Hyperplasia adrenal - kuyini? Izimpawu nasekwelashweni kwezifo kungakephuzi

Endocrinologists practice yabo babhekana kwezinso ku izinso. Hyperplasia adrenal - kuyini? Izinso - abhanqiwe sitho, izindlala adrenal zitholakala ngenhla nje kokuba ifomu yezindlala. kwakhiwa Kukhona ezidingekile amahomoni umzimba womuntu (i-adrenalin, noradrenaline, glucocorticoids, kanye nasocansini). Hyperplasia kwephula hormone kwesokudla, futhi lokhu kuhambisana nokubuka izimpawu ezahlukene.

Hyperplasia adrenal - kuyini?

Lapho adrenal Hyperplasia iseli izicubu nezindlala abhanqiwe ngokuqhubekayo yandisa, umzimba luyanda kakhulu ngobukhulu, nakuba kugcina ezakheke siqu. Adrenal izidakamizwa medullary siqukethe nebhalsamu namagxolo.

Ngokuvamile kuthinta adrenal cortex Hyperplasia, lapho eba inqubo sokugembula. isimila abahlukahlukene ngokuvamile kutholakala le medulla.

Kubonisa sifo ngasiphi yobudala abesifazane, amadoda kanye nezingane.

Azalwa naso Hyperplasia adrenal itholakala imithi ngokuvamile kakhulu. Ngokuvamile athwala ngofuzo, kodwa kungase futhi zenzeka eziningi ezinye zezici enqabayo zasekhaya noma zangaphandle. Njengoba zokugula ahlobene itholwa in iziguli Cushing Syndrome (40% amacala) syndrome. Lesi sifo ngokuvamile kutholakala yobudala emaphakathi futhi ubudala.

Lokhu zokugula okungathí sina bangabuyela banganakwa. Lapho Hyperplasia iphazamisekile ekukhiqizweni kwama-hormone kunesidingo. Ngo abesifazane, ngokuvamile kubangela nenzalo. Kunezinhlobo eziningana zesifo: Hyperplasia nodular we ndlala adrenal, nodular, ehlasela umzimba wonke, uyisithulu futhi micronodular, futhi Hyperplasia imilenze medial. Ngokuvamile lesi sifo kwenzeka kwabesifazane.

Izimbangela zesifo

Ubangela izimpawu ezivela uma Hyperplasia adrenal ezinganeni, abesilisa nabesifazane zizohluka. Konke kuzoya ngohlobo sifo. Hyperplasia libhekisela ingenye kwezinhlobo, kungase idiopathic, solteryayuschey, virility.

Lapho kukhona esebenzayo uhlobo ukukhiqizwa abanomfutho wegazi ophakeme ka androgens futhi mineralocorticoids, inqubo enjalo ithonya elibi izitsha kwezinso futhi fundus, ngokuvamile kuholela nomfutho wegazi ophezulu syndrome.

Lapho solteryayuschem uhlobo Hyperplasia lenyuka production androgen, ngaleyo ndlela kukhona ukuntuleka yezinye hormone ekhiqizwa cortex adrenal. Iza hyperkalemia noma kahle kungakhuphula izinga likashukela. Ingozi iba ukuthi umzimba wakhe ngamanzi emzimbeni, ukunciphisa umzimba.

Lapho virilnoe uhlobo Hyperplasia androgen imfihlo superaktiven. Izitho zangasese kwanda kakhulu ngobukhulu, zikhona induna, kukhuphuke umzimba izinwele, ezicutshini kakhulu athuthukile inqwaba.

Okokuqala zokugula iqala ukuba bathuthuke ngenxa uketshezi lenyuka hormone steroid. Ifomu atholwe lesi sifo has ngenxa yezizathu eziningana ezinkulu zokuthi kungani kwaphakama ke:

• disorder umzimba;
• izingcindezi eqinile;
• isifo Cushing sika;

Azalwa naso Hyperplasia adrenal ngenxa yokuthi ngisho nalapho ngikhulelwe, ngesikhathi sokukhulelwa, izinguquko obusebenzayo ukuthuthukisa. Esinye isiphakamiso - ukudluliswa kwalesi sifo ezakhini zofuzo. Ingabe Zikhona Izimo Ezenza ingqondo ukubonakaliswa izimpawu zesifo: ukungasebenzi le ngxenye futhi pituitary kwezinso ezakhini zofuzo, i isegazini okuzimela cortex abhanqiwe nezindlala, ngofuzo okhokho babo.

Hyperplasia nodular

Odokotela ukwehlukana Ukulandelana Hyperplasia adrenal ngemacembu eziningana ngokusho isithombe emtholampilo, kanye nohlobo ukugeleza.

