Cushing chirwere

Cushing chirwere chiitiko mune iyo pituitary gland inoburitsa yakawandisa adrenocorticotropic hormone (ACTH). Iyo pituitary gland inhengo yeiyo endocrine system.

Cushing chirwere chimiro cheCushing syndrome. Mamwe mafomu eCushing syndrome anosanganisira exogenous Cushing syndrome, Cushing syndrome inokonzerwa nedrenal tumor, uye ectopic Cushing syndrome.

Cushing chirwere chinokonzerwa nebundu kana kuwanda kukura (hyperplasia) yeiyo pituitary gland. Iyo pituitary gland iri pazasi pezasi pezasi pehuropi. Rudzi rwepituitary bundu inonzi adenoma ndiyo inonyanya kukonzera chikonzero. Adenoma ibundu rinotapira (kwete kenza).

NeCushing chirwere, iyo pituitary gland inoburitsa yakawandisa ACTH. ACTH inokurudzira kugadzirwa uye kuburitswa kwecortisol, inoshungurudza mahormone. Yakawandisa ACTH inokonzera adrenal glands kuti iite yakawandisa cortisol.

Cortisol inowanzo kuburitswa panguva yekushushikana. Iyo zvakare ine mamwe akawanda mabasa, kusanganisira:

• Kudzora kushandiswa kwemuviri wemakabohydrate, mafuta, uye mapuroteni
• Kuderedza immune system kupindura kuzvimba (kuzvimba)
• Kudzora kukanganiswa kweropa uye chiyero chemvura yemuviri

Zviratidzo zveCushing chirwere zvinosanganisira:

• Kuwedzera muviri kufutisa (pamusoro pechiuno) uye maoko matete nemakumbo
• Denderedzwa, tsvuku, izere kumeso (kumeso kwemwedzi)
• Inononoka kukura mwero muvana

Kuchinja kweganda kunowanzoonekwa kunosanganisira:

• Acne kana hutachiona hweganda
• Purple yakatambanudza mamaki (1/2 inch kana 1 sentimita kana kupfuura yakafara), inonzi striae, paganda redumbu, zvidya, kumusoro maoko, uye mazamu
• Ganda rakatetepa nekupwanya kuri nyore, kazhinji pamaoko nemaoko

Tsandanyama uye pfupa shanduko dzinosanganisira:

• Backache, inoitika nemabasa enguva dzose
• Kurwadziwa kwepfupa kana hunyoro
• Unganidzo yemafuta pakati pemapfudzi (nyati hump)
• Kupera simba kwemapfupa, ayo anotungamira kumbabvu uye musana kutsemuka
• Tsvina dzisina kusimba dzinokonzera kusagadzikana kwekurovedza muviri

Vakadzi vanogona kuva:

• Bvudzi rakawandisa kukura kumeso, mutsipa, chifuva, dumbu, uye zvidya
• Kuenda kumwedzi kunova kusinganzwisisike kana kumira

Varume vanogona kuva:

• Yakadzikira kana isina chishuwo chebonde (yakaderera libido)
• Matambudziko ekugadzirisa

Zvimwe zviratidzo kana matambudziko anogona kusanganisira:

• Pfungwa shanduko, senge kushushikana, kushushikana, kana shanduko mumaitiro
• Kuneta
• Kakawanda zvirwere
• Kutemwa nemusoro
• Kuwedzera nyota uye kuita weti
• Kuwedzera kweropa
• Chirwere cheshuga

Anopa hutano anozoongorora muviri uye obvunza nezve zviratidzo zvako.

Kuyedza kunoitwa kutanga kuratidza kuti pane cortisol yakawandisa mumuviri, uyezve kuona chikonzero.

Iyi bvunzo inosimbisa yakawandisa cortisol:

• 24-awa weti urisortis
• Dexamethasone kudzvinyirira bvunzo (yakaderera dosi)
• Salivary cortisol mazinga (mangwanani-ngwanani uye pakati pehusiku)

Aya bvunzo anoona chikonzero.

• Ropa ACTH mwero
• Ubongo MRI
• Corticotropin-inosunungura mahormone bvunzo, iyo inoshanda pane iyo pituitary gland kukonzera kusunungurwa kwe ACTH
• Dexamethasone kudzvinyirira bvunzo (yakakwira dosi)
• Yakaderera petrosal sinus sampling (IPSS) - zviyero ACTH mazinga mutsinga dzinoburitsa pituitary gland ichienzaniswa neiyo tsinga dziri muchipfuva.

Mimwe bvunzo inogona kuitwa inosanganisira chero yeanotevera:

• Kutsanya ropa glucose uye A1C kuyedza chirwere cheshuga
• Lipid uye cholesterol kuyedzwa
• Bone mineral density scan kuti utarise osteoporosis

Kupfuura kumwe kuongorora bvunzo kunogona kudikanwa kuti uongorore chirwere cheCushing. Mubatsiri wako anogona kukukumbira kuti uone chiremba anonyanya kugadzirisa zvirwere zvepituitary.

Kurapa kunosanganisira kuvhiyiwa kubvisa bundu repituitary, kana zvichibvira. Mushure mekuvhiyiwa, iyo pituitary gland inogona zvishoma nezvishoma kutanga kushanda zvakare uye kudzokera kune yakajairwa.

Munguva yekudzoreredza kubva pakuvhiyiwa, ungangoda cortisol kutsiva kurapwa nekuti iyo pituitary inoda nguva yekutanga kugadzira ACTH zvakare.

Radiation kurapwa kwepituitary gland inogona zvakare kushandiswa kana bundu racho risina kubviswa zvachose.

Kana bundu rikasapindura pakuvhiya kana nemwaranzi, ungangoda mishonga yekumisa muviri wako kubva mukugadzira cortisol.

Kana aya marapirwo asina kubudirira, adrenal gland angangoda kubviswa kuti amise huwandu hwecortisol kubva mukugadzirwa. Kubviswa kweadrenal glands kunogona kukonzera kuti pituitary bundu riwedzere kukura (Nelson syndrome).

Kusarapwa, Cushing chirwere chinogona kukonzera chirwere chakakomba, kunyangwe rufu. Kubviswa kwebundu kunogona kutungamira mukuzara zvizere, asi bundu racho rinogona kukura zvakare.

Matambudziko ehutano anogona kukonzerwa neCushing chirwere anosanganisira:

• Kudzvinyirira kupwanya musana
• Chirwere cheshuga
• Kuwedzera kweropa
• Zvirwere
• Itsvo matombo
• Mafungiro kana zvimwe zvinetso zvepfungwa

Fonera mupiki wako kana iwe ukava nezviratidzo zveCushing chirwere.

Kana iwe uchinge wabviswa pituitary bundu, daidza wako mupi kana iwe uine zviratidzo zvematambudziko, kusanganisira zviratidzo zvekuti bundu radzoka.

Pituitary Cushing chirwere; ACTH-yekuvanzika adenoma

• Endocrine masero
• Striae mune popliteal fossa
• Striae pagumbo

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Molitch INI. Anterior pituitary. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chitsiko 224.

Stewart PM, Newell-Mutengo JDC. Iyo adrenal cortex. Mune: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Chinyorwa cheEndocrinology. 13 ed. Philadelphia, PA: Elsevier; 2016: chits.