwe matenda. Kuzindikira koyenera kumapangitsa kuti athe kuzindikira bwino lomwe zomwe zimayambitsa matendawa ndikuwapatsa chithandizo choyenera.

Adrenal gizi: ndi chiyani?

Kuwonongeka kwa adrenal cortex kumatha kuchitika chifukwa cha kubisala. Izi ndi zofunikira kwambiri thupi la munthu. Amathandizira kugwira ntchito kwokhazikika kwamakina ambiri. Chitsulo chimakhala ndi zigawo ziwiri zomwe zimagwira ntchito zosiyana.

Katundu wa cortical amapanga pafupifupi mitundu 30 ya mahomoni, omwe atha kukhala ndi chifukwa:

• Kukula kwa kugonana kwa anthu.
• Kuletsa kutupa.
• Carbohydrate kagayidwe.
• Mchere ndi mchere wamagetsi.

Zinthu zaubongo ndizomwe zimayambitsa kupangika kwa oimira pakati pa CNS. Izi ndi:

Ma mahormoni ochokera kuiziwa amatithandizanso kugwira ntchito kwina. Makamaka, ali ndiudindo pazinthu izi:

• Bweretsani muyezo wa kuthamanga kwa magazi.
• Patsani mchere ndi madzi m'thupi.
• Tetezani anthu ku zipsinjo.
• Kukhudza chitetezo chokwanira.

Hypofunction ya adrenal kotekisi: zimayambitsa

Ngati pali kuphwanya kwa gren ya adrenal, ndiye kuti izi zimayambitsa zovuta zazikulu komanso ma pathologies omwe amalumikizidwa ndikuti padzakhala kuchuluka kosakwanira kwamahomoni m'thupi.

Kutengera momwe matendawa amachitikira, madotolo amagawa kuti:

Komanso, matenda am'mimba amatha kufotokozedwa potengera kuwonongeka. Izi ndi:

• Poyamba Zitha kuchitika pambuyo pobereka kapena chifukwa cha matenda obadwa nawo.
• Sekondale Zimachitika pamene chida cha pituitary chawonongeka.
• Tertiary. Kuphatikiza kwa mahomoni sikulakwitsa. Zomwe zingayambitse kufalikira kwa adrenal.

Zizindikiro

Ndi matenda a adrenal, zizindikirazo zimatha kukhala zosiyanasiyana. Izi ndichifukwa choti njira zingapo zoyipa zimachitika mthupi. Zina mwa izo ndi:

• Kachulukidwe kakang'ono ka aldosterone kamayambitsa kuperewera kwamadzi, komwe kumakhala ndi vuto lililonse pakatikati wamanjenje, m'mimba komanso mtima.
• Cortisol yochepa imayambitsa kusokonezeka kwa metabolic. Thupi limaleka kuyamwa michere.

Kuwonetsedwa kwa matenda

Kumayambiriro kwa matendawo, munthu amamva:

• Anachepetsa chilako.
• Kuchepetsa ntchito.
• Kuchepetsa thupi.
• Kuphwanya kwam'mimba.
• Mtundu wa khungu la chikasu.
• Kufunafuna mchere.

Khungu lowala khungu limachitika chifukwa chakuti cortisol yambiri imapangidwa m'thupi. Izi zimapangitsa kuti mahomoni ayambe kupanga zochuluka, zomwe zimayang'anira khungu la khungu. Kukula kwa chiwonetserochi kumadalira gawo la m'thupi la timadzi totere.

Ndi chitukuko cha matendawa, munthu amathanso kudandaula kuti:

• Kuwonongeka kwamtima.
• Ntchito yodzidzimutsa mwachangu.
• Kutsitsa magazi.
• Kukhumudwa
• Kutayika kwa tsitsi mu perineum.
• Kutulutsa mkodzo mwachangu.

Zizindikiro zina zimatha kuchitika ndi mtundu wachiwiri wa matenda. Izi zitha kukhala zizindikiro zopanda tanthauzo. Izi zimachitika chifukwa chokhala ndi shuga m'magazi. Izi zitha kuchitika:

• Kutukwana.
• Zofooka.
• Mutu.
• Zovuta.
• Mutu ukupindika.
• Kuchulukitsa kwa myocardial ntchito.
• The pallor of the epidermis.
• Njala.
• Kuyanjana pakati.

Mtundu wodwala wa matenda amakhalanso ndi zizindikiro zake, zomwe zimapangitsa kuti adotolo azindikire molondola panthawi ya mayeso. Nthawi zambiri, matenda amtunduwu amawonekera chifukwa chogwiritsa ntchito waukulu Mlingo wa mankhwala opangidwa ndi mahomoni.

Njira Zodziwitsira

Kuzindikira masiku ano nthawi zambiri kumachitika pogwiritsa ntchito njira zamakono. Kuti mumvetsetse molondola, wodwalayo amayenera kuyesedwa kogwiritsa ntchito ma labotale, monga:

Koma ndi matenda oterewa, monga momwe akatswiri amanenera, kuzindikira njira zogwiritsira ntchito ma labotale ndizovuta. Nthawi zambiri, wodwalayo amapaka jakisoni m'madzi, kenako amawunika momwe thupi lake lilili. Chizindikiro chodziwika bwino cha matenda atatha kukhazikitsidwa kwa mahormoni ndicho:

• Kuchuluka kwa cortisone m'magazi.
• Kuwonjezeka kwa potaziyamu m'magazi.
• Kuchepa kwa shuga.

Kuzindikira koyenera kumaphatikizapo kuyezetsa kachirombo ka HIV. Mukamayesedwa, ntchito ya chithokomiro komanso chitetezo chokwanira imayendera.

Hypocorticism: chithandizo ndi njira zake

Masiku ano, madokotala amatha kugwiritsa ntchito njira zamakono zosiyanasiyana popangira matenda amtunduwu. Pa chithandizo, ntchito yayikulu ya dotolo ndikuchotsa zomwe zimayambitsa mawonetseredwe am'magazi ndikubwezeretsa kuchuluka kwa mahomoni kukhala abwinobwino.

Kuti athetse zomwe zimayambitsa matendawa, njira zotsatirazi zimagwiritsidwa ntchito:

1. Mankhwala.
2. Opaleshoni
3. Magetsi.

Pa gawo loyambirira la matendawa, wodwalayo amapatsidwa mankhwala okhala ndi mahomoni ndi mchere. Mtundu wachiwiri wa matenda, kugwiritsa ntchito glucocorticoids kokha ndi komwe kumatchulidwa. Mtundu wa matenda, matenda a mahomoni ogonana ndi mankhwala.

Komanso pochita mankhwalawa mothandizidwa ndi mankhwala, dokotalayo amawunika momwe wodwalayo alili. Amawafotokozera ndi:

• Sinthani kulemera.
• Kupsinjika kwa magazi.
• Sinthani mtundu wa khungu.
• Kutha kwa kukhumudwa.
• Kupititsa patsogolo thanzi.

Kukonzanso kumachitika, chisamaliro chofunikira chimafunikira wodwala. Kuti achite izi, ayenera:

• Bwezeretsani madzi mthupi.
• Tengani mahomoni.
• Chotsani zizindikiro.

Pazinthu zingapo zovuta, tikulimbikitsidwa kuti muwonjezere kuchuluka kwa mahomoni katatu kuti zizindikiro zoyipa zisamawonekere. Koma pa nthawi yomwe ali ndi pakati, mlingo sayenera kuchuluka.

Kupewa

Ngati, matenda atazindikira, ayamba kuthandizidwa molondola, ndiye kuti madokotala zakukula kwawo ndiabwino. Moyo wa munthu wina pambuyo poti alandire chithandizo sichingafanane ndi m'mbuyomu.