Nodular Hyperplasia adrenal. Leli fomu omkhulu sitholwa njengefa. Ngokuvamile kutholakala asebekhulile, sibe sibi nge sikhathi. Lapho uqhuba uphethwe lwembula isici isici - amagxolo ngamaqhubu adrenal kwakhiwa. Zingaba amaningi (isakhiwo Lobed) kanye olulodwa, kuze 4-5 cm. Utfutfukisa Cushing Syndrome. I zokugula kungenxa ukushukuma eqinile hormone adrenocorticotropic, is kuhlelwe indlala pituitary. Izici eziyinhloko Hyperplasia nodular nge Cushing Syndrome zihlanganisa:

• ikhanda;
• "Izimpukane" phambi kwamehlo;
• Ukudlikizela;
• isiyezi;
• ukucobeka jikelele;
• kwesisindo (ngokuyinhloko esiswini, entanyeni, ubuso);
• anda esesuthi;
• yokwelula izimpawu esikhumbeni;
• induna;
• hirsutism (e abesifazane);
• ukuvuselelwa abampofu;
• hyperpigmentation;
• umfutho wegazi ophakeme;
• Ngokuvamile abantu baphuka izinqulu njalo;
• ukucindezeleka.

Hyperplasia ngokukhukhumala kwentamo

Kulesi uhlobo wendlala Hyperplasia awushintshanga ezakheke, ukwanda kancane kancane. Kodwa ngesikhathi esifanayo akha ngamaqhubu. Khomba uhlobo lesi sifo kunzima. Ngo indlela esezingeni ekuxilongweni ultrasound kungekho yi. Izinguquko emzimbeni atholakala kuphela MRI noma CT. Ngokuvamile ukuthuthukisa amafomu hybrid, okuyinto kuzokwenzeka uma lezi zimpawu ezilandelayo: Hyperplasia adrenal e abesifazane ngokuvamile kuholela uboya ezingxenyeni ezithile zomzimba, ebonakaliswa ukushaywa uvalo ngaphandle kwesizathu, umfutho ophakeme wegazi, ukukhuluphala. Kwezinye izindawo kukhona umonakalo glomerular nokuthuthukisa Hyperplasia zamazwe amabili.

I zokugula we aldosteronism idiopathic kusekelwe ukwanda aldosterone uketshezi. Lapho Hyperplasia zone glomerular ubukisa zimpawu ezilandelayo: umfutho wegazi ophakeme, Ukudlikizela, ukuba buthakathaka kwezicubu, ukunqunywa ukunyakaza, ukuqina kuze kube nokukhubazeka, ukoma, kukhuphuke umchamo okukhipha, ukuchama ebusuku. Ukwephulwa kubangela ukwenyuka igazi potassium, lactic. igazi Ukwandiswa ingcindezi siyenzeka njalo.

Nodular futhi azalwa naso amafomu

ifomu nodular ngokuvamile iqhubeka ezinganeni kanye intsha. Kungaba ukuzibonakalisa ngenxa semfene noma umsebenzi adrenal ngenxa yokweqisa ka glucocorticoids. imphawu letibalulekile ukuma nodular: okungajwayelekile amafutha imali, imisipha yoma, lesikhumba kwesikhumba, izimpawu zesifo sikashukela, ukulimala kwenzwa futhi senhliziyo, kwamathambo. Uma izingane izimpawu zesifo kutholwa ngesikhathi, eyenziwa ukwelashwa kwama-hormone, onalesi sifo sisihle. Hyperplasia kwesokunxele indlala adrenal - kuyini? Kulokhu, Hyperplasia akuxhomekile isenzo hormone. Lapho amila izimila ukusebenza kukhulu kune 3 cm liyadingeka. Laparoscopy isetshenziswa noma ngokuvumelana Fedorov indlela lyumbotomicheskim ukufinyelela peritoneum ohlangothini lwesobunxele.

Azalwa naso Hyperplasia adrenal (VDKN) sitholakale kaningi ngaphezu yezinye izinhlobo. Ngo izinsana ezitholakale ngesikhathi imvamisa 1 kuya kwezingu-12. Kulesi simo, ingane umzimba obonakalayo futhi ukubukeka. Kukhona izinhlobo ezintathu oyinhloko (non-classic, elula classical, virility futhi solteryayuschaya.

Ifomu obujwayelekile solteryayuschaya. Ebonakaliswa amantombazane ke germofroditizm zingamanga, abafana isikhumba omnyama emhlabeni scrotum, umthondo inyuka ngosayizi. Ezigulini libhekene ukukhula ongaphakeme kanye nezimpawu ezifana ukozela, isicanucanu, ukucobeka, umfutho ophansi wegazi, ukuntuleka kwamanzi emzimbeni, imnyama. Lesi sifo kufanele baphathwe ezinsukwini zokuqala khona, noma kungenzeka ukufa.

