Cushing's Syndrome Inokonzerwa neCortisol Yakawedzerwa
Cushing's syndrome chirwere chinowanikwa apo muviri unotarisana ne cortisol yakawanda. Cortisol inokonzerwa nemuviri uye inoshandiswawo mu corticosteroid madhiragi. Cushing's syndrome inogona kuitika nokuti cortisol iri kunyanya kuderedzwa nemuviri kana kubva pakushandisa zvinodhaka zvine cortisol (sainzi prednisone). Apo Cushing's syndrome inokonzerwa nekushandiswa kwenguva refu kwemishonga ye corticosteroid, inonziwo hypercortisolism.
NezveCortisol
Cortisol ndiyo inonyanya kushungurudza hormone. Cortisol yakavanzwa nemadonal glands mukupindura kuvhara kweAdrenocorticotropic hormone (ACTH) neyo pituitary. Chimwe chimiro cheCushing's syndrome chinogona kukonzerwa nekudzvinyirira kweAACTH ne pituitary inotungamirira kuwandisa kwe cortisol.
Cortisol ine mabasa akawanda, kusanganisira mutemo wekutsamwa uye kuraira kuti muviri unoshandisa sei marhydrates, mafuta, uye mapuroteni. Corticosteroids yakadai sa prednisone, iyo inowanzoshandiswa kurapa mamiriro ekuvhiringidza, kuenzanisa migumisiro ye cortisol.
Zvinokonzera Cushing's Syndrome
Pane zvikonzero zvakasiyana-siyana zvakasiyana zveCushing's syndrome.
Cushing's Disease. Chirwere cheCushing ndicho chinokonzera chikonzero cheCushing's syndrome iyo inowanikwa apo pituitary inodzinga ACTH yakawanda, zvichiita kuti cortisol yakawedzerwa iite. Izvi zvinogona kuguma kubva pakuronda kwepituitary kana kumwe kukura.
Iatrogenic Cushing's Syndrome. Kushandiswa kwemaitiro akakwirira emishonga inonzi steroid kwenguva yakareba kunogona kukonzera chimiro cheCushing's syndrome.
Steroid mishonga kana corticosteroid zvinoshandiswa kuporesa zvirwere zvakawanda zvinopesana, kusanganisira asthma, lupus, rheumatoid arthritis, uye chirwere chinoputika (IBD) . Mune zvimwe zviitiko, vanorayirwa pamitambo yakakwirira uye kwenguva yakareba.
Adrenal Gland Tumor. Pakupedzisira, chimwe chinokonzera, kunyange chisingawanzozivikanwi, chinokonzerwa zvakananga nechirwere pamadonal glands.
Aya marudzi emakumbo anokonzera huwandu hwakawanda hwecortisol, husingagumi neAACTH kuburitsa kubva planduri yepituitary. Apo bundu iri riri mune imwe chete yegrenal gland, iyo yakawandisa yakawanda yekortisol yakabudiswa inogona kukonzera kusakanganiswa kwemajoni adrenal kuti atange kuwedzera uye kupera.
Zviratidzo zveCushing's Syndrome
Zviratidzo nezviratidzo zveCushing's syndrome zvinogona kusanganisira zvinotevera:
- acne
- Buffalo hump (mamwe mafuta akaiswa pamusana pemutsipa)
- akakwirira glucose mazinga
- nyota yakawandisa
- kuneta
- kuwedzera kukwira
- headache
- high blood pressure
- hirsutism (kunyanya bvudzi kukura)
- kuenda kumwedzi kuchinja
- Kuninipiswa kwakapoteredza trunk
- zviratidzo zvepfungwa zvakadai sekunetseka kwepfungwa, kushungurudzika, kuzvidya mwoyo, kutya kwekutya
- kumativi ose, chiso chakakwana (inozivikanwa semwedzi chiso)
- ganda rinoshanduka
- kutambanudza marwadzo pamimba, maoko, mazamu, mabheti, uye mahudyu (anonziwo striae)
- kushaya simba
Ikoko kunogona kuva nezvimwe zviratidzo nezviratidzo zvechiitiko ichi chisina kuvharwa pamusoro apa. Zvakakosha kuona chiremba ane zvinetso zvose pamusoro pezviratidzo zveCushing's syndrome.
Kuongororwa kweCushing's Syndrome
Iko kune zvakasiyana-siyana zvemuviri, zvakadai semhepo yakatarisana nemwedzi uye nenyuchi, izvo zvinowanzoonekwa pakati pevanhu vane Cushing's syndrome. Kana chiremba achirangarira Cushing's, mushure mekuitika kwezvakaitika kare, kuongorora muviri, uye basa rekuropa reropa, iye acharonga kuongorora ropa uye urini kuti aone kuwanda kwecortisol iri mumuviri.
Kana mazinga aya ari akakwirira, chiremba angarayira chirwere chinonzi dexamethasone kuderedza test. Ichi chiyero apo steroid yemuromo inonzi dexamethasone inopiwa uye ropa uye urini kuongororwa kunotorwa zvakare kuyera cortisol uye mamwe mahomoni adrenal. Mimwe miedzo inogona kurayirwa kana iyi miedzo yekutanga inodzoka nemigumisiro inoratidza kuti Cushing's syndrome inogona kuva nehanya.
