Cushing chirwere

Cushing syndrome chirwere chinoitika kana muviri wako uine huwandu hwehormone cortisol.

Chikonzero chakajairika cheCushing syndrome chiri kutora zvakawandisa glucocorticoid kana corticosteroid mushonga. Iyi fomu yeCushing syndrome inonzi exogenous Cushing syndrome. Prednisone, dexamethasone, uye prednisolone mienzaniso yerudzi urwu rwemushonga. Glucocorticoids inotevedzera zvinoitwa nemuviri wemunhu mahormone cortisol. Iyi mishonga inoshandiswa kurapa akawanda mamiriro akaita seasima, kuzvimba kweganda, gomarara, chirwere chemuviri, marwadzo akabatana, uye rheumatoid arthritis.

Vamwe vanhu vanoita Cushing syndrome nekuti muviri wavo unoburitsa yakawandisa cortisol. Iyi hormone inogadzirwa mune adrenal gland. Zvinokonzera cortisol yakawandisa ndezvi:

• Cushing chirwere, chinoitika kana iyo pituitary gland ichiita yakawandisa yehormone adrenocorticotrophic hormone (ACTH). ACTH inobva yaratidza maadrenal glands kuti abudise cortisol yakawandisa. Iyo pituitary gland bundu inogona kukonzera iyi mamiriro.
• Bundu readrenal gland
• Tumor kumwe kunhu mumuviri unoburitsa corticotropin-kusunungura mahormone (CRH)
• Tumota kumwe kunhu mumuviri unoburitsa ACTH (ectopic Cushing syndrome)

Zviratidzo zvinosiyana. Haasi munhu wese ane Cushing syndrome ane zviratidzo zvakafanana. Vamwe vanhu vane zviratidzo zvakawanda asi vamwe vasina kana zviratidzo.

Vazhinji vanhu vane Cushing syndrome vane:

• Denderedzwa, tsvuku, izere kumeso (kumeso kwemwedzi)
• Inononoka kukura mwero (muvana)
• Kurema kwekurema nemafuta kuwanda padanda, asi kurasikirwa kwemafuta kubva pamaoko, makumbo, uye magaro (wepakati kufutisa)

Kuchinja kweganda kunogona kusanganisira:

• Zvirwere zveganda
• Mavara epepuru (1/2 inch kana 1 sentimita kana kupfuura paupamhi) anonzi striae paganda remudumbu, maoko ekumusoro, zvidya, uye mazamu
• Ganda rakatetepa nekupwanya kuri nyore (kunyanya pamaoko nemaoko)

Tsandanyama uye pfupa shanduko dzinosanganisira:

• Backache, inoitika nemabasa enguva dzose
• Kurwadziwa kwepfupa kana hunyoro
• Unganidzo yemafuta pakati pemapfudzi uye pamusoro pekora mapfupa
• Ribvu uye musana kutsemuka kunokonzerwa nekuonda kwemapfupa
• Misungo isina kusimba, kunyanya yehudyu nemapendekete

Muviri-wakapamhama (systemic) shanduko dzinosanganisira:

• Nyora 2 chirwere cheshuga mellitus
• Kuwedzera kweropa (hypertension)
• Kuwedzera cholesterol uye triglycerides (hyperlipidemia)

Vakadzi vane Cushing syndrome vanogona kunge vaine:

• Bvudzi rakawandisa kukura kumeso, mutsipa, chifuva, dumbu, uye zvidya
• Nguva dzinova dzisina kujairika kana kumira

Varume vanogona kuva:

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

Zvimwe zviratidzo zvinogona kuitika nechirwere ichi:

• Pfungwa shanduko, senge kushushikana, kushushikana, kana shanduko mumaitiro
• Kuneta
• Kutemwa nemusoro
• Kuwedzera nyota uye kuita weti

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezvezviratidzo zvako nemishonga yauri kutora. Udza mupiki nezve mishonga yese yawanga uchinwa kwemwedzi yakati wandei yapfuura. Uyezve udza mupi nezve mapfuti awakatambira kuhofisi yemupi.

Laboratory bvunzo dzinogona kuitwa kuti uongorore Cushing syndrome uye woziva chikonzero chacho ndeichi:

• Ropa cortisol level
• Ropa shuga
• Saliva cortisol nhanho
• Dexamethasone kudzvinyirira bvunzo
• 24-awa weti weti cortisol uye creatinine
• ACTH mwero
• ACTH kusimudzira bvunzo (mune zvisingawanzoitika zviitiko)

Miedzo yekuziva chikonzero kana matambudziko anogona kusanganisira:

• Abdominal CT
• Pituitary MRI
• Bone chicherwa kuwanda

Kurapa kunoenderana nechikonzero.

Cushing syndrome inokonzerwa nekorticosteroid kushandiswa:

• Wako mupi anokuraira kuti udzike zvishoma nezvishoma muyero wemishonga. Kumisa mushonga kamwe kamwe kunogona kuva nenjodzi.
• Kana iwe usingakwanise kurega kutora mushonga nekuda kwechirwere, shuga yako yepamusoro muropa, cholesterol yakawanda, uye kuponda kwemapfupa kana osteoporosis inofanirwa kutariswa nekuongororwa.

NeCushing syndrome inokonzerwa nepituitary kana bundu rinoburitsa ACTH (Cushing chirwere), ungangoda:

• Kuvhiya kubvisa bundu
• Radiation mushure mekubviswa kwepituitary bundu (mune zvimwe zviitiko)
• Cortisol kutsiva kurapwa mushure mekuvhiyiwa
• Mishonga kutsiva pituitary mahormone anova anoshomeka
• Mishonga inodzivirira muviri kubva mukugadzira cortisol yakawandisa

Ndiine Cushing syndrome nekuda kwepituitary bundu, adrenal bundu, kana mamwe mamota.

• Ungangoda kuvhiyiwa kuti ubvise bundu.
• Kana bundu risingakwanise kubviswa, ungangoda mishonga yekubatsira kuburitsa kusunungurwa kwecortisol.

Kubvisa bundu kunogona kukonzera kupora kuzere, asi pane mukana wekuti mamiriro acho achadzoka.

Kupona kwevanhu vane Cushing syndrome kunokonzerwa nemamota kunoenderana nemhando yemota.

Kusarapwa, Cushing syndrome inogona kutyisidzira hupenyu.

Matambudziko ehutano anogona kukonzerwa neCushing syndrome anosanganisira chero eanotevera:

• Chirwere cheshuga
• Kuwedzera kwepituitary bundu
• Bone kutyoka nekuda kweosteoporosis
• Kuwedzera kweropa
• Itsvo matombo
• Zvirwere zvakakomba

Fonera mupiki wako kana iwe uine zviratidzo zveCushing syndrome.

Kana iwe ukatora corticosteroid, ziva zviratidzo nezviratidzo zveCushing syndrome. Kurapwa nekukurumidza kunogona kubatsira kudzivirira chero mhedzisiro yenguva refu yeCushing syndrome. Kana iwe ukashandisa inhaled steroids, iwe unogona kudzikisa kuratidzwa kwako kune iyo steroid nekushandisa spacer uye nekushambidza muromo wako mushure mekufema mune iyo steroids.

Hypercortisolism; Cortisol yakawandisa; Glucocorticoid yakawandisa - Cushing syndrome

• Endocrine masero

Nieman LK, Biller BM, Kutsvaga JW, et al; Endocrine Sosaiti. Kurapa kweCushing's syndrome: iyo Endocrine Society kiriniki yekudzidzira nhungamiro. J Clin Endocrinol Metab. 2015; 100 (8): 2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

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 Saunders; 2016: chits.