Ngendlela classical akangaphezu izimpawu, kodwa kukhona ukwanda synthesis ubulili hormone wesilisa. Uma lesi sifo singelashwa, nazinkinga zenzeka kwabesifazane nempilo yezocansi nangokwengqondo.

Ifomu non-classical livela abesifazane abadala nentsha. Izikhalazo eyinhloko ukungazali, ukuphazamiseka kokuya esikhathini, hirsutism kanye induna.

Hyperplasia adrenal: izimpawu jikelele

Isikhathi esining impela, izingane, abesilisa nabesifazane yathi kusulwe uhlobo lesi sifo, uma kungekho zimpawu evelele, ezimweni ezinjalo kuba nzima ukuhlonza isifo. ifomu azalwa naso ichazwa izingane kakade ngonyaka wokuqala nowesibili zokuphila.

Ngokuvamile, Hyperplasia adrenal (kuyini, siye wachaza kakade) has zimpawu ezilandelayo esemqoka:

• engazinzile komfutho wegazi (ongaphakeme noma ukuphakama);
• ijubane inqubekela phambili ngesifo sikashukela;
• isisindo ukwanda;
• ukubonakaliswa kwamathambo;
• ukungabi namizwa imisipha, yoma kamuva;
• Abesifazane kufanele "inyanga-like ubuso";
• inkumbulo ukungakhuli;
• iloli kwemizwa;
• lesikhumba;
• yokwelula izimpawu esikhumbeni;
• yokuphazamiseka pheshana emathunjini;
• ukwehlisa amasosha omzimba;
• Ukukhululwa ebusuku azo umchamo;
• ukoma ngokweqile;
• kwengqondo;
• ukungazali;
• amenorrhea;
• hhayi okufanele iminyaka ukukhula okusezingeni eliphezulu;
• ebohla hairline esifundeni yesikhashana;
• hirsutism.

Abesilisa nabesifazane asebeneminyaka zingafani izimpawu zokwelapha lesi sifo.

izinkombandlela ukwelashwa

Ngesisekelo uphathwa ngokuqinisekile yokwelapha hormone. Ososayensi baye okwamanje isinqumo indlela engcono kakhulu yokubhekana phezu Hyperplasia adrenal. Ukwelashwa ngokuvamile kuhlanganiswe. androgens - Ukuze intsha isuke izindlela okuyinto kujwayeleke ukubonakaliswa yesibili ubulili izici, amantombazane kuboniswe estrogens nabafana kunikezelwe.

Esetshenziswa ekwelashweni kwe-inhlanganisela elandelayo glucocorticoids:

• acetate cortisone;
• hydrocortisone;
• dexamethasone;
• prednisolone.

Emini isiguli uthola 2 noma 3 ngemithamo amahomoni (imali alinganayo). Regista kanye 5% isixazululo glucose. Girls, ngokungafani abafana, zonke ekuphileni kufanele sikulungisele kunesidingo.

Ukuze isiguli ngasinye udokotela kufanele uthole indlela ekhethekile ukuze unike amasu ayo impatho (konke kuncike nakho kwakhe nolwazi). yokwelapha Single ekwelapheni lesi sifo alikho.

Hyperplasia azalwa naso we cortex adrenal ezinzima iphathwa abahlinzayo. Kukhona amacala ukuthi umthondo ayikwazi umahluko njengoba ungowesifazane noma owesilisa. Emantombazaneni kunconywa plastic nge ukuma okungajwayelekile we labia. Kakade ngonyaka wokuqala wokuphila ukukhombisa ukusebenza enjalo, ngezinye izikhathi (zisesimweni esibi kakhulu) ke wenziwa emva kwesikhathi. Yenza ukusebenza futhi izimila.

Uma umzimba sintula usawoti, isiguli kufanele kwandiswe umthamo wansuku zonke 1-3 amagremu. Kuzoqokwa Ezimweni ezinjalo, futhi mineralocorticoid.

Ehlasela umzimba yokwelapha Hyperplasia izidakamizwa akanayo effect okuningi. Kudingeka e anjalo adrenalectomy. ukwelashwa kuphumelele futhi aldosteroma lapho kuhlangene Hyperplasia ehlasela umzimba. Isibikezelo okungekuhle. Isihloko Nguwena yokwelapha izidakamizwa kanye zona glomerulosa Hyperplasia zamazwe amabili (hyperaldosteronism idiopathic). Ukusebenza kuleli cala - kuyinto ngesilinganiso kakhulu.

I kuwumgogodla ukwelashwa Iga - ethola spironolactone, kuba omelene ka aldosterone. Futhi ngempumelelo iyona eplerenone izidakamizwa. Spironolactone ngokuvamile kuthathwe lihambisana omelene calcium. Uma izimpawu samanje umfutho wegazi ophakeme emithanjeni, ukwelashwa nge-ACE inhibitor ixhunyiwe.

