Chiganda chimiro, muviri wehutachiona, hutano hwehutano hwemagetsi uye zvimwe zvipimo zvepanyama zvinodzorwa nemahomoni. Izvo zvinogadzirwa nemaronda anokosha - adrenal glands uye gland pituitary. Kana kushanda kwezvikamu kuchivhiringidzika, kusagadzikana kwemugodhi kunoitika.
Isenko-Cushing syndrome - chii ichocho?
Iyo yakatsanangurwa chirwere (hypercorticosis) iboka rezvirwere umo adrenal cortex inowedzera yakawandisa ye cortisol kana adrenocorticotropic hormone. Zvakakosha kusiyanisa pakati penharo iri kuongororwa uye Cushing's disease. Icho chironda chechipiri chegadziriro ye endocrine, ichikurwisana nechekupedzisira kwezvirwere zve hypothalamus uye gland pituitary.
Cushing's Syndrome - Zvinokonzera
Pane zvinhu zvakawanda zvinokonzera kukanganisa urwere. Zvose zvinokonzera hypercorticism zvinowanzogadzirwa kuva zvitatu:
- exogenous;
- endogenous;
- zvinoshanda.
Exogenous hypercorticosis
Iyi syndrome yaItenko-Cushing inokura pasi pesimba rekunze kwezvinhu. Chikonzero chikuru chekuitika kwaro ndiko kushandiswa kushandiswa kwema hormone glucocorticosteroid. Urwu rudzi rwehutano hunokonzerwa nerapi, naizvozvo inonziwo iatrogenic hypercorticism. Inowanzochengetwa mushure mekugadziriswa - mahomoni ekugadzirira anorayirwa kuti adzivirire hutachiona uye edzivisa kurambwa kwechirongwa chakaiswa. Kurapa hypercorticism kunotangawo nekurapwa kwekugara kusingaperi:
- rheumatoid arthritis;
- bronchial asthma;
- systemic lupus erythematosus.
Endogenous hypercorticosis
Izvi zvakasiyana-siyana zvechirwere zvinoitika nekuda kwekushungurudzika kwemukati mumuviri. Zvimwe zvinokonzera kukurudzirwa ndezvipi zvinotungamirira kusakosha kwe adrenal cortex:
- hyperplasia ;
- kenza;
- benign neoplasm;
- dystrophy.
Kukonzera kukura kwezviputi zvinodarika zvinogona kuva hutano, saka chimwe chezvikonzero zvekubuda kwehupircorticism inotarisa maitiro. Itenko-Cushing's disease inokonzerwawo neoplasms, asi mune dzimwe nhengo:
- pituitary gland;
- ovaries;
- chiedza;
- thymus;
- matete;
- pancreas kana thyroid gland;
- bronchi.
Cushing's pseudo-syndrome
Pane mamiriro ezvinhu umo kuwedzerwa kwekodisoloni yakawandisa kunoitika, asi hapana maitiro ekuvhara hormone muviri. Uyu unoshanda hutano hwe hypercorticism, inowanzoenda neurological and mental pathologies. Nokuda kwekuputsika kunoitwa nekliniki yemifananidzo, zvakafanana zvakakwana nechirwere chechokwadi. Dzimwe nguva pseudo-syndrome Itenko-Cushing anomutsa:
- kuneta;
- pamuviri;
- kudhakwa (kusagadzikana kwenguva refu);
- hypertension ;
- kukanganisa kwekhabhohydrate metabolism.
Kurwara kwaItenko-Cushing - zviratidzo
Chimwe chinhu chikuru che hypercorticism ndiyo kuisa mafuta munzvimbo dzakawanda:
- mutsipa;
- musoro;
- dumbu;
- chifuva.
Nokuda kwekuneta, zvinotaridzika zviri nyore kuona iyo Itenko-Cushing syndrome, zviratidzo zvayo ndeizvi:
- kumativi ose;
- zvisingatauriki zvikamu zviduku kana zvienzaniswa nemuviri;
- ruvara rwepepuru-bhuruu rinotambanudzwa pamakumbo, zviuno, mimba, mapepa;
- kuora mwoyo uye psychosis nekuda kwekuwedzera kwakanyanya uye kuonekwa kusingagutsiki.
Kana pasina mushonga, hutoni hunowedzera nokukurumidza. Kukurudzira kuenderera mberi kweCushing's syndrome, zviratidzo zvaro ndezvi:
- bvudzi rakanyanya kuwedzera mukati mevakadzi (hirsutism munhurume);
- high blood pressure;
- Kusangana kwemwedzi kushungurudzika;
- kusava nesimba;
- myopathy;
- osteoporosis uye inosangana nayo kakawanda kuputsika kwemapfupa;
- headaches;
- kugona;
- kukanganisika kwepfungwa;
- kushaya simba;
- muscle atrophy;
- mimba hernia;
- sweating;
- acne ;
- hyperpigmentation yeimwe nzvimbo dzeganda;
- kuputika kwemupaka;
- zvisizvo zvemuviri masumbu;
- kuderera kwemuitiro wezvirwere zvemuviri;
- bright blush.