Zidziwikiranso kuti pakadali pano palibe malingaliro enieni a kupewa. Njira zazikulu zopewera ndi kuchepetsa kumwa mowa ndi chikonga.

Ndi matenda awa, munthu ayenera kulembetsedwa ku chipatala ndikuyang'aniridwa ndi dokotala pafupipafupi. Malangizowo akugwiranso ntchito kwa iwo omwe ali pachiwopsezo. Kukwanira kwa adrenal mwa akhanda ndi chifukwa cholembetsa khanda.

Pomaliza

Monga momwe titha kuweruzidwira kuchokera pamwambapa, kusakwanira kwa adrenal ndi matenda oopsa komanso osatsimikizika, chifukwa chake munthu amene ali ndi vutoli ayenera kuyang'anitsitsa thanzi lawo.

Hyperthyroidism Zovuta za chithokomiro cha chithokomiro gawo 2 Kutaya kwa m'mimba pamalingaliro othandizira ndi mankhwala a PreventAge. Matenda a Addison Adrenal kusakwanira ndi florevitis.Mphamvu Yoleza Yogwira ntchito imakhudzana ndi flourevitis .. kukomoka kwa adrenal gland.

Dokotala wa maopaleshoni a Endocrinologist Sergei Cherenko: "zotupa za Adrenal zimadzipangitsa kumva kuwonjezereka ..

Pali lingaliro lakuti endocrinologist ndi dokotala yemwe amathana ndi chithokomiro cha chithokomiro ndipo amathandizira matenda a shuga. Zikuwoneka kuti nthawi zina dokotala mwiniyo amaganiza motero.

Ndi chiyani china chomwe chingafotokoze zomwe zimachitika pamene wodwala yemwe amadzikayikira yekha kuti ali ndi vuto la gren adrenal, akakumana ndi kusazindikira kwa endocrinologist? Panali nkhani yomwe mayi yemwe adabwera ku chipatala china cha endocrinology amayenera kufunafuna zipatala zina momwe angayang'anire kuti amutsimikizire.

Komabe, ngakhale atawona zotsatira zodalirika, katswiriyo adadziumirira yekha: palibe matenda, chifukwa ndizosowa kwambiri ... Adalankhula za gawo losatsutsika ili lazopanda pake pamzere wolunjika wa ZINTHOZO dokotala wa opaleshoni ya endocrinologist, wamkulu wa dipatimenti ya opaleshoni ya endocrine yaukadaulo waukadaulo waku Ukraine komanso wothandiza pakuchita opaleshoni ya endocrine, kupatsirana ziwalo ndi minyewa ya endocrine, dokotala wa pulofesa wa sayansi ya zamankhwala Sergey Cherenko. Kodi ndizovuta ziti zomwe zingakhale zovuta kudziwa matenda a adrenal? Kodi kuwachitira? Kodi opaleshoni ndiyofunikira? Werengani mayankho a mafunso awa ndi enanso masiku ano.

* - Moni, Sergey Makarovich! Mukuda nkhawa ndi Nadezhda Mikhailovna wa ku Kiev. Tsopano ndili ndi zaka 45, kupanikizika kunayamba kukwera pomwe panali 32. Tsopano akufika pa 180 mpaka 110. Ndichitenji?

- Yang'anani chomwe chikuyambitsa matenda oopsa, ndipo pochita izi - adzifufuza mosamala. Kuchulukitsa kwapanthawi yomwe kumachitika muubwana komanso wapakati, kumayimira kuphwanya thupi - matenda amtima, mitsempha yamagazi, impso.

Zizindikiro zoopsa zamagazi nthawi zambiri zimagwirizanitsidwa mwachindunji ndi zotupa za adrenal.

Pafupifupi zotupa zonse zomwe zimapezeka m'minyewa yotere ya endocrine zimatha kuyambitsa matenda oopsa: kuchuluka kwa mahomoni kumapangidwa - ndipo zotengera zimachepetsedwa.

Zatsimikiziridwa kuti chochititsa chachikulu kwambiri cha matenda oopsa ndicho kuchuluka kwa mahomoni aldosterone.

Kuti mumvetse bwino za matendawa (umatchedwa hyperaldosteronism), muyenera kuyesa mayeso apadera a magazi, omwe endocrinologist adzakulemberani, pang'onopang'ono.

Ngati mankhwalawa otchulidwa ndi zotsatira za mayeso amakhala ndi matendawa, matendawa nawonso adzachepa. Zotsatira zake zimadalira kutalika kwa matendawa: ngati munthu akuvutika kwa zaka zoposa zisanu mpaka zisanu ndi chimodzi, kukwaniritsa zotsatira zabwino kumakhala kovuta kwambiri.

* - "ZOONA"? Uyu ndi Olga wochokera kudera la Zhytomyr, wazaka 47. Chaka chatha magazi anga adayamba kudumphadumpha. Ndikhulupilira kuti izi zitha kukhala chifukwa cha ma adrenal glands. Momwe mungayang'anire?

- Kuti mudziwe ngati izi zili choncho, funsani endocrinologist. Kuunika kumayamba ndi kuwunika kwa kuchuluka kwa aldosterone kwa enzyme yopangidwa ndi impso (renin).

Ndikukulangizani kuti muchenjeze adotolo ngati mukumwa mankhwala a antihypertensive: ena mwa iwo amatha kupotoza zotsatira zake.

Katswiri, wotsogolera wodwalayo kuti athe kuwunika, akuyenera kuchotsa diuretic (veroshpiron) isanachitike, ndikuyimitsa kwakanthawi oletsa beta-blockers ndi ACE blockers ndi mankhwala ena.

Chiyeso china chofunikira chomwe chikufunika kuchitidwa ndi kuchuluka kwa potaziyamu m'magazi. Uku ndi kuphunzira kosavuta komwe kumachitika pogwiritsa ntchito chosanthula chawokha.

Nthawi zina kusowa kwa potaziyamu kumachitika ndi matenda ena a impso, kuwonongeka kwambiri m'matumbo (nthawi zambiri kumayendetsedwa ndi kusanza, kutsegula m'mimba), koma nthawi zambiri kumawonetsa kuchuluka kwa aldosterone. Ngati dokotala akuwona matenda oopsa pamaso pake, momwe potaziyamu amatsitsidwa, munthu ayenera kuyang'ana zomwe zimayambitsa gren.

Chifukwa chake, mwanjira, ndizachikhalidwe kumayiko ena: munthu yemwe amakula kufooka, kufooka minofu motsutsana ndi kuthamanga kwambiri, amakhala ndi vuto ndi matumbo, mosalephera amadutsa kuwunika kwa potaziyamu m'magazi.

Vuto la ma endocrinologists achiyukireniya ndikuti amawona matenda a adrenal kukhala osowa kwambiri. Mzochita zanga, panali vuto lonyezimira pamene mzimayi wogwira ntchito ku Poland adayamba kukhala ndi hyperaldosteronism, ndipo, atakambirana ndi madokotala aku Poland, adapita kwawo kukalandira chithandizo.

Koma kuchipatala cha endocrinology amodzi mwa oyang'anira zigawo, adotolo "sanawone" vutoli. Wodwalayo adakakamizidwa kuti ayang'ane labotale payekha kuti achite mayeso ofunikira, kuti akhale ndi scan ya CT pamalo opangira malonda. Komabe, izi sizingathe kutsimikizira katswiri wa chisoni.

M'mayendedwe omwe adafunsira ku Kiev, kudali kodziwikiratu (komanso wokayikitsa) wodwala.

