Adrenal hyperplasia - ndichiyani? Zizindikiro ndi mankhwala a matenda

Endocrinologists mu zawo nthawi zambiri anakumana ndi kuvutika mu impso. Adrenal hyperplasia - ndichiyani? Impso - wophatikizidwa limba, ndi zopangitsa adrenal zili pamwamba chabe yotere glandular. Pali anapanga koyenera kuti mahomoni thupi (zikuwonjezereka masiku ano, noradrenaline, glucocorticoids, ndi kugonana). Hyperplasia akuphwanya mahomoni lamanja, ndi ichi limodzi ndi zizindikiro zosiyana.

Adrenal hyperplasia - ndichiyani?

Pamene adrenal minofu hyperplasia selo wophatikizidwa zopangitsa pang'onopang'ono zambiri, thupi kwambiri mu kukula, ngakhale akuzisunga mawonekedwe yake. Adrenal medullary mankhwala imakhala ndi khungwa.

Kawirikawiri amakhudza adrenal kotekisi hyperplasia, pali akufotokozera ndondomeko pathological. Various chotupa zambiri anapezeka ku medulla lapansi.

Kumaonetsa matenda pa m'badwo uliwonse pa amuna ndi akazi ndi ana.

Kobadwa nako adrenal hyperplasia opezeka mu mankhwala zambiri. Kawirikawiri amanyamula cholowa, koma kudzali zingapo za zinthu zina chokhwima m'banja kapena kunja. Monga ofanana kudwala ndi wapezeka odwala ndi matenda Cushing a (40% milandu) syndrome. syndrome Izi kawirikawiri anapezeka mu m'badwo pakati ndi akale.

Izi kudwala kwambiri sangathe kuwasamalira. Pamene hyperplasia ndi akusokoneza ulimi wa mahomoni kutero. Mu akazi, zimayambitsa osabereka. Pali mitundu ingapo ya matenda: nodular hyperplasia ya England adrenal, nodular, akakufunsani, kobadwa nako ndi micronodular, ndi hyperplasia wa miyendo medial. Nthawi zambiri matenda amapezeka akazi.

Zimayambitsa matenda

Amachititsa zizindikiro kuonekera pamene adrenal hyperplasia ana, amuna kapena akazi akhale osiyana. Zonse zimadalira mtundu wa matenda. Hyperplasia amatanthauza munthu wa mtundu, kungakhale idiopathic, solteryayuschey, virility.

Pamene pali yogwira mtundu hypertensive yopanga androgens ndi mineralocorticoids, ntchito ngati anapotoza pa zotengera aimpso ndi fundus, nthawi zambiri kumayambitsa matenda oopsa.

Pamene solteryayuschem mtundu hyperplasia kuchuluka kupanga androgen, motero pali kusowa mahomoni ena mwa kotekisi adrenal. Zimakwaniritsidwa hyperkalemia kapena hypoglycemia. Kuopsa ndi thupi limafooka, kuonda.

Pamene virilnoe mtundu hyperplasia chinsinsi androgen superaktiven. maliseche kunja kwambiri kuchuluka kukula, pali ziphuphu zakumaso, kuchuluka thupi tsitsi, musculature kwambiri anayamba lalikulu zedi.

Choyamba kudwala konse kumayamba patsogolo chifukwa katulutsidwe kuchuluka kwa timadzi steroid. Anapeza mtundu wa matenda ali zifukwa zingapo chinsinsi chake adanyamuka:

• kagayidwe kachakudya chisokonezo;
• nkhawa amphamvu;
• matenda Cushing ndi;

Kobadwa nako adrenal hyperplasia chifukwa chakuti ngakhale woyembekezera, nthawi gestation, kusintha zinchito kukhala. Wina malingaliro - kufala kwa matenda pa mlingo chibadwa. Zinthu n'zothandiza mawonetseredwe a zizindikiro za matenda: a wonongeka ya ubongo imene imalamulira kutentha ndi pituitary kuvutika pa mlingo majini, ndi titadziwa kudziyimira pawokha kotekisi wophatikizidwa zopangitsa tinalandira kwa makolo awo.

hyperplasia nodular

Madokotala kugawanitsa kupitirira wa hyperplasia adrenal m'magulu angapo monga mwa chithunzi matenda, komanso mtundu wa otaya.