Isenko-Cushing syndrome - kuongororwa
Chinhu chikuru chinobvumira kusafungidzira hypercorticism ndiyo zviratidzo zvehutano. Mushure mokuunganidza anamnesis uye kunyatsorongororwa, mupotopinologist anopa ruongororwo rwezvidzidzo kuti aone zvinokonzera zviitiko zvekurapa, kusiyanisa kwezvinorondedzwa zvirwere nezvimwe zvinetso. Cushing's syndrome - diagnostic:
- kuongorora urine neropa pane zvakagadzirwa neorticticosteroid hormones;
- radiography yenharaunda yechigaro cheTurkey nehenya;
- kombiyuta kana magnetic resonance imaging ye pituitary uye adrenal glands;
- dexamethasone samples;
- biochemistry yeropa;
- X-ray yepamusoro uye thorax;
- kugadziriswa kwezvinyorwa zvezere.
Isenko-Cushing chirwere - kurapwa
Maitiro ekurapwa anobva pane zvikonzero zvinokonzera hypercorticism. Nezvinhu zvisingazivikanwi, kuregererwa kwekupedzisira, kuderedzwa kweyero ye glucocorticoids kana kushandiswa kwadzo nemamwe mishonga inoruzhinji inokurudzirwa inokurudzirwa. Mukufananidza, kurwara kwechiratidzo kweItenko-Cushing's disease, chinangwa chekudzorera mitambo yemagetsi uye normalizing muviri wehuremu, inoitwa.
Muchiitiko chekuguma kwekugadzirisa kwekugadzirwa kwecortisol yakawanda, chikonzero chacho chinofanira kubviswa. Iyo chete inoshandiswa kusarudzo muhupo hwemakumbo anokonzera Cushing's syndrome inorapwa. Neoplasm inobviswa, inoteverwa nemirairo uye kwenguva yakareba mushonga wezvinodhaka. Sarudza mapurisa anoshandura iyo inoderedza huwandu hwemakoroni e corticosteroid muropa uye kudzivisa kukanganisa kwavo:
- Mitotane;
- Aminoglutethimide;
- Mammoth nevamwe.
Mukuwedzera, zvakakosha kumisa zviratidzo zvehutano. Kuti uite izvi, shandisa (pakusarudzwa kwemugumo wemagumo):
- Kugadzirira potaasium;
- antihypertensive drugs;
- kudya;
- vitamini uye minerals;
- hypoglycemic mishonga;
- calcitonins;
- bisphosphonates;
- anabolic steroids;
- sedatives;
- antidepressants.
Nutrition ye hypercortisy
Zvokudya hazvibatsiri zvakanyanya kugadziriswa kwekugadzira cortisol, asi zvichaita kuti kuve nekugadzirisa kwemagetsi ekugadzirisa mumuviri. Zvakakosha kuoma zvakanyanya kudzvinyirira hypercorticism - kurapwa kunosanganisira kururamisa kwekudya pamwe nekudziviswa kana kubviswa kwezvinhu zvinotevera:
- margarine;
- mhuka dzemhuka;
- mayonnaise;
- bhotela;
- tsvina;
- munyu;
- nyama yakakora nehove;
- kubika;
- marinades;
- pickling;
- tiki yakasimba nekofi;
- doro;
- sweets.
Kuita kuti chirwere che Itzenko-Cushing chive chakakosha kushandisa:
- mazai;
- yakabikwa mukaka michina;
- hard cheese;
- pasi-fat-fat or vegetarian soups;
- porridge;
- nyama yakabikwa nyama;
- michero nemiriwo;
- greens;
- herbal teas;
- kwete-asidi acid uye zviyo zvinwiwa.
Matambudziko eItenko-Cushing's disease
Ihwo hutano hunofungidzirwa huri nyore kuenderera mberi, pasina kushandiswa kwakakwana kunogona kutungamirira kumigumisiro yakakomba. Chirwere ichi neItenko-Cushing syndrome chinosangana nematambudziko akadaro:
- kurohwa;
- kuderedzwa kwebasa romwoyo;
- sepsis;
- chisingakoshi renal failure;
- rakanyanya pyelonephritis;
- phlegoni;
- kuwanda kwemapfupa;
- kukanganisa kusingagadziriswi kumutsana;
- furunculosis;
- kuumbwa kweminwe nemabwe;
- Fungal uye bhakitiriya maronda ane chironda;
- kupererwa kwepamuviri;
- zvakaoma kuendesa.
Dzimwe nguva chirwere kana chirwere cheItenko-Cushing chinokonzera chirwere chinotyisa zvikuru chinogona kupedza chinouraya-adrenal (adrenal) dambudziko. Zviratidzo zvayo:
- hypoglycemia;
- kurwadziwa kwakanyanya mumimba;
- kurutsa kusingagadzi;
- hyperkalemia;
- kurasikirwa kwekuziva;
- donho rinopinza muropa;
- hyponatremia;
- metabolic acidosis.