* - Masana abwino! Ivan Romanovich akuyimba, wazaka 51. Ndinawerenga mu "ZOONA" kuti kuperewera kwa potaziyamu m'thupi kumayambitsa kufooka, chizungulire, ludzu lambiri komanso kukoka pafupipafupi. Ndi zakudya ziti zomwe ndikufunikira kuti ndipeze potaziyamu yambiri?

- Potaziyamu yambiri imapezeka mu zipatso zouma: ma apricots zouma, zoumba zamphesa, mitengo yamapiri, komanso nthochi, mbatata zophika. Koma munthu wathanzi komanso chakudya chomwe amakhala nacho nthawi zonse amalandila zokwanira zofunikira zonse za kufufuza.

Ngati mukukhudzidwa ndi izi, ndikukulangizani kuti mufufuze ndulu za adrenal: kuphwanya kwina kwa ntchito zawo kumayambitsa kusowa kwa potaziyamu, ndipo hypokalemia imachitika. Muyenera kukayezetsa magazi a electrolyte (potaziyamu, calcium, chlorine).

Zabwino, izi zimayenera kuchitika pafupipafupi, monga, kunena, kuyezetsa magazi kapena kuyezetsa magazi. Ngati ndi kotheka, adotolo adzalembanso kusanthula kwina kwapadera (kwa aldosterone ya mahomoni).

Koma kuti zotulukapo zake zitheke, katswiri amalimbikitsa momwe angapangire potaziyamu wambiri m'thupi. Nthawi zambiri mumayenera kumwa mankhwala okhala ndi potaziyamu komanso wogwiritsa ntchito ma micronutrient.

* - Mzere wowongoka? Dzina langa ndine Natalia. Ndimakhala ku Yagotin, m'chigawo cha Kiev. Kwa zaka khumi, kupanikizika kwamphamvu kwakhala kusokoneza, ndipo nthawi zina kutentha kwa thupi kumachepa. Ndikuganiza kuti chifukwa chake chili m'matumbo a chithokomiro. Kodi zili choncho?

- Ndikukulangizani kuti mupange kusanthula kwa mahomoni opatsirana a chithokomiro cha pituitary gland (TSH). Kutengera ndi zotsatira zake, endocrinologist, ngati ikuwoneka kuti ndiyofunikira, imayambitsa maphunziro owonjezera. Pazonse, ndikuganiza kuti chithokomiro cha chithokomiro sichikhala ndi kukakamiza kwenikweni.

Ngakhale kwambiri thyrotoxicosis nthawi zambiri imayambitsa kuwonjezeka pang'ono pazapanthawi, ndipo kutsika kumakhalabe kosadukiza malire.

Koma pankhani yotsutsana - ndi hypothyroidism - kuthamanga kwa atherosulinosis kumatheka, chifukwa chomwe kulimbikira kwamankhwala kumapangidwa.

* - Masana abwino! Nina waku Kirovograd akulumikizani. Ngati ludzu likuvutitsidwa ndi kuthamanga kwa magazi - kodi mavutowa ndi ndulu za adrenal kapena ndiyenera kuyang'ana matenda ashuga?

- Kuyankha mosaganizira funso lanu ndikotheka atawona zotsatira za kafukufukuyu. Ndimakonda kubwereza odwala omwe ali ndi matenda oopsa: ngati matendawa adayamba asanakwanitse zaka 40 ndipo zovuta kuvuta, ndikofunika kuyang'ana ndulu za adrenal.

Gawo loyamba ndikutenga mayeso omwe endocrinologist akupatseni, gawo lachiwiri ndi kuchita tomography.

Kuchita koteroko ndikofunikira chifukwa chiwonetserocho chikuwonetsa zotupa zowoneka bwino ndipo sizingatheke "kupanga" zazing'ono kapena kukulitsa pang'ono gland.

Komabe, sitiyenera kuiwala: kuthamanga kwa magazi ndi chizindikiro cha matenda ena. Hypertension nthawi zambiri imayenderana ndi matenda ashuga. Kupsinjika kwamphamvu kumachitika mwa odwala matenda ashuga chifukwa chakuti mitsempha yamagazi imawonongeka ndi shuga wambiri wamagazi, zopangidwa ndi oxidrate wa carbohydrate.

Ichi ndichifukwa chake munthu amene ali ndi matenda ashuga komanso matenda oopsa ayenera kuunika bwino. Zochita zikuwonetsa kuti munthu aliyense wazaka zisanu ndi ziwiri mpaka khumi ndi zisanu ndi ziwiri zokhala ndi shuga amapitilira mahomoni a adrenal.

Ngati kuphwanya kumachotsedwa, ndikosavuta kuthana ndi matenda onse awiri, zomwe zikutanthauza kuti moyo wa wodwalayo umayamba kuyenda bwino, nthawi yake imachuluka.

* - Moni! Uyu ndi Inna Vyacheslavovna wochokera ku Melitopol. Mwamuna wanga ndiwodwala wodwala wazaka makumi awiri. Tsopano akumamwa mankhwala atatu nthawi imodzi, ndipo zimapanikizika nthawi zina.Mwamuna amafunsa adotolo kuti amutumize kumuyesa, koma akuti chinthu chachikulu ndikumwa mapiritsi ... Tipange chiyani?

-Mikhalidwe yomwe mukuyankhula si yachilendo. Ndikutha kungolingalira chifukwa chiyani "sizosasangalatsa" akatswiri kuti ayang'ane chifukwa cha kuthamanga kwa magazi.

Ngati matenda oopsa akuphatikizidwa ndi kuchuluka kwa adrenal hormone aldosterone, nthawi zambiri, wodwalayo ayenera kusintha mwamphamvu njira zamankhwala.

Pafupifupi 70 peresenti ya odwala omwe ali ndi vutoli amathandizidwa ndi mankhwala otsika mtengo kwambiri omwe amatchinga ma aldosterone receptors.

Ndikulangizani amuna anu kuti atembenukire kwa akatswiri odziwa bwino za matenda komanso matenda a adrenal. Mutha kufunsa kuchipatala chathu cha Ukraine komanso chogwira ntchito pa opareshoni ya endocrine, kupatsirana ziwalo za endocrine ndi minyewa ya Unduna wa Zaumoyo ku Ukraine.

Kuti muyesedwe, mudzabwerenso: 0(44) 564-09-20 kapena 0(44) 560-75-46 kapena bwerani ku chipatala, chomwe chili ku adilesi: Kiev, Klovsky fuko, 13a. Funsani mafunso pa intaneti pa www.endosurg.com.ua.

- Ndi mu zochitika ziti pamene ntchito ikufunika?

- Ndi mwambo kuganiza kuti dokotalayo nthawi zonse amathandizira opareshoni, koma izi ndi zolakwika. Pafupifupi 30 peresenti ya odwala omwe ali ndi aldosterone yowonjezereka, mwachitsanzo, ali ndi chotupa chimodzi kapena kwambiri adrenal hyperplasia, amafunika kuchitidwa.

Opaleshoniyo singayimitsidwe kwa nthawi yayitali: m'malo apamwamba, pamene zombo zayamba kale kutupa, kufinya, mavuto sangabwerere mwakale.

Koma zimachitika kuti wodwalayo safuna kulowererapo kapena dokotala safuna kuchita ngozi pazifukwa zamankhwala - ndiye kuti mutha kupereka mankhwala omwe amaletsa ma receptors oopsa a mahomoni.

Koma mulimonse momwe zingagwiritsidwe ntchito, achire kapena opaleshoni, munthu sangakane kulandira chithandizo. Amachepetsa kuthamanga kwa magazi komanso kupewa stroke, komanso kutchinjiriza mtima.

