Hypogonadism Hypogonadotropic: izimpawu, ukwelashwa

Njengomthetho, hypogonadism hypogonadotropic elihlobene ne nokungathuthuki kwezitho zobulili nezici ngokobulili yesibili. Fat and amaprotheni exchange ku zokugula futhi kuhlukumeza, elibangela ukukhuluphala, cachexia, iziyaluyalu uhlelo lwamathambo kanye ukungasebenzi inhliziyo.

Ngendlela odokotela aphathe?

Kufanele kuqashelwe ukuthi owesilisa ezahlukene nowesifazane hypogonadotropic hypogonadism.

Ukuxilongwa kanye nokwelashwa kwezifo Kwenziwa ngokuhlanganyela endocrinologists, obstetricians futhi gynecologists, endokrinolongami uma isiguli sifuna owesifazane, futhi andrology, uma isiguli - indoda.

Ngesisekelo ekwelapheni yokwelapha i-hormone. Uma wayefisa ukuhlinzwa eboniswe, ukuhlinzwa kokulungisa ukubukeka.

Njengoba isifo libhekwa?

Hypogonadism kungaba zamabanga aphansi naphezulu. Ifomu eyinhloko izicubu wamasende ayephuli okwagqugquzelwa ukusebenza ngenxa ukuphazamiseka testes. ngesikhathi chromosomal ezingeni kwezinso angase avuse hypoplasia noma aplasia wamasende izicubu, okuyinto kubonakala ukungabi noma alanele uketshezi of androgens ekukhiqizeni kwabo kumiswa egcwele izitho zangasese kanye nezici ngokobulili yesibili.

hypogonadism Hypogonadotropic kwabesilisa lubonakaliswa infantilism ngemilingo.

Ifomu yesibili kubangelwa ukuhlukumeza isakhiwo pituitary indlala, ukunciphisa umsebenzi gonadotrophic noma ukuhlulwa izikhungo zayo hypothalamic ukuthi sinomthelela indlala pituitary futhi ulawula umsebenzi wayo. Lesi sifo kubonakala e okuthile engqondweni.

Bobabili ifomu zamabanga aphansi naphezulu kungenzeka azalwa naso noma bathenga. I zokugula kungase kube nomthelela ukungazali owesilisa e 40-60% of amacala.

Izimbangela sifo amadoda

amanani eliphansi androgens kungadalwa ukwehla inani hormone ekhiqizwa isimo sokugembula noma testes ngokwabo, ukwephulwa ngxenye futhi pituitary umsebenzi.

Ngu omsakazo ukubonakaliswa eyinhloko isifo angabhekwa:

• azalwa naso nezindlala ngokobulili nokungathuthuki, okwenzeka lapho izinkinga zofuzo uhlamvu,
• aplasia ka amasende.

izici ungalokothi uphuze kungabandakanya:

• ukwephulwa abadabuka wamasende;
• ukuchayeka ezinobuthi;
• ngelashwa nangemithi;
• imiphumela kuphela njalo organic, nitrofurans, imithi yokubulala izinambuzane, utshwala, tetracycline, esekelwe i-hormone izidakamizwa ngemithamo ephakeme, njll.;
• ubunjalo ezithathelwanayo lesi sifo (mumps, isimungumungwana orchitis, vesicles);
• khona ukugula ngemisebe;
• atholwe zokugula we testes;
• kuhlanekezela intambo spermatic;
• volvulus we testes;
• inqubo atrophic emva kokuhlinzwa;
• excision we hernia;
• ukuhlinzwa kule scrotum.

Ngo hypogonadism eyinhloko ukwehla ezingeni androgens egazini siyenzeka. Utfutfukisa impendulo compensatory we nezindlala adrenal, kwandisa ukukhiqizwa gonadotropins.

Ukuze wakhe owakho secondary phambili ngxenye futhi pituitary iziyaluyalu (izinqubo ukuvuvukala, izimila, ukuphazamiseka semithambo zokugula kwengane esiswini).

Tfutfukisa hypogonadism yesibili unga:

• pituitary adenoma, odala ozokusebenzisa;
• i-hormone adrenocorticotropic (isifo Cushing sika);
• prolactinoma;
• ukungasebenzi kwekhono indlala pituitary noma ngxenye emva kokuhlinzwa;
• inqubo yokuguga, elibangela ukwehla kwe-testosterone egazini.

Ngesimo yesibili imakwe nokwehlisa gonadotrophins, kuphumele ukukhiqizwa ukwehla androgen yi testes.

Enye indlela lesi sifo, kuthinta amadoda, ukunciphisa ukukhiqizwa kwesidoda nge evamile testosterone Inkomba. Akuvamile kukhona ukwehla kwamazinga testosterone ezingeni evamile kwesidoda.