Endabeni a yokwamukela virilization izidakamizwa yesondlo njalo. Uma uhlobo Hyperplasia adrenal kubhekisela esenzakalweni esiyisimangaliso virilizing, kufanele kube ukuqokwa kwe-cortisol. Ingasetshenziselwa njengenhlangano ujove esicutshini. Dose abelethwe udokotela. Ukuze izingane ezindadlana zingasebenzisa prednisolone.

Uma kungekho Ngokwelashwa okufanele, Hyperplasia kungaholela ukuthuthukiswa sifo Kona noma isifo Cushing sika. Ngemva ukwelashwa okufanelekile uphethwe yini kufanele baqale ngokushesha.

sitholakele isifo

Hyperplasia adrenal - kuyini? Indlela ukuxilonga izifo? Hyperplasia nodular futhi ehlasela umzimba Kutholwe ngokuhamba ucwaningo wezinsimbi futhi laboratory. Ukuhlahlwa zihlanganisa: inhlolovo isiguli, behlolwa, luhlolo yomtholampilo, luhlolo obangelwa imisebe noma-magnetic resonance imaging, ukuskena radionuclide. Ngokusho imiphumela ukubaluleka alinganiswa ngayo, kanye nefomu kokubili nezindlala adrenal. Radioimmunoassay wenziwa zocwaningo laboratory. Ezimisele umchamo futhi igazi cortisol. Ukuze ukuhlola isimo hormone, bamba-exhumene Assay immunosorbent. Ngesinye isikhathi kuyadingeka ukuba ukuqhuba nenshisekelo wokubhoboza.

Ngokusho imiphumela ukuxilongwa udokotela lidalula Ihlahlubo ekwabela indlela elungile kakhulu sokwelashwa.

Hyperplasia abadala: yini okufanele uyenze?

Ngokuvamile hyperactivity we- cortex adrenal uxilongwe esewusana, kodwa izimpawu zesifo avele abadala. Hyperplasia adrenal kwabesifazane elinesimo ukukhula eliphezulu izinwele pubic, enephimbo elibhodlayo, induna, ubuhlungu ngemuva ekhanda, ukuquleka ebusuku, yokudla abampofu, kukhuphuke blood pressure, adrenal syndrome.

Uma uzithola kulezi zimpawu, ungazami ukuxilonga ngokwakho. Kulezi zimo musa asize, futhi amakhambi abantu. Ngokuphuthuma kodokotela. Kuyadingeka ukuba ukwelashwa kwama-hormone. Ngokuvamile, abesifazane kanye kokutshelwa ngokukhubazeka kwengane is hhayi Kunconywa ukuba ukuhlela sokukhulelwa. Ezimweni eziningi, ngisho kungavunyelwe okubeletha. Ngezinye izikhathi kuyikhambi elingcono kakhulu lenkinga - ukuqedwa ephelele izinso onesifo, futhi zonke izinto ezihlobene yayo.

zokuvimbela

Kuyini Hyperplasia adrenal - kuyinto ikakhulukazi kudingeka bazi labo abashadile abazama buhambe kokuzalwa komntwana futhi umndeni bona (zofuzo) kufanele amacala Hyperplasia azalwa nako. Sicela ubheke zofuzo - onekhono, ochwepheshe onolwazi. Ukuze ukuvimbela izifo kuzodingeka ukuthi wenze sitholakele perinatal (isikhathi lapho ingane namanje okhulayo futhi esizalweni umama). Ngo senyanga yokuqala sokukhulelwa Kwenziwa chorionic villus izibonelo zalokho. Engxenyeni ukuhlaziya okudingekayo-amniotic fluid, okuzokwenza ukunquma izinga lama-hormone yesibili.

Inketho - IVF. Kulokhu, ungenza ukuhlaziywa kwangaphambilini zofuzo lwegciwane amaseli ngaphambi kokuba avundiswa.

Phakathi sokukhulelwa abesifazane ukuthi nginesifo Hyperplasia kufanele kube ngaphansi kweso njalo udokotela ukudlula njalo konke ukuhlolwa okudingekayo. Kufanele babe yingxenye yokuphila kwazo zonke ezinobuthi kungenzeka futhi ngemiphumela yokukhishwa kwemisebe.

Ngokuba nokuvimbela Hyperplasia adrenal ufeza ababalulekile futhi screening test ukuba kwenziwe olusanda kuzalwa. Ukuze ukuhlaziywa kubalulekile ukuthatha igazi kusuka capillary (endaweni ekhethelwe bona abantu wokubhoboza isithende kid).