Aldosterone yowonjezera sikuti imangowononga mitsempha yamagazi, komanso imatsogolera pakuwonjezeka kwa minofu yamtima. Ngati mtima ukuvutika ndi vuto la kuchepa kwa mpweya, matenda am'mitsempha ya m'magazi, vuto la mtima limachitika.

Chifukwa cha kuchuluka kwa kupanikizika, kupenya kumalephera, impso zimavutika, ndipo pakapita nthawi, kulephera kwa impso kumachitika.

* - Masana abwino! Zosokoneza Dina Dmitrievna kuchokera ku Melitopol. Mu 2008, adandipeza ndi corticosteroma kumanja kwa adrenal gland. Tsopano chotupa chachepa pang'ono, koma mahormoni a cortisol achuluka kuposa abwinobwino. Mukupangira chithandizo chiti?

- Kuzindikira kuti chotupa chonga chanu chikuyenera kutsimikiziridwa.

Ngati mapangidwe sanakule, ndipo ngakhale, monga mukunenera, amachepera, ichi ndi chizindikiro chabwino: wokhala ndi chotupa chachikulu kuposa mamilimita anayi, chiwopsezo cha kufooka koyipa chikukula.

Chomwe chimayambitsa nkhawa chanu ndi kuchuluka kwa mahomoni pantchito ya chotupa - kuchuluka kwa cortisol kukuwonetsa izi. Kuti mudziwe mankhwalawa, muyenera kuchita mayeso omwe amatchedwa usiku dexamethasone.

Lumikizanani ndi omwe amapezeka ku endocrinologist - apanga kafukufuku. Ndiwosavuta, koma wodalirika komanso wolondola. Usiku, nthawi ya khumi ndi limodzi madzulo, mudzatenga milligram imodzi ya mankhwala otchedwa dexamethasone, ndipo m'mawa mumayesedwe magazi a cortisol mu labotale.

Ngati chizolowezicho chidapitilira, ndikuganiza kuti muyenera kusankha pa opareshoni. Sikoyenera kuchita mantha ndi kulowererapo, makamaka popeza kuti ma gren adrenal tsopano imagwiritsidwa ntchito kwambiri ndi njira yofatsa, popanda mawonekedwe.

Wina ayenera kukhala osamala ndi cortisol yayitali, chifukwa minofu, mafupa, ndi mafinya zimavulala.

- Inde, ndili ndi arthrosis ...

- Mwambiri, izi ndi zotsatira za kuchuluka kwa cortisol. Matenda omwe mumadwala nawo ndi owopsa chifukwa amachititsa kuti munthu akhale pachiwopsezo cha matenda, amawonjezera chiwopsezo cha matenda ashuga, amathandizira kuwonjezeka.Ndizotheka kuti mwachulukitsa kupanga mahomoni ena a adrenal, chifukwa chake ndikukulangizani kuti muyesedwe bwino ndikuchiritsidwa.

* - Sergey Makarovich, moni! Vladimir Alexandrovich, wa ku Kievite, akukuyimbirani. Ndidapeza choopsa. Kodi zikugwirizana ndi matenda adrenal?

“Sindikuganiza choncho.” Koma kusawona bwino kungakhale chimodzi mwazomwe zimapangitsa kuti adrenal gland iwonongeke. Monga lamulo, munthu amadwala matenda oopsa. Muyenera kulumikizana ndi endocrinologist ndikumupempha kuti akupatseni kuyesa kwa magazi kwa mahomoni ndi cheke cha kuchuluka kwa potaziyamu.

* - Dzina langa ndi Liliya Viktorovna, ndine wochokera ku Kiev. Nthawi zina, pazifukwa zosadziwika, zimakhala zoipa: mutu umapweteka kwambiri, kupsinjika kumadumpha kwambiri. Dotoloyo akuti muyenera kuyang'ana ma tezi a adrenal kupezeka kwa pheochromocytoma. Zizindikiro za nthendayi ndi ziti?

- Mumagwedezeka pa nthawi youkira?

- Nthawi zina zimachitika.

- Izi zimachitika chifukwa cha kutulutsidwa kwa mahomoni a adrenaline. Nthawi zambiri zimawonekera ngati munthu akufunika kuchoka pangozi - kuthawa galu wokwiya, kupewa kuukira kwa achifwamba.

Koma ndikuwoneka ngati kopanda tanthauzo panjenjemera m'thupi, yomwe imayendetsedwa ndi vuto lodana ndi mutu komanso kuthamanga pakukakamizidwa, ndikofunikira kuyang'ana chotupa kuchokera ku adrenal medulla yomwe imatulutsa adrenaline - pheochromocytoma.

Ndiwowonjezera adrenaline ndi zinthu zina zomwe zimapangitsa kuti mitsempha yayifupi; Pambuyo povutitsidwa, munthu nthawi zambiri amamva kusweka, kufooka, kufunitsitsa kugona - izi zimayambitsidwa ndi kusowa kwa adrenaline ndi vasodilation.

Ndikofunikira kudziwa kuti pheochromocytoma nthawi zambiri imakula pang'onopang'ono, ndipo munthu amawona vuto pamene chotupa, chofika masentimita awiri kapena atatu, chimayamba kupanga adrenaline yambiri, potero imapangitsa kupanikizika kwamphamvu.

Zambiri mwa pheochromocytes zimapezeka mwangozi - ndi ultrasound, computer tomography kapena MRI ya msana.

Ngati muli ndi zizindikilo zomwe ndidakambirana, muyenera kukayezetsa pamalo apadera a endocrinology.

Mwa 95 peresenti ya milandu, pheochromocytoma imakhala yodziwika, ndipo atachotsedwa, munthu amabwerera kumoyo wake. Ngakhale ngati gland imodzi ya adrenal imachotsedwa, palibe vuto ndi lina.

- Kodi ntchitoyo idadutsa "mabowo" awiri?

- Kugwiritsa ntchito laparoscopy, pankhani ya zotupa zakumanzere, timapanga punctures zitatu, mbali zamanja - zinayi. "Bowo" lowonjezera, monga momwe mudanenera, likufunika "kusuntha" chiwindi.

Opaleshoni ya Laparoscopic ndiye kulowerera modekha kwambiri komwe sikumawononga minofu ndipo sikuvulaza khoma lakumbuyo lakumbuyo.

Kwa wodwala, kusakhala pachiwopsezo chotaya magazi ndikofunikanso, chifukwa motsogozedwa ndi kamera yaying'ono yamakanema, dokotala wa opaleshoni amatha kufinya bwino ziwiyazo ndi zida kapena zida zapadera (ultrasound kapena magetsi). Nthawi zambiri madzulo pambuyo pa opaleshoni, munthu amadzuka, ndipo patapita masiku angapo kupita kwawo.

Kodi matendawa ndi ati?

Matenda a Steroid amakula pang'onopang'ono. Kuwonongeka kwa thanzi la wodwalayo kumawonetsedwa ndi mawonekedwe ena popanda chithunzi chomveka bwino chachipatala, makamaka ndi chitukuko cha matenda oyamba. Laboratory mayeso magazi ndi mkodzo alibe kwambiri kupatuka, shuga mfundo malire pa mwanjira, acetone kulibe.

Zizindikiro zazikulu za matendawa:

• ludzu, kumwa madzi ambiri,
• kukodza mwachangu ndi kutulutsa,
• kutopa,
• kufooka, ulesi,
• kuwonongeka kwakukulu.

Mawonetsero pawokha am matendawa:

• kawirikawiri njala
• kutsika pang'ono kwa thupi,
• kusowa pogonana,
• kumva kulira ndi miyendo.
• zosokoneza zowoneka - kuwonongeka, kuwona kwamaso,
• chiwopsezo cha akazi ku matenda apabanja,
• kununkhira kwa acetone kuchokera mkamwa.

