Isimo sesikhumba, isisindo somzimba, umsebenzi wesimo senhliziyo neminye imingcele yemvelo ilawulwa ama-hormone. Zakhiwa yizigulane ezikhethekile - izigulane ezibandayo kanye ne-pituitary gland. Uma ukusebenza kwezitho kuphazanyiswa, ukungalingani kwe-endocrine kwenzeka.
Isenko-Cushing syndrome - kuyini?
Isimo esichazwe (i-hypercorticosis) yiqembu lama-pathologies lapho i-cortex ene-adrenal ikhiqiza inani eliningi kakhulu le-cortisol noma i-horrenone ye-adrenocorticotropic. Kubalulekile ukuhlukanisa phakathi kwenkinga okucatshangelwayo nesifo sikaCushing. I-lesion yesibili yesistimu ye-endocrine, ikhula ngokumelene nesizinda sezifo ze-hypothalamus ne-pituitary gland.
I-Cushing's Syndrome - I-Causes
Kunezici eziningana okungenzeka ukuthi ziphulukisa lesi sifo. Zonke izimbangela ze-hypercorticism zihlukaniswa ngezigaba ezintathu:
- okungajwayelekile;
- ukuphelela;
- ukusebenza.
I-hypercorticosis engavamile
Le syndrome ye-Itenko-Cushing iqala ngaphansi kwethonya lezinto zangaphandle. Isizathu esiyinhloko sokwenzeka kwayo ukusetshenziswa okuqhubekayo kwama-hormone glucocorticosteroid. Lolu hlobo lwe-syndrome lubangelwa ukwelashwa, ngakho-ke libizwa nangokuthi iatrogenic hypercorticism. Kuvame ukugcinwa emva kokufakelwa kwesitshalo - ama-hormonal amalungiselelo anqunyelwe ukuvimbela ukuzivikela komzimba nokuvimbela ukwenqatshwa kwendikimba yokufakelwa. I-hypercorticism yezokwelapha iqala futhi ngokuphathwa kwezibilini ezingelapheki:
- i-arthritis ye-rheumatoid;
- i-asthma ye-bronchial;
- i-systemic lupus erythematosus.
I-hypercorticosis endogenous
Lokhu okuhlukile kwesifo kwenzeka ngenxa yezifo zangaphakathi emzimbeni. Izimbangela eziyinhloko zentuthuko yizimo eziholela ekusebenziseni ukungasebenzi kwe-cortex ephezulu:
- i-hyperplasia ;
- umdlavuza;
- i-neoplasm ene-benign;
- i-dystrophy.
Ukuvusa ukukhula kwezidumbu ezinzima kungaba yindlalifa, ngakho-ke esinye sezici zokuvela kwe-hypercorticism yisimo esithile sokuzalwa kwezakhi zofuzo. Isifo sika-Itenko-Cushing nayo ibangelwa ama-neoplasms, kodwa kwezinye izitho:
- i-pituitary gland;
- ama-ovaries;
- ukukhanya;
- i-thymus;
- amacici;
- i-pancrea noma ingubo ye-thyroid;
- i-bronchi.
I-Cushing's pseudo-syndrome
Kunezimo lapho kutholakala ukukhiqizwa kwe-cortisol ngokweqile, kodwa azikho izicubu zokuvimbela ama-hormone emzimbeni. Lesi yisifo esisebenzayo se-hypercorticism, ngokuvamile ihambisana ne-pathologies yengqondo neyengqondo. Ngenxa yokwephulwa okuvezwe isithombe somtholampilo, kufana nesifo sangempela. Ngezinye izikhathi izidakamizwa-izifo zakwa-Itenko-Cushing zivusa:
- ukukhuluphala;
- ukukhulelwa;
- ukuphuza ngokweqile (ukuphuza ngokweqile);
- i-hypertension ;
- ukwephulwa kwe-carbohydrate metabolism.
Ukugula kuka-Itenko-Cushing - izimpawu
Isici esiyinhloko sokuxoshwa kwe-hypercorticism ukufakwa kwamafutha ezindaweni eziningana:
- intamo;
- ikhanda;
- isisu;
- isifuba.
Ngenxa yokukhuluphala, kubonakala kube lula ukubona i-Itenko-Cushing syndrome, izimpawu zazo zilandelayo:
- ubuso obunzima;
- izingalo ezincane ngokungafani uma kuqhathaniswa nomzimba;
- iluhlaza okwesibhakabhaka-oluhlaza okwesibhakabhaka lisezintweni, emaceleni, esiswini, emahlombe;
- ukucindezeleka nokucindezeleka kwengqondo ngenxa yesisindo esiningi nokubukeka okunganelisi.
Uma kungekho ukwelashwa, isizinda se-hormonal siphume ngokushesha. Ukuthuthukisa i-Cushing's syndrome eqhubekayo, izimpawu zazo ziyi:
- ukunweba izinwele ngokweqile kwabesifazane (i-hirsutism ngohlobo lwesilisa);
- umfutho wegazi ophezulu;
- ukuphazamiseka komjikelezo wesisindo;
- ukungabi namandla;
- ukuzithemba;
- ukuphefumula kwesifo sofuba futhi kuhambisana nokuwohloka kwamathambo njalo;
- ikhanda;
- ukulala;
- ukuphazamiseka kwengqondo;
- ubuthakathaka;
- i-muscle atrophy;
- i-hernia yesisu;
- ukuthuthumela;
- i-acne ;
- ukugxila kwezinye izindawo zesikhumba;
- ukuvuthwa komgogodla;
- imisipha yomzimba engavamile;
- ukwehla komzimba wesimiso;
- ukukhanya okukhanyayo.