Nodular adrenal hyperplasia. fomu iyi ndi cholowa. Nthawi zambiri anapezeka okalamba, zikuchitika ndi nthawi. Pochititsa matenda kuwululidwa mbali khalidwe - pa makungwa a tinatake tozungulira adrenal anapanga. Iwo akhoza kukhala angapo (lobed dongosolo) ndi umodzi, mpaka 4-5 cm. Mpatuko syndrome Cushing a. The kudwala chifukwa kukondoweza amphamvu timadzi adrenocorticotropic, ndi apanga mu pituitary England. Mbali yaikulu ya hyperplasia nodular ndi matenda Cushing ndi awa:

• mutu;
• "Ntchentche" pamaso pa;
• kupweteka;
• chizungulire;
• ambiri malaise;
• kunenepa (makamaka m'mimba, khosi, nkhope);
• kuchuluka kudya;
• kutambasula malikisi pa khungu;
• ziphuphu zakumaso;
• hirsutism (akazi);
• osauka kusinthika;
• hyperpigmentation;
• kuthamanga magazi;
• pafupipafupi fractures;
• maganizo.

akakufunsani hyperplasia

Mu mawonekedwe a Prostate hyperplasia sanasinthe kake, kuwonjezeka pang'onopang'ono. Koma pa nthawi yomweyo iwo apanga tinatake tozungulira. Kudziwa mtundu wa matenda ndi zovuta. Mu njira muyezo wa Kupeza Vuto ultrasound palibe chifukwa. Kusintha mu thupi zimapezeka kokha pa Kujambula kapena CT. Nthawi zambiri kukhala mitundu hybrid, zimachitika pamene zizindikiro zotsatirazi: adrenal hyperplasia mu akazi nthawi zambiri kumayambitsa kuwonjezeka mu tsitsi thupi, akuwonetseredwa kuukira, matenda oopsa, kunenepa mantha. M'madera ena pamakhala zinthu zowonongeka glomerular ndi kukhala amgwirizano hyperplasia.

The kudwala wa aldosteronism idiopathic zachokera kuwonjezeka aldosterone katulutsidwe. Pamene hyperplasia glomerular zone akusonyeza zizindikiro zotsatirazi: oopsa, khunyu, kufooka kwa thupi, malire a kayendedwe, kuuma uko kwa ziwalo, ludzu, kuchuluka mkodzo linanena bungwe, usiku pokodza. Violation zimayambitsa kuwonjezeka potaziyamu magazi, acidosis. Kuthamanga magazi zimawonedwa zonse.

Nodular ndi kobadwa nako mitundu

mawonekedwe Nodular zambiri m'kati mwa ana ndi achinyamata. Chingathe kuonekera chifukwa cha monyanyira kapena ntchito adrenal chifukwa ambiri osokoneza wa glucocorticoids. mbali kiyi wa mawonekedwe nodular: osasamba madipoziti mafuta, minofu ya manja, mtundu wa khungu, zizindikiro za matenda a shuga, kuwonongeka kwa mitsempha ndi mtima, kufooka kwa mafupa. Ngati zizindikiro ana a matenda wapezeka mu nthawi ikuchitika mankhwala m'thupi, kuti madokotala ananena zawo bwino. Hyperplasia ya kumanzere adrenal England - ndichiyani? Pankhaniyi, hyperplasia sikudalira zochita za mahomoni. Pamene kumera zotupa zazikulu kuposa 3 cm ntchito chofunika. Laparoscopy ntchito kapena malinga Fedorov njira lyumbotomicheskim kupeza peritoneum ya kumanzere.

Kobadwa nako adrenal hyperplasia (VDKN) amawapeza zambiri kuposa mitundu ina. Makanda opezeka pa pafupipafupi 1 mpaka 12 chikwi. Mu chikhalidwe ichi, ndi mwana noticeable kagayidwe kachakudya ndi maonekedwe. Pali njira zitatu zikuluzikulu zomwe (sanali Agiriki, yosavuta chakale, virility ndi solteryayuschaya.

The yofala kwambiri ndi solteryayuschaya. Akuwonetseredwa mu atsikana ngati onyenga germofroditizm, anyamata mdima khungu padziko scrotum ndi, umachuluka mbolo kukula. Kwa odwala yodziwika ndi kukula otsika ndi zizindikiro monga kugona, nseru, ulesi, kuthamanga otsika magazi, madzi m'thupi, kusafuna chakudya. Matendawa amafunika chithandizo ndi masiku oyamba a kukhalapo, kapena imfa zotheka.