Chithandizo cha adrenal glands ndi shuga

Pankhani ya mankhwala osokoneza bongo komanso kuthekera kwa kusiya kwawo, matenda a shuga aidid amapita popanda zotsatirapo zake. Ndi isanayambike Zizindikiro pochiza matenda oyambitsidwa, kusintha kwa mankhwala omwe ali ndi vutoli popanda zotsatira zoyipa kumaganiziridwa. Njira zotsatirazi zimagwiritsidwa ntchito pochiza matenda a shuga a steroid:

• kukonza zakudya ndikusinthira kwa chakudya chamafuta ochepa,
• kukhala ndi moyo wathanzi ndi nthawi yokwanira yopuma komanso kuchita masewera olimbitsa thupi,
• mankhwala omwe amaganizira matenda omwe amayambitsidwa ndi chiwonetsero cha matenda a shuga a steroid,
• jakisoni mankhwala
• Kuchotsa opaleshoni minofu ya adrenal kuti ikhale yofanana ndi mahomoni ena.

Basic mankhwala

Mankhwala osokoneza bongo amayang'aniridwa ndi endocrinologist. Kusankhidwa kwa mankhwala kumatengera thanzi la wodwalayo komanso kupezeka kwa matenda, kuopsa kwa zizindikiro za matendawa. Chithandizo cha mankhwala ophatikizira

• Antidiabetesic - antipyretic mankhwala. Sungani kuchuluka kwa shuga, khalani bwino, onjezani mphamvu.
• Jekeseni wa Insulin. Amagwiritsidwa ntchito kuteteza shuga m'magazi, kukonza pancreatic ntchito.
• Mankhwala osokoneza bongo. Amagwiritsidwa ntchito kukonza kagayidwe, kuyamwa ndi kukonza kwa glucose ndi minofu, ndikuchepetsa zotsatira za mankhwala a mahomoni.

Njira zopewera

Kupewera kupewa matenda Kuyangʻaniridwa ndi achipatala pafupipafupi ndi kuyeza shuga kwa magazi kumafunika.

Adrenal hyperplasia ndi matenda ashuga

Tizilombo ta adrenal timagwira ntchito zingapo zofunika mthupi, kuphatikizapo, zimathandizira kupanga mahomoni ena (adrenaline, norepinephrine, mahomoni a gulu la corticoid, mahomoni ogonana).

Kuphwanya maselo a adrenal, mwachitsanzo, ndi ma hyperplasia awo, kumakhudza mkhalidwe wam'madzi, kukula kwa thupi, ziwalo zake zonse ndi machitidwe ake.

Kodi ndi chiyani: mawonekedwe a matendawa

Gren adrenal imakhala ndi minyewa ya glandular, medulla ndi kotekisi.

Hyperplasia ikachitika kuchuluka kwa ziwalo, zomwe, zimatsogolera kukula kwake. Poterepa, mawonekedwe a chiwalo amakhalabe osasinthika.

Kukula kwa minofu ya adrenal kumabweretsa kuphwanya ntchito yawo ya mahomoni, chifukwa chomwe kuchuluka kwakulu kwama mahomoni ambiri kumapangidwa m'thupi, zomwe zimasokoneza kugwira ntchito kwa thupi lonse.

Makamaka, adrenal hyperplasia imatha kuyambitsa matenda opatsirana.

Njira yopanga mahomoni imatengera mtundu wa matendawa. Chifukwa chake, ndi androgenic mawonekedwe pali chidziwitso chowonjezeka cha mahomoni androgen ndi mineral corticoids, omwe amawonongera molakwika mkhalidwe wamkati mwa mtima wamthupi.

Fomu lamchere yodziwika ndi kupanga kwa androgens ochulukirapo, pomwe kuchuluka kwa mahomoni ena omwe amapangidwa amachepetsedwa kwambiri. Zotsatira zake, munthu amakhala ndi kuchepa thupi komanso kuchepa thupi.

At mawonekedwe oyipa Kupanga kwa adrenaline kumathandizanso kwambiri, zomwe zimayambitsa kusokoneza ziwalo zoberekera.

Matendawa amatha kuchitika mwa anthu azaka zosiyanasiyana, ngakhale atakhala kuti ndi amuna kapena akazi. Mu ana, mtundu wobadwa nawo wa matenda amapezeka nthawi zambiri, ngakhale umatha kukhalanso ndi vuto.

Adrenal hyperplasia imasiyana ndi mitundu ina yowonongeka kwa ziwalo.Makamaka, ndi hypoplasia kapena dysplasia amapangidwa mahomoni ochepa, zomwe zimawonanso molakwika pakugwira ntchito kwa thupi lonse.

Gulu ndi mitundu ya matenda

Mitundu yosiyanasiyana yamatendawa imasiyanitsidwa, yomwe imasiyana ndi inzake mu mawonekedwe amtundu, zosiyanasiyana zamaphunziro.

Mtundu wa matendawa umadziwika ndi maonekedwe a chiwalo mumitsempha. mayina apaderaomwe amatha kukhala osakwatiwa kapena angapo.

Pathology ili ndi mawonekedwe apawiri, ndiye kuti, imakhudza ndulu zakumanja ndi kumanzere kwa adrenal. Nthawi zambiri amapezeka mwa okalamba. Ma nodule amatha kukhala opindika kapena kukhala ndi mawonekedwe.

Matendawa amawonekera ngati Zizindikiro ngati:

• Zizindikiro zowonjezera magazi,
• Matenda a impso,
• Kuwonongeka kwa maselo am'mitsempha m'matumbo amisempha, kuwonetsedwa mwa kukomoka, kufooka kwa minofu.

Fomuyi imadziwika ndi kusunga mawonekedwe a adrenal glands, pomwe kukula kwa ziwalo kumachuluka. Magulu apadera a hypoechoic a mawonekedwe osakanikirana ozunguliridwa ndi mawonekedwe a adipose minofu ya adrenal.

Kudandaula kwamwano

Ndi matenda amtunduwu amachitika kuchuluka katulutsidwe wa mahomoni cortisol, zomwe zimathandizira kuoneka ngati matenda azachipatala monga:

Hyperplasia wa kotekisi

Fomu iyi ndi matenda omwe Kupanga kwa cortisone kumasokonekera. Zotsatira zake, pamakhala zikhalidwe monga:

Zomwe zimachitika

Zifukwa zosiyanasiyana zimatha kubweretsa kutulutsa ndi kukhazikika kwa matenda, zomwe zimaphatikizapo kutsatira zovuta:

1. Anomalies mu intrauterine kukula kwa glandular minofu ya mwana wosabadwayo,
2. Kuwonongeka kwa chiwopsezo ndi zovuta zina pamtundu wa chibadwa,
3. Mimba yayikulu ikuphatikizidwa ndi kupsinjika kwa mayi woyembekezera, kukula kwa toxicosis, zina zoyipa,
4. Kupsinjika pafupipafupi, kukhumudwa, kuvutikira kwambiri,
5. Kukhala ndi zizolowezi zoipa monga kusuta fodya kapena kumwa mowa
6. Kugwiritsa ntchito nthawi yayitali mankhwala osokoneza bongo
7. Kuphwanya njira za kagayidwe kachakudya mthupi,
8. Matenda a Cushing.