Isenko-Cushing syndrome - ukuxilongwa
Isici esiyinhloko evumela ukuthi umuntu asolise ukucwaswa yizimpawu ze-pathology. Ngemuva kokuqoqa i-anamnesis nokuhlolwa okuphelele, i-endocrinologist inikeza uchungechunge lwezifundo ukucacisa izimbangela zezenzakalo zemitholampilo, ukuhlukaniswa kwezifo ezichazwe kanye nezinye izifo. I-Cushing's syndrome - ukuxilongwa:
- ukuhlaziywa komchamo negazi kokuqukethwe kwama-hormone e-corticosteroid;
- i-radiography yesifunda se-saddle ne-skull yaseTurkey;
- ikhompiyutha noma i-magnontic resonance imaging yama-pituitary ne-adrenal glands;
- amasampuli e-dexamethasone;
- i-biochemistry yegazi;
- I-X-ray yomgogodla ne-thorax;
- ukudweba kwezinhlayiya ze-adrenal.
Isenko-Cushing syndrome - ukwelashwa
Amaqhinga wezokwelapha ancike kwizimbangela ezibangelwa ukuxuba. Ngezici ezingavamile, ukukhanselwa kancane kancane, ukunciphisa umthamo we-glucocorticoids noma ukushintshwa kwazo nezinye izidakamizwa zokuzivikela kunconywa. Ngokufanayo, ukwelashwa okuphawulekayo kwesifo se-Itenko-Cushing, okuhloswe ngaso ukubuyisela izinqubo zesimiso somzimba nokujwayelekile kwesisindo somzimba, kwenziwa.
Uma kwenzeka umsuka wokugcina wokukhiqiza kwe-cortisol ngokweqile, imbangela yayo kufanele isuswe. Okuwukuphela kokukhetha okusebenzayo phambi kwamathumba okuvusa ukucindezeleka kwe-Cushing's syndrome. I-neoplasm isusiwe, ilandelwa yimisebe kanye nokwelapha isikhathi eside. Khetha ama-pharmacy ehlisa ukunciphisa ama-hormone e-corticosteroid egazini futhi agweme ukukhiqizwa kwawo:
- IMototane;
- Aminoglutethimide;
- Amammoth nabanye.
Ngaphezu kwalokho, kubalulekile ukuyeka izimpawu ze-pathology. Ukuze wenze lokhu, sebenzisa (ekukhethweni kwe-endocrinologist):
- amalungiselelo we-potassium;
- izidakamizwa ezinamandla;
- ukudla;
- amavithamini namaminerali;
- imithi ye-hypoglycemic;
- i-calcitonins;
- bisphosphonates;
- i-anabolic steroids;
- ukuxhuma;
- ukucindezeleka.
Ukudla okunomsoco we-hypercortisy
Ukudla akusizi kakhulu ukunciphisa ukukhiqizwa kwe-cortisol, kodwa kuzoqinisekisa ukuthi kusetshenziselwa izinqubo zamathambo emzimbeni. Kubalulekile ukucindezela ngokucindezela ukucindezeleka - ukwelashwa kubandakanya ukulungiswa kokudla kanye nokuvinjelwa noma ukukhishwa kwemikhiqizo elandelayo:
- i-margarine;
- amafutha ezilwane;
- imayonnaise;
- ibhotela;
- imikhiqizo yokubhema;
- usawoti;
- inyama enenhlanzi nenhlanzi;
- ukupheka;
- izimoto zemikhumbi;
- ukukhethwa;
- itiye eliqinile nekhofi;
- utshwala;
- amaswidi.
Ukusiza i-Itzenko-Cushing syndrome kubalulekile ukusebenzisa:
- amaqanda;
- imikhiqizo yobisi evutshiwe;
- ishizi enzima;
- isobho esincane noma sama-vegetable;
- iphalenda;
- inyama yokupheka ebilisiwe;
- izithelo nemifino;
- imifino;
- i-herbal teas;
- ama-compotes angewona ama-acid neziphuzo zezithelo.
Izinkinga zesifo sika-Itenko-Cushing
I-pathology ecatshangelwayo ijwayele ukuqhubekela phambili, uma kungekho ukwelashwa okwanele kungabangela imiphumela embi. Lesi sifo kanye ne-Itenko-Cushing syndrome zihlobene nezinkinga ezinjalo:
- ukushaywa;
- ukuchithwa kwemisebenzi yenhliziyo;
- i-sepsis;
- ukwehluleka kwezintuthwane ezingapheli;
- i-pyelonephritis enamandla;
- i-phlegmon;
- ukuqubuka kwamathambo amaningi;
- umonakalo ongaphenduki emgodini;
- i-furunculosis;
- ukwakheka kwamatshe ezinso;
- Izilonda zesikhumba ze-fungal ne-bacterial nge-suppuration;
- ukukhulelwa kwesisu;
- ukulethwa okunzima.
Ngezinye izikhathi isifo noma isifo sika-Itenko-Cushing sibangela isimo esiyingozi kakhulu esingagcina isifo esibuhlungu - esiyingozi (adrenal). Izimpawu zalo:
- i-hypoglycemia;
- ubuhlungu obukhulu esiswini;
- ukuhlanza okungenakulungiswa;
- i-hyperkalemia;
- ukulahlekelwa kokuqonda;
- ukudonsa okubukhali ekucindezeni kwegazi;
- i-hyponatremia;
- i-acidosis ye-metabolic.