Mu mawonekedwe chakale saposa zizindikiro, koma pali kuwonjezeka mu kaphatikizidwe mahomoni mwamuna kugonana. Ngati matenda si ankachitira, mavuto zina zimachitika akazi a umoyo wogonana ndi m'maganizo.

Mawonekedwe sanali chakale limapezeka akazi ndi achinyamata wamkulu. Madandaulo waukulu kukhala osabereka, kulephera kupita kumwezi, hirsutism ndi ziphuphu zakumaso.

Adrenal hyperplasia: zizindikiro ambiri

Nthawi zambiri, ana, amuna ndi akazi mwaona achotsa mawonekedwe a matenda, pamene pali popanda zizindikiro kutchulidwa, mu Zikatero n'zovuta matenda a. mawonekedwe kobadwa nako akufotokozera ana kale pa chaka loyamba ndi lachiwiri la moyo.

Ambiri, adrenal hyperplasia (icho chiri, ife kale anafotokoza) ali zotsatirazi zizindikiro zazikulu:

• wosakhazikika magazi (otsika kapena mkulu);
• mayendedwe a ikuyendera shuga;
• kulemera kuwonjezeka;
• maonekedwe a kufooka kwa mafupa;
• dzanzi minofu, manja awo wotsatira;
• Akazi "mwezi ngati nkhope";
• kuwonongeka kwa chikumbukiro;
• kusokonezeka wamanjenje;
• mtundu;
• kutambasula malikisi pa khungu;
• chisokonezo thirakiti m'mimba;
• kutsitsa chitetezo chokwanira;
• nocturnal amasulidwe mkodzo;
• kwambiri ludzu;
• psychoses;
• osabereka;
• amenorrhea;
• osati msinkhu mkulu kukula;
• zikuzimiririka pang'onopang'ono hairline m'dera kanthawi;
• hirsutism.

Amuna ndi akazi amasiyana zizindikiro matenda a matenda.

Malangizo chithandizo

Chifukwa cha mankhwala Ndithu mankhwala m'thupi. Asayansi sanasankhebe mmene zinthu pa hyperplasia adrenal. Chithandizo kawirikawiri pamodzi. Achinyamata amapatsidwa njira yomwe matenda mawu a makhalidwe sekondale kugonana, atsikana wasonyeza estrogens ndi anyamata - androgens.

Ntchito pa matenda a osakaniza a glucocorticoids:

• cortisone nthochi;
• hydrocortisone;
• dexamethasone;
• prednisolone.

Masana wodwala amalandira 2 kapena 3 Mlingo wa mahomoni (mu mulingo ofanana). Akaundula ndi 5% shuga njira. Atsikana, mosiyana ndi anyamata, moyo onse ali kukonzekera zofunika.

Kwa wodwala aliyense dokotala ayenera kupeza njira yapadera imene njira zake chithandizo (izo zonse zimadalira zimene zinamuchitikira ndi nzeru). Single mankhwala mankhwalawa matenda kulibe.

Kobadwa nako hyperplasia wa kotekisi adrenal aakulu ankachitira madokotala. Pali milandu kuti kumaliseche sangathe kusiyanitsidwa monga mkazi kapena mwamuna. Kwa atsikana Ndi bwino pulasitiki ndi mawonekedwe osasamba wa labia lapansi. Kale mu chaka choyamba cha moyo amasonyeza ntchito zimenezi, nthawi zina (mu chikhalidwe chaukali) izo ikuchitika ina. Pangani ntchito ndi zotupa.

Ngati thupi silingathe mchere, wodwala ayenera kuwonjezera mlingo tsiku la magalamu 1-3. Nchitozi Zikatero, ndipo mineralocorticoid.

Akakufunsani hyperplasia mankhwala mankhwala alibe zotsatira kwambiri. Ndi chofunika Zikatero adrenalectomy. chithandizo osamveka ndi aldosteroma pamene pamodzi hyperplasia akakufunsani. The Mapa ndi zovuta. Phunziro la kusankha ndi mankhwala mankhwala ndi zona glomerulosa amgwirizano hyperplasia (idiopathic hyperaldosteronism). Opaleshoni Pankhaniyi - ndi muyeso kwambiri.