Zizindikiro ndi mawonetseredwe azachipatala

Pali chiwerengero chachikulu Zizindikiro zapadera, kupezeka kwake komwe kungasonyeze kukula kwa adrenal hyperplasia. Zina mwazomwe tikuwonetsa muzipatala ndi izi:

Zizindikiro

Kuti muzindikire kukhalapo kwa matendawa, ndikofunikira kuchita kafukufuku wa wodwalayo, kuyesa kwake kowoneka, komanso maphunziro angapo a labotale ndi othandizira.

Makamaka, wodwala ayenera:

• imwani mayendedwe a mkodzo ndi magazi kwa mahomoni opangidwa ndi ma adrenal gland,
• mumayesedwa x-ray ndi impso,
• CT
• MRI
• kuphunzira kwa radionuclide.

Kodi ma ad adalal glands amawerenga bwanji munkhaniyi.

Mankhwala

Chithandizo chotchuka kwambiri m`malo mankhwala kugwiritsa ntchito mankhwala ena. Nthawi zambiri, wodwalayo amapatsidwa mankhwala ngati awa:

Nthawi zina, mitundu yonse ya mankhwala a mahomoni imasonyezedwa, monga tafotokozera pamwambapa. Mankhwala amatengedwa Katatu patsiku Mlingo wofotokozedwa ndi dokotala aliyense payekha kwa wodwala aliyense.

Popeza mankhwala a mahomoni nthawi zambiri amapereka zovuta zoyipa, wodwalayo ayenera kumwa mankhwala omwe amachepetsa mawonekedwe awo.

Kuphatikiza apo, kutengera jenda, wodwalayo amapatsidwa mankhwala okhala ndi zina mahomoni ogonana (kwa akazi, kukonzekera kwa estrogen, kwa amuna - androgen).

Opaleshoni

Woopsa milandu, wodwala amamuika opaleshoni ya adrenal gland. Opaleshoni ikuchitika laparoscopy. Njirayi imawonedwa ngati yofatsa kwambiri, yosasokoneza.

Zolimba zaumoyo sizikhudzidwa, kuchepa kwa magazi ndizochepa. Chifukwa chake, nthawi yobwezeretsa pambuyo pochita opaleshoni imakhala yochepa kwambiri.

Ndipo komabe, atangochita opaleshoni, wodwalayo ayenera kutsatira malamulo ena.

Makamaka, masana pambuyo pa opareshoni, simungathe kudya chakudya, kuwonetsa zochitika zolimbitsa thupi.

Mankhwala achikhalidwe

Monga mankhwala othandizira, othandizira pakumwa mankhwala osokoneza bongo, mutha kugwiritsa ntchito maphikidwe a mankhwala achikhalidwe.

Makamaka, kugwiritsa ntchito mankhwala azitsamba kumakhala ndi zotsatira zabwino pa ntchito ya adrenal glands. Pokonzekera, mutha kugwiritsa ntchito masamba monga masamba a mabulosi, chingwe, medunica.

Muyenera kutenga 2 tbsp. zopaka zouma, zitsanulira ndi kapu ya madzi otentha, kutentha mu kusamba kwa madzi kwa mphindi 10-15. Pambuyo pa izi, msuzi wokonzedwa umakhazikika, umasefedwa. Msuzi womwe unayambitsidwa umathandizidwa ndi madzi otentha kupita ku voliyumu yoyambirira, yogawidwa pawiri. Chidacho chimatengedwa kawiri patsiku, m'mawa ndi madzulo.

Adrenal hyperplasia ndimatenda oopsa omwe angayambitse zovuta zazikulu zingapo. Kuwonongeka kwa ma gren adrenal nthawi zambiri kumakhala chifukwa khansa. Ngakhale, ndikuwonetsetsa ndikuthandizira kwakanthawi, matendawo amayambiranso bwino.

Kuti muwone dokotala munthawi ndikuyamba kulandira chithandizo, muyenera kuyang'anitsitsa thanzi lanu, kumvetsera mosintha kusintha kulikonse. Izi zipereka nthawi kuti mudziwe kupezeka kwa mawonetseredwe azachipatala.

Dziwani zambiri zokhudzana ndi kubadwa kwa adrenal hyperplasia ndi zotsatira zake kuchokera Kanemayo:

Matenda a shuga a Adrenal

Matenda omwe amayamba chifukwa cha kuchuluka kwamahomoni m'magazi a adrenal cortex amatchedwa matenda a shuga. Nthawi yachiwiri yaudokotala pamatenda a shuga ndi yachiwiri ya insulin.Amatanthauzanso mawonekedwe oopsa a insulin omwe amadalira shuga.

Type 2 shuga

Type 2 shuga - Matenda a endocrine osachiritsika omwe amayamba chifukwa cha insulin kukana komanso kukanika kwa maselo a pancreatic beta, amadziwika ndi matenda a hyperglycemia.

Imadziwonetsa lokha ndi kukodza kwakukulu (polyuria), ludzu lochulukirapo (polydipsia), kuyabwa kwa khungu ndi mucous nembanemba, kulakalaka kudya, kutentha kwambiri, kufooka kwa minofu. Kuzindikira kumakhazikitsidwa pazotsatira za labotale.

Kuyesedwa kwa magazi kumachitidwa pakupanga glucose, glycosylated hemoglobin level, glucose tolerate test. Mankhwalawa, mankhwala a hypoglycemic, zakudya zama carb ochepa, komanso zochitika zolimbitsa thupi zimagwiritsidwa ntchito.

Liwu loti "shuga" limamasuliridwa kuchokera ku Chigriki kuti "kumatha, kutanthauza" matendawa amatanthauza "kutuluka kwa shuga", "kutayika kwa shuga", lomwe limafotokozera chizindikiro chachikulu - kuchuluka kwa shuga mkodzo.

Mtundu wachiwiri wa matenda a shuga a mellitus, kapena matenda osokoneza bongo omwe amadalira insulin, amakula motsutsana ndi maziko a kuchuluka kwa minofu yolimbana ndi insulin komanso kuchepa kwamphamvu kwa magawo a ma islets a Langerhans.

Mosiyana ndi matenda amtundu wa 1 shuga, momwe kuperewera kwa insulin kumayambira, matenda amtundu wa 2, kuchepa kwa ma cell ndi chifukwa cha insulin. Ma data a Epidemiological ndi opambana kwambiri, kutengera mtundu, chikhalidwe chachuma.

Ku Russia, kuchuluka kwakukulu ndi 7%, 85% ya mitundu yonse ya matenda ashuga. Izi zimachuluka pakati pa anthu azaka zopitilira 40-45.

Zomwe zimayambitsa matenda A shuga A Type 2

Kukula kwa matendawa kumayambitsidwa ndi kuphatikizika kwa cholowa chamtsogolo ndi zinthu zomwe zimakhudza thupi moyo wonse. Mwa kukula, zovuta zakunja zimachepetsa chidwi cha maselo a thupi kupita ku insulin, chifukwa chomwe amasiya kulandira shuga wokwanira. Zomwe zimayambitsa matenda a shuga wachiwiri:

• Kunenepa kwambiri Minofu ya Adipose imachepetsa kuthekera kwa maselo kugwiritsa ntchito insulin. Kunenepa kwambiri ndi chiopsezo chachikulu pakukula kwa matendawa, amatsimikiza mu 80-90% ya odwala.
• Hypodynamia. Kuchepa kwa ntchito zamagalimoto kumayipira ntchito ya ziwalo zambiri ndipo kumathandizira kuchepetsa njira ya metabolic m'maselo. Khalidwe la hypodynamic limayendera limodzi ndi shuga wambiri ndi minyewa yake komanso kuchuluka kwake m'magazi.
• Zakudya zopanda pake. Choyambitsa chachikulu cha kunenepa kwambiri mwa anthu omwe ali ndi matenda ashuga ndi kudya kwambiri - kudya kwambiri zopatsa mphamvu. Choipa china ndikugwiritsa ntchito shuga wambiri woyengeka, yemwe amalowa m'magazi mwachangu, ndikupangitsa "kudumpha" mu insulin yotulutsa.
• Matenda a Endocrine. Mawonekedwe a shuga amatha chifukwa cha endocrine pathologies. Milandu yodwala yokhudzana ndi pancreatitis, zotupa za pancreatic, kuchepa kwa pituitary, hypo- kapena hyperfunction ya chithokomiro cha tezi kapena adrenal gland.
• Matenda opatsirana. Mwa anthu omwe ali ndi vuto lobadwa nalo, chiwonetsero chachikulu cha shuga chimalembedwa ngati chovuta cha matenda oyamba ndi kachilombo. Oopsa kwambiri ndi fuluwenza, herpes ndi hepatitis.

Pa mtima wa mtundu wa 2 shuga ndikuphwanya kagayidwe ka chakudya chifukwa cha kukana kwa maselo ku insulin.

Kuthekera kwa minofu kutenga ndikugwiritsa ntchito glucose kumachepetsedwa, mkhalidwe wa hyperglycemia, kuchuluka kwa shuga wa plasma, ukupanga, njira zina zopangira mphamvu kuchokera ku mafuta acidule acids ndi amino acid zimayambitsa.

Kulipiritsa hyperglycemia, thupi limachotsa kwambiri glucose kudzera mu impso. Kuchuluka kwake mu mkodzo kumawonjezeka, glucosuria amakula.

Kuchuluka kwa shuga m'madzi azinthu zachilengedwe kumapangitsa kuti magazi azikhala ochepa, zomwe zimakwiyitsa polyuria - kukodza kambiri pafupipafupi ndi kuchepa kwamadzi ndi mchere, zomwe zimapangitsa kusowa kwamadzi komanso kusowa kwa madzi m'magetsi. Zizindikiro zambiri za matenda ashuga zimafotokozedwa ndi njirazi - ludzu kwambiri, khungu lowuma, kufooka, arrhythmias.

Hyperglycemia amasintha njira ya peptide ndi lipid metabolism.

Zotsalira za shuga zimaphatikizidwa ndi mamolekyulu a mapuloteni ndi mafuta, kusokoneza ntchito zawo, kusokonekera kwa glucagon mu kapamba kumachitika, kuwonongeka kwa mafuta komwe kumapangitsa mphamvu yamagetsi, kuyambiranso kwa glucose ndi impso kumakulitsidwa, transmitter imalekeka mu dongosolo lamanjenje, ndipo minyewa yamatumbo imayatsidwa. Chifukwa chake, njira za pathogenetic za matenda ashuga zomwe zimayambitsa maselo pathologies (angiopathy), dongosolo lamanjenje (neuropathy), dongosolo logaya chakudya, komanso timimba ta endocrine secretion. Njira yotsatira ya pathogenetic ndikusowa kwa insulin. Amapangidwa pang'onopang'ono zaka zingapo, chifukwa cha kufooka komanso kufa mwachilengedwe kwa β-cell. Popita nthawi, kuchepa kwa insulini m'malo mwake kumasinthidwa. Kudalira kwachiwiri kwa insulin kumachitika, odwala amadziwika ndi insulin.

Mavuto

Njira yowonongeka ya matenda a shuga a 2 imayendera limodzi ndi kupezeka kwa zovuta komanso zovuta. Zovuta pachimake ndi zomwe zimachitika mwachangu, mwadzidzidzi ndipo zimagwirizanitsidwa ndi chiopsezo cha kufa - hyperglycemic coma, lactic acid chikomokere ndi hypoglycemic coma.

Matenda osakhazikika amapangidwa pang'onopang'ono, kuphatikizapo matenda ashuga- ndi macroangiopathies, owonetsedwa ndi retinopathy, nephropathy, thrombosis, mtima atherossteosis.

Anthu odwala matenda ashuga polyneuropathies apezeka, monga, zotumphukira za mitsempha ya polyneuritis, paresis, ziwalo, kudziyimira pawokha pantchito ya ziwalo zamkati.

Matenda a diabetes a arthropathies amawonetsedwa - kupweteka kwapawiri, kuletsa kuyenda, kuchepa kwa kuchuluka kwa madzimadzi, komanso matenda ashuga - matenda amisala omwe amasonyezedwa ndi kukhumudwa komanso kusakhazikika mtima.

Type 2 shuga

Mu endocrinology, njira yodziwika bwino yothandizira mankhwalawa ndiofala. M'mayambiriro oyamba a matendawa, cholinga chachikulu ndikuwonetsa kusintha kwa moyo wa odwala ndi upangiri komwe akatswiri akukambirana za njira za shuga ndi shuga. Ndi hyperglycemia yosatha, funso la kugwiritsa ntchito mankhwala limathetsedwa. Mulingo wathunthu wa zochizira umaphatikizapo:

• Zakudya. Njira yayikulu yazakudya ndikuchepetsa kuchuluka kwa zakudya zopezeka m'mafuta ndi chakudya chamafuta ambiri. Makamaka "owopsa" ndizopangira shuga - zotsekemera, maswiti, chokoleti, zakumwa zotsekemera za kaboni. Zakudya za odwala zimakhala ndi ndiwo zamasamba, zamkaka, nyama, mazira, ufa wambiri. Zakudya zowoneka bwino, zoperewera zochepa, kukana mowa ndi zonunkhira ndizofunikira.
• Kuchita masewera olimbitsa thupi pafupipafupi. Odwala omwe alibe zovuta zovuta za matenda ashuga amawonetsedwa masewera olimbitsa thupi omwe amalimbitsa njira za oxidation (masewera aerobic). Kutalika kwawo, kutalika ndi kulimba kwake kumatsimikiziridwa payekhapayekha. Odwala ambiri amaloledwa kuyenda, kusambira ndi kuyenda. Nthawi yapakati pa phunzilo limodzi ndi mphindi 30-60, mafupipafupi amakhala katatu pa 3-6 pa sabata.
• Mankhwala. Ntchito mankhwala a magulu angapo. Kugwiritsa ntchito ma gluuanides ndi thiazolidinediones, mankhwala omwe amachepetsa kukana kwa insulin, maselo omwe amapezeka m'magazi komanso kupangira chiwindi, ndi ponseponse. Ndi mphamvu yawo yokwanira, mankhwalawa amayikidwa kuti apititse patsogolo ntchito za insulin: DPP-4 inhibitors, sulfonylureas, meglitinides.

Zotsogola ndi kupewa

Kuzindikira kwakanthawi ndi malingaliro a odwala pakumwa matenda a shuga kungathe kubwezeretsa ndalama zomwe zimakhalapo, pomwe standardoglycemia imangokhalapo kwanthawi yayitali, ndipo moyo wa odwala amakhalabe wokwera.

Popewa matendawa, ndikofunikira kutsatira zakudya zopatsa thanzi zomwe zimakhala ndi fiber yayikulu, kuletsa zakudya zotsekemera ndi zamafuta, boma lazakudya. Ndikofunika kupewa kusachita masewera olimbitsa thupi, kupatsa thupi ntchito zolimbitsa thupi ngati mukuyenda tsiku lililonse, kusewera masewera kawiri pa sabata.

Kuwunikira pafupipafupi shuga kumakhala kofunikira kwa anthu omwe ali pachiwopsezo (onenepa kwambiri, okhwima ndi ukalamba, milandu ya matenda ashuga pakati pa abale).