Symptomatology lesi sifo amadoda

hypogonadism Hypogonadotropic ezingabantu has zako emtholampilo. Basuke kubangelwa yobudala lesiguli kanye nezinga esingamahlalakhona androgen.

Uma emasendeni kuthiwa usindwa umfana phambi ukuthomba, khona-ke bakha syndrome ejwayelekile. ngaleyo ndlela Skeleton iba uhlasela ezinkulu. Lokhu kungenxa ukubambezeleka esikhathini Ukuqina sekuyenzeka zone ukukhula. Ehlombe nasesifubeni nazo emuva ekuthuthukisweni, izitho made, imisipha lwamathambo ayiqondakali athuthukile.

Ukukhuluphala kungabonakala nasemkhakheni ngohlobo zesifazane, gynecomastia, gipogenitalizme ukuthi okuboniswe usayizi encane umthondo, akukho imibimbi ku scrotum, hypoplasia wamasende, le nokungathuthuki we wendlala yabesilisa, ukungabi khona izinwele endaweni pubic, le nokungathuthuki we umphimbo, ithoni eliphezulu izwi.

Ngo wawubonakalisa yesibili isifo njalo waphawula isisindo okusezingeni eliphezulu umzimba, ephakeme adrenal cortex umsebenzi, yegilo ukusebenza kahle.

Uma umsebenzi wamasende kuyehla emva kokuthomba, izimpawu zezifo ezifana hypogonadotropic hypogonadism, usukela buthaka.

ISidlo izenzakalo ezilandelayo:

• nokwehlisa testes;
• kancane zonke iziboya emzimbeni ebusweni nasemzimbeni;
• ukulahlekelwa isikhumba kuyaqina kanye thinning;
• kwehle umsebenzi zocansi;
• iziyaluyalu autonomic.

Ukwehla usayizi wamasende njalo ehambisana nomkhiqizo isidoda esincishisiwe. Lokhu kubangela ukungazali, kukhona ekuhlehleni ngezici ngokobulili yesibili, imakwe buthakathaka kwezicubu, ukukhathala.

Ukuxilongwa hypogonadism ezingabantu

Sifo senziwa anthropometry, kuhlolwa palpation we umthondo, ukuhlolwa izimpawu zokwelashwa degree nokuthomba.

-X-ray luhlolo kuzosiza ukuhlola yobudala ithambo. Ukuze sithole saturation ithambo amaminerali densitometry isetshenziswa. Lapho-x-reyi we turcica sella kunqunywa ubukhulu bawo khona izimila.

Ukulinganisa ithambo yobudala ivumela izinkathi Ukuqina sekuyenzeka esandleni ngokuhlanganyela kanye esihlakaleni ukucacisa lapho kuqala nezingokomzwelo zokuthomba. Kufanele ikhumbule ukuthi kungenzeka ekuqaleni (for iziguli ozalwa eningizimu) futhi kamuva (for iziguli owazalwa enyakatho) Ukuqina sekuyenzeka, kanye lokuthi osteogenesis disorder kungenziwa zibangelwa ngezinye izinto ezisemaceleni.

Kungase kudingeke ukucwaninga amagama isidoda laboratory kusivumela ukukhuluma mayelana nezimo ezifana nitrogen noma oligospermia.

Kuboniswa okuqukethwe hormone ezifana:

• gonadotropins ngokobulili;
• Imininingwane kanye khulula testosterone ;
• luteinizing i-hormone;
• GnRH;
• i-hormone antimyullerovsky;
• prolactin;
• estradiol.

Lapho ifomu eyinhloko Inkomba isifo gonadotropins egazini kwaqinisa futhi yesibili - behliselwe phansi. Ngezinye izikhathi izinga kwabo imithetho nokwabela abantu indawo.

Ukunqunywa serum estradiol ezidingekayo lapho feminization lingaze nokubonakaliswa yesibili isifo esimweni izimila kule testes esikhiqiza i-estrogen, noma izimila in the nezindlala adrenal.

Inkomba okuqukethwe ketosteroids umchamo kungenzeka evamile noma encishisiwe. Uma usola khona Klinefelter syndrome chromosome ukuhlaziywa kuboniswe ubambe.

biopsy wamasende akakwazi ukunikeza ulwazi uphethwe yini.

ukwelashwa

Ukwelashwa nokuvikelwa hypogonadism hypogonadotropic kuhloswe imbangela enkulu yokuqothulwa kwehlathi lase egunjini lokuhlolwa kwezifo. Umgomo yokwelapha itholakala okusigwema enesandla ukuzinza yentuthuko ngokobulili, ukunciphisa okwalandela kwezicubu wamasende futhi wamasende ukuqeda nenzalo. Ukwelashwa uqhutshwa ngaphansi kokuqondisa Urologist futhi endocrinology.

iqedwe kanjani hypogonadotropic hypogonadism ezingabantu? Ukwelashwa kuxhomeke ezicini eziningana:

• ifomu basemtholampilo isifo;
• kobukhulu ukungasebenzi le ngxenye, le ndlala pituitary kanye uhlelo zokuzala;
• ukutholakala zihlala pathologies;
• isikhathi nesenzakalo kwezifo;
• yobudala lesiguli.