The chamankhwala chodalirika chithandizo IGA - kulandira spironolactone, ndi antagonist wa aldosterone. Wogwira ndi eplerenone mankhwala. Spironolactone nthawi zambiri anatengedwa osakaniza ndi antagonist calcium. Ngati zizindikiro pano wolumikizira oopsa, mankhwala ndi zoletsa Ace chikugwirizana.

Mu nkhani ya phwando virilization mankhwala kukonza nthawi zonse. Ngati mtundu wa hyperplasia adrenal amatanthauza virilizing, kodi kukhala poika tochepa. Thiabendazole angagwiritsidwe ntchito ngati jekeseni mu mnofu. Mlingowu anatola dokotala. Kwa ana okulirapo akhoza kugwiritsa ntchito prednisolone.

Ngati palibe mankhwalawa hyperplasia ndi zingachititse kuti chitukuko cha matenda Kona kapena matenda Cushing a. Pambuyo matenda mankhwalawa ayenera kuyamba pomwepo.

matenda a matenda

Adrenal hyperplasia - ndichiyani? Kodi matenda ya? Nodular ndipo akakufunsani hyperplasia wapezeka mu njira ya kafukufuku zoimbidwa ndi zasayansi. The diagnostics monga: kafukufuku mtima, Kupenda thupi, Kupenda matenda, Kupenda radiological kapena chapamwamba kwambiri radionuclide chindodo. Malinga ndi zotsatira imawunikidwa phindu, ndi mawonekedwe a zopangitsa onse adrenal. Radioimmunoassay anachita kafukufuku zasayansi. Anatsimikiza mu mkodzo ndi magazi tochepa. Kuti aone mmene alili m'thupi, gwirani-zogwirizana immunosorbent zofufuza. Nthawi zina m'pofunika kuchita kukhumba puncture.

Malinga ndi zotsatira za matenda dokotala poyera matenda ndipo anapereka njira yoyenera kwambiri mankhwala.

Hyperplasia akulu: chochita?

Kawirikawiri ofuntha wa kotekisi adrenal amapezeka mu wakhanda, koma zizindikiro za matenda kuoneka akuluakulu. adrenal hyperplasia azimayi amakhala ndi kukula mkulu wa tsitsi obisika, mawu kwambiri, ziphuphu, kupweteka kumbuyo kwa mutu, khunyu nocturnal, kudyetsa osauka, kuthamanga magazi, adrenal syndrome.

Ngati inu nokha mu zizindikiro, musayese oterewa nokha. Nthawi izi kuthandiza ndi mankhwala wowerengeka. Modzipereka kuthetsa kwa madokotala. M'pofunika mankhwala m'thupi. Kawirikawiri, akazi ndi matenda otere osavomerezeka kukonza mimba. Nthawi zambiri, ngakhale zoletsedwa kubereka. Nthawi yabwino yothetsera vutoli - kuwonongedwa kwathunthu kwa impso matenda, ndi zokhudzana zake zonse.

kupewa

Kodi adrenal hyperplasia - makamaka ayenera kudziwa mabanja amene anakonza kubadwa kwa mwana ndi banja iwo (majini) ndi milandu hyperplasia kobadwa nako. Chonde amatchula geneticists - aluso odziwa akatswiri. Pakuti kupewa matenda ayenera kupanga matenda a perinatal (imene mwana akadali osauka ndipo m'mimba mwa mayi). Mu trimester mimba ikuchitika chorionic villus zitsanzo zosankhidwazi. Mu theka lachiwiri la kusanthula ofunikira madzimadzi amniotic, umene kudziwa mlingo wa mahomoni.

Yankho - lidzawagwiritsenso. Pankhaniyi, mukhoza kupanga kuyambirira majini kusanthula maselo nyongolosi pamaso iwo ukala.

Pa gestation akazi anapezeka ndi hyperplasia akhale moyang'aniridwa nthawi zonse dokotala nthawi zonse mayeso onse chofunika. Tisawasale moyo wa zinthu zonse zitheka poizoni ndi zotsatira cheza.

Pakuti kupewa hyperplasia adrenal amasewera yofunika ndi kuyezetsa magazi mayesero kuchitidwa mu khanda. Pakuti kuwunika m'pofunika kutenga magazi kuchokera capillary (a malo osankhidwa puncture chidendene mwana).