Mahomoni ndi matenda ashuga

Thupi laumunthu limakhala ndi mahomoni ambiri, omwe aliyense amagwira ntchito yake. Melatonin mu shuga ndiwofunikira monga insulin kapena mahomoni okula. Amayang'anira metabolic zochita ndi biorhythms.

Kuperewera kwa mahomoni kumatha kubweretsa kukula kwa matenda a shuga kapena matenda ena ammimba ndi machitidwe. Chifukwa chake, ndikofunikira kuyang'anira momwe thupi liliri komanso poyambira matendawa muyenera kufunsa katswiri.

Dokotala adzafotokozera mtundu wa matendawa ndikuwapatsa chithandizo choyenera chomwe chithandiza kupewa matenda aliwonse.

Zolinga zakukula kwa matenda amisala

Steroid shuga mellitus ndi mtundu wina wa matenda a insulin. Corticosteroids, yomwe imapangidwa ndi adrenal cortex, idapangidwa kuti izitha kuyendetsa kagayidwe kazinthu kazathupi ndi chitetezo.

Kuchulukirapo, mahomoni a steroid amatha kukhala ndi vuto pa ziwalo ndikupangitsa kukula kwa matendawa.

Komabe, chifukwa chachikulu chomwe chikulepheretsa matendawa ndikugwiritsa ntchito mankhwala a mahomoni, chifukwa chake matenda amtundu wa shuga amawonekera.

Zitha kuputa matenda a shuga:

• Mankhwala osokoneza bongo. Kugwiritsidwa ntchito pakupanga mphumu ya bronchial, matenda a autoimmune. Izi zikuphatikizapo Dexamethasone, Hydrocortisone, Prednisolone.
• Kukula kwamafuta. Imathandizira kuthamangitsa kaphatikizidwe kazakudya zama protein komanso zimachotsa gawo lamafuta amkati. Amagwiritsidwa ntchito ndi osewera omwe akuchita masewera olimbitsa thupi. Kuchuluka kwake mthupi kumakhudza mapangidwe a shuga.
• Zodzikongoletsera. Thiazide diuretics: Dichlothiazide, Hypothiazide, Nephrix angayambitse matenda ashuga.
• Zinthu zomwe zimapangitsa kugona. Makamaka mankhwala "Melaxen", omwe amachititsa kuchuluka kapena kutsika kwa shuga.

Matenda a shuga a Steroid samakhala gawo la gulu la pancreatic ndipo samalumikizidwa ndi chithokomiro cha ntchito.

Zizindikiro zakukula kwa matendawa

Kumayambiriro kwa matendawa, maselo a beta amagwira ntchito.

Matenda a shuga a steroid amaphatikiza mawonekedwe a mawonekedwe a matenda a 1 ndi 2. Choyamba, kusintha kwa maselo a beta omwe amapanga kapamba kumachitika.

Mtundu woyamba wa matenda ashuga, maselo akupitiliza kugwira ntchito kwakanthawi. Kupita patsogolo, matendawa amatsogolera kuchepa kwa insulin komanso kuphwanya chidwi cha minofu, mtundu wachiwiri wa matenda umayamba. Ndipo pali kuthera kwathunthu kwa kupanga kwa insulin, komwe kumadziwika ndi matenda a shuga omwe amadalira insulin.

Chithunzi cha chipatala chokhala ndi matenda a shuga chimafanana ndi mitundu ina:

• kukodza kumachulukana
• kufunika kwa madzi kukuchulukirachulukira
• pamakhala kufulumira kwa thupi.

Insulin ndi kuchepa kwake m'thupi

Kuchuluka kwa mahomoni opangidwa ndi ma adrenal gland kumachulukana payekhapayekha. Mukatha kugwiritsa ntchito glucocorticoids, si anthu onse omwe amadwala matenda a shuga.

Zinthu zotere zimakhudza kapamba komanso zimachepetsa kupanga kwa insulin. Kuti thupi likhale lolimba, thupi limayenera kugwira ntchito molimbika.

Nthawi yomweyo, odwala matenda ashuga asokoneza kale kagayidwe kazakudya ndipo chitsulo sichigwira ntchito ndi mphamvu zosakwanira, zomwe zimabweretsa zovuta posagwiritsa ntchito bwino ma steroid.

Mayeso a Pathology

Phwando, endocrinologist imalemba mndandanda wa mayeso ofunikira.

Ngati zizindikiro za matenda zimapezeka, funsani endocrinologist. Alemba mbiri yakale ya matendawa ndikuwapatsa njira zotsatirazi:

• magazi ndi mkodzo mayeso,
• Kuphunzira kuchuluka kwa shuga m'magazi musanadye,
• magazi kuyesa shuga pambuyo kudya,
• Kuwona kuchuluka kwa matupi a ketone,
• mayeso a mahomoni.

Zomwe mankhwala amathandizira kukulitsa kuchuluka kwa insulin mthupi

Kuchepa kwa mahomoni opangidwa mu matenda osokoneza bongo kuyenera kuyambiranso. Kuti muchite izi, mutha kugwiritsa ntchito:

• Suluble insulin ndi chida chofunikira kwambiri polimbana ndi matenda. Ubwino wake ndikutheka kwa subcutaneous, intravenous and intramuscular management. Pambuyo pa utsogoleri, imayamba kugwira ntchito mkati mwa mphindi 15-30 ndikutha mu maola 6-8.
• Mndandanda wa mawonekedwe obwerezabwereza. Kutumizidwa ngati mankhwala amafunikira mosalekeza. Kupadera kwa ndalama zotereku ndikogona kuti akhoza kugwiritsa ntchito musanadye chakudya. Nthawi yowonetsera thupi siyopitilira maola atatu.
• "Isofan-Insulin PE" - amasintha mayendedwe amadzimadzi a glucose ndi ions.
• Kusakaniza kwa mankhwala osiyanasiyana. Amapezeka m'makalata apadera a ma syringe pens. Ndiosavuta kugwiritsa ntchito.

Kodi ndi mitundu iti ya matenda omwe alipo ndi mawonekedwe awo?

Matenda a mahomoni mu matendawa ali ndi kusiyana kwawo. Mitundu yotsatirayi imasiyanitsidwa:

Matenda amtundu WAMODZI amapatsira majini mosiyanasiyana.

• Matenda A shuga. Uku ndikupatuka kwa mtundu wa 2, womwe umadziwoneka wocheperako (zaka zapakati pa 15-30). Chomwe chimayambitsa chitukuko chake ndizovuta zamtundu wa insulin secretion. Ndiwosunga khosi - kwakukulu
• Matenda a shuga a LADA. Autoimmune matenda omwe amakhudza anthu ochulukirapo (zaka 35 mpaka 45). Amapezeka makamaka mwa anthu omwe sangatengeke kwambiri ndi kunenepa kwambiri panthawi ya matendawa. Kuchiza kumafunikira mankhwala a insulin, chifukwa othandizira pakamwa sakubweretsa zomwe zimafunidwa ndipo nthawi zambiri amakhala osathandiza kwenikweni.

Melatonin mu shuga, monga mahomoni aliwonse, ayenera kugwiritsidwa ntchito mosamala. Ndi kugwiritsa ntchito kwakanthawi, mankhwalawa amathandizira kuthana ndi kusowa tulo komanso kukonza mkhalidwe wa wodwalayo.

Koma kutalika kwa nthawi yayitali kumachepetsa hemoglobin ya glycated ndipo kumatha kubweretsa zovuta.

Chifukwa chake, pakuwonekera koyamba kwa vuto la kusalingana kwa mahomoni, muyenera kulankhulana ndi dokotala yemwe adzakupatseni mankhwala omwe akupatsirani chithandizo, mukuganizira za matendawo.