Ukwelashwa nokuvikelwa izimo omdala ukuba ulungise amazinga androgens nekugwema nenkinga ocansini. Okungavundile, esadaleka ngesimo hypogonadism azalwa naso, impatho akukwazi.

Endabeni amafomu eyinhloko kwezinso azalwa naso noma isifo aluthola ngesikhathi ukuphepha endocrine lamaseli testes esetshenziswa evuselela. Boys ziphathwa ejenti non-hormone, kanye neziguli omdala - izidakamizwa esekelwe ama-hormone (androgen futhi gonadotropins ngemithamo emincane).

Uma kungekho isipele umsebenzi wamasende okwaboniswa androgen esikhundleni therapy ne-testosterone. Ukuthatha hormone wenziwa kukho konke ukuphila.

Lapho ifomu yesibili isifo ezinganeni nakubantu abadala kudingeka zisebenzisa i-hormone gonadotropin. Uma kudingekile, basuke kuhlangene hormone ocansini.

eboniswe Futhi impatho okubuyisela, futhi umsebenzi.

Ukusebenza nge isifo ukufakela esibelethweni ne cryptorchidism, wasebenzisa ukuhlinzwa kokulungisa ukubukeka e umthondo ampofu. Nge yezimonyo injongo noma aphendukele ekuthengiseni Iqanda yenzeka zokwenziwa based (ngokungabi bikho testis undescended ku ingaphakathi lesisu).

Ukuhlinzwa isetshenziswa uma usebenzisa amasu microsurgical, kanye nokulawula uhlelo mzimba, amazinga ama-hormone, kanye isitho otshaliwe.

Phakathi ukwelashwa ehlelekile incipha androgen esingamahlalakhona, iyaqala ukuthuthukiswa izici yesibili ngokobulili, potency encishisiwe kancane, ukubonakaliswa encishisiwe kwamathambo bone yobudala lag.

Kangakanani lesi sifo abesifazane

hypogonadism Hypogonadotropic kwabesifazane libhekene nokungathuthuki umsebenzi zocansi futhi ngakhula nezindlala wesibeletho. ifomu Primary azalwa naso ngenxa umonakalo nokungathuthuki noma wesibeletho esikhathini ezisanda kubelethwa.

It is ukwehlisa ekukhiqizweni kwama-hormone ocansini, okuyinto kuphakamisa ukwanda ezingeni gonadotropins, okuyinto zishukumisa ezikhiqiza amaqanda.

Esikhathini ukuhlaziya izinga okusezingeni eliphezulu hormone ukufukula follicle futhi lutein, kanye namazinga aphansi estrogen. sehliselwe estrogen kubangela yoma noma ampofu zesifazane Izitho zokuzala, nezindlala mammary, ukungabi khona esikhathini.

Uma umsebenzi wesibeletho ukuthi kahle ngaphambi ukuthomba ke kukhona ukuntuleka izici ngokobulili yesibili.

hypogonadism Hypogonadotropic kwabesifazane eyinhloko njengoba kukhonjisiwe kwale mibandela elandelayo:

• iziyaluyalu azalwa naso ezakhini zofuzo;
• hypoplasia azalwa naso ezikhiqiza amaqanda;
• izinqubo ezithathelwanayo (ugcunsula, isifo sofuba, Mumps, ngemisebe, ukususwa kuhlinzwa ezikhiqiza amaqanda);
• kokunqotshwa imvelo sokuhlasela kwamasosha omzimba;
• ngalesi sifo, feminization wamasende ;
• amaqanda polycystic.

Secondary hypogonadism hypogonadotropic besifazane kwenzeka zokugula we pituitary futhi ngxenye. It is zihlukaniswa a ukumisa ongaphakeme okuqukethwe noma ephelele ukukhiqizwa gonadotropins lokulawula umsebenzi wesibeletho. Le nqubo ibizwa senziwa ukuvuvukala esifundeni ingqondo. Lezi zifo abe nomthelela elimazayo futhi ahambisana ukwehla ezingeni yokuchayeka gonadotropins ukuze ezikhiqiza amaqanda.

kanjani izifo ezifana hypogonadism hypogonadotropic kwabesifazane, futhi ukhulelwe? Esibi ukuthuthukiswa intrauterine umbungu kungