Syndrome isina kukodzera antidiuretic hormone secretion

Syndrome isina kukodzera antidiuretic hormone secretion (SIADH) mamiriro umo muviri unoita yakawandisa antidiuretic hormone (ADH). Iyi hormone inobatsira itsvo kudzora huwandu hwemvura inorasikirwa nemuviri wako kuburikidza neweti. SIADH inokonzeresa kuti muviri uchengete mvura yakawandisa.

ADH chinhu chinogadzirwa zvakasikwa munzvimbo yeuropi inonzi hypothalamus. Inobva yaburitswa nepituitary gland iri pasi peuropi.

Pane zvikonzero zvakawanda nei muviri uchida kugadzira yakawanda yeADH. Mamiriro ezvinhu akajairika kana ADH yaburitswa muropa iyo payisingafanirwe kugadzirwa (isina kukodzera) inosanganisira:

• Mishonga, yakadai seimwe mhando 2 chirwere cheshuga, zvinodhaka, mishonga yekudzvinyirira, moyo uye BP, zvinodhaka, gomarara, anesthesia
• Kuvhiya pasi peanesthesia
• Kukanganiswa kwehuropi, sekukuvara, kutapukirwa, sitiroko
• Kuvhiya kwehuropi mudunhu reiyo hypothalamus
• Zvirwere zvemapapu, zvakadai semabayo, tibhii, gomarara, hutachiona husingaperi

Kazhinji zvikonzero zvinosanganisira:

• Zvirwere zvisingawanzo zveiyo hypothalamus kana pituitary
• Kenza yemapapu, ura hudiki, rwatata, huropi, leukemia
• Matambudziko epfungwa

NeSIADH, weti yakanyanyisa kukosheswa. Haina kukwana mvura inoburitswa uye kune mvura yakawandisa muropa. Izvi zvinosanganisa zvinhu zvakawanda muropa senge sodium. Ropa rakaderera rerodium ndiyo inonyanya kukonzera zviratidzo zveADH yakawandisa.

Kazhinji, hapana zviratidzo kubva kune yakaderera sodium chikamu.

Kana zviratidzo zvikaitika, zvinogona kusanganisira chero zvinotevera:

• Kusvotwa uye kurutsa
• Kutemwa nemusoro
• Matambudziko nekuenzanisa izvo zvinogona kukonzera kudonha
• Shanduko dzepfungwa, senge nyonganiso, matambudziko ekurangarira, hunhu husingazivikanwe
• Kufenda kana coma, mune zvakakomba zviitiko

Mutapi wezvehutano anozoongorora zvizere muviri kuti abatsire kuziva chinokonzera zviratidzo zvako.

Lab miedzo iyo inogona kusimbisa uye kubatsira kuongorora yakaderera sodium inosanganisira:

• Inonzwisisika metabolic pani (inosanganisira ropa sodium)
• Osmolality yeropa bvunzo
• Weti osmolality
• Weti sodium
• Toxicology inojekesa mimwe mishonga
• Unogona kuda zvidzidzo zvekufungidzira zvakaitirwa mapapu madiki uye huropi Lung uye bvunzo dzekufungidzira muvana vanofungidzirwa kuti vane SIADH

Kurapa kunoenderana nechinokonzera dambudziko. Semuenzaniso, kuvhiya kunoitwa kubvisa bundu rinogadzira ADH. Kana, kana mushonga uri iwo chikonzero, iwo madhiri anogona kuchinjwa kana mumwe mushonga ungayedzwe.

Muzviitiko zvese, danho rekutanga kudzora kunwa kwemvura. Izvi zvinobatsira kudzivirira kuwanda kwemvura kubva pakuvaka mumuviri. Wako mupi achakutaurira izvo zvaunofanira kuita zuva nezuva zvekushandisa mvura.

Mishonga inogona kudikanwa kuvhara mhedzisiro yeADH pane itsvo kuitira kuti mvura yakawandisa ibudiswe neitsvo. Iyi mishonga inogona kupihwa semapiritsi kana majekiseni anopiwa mutsinga (intravenous).

Mhedzisiro inoenderana nemamiriro ari kukonzera dambudziko. Yakaderera sodium iyo inoitika nekukurumidza, mumaawa asingasviki makumi mana nemasere (acute hyponatremia), ine njodzi kupfuura yakaderera sodium iyo inokura zvishoma nezvishoma nekufamba kwenguva. Kana mwero we sodium paunowira zvishoma nezvishoma pamusoro pemazuva kana mavhiki (chisingaperi hyponatremia), maseru ehuropi ane nguva yekugadzirisa uye zviratidzo zvakakomba senge kuzvimba kwehuropi hazviitike. Chirwere hyponatremia inosanganisirwa nematambudziko ehurongwa hwehurombo senge hurombo hwakaringana uye ndangariro yakaipa. Zvakawanda zvinokonzera SIADH zvinodzoserwa.

Muzviitiko zvakakomba, yakaderera sodium inogona kutungamira ku:

• Kuderera kwekuziva, kuona zvisizvo kana coma
• Brain herniation
• Rufu

Kana mwero wemuviri wako uchidonha zvakanyanya, inogona kuve inotyisa hupenyu. Fonera waunopa ipapo ipapo kana uine zviratidzo zveichi chiitiko.

SIADH; Chakavanzika chisina kukodzera cheantidiuretic hormone; Syndrome yekusakodzera ADH kusunungurwa; Syndrome yeasina kunaka antidiuresis

Hannon MJ, Thompson CJ. Vasopressin, chirwere cheshuga insipidus, uye chirwere cheasina kukodzera antidiuresis. Muna: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Vakuru uye Chiremba. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits.

Verbalis JG. Kukanganiswa kwemvura yakaringana. Mune: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner uye Rector Iyo Itsvo. 10th ed. Philadelphia, PA: Elsevier; 2016: chits.