Chiremba angaenda kune imwe nzira yekuedza yakaoma kana kuongorora kwekutanga kunoratidza kuti izvi zvinodiwa. Kana chirwere chikafungidzirwa sechikonzero che Cushing, zvimwe zviedzo zvinogona kurayirwa zvinosanganisira CT scan kana MRI .
Kunyange zvazvo kuedza kunogona kuonekwa sekuita basa rakawandisa kana kusakanganisika, zvakakosha kutevera uye kupedza zvose zvekuedzwa izvo chiremba anorayira.
Mushonga weCushing's Syndrome
Cushing's syndrome inonyatsorapwa nekugadzirisa chinokonzera mazinga akawandisa e-cortisol nekuibvisa.
Cushing's disease. Kuvhiya kunowanzotanga mutsara wokurapa kune varwere vane chirwere cheCushing. Kubviswa kwechirwere chepituitary uye dzimwe nguva yose pituitary gland, kuburikidza nenzira inonzi transsphenoidal resection (mushure mehuno) neurosurgeon inowanzodiwa. Kana iyo pituitary yose inoda kubviswa, zvinowedzera zve cortisol, utachiona, uye mahomoni epabonde achada kupiwa. Kana kuvhiyiwa kunopesana kana kuti chirwere chisingagoni kubviswa, chirwere chemaawa chinogona kushandiswa kupedza tumarara. Kana chirwere chacho chinowanikwa chakaipa , chemotherapy kana kuti rayation inogona kurongerwa kuderedza dambudziko rekudzoka zvakare. Kune mishonga yekurapa inowanikwa mukurapa chirwere chaCushing pamwe chete, kusanganisira Pasireotide (Signifor) uye Mifepristone (Korlym).
Iatrogenic Cushing's syndrome. Kana chirwere ichi chiri kukonzerwa nemishonga yakatemwa, zvakanakisisa kutanga kutora mishonga pasi, inotarisirwa nachiremba, kubvisa steroid yakawandisa. Zvakakosha kuderera zvishoma nezvishoma chiyero che corticosteroid kutorwa kwemavhiki mashoma kana kunyange mwedzi. Imwe mishonga yakasiyana kana chirwere chinogona kuwanikwa kuva chirwere chakakosha chechikonzero chiripo. Zvakakosha kutevera mirairo chaizvoizvo, sezvo steroids isingagoni kumira pakarepo, asi inofanira kunge ichiderera zvishoma nezvishoma.
Kana steroid isingagoni kumira, kana kuti inotora nguva yakareba kuti idzimise, dzimwe nzira dzokurapa dzinogona kupiwa kuti dzishandise zvimwe zviratidzo nezviratidzo zveCushing's syndrome. Zvimwe zvezvinhu zvechirwere ichi zvinogona kudiwa kurapwa nemimwe mishonga uye kuchinja kune kudya kunosanganisira shuga yakakosha yeropa uye yakakwirira cholesterol. Kuderedza mungozi yezviputi nemishonga inoshandiswa kurapa osteoporosis inogonawo kudiwa. Munyaya yekuodzwa mwoyo kana kushungurudzika, kutumira kune unyanzvi hwehutano hwepfungwa kune mushonga unogonawo kubudirira.
Tsananguro Inobva
Mukutenda kwechirwere cheCushing, vanhu vazhinji vanorarama mushure mekuvhiyiwa. Zvimwe zviratidzo zvechirwere zvinogona kupfuurira mushure mekuvhiyiwa, zvakadai sehutachiona, asi izvi zvinowanzogadziriswa nemishonga. Kana chirwere chisingaitike, kunewo marapirwo ehutano anowanikwa anokwanisa kuderedza migumisiro yekuwedzera kortisol.
Cushing's syndrome ingozi yekutora mishonga inonzi steroid, asi hazvina kufanira. Kushandiswa kweSteroid uye kukanganisa kunogona kuenzaniswa nezvipo kunofanira kukurukurwa nachiremba. Cushing's syndrome inogona kurapwa nekuderedza kuwandisa kwematokari ekutorwa, uye nekurapa zvimwe zviratidzo nezviratidzo. Chinangwa chacho nguva dzose kuwana varwere kubva kune steroid nokukurumidza uye sekuchengeteka sezvinobvira.
> Sources:
> Margulies, P. "Adrenal Diseases - Cushing's Syndrome: Chokwadi Chaunofanira Kuziva." National Adrenal Diseases Foundation. 2017.
> National Institutes of Health. "Cushing's Syndrome." National Institute of Diabetes uye Digestive uye Kidney Diseases (NIDDK) Apr 2012.
> Sharma ST, Nieman LK. "Cushing's syndrome: kusiyana kwose, kuonekwa, uye kurapwa." E ndocrinol Metab Clin North Am . 2011 Jun; 40: 379-391, viii-ix. doi: 10.1016 / j.ecl.2011.01.006
> Sharma ST, Nieman LK. Cushing's Syndrome: Zvose zvakasiyana, kuziva, uye kurapa. "Endocrinol Metab Clin North Am. 2011; 40: 379-391. doi: 10.1016 / j.ecl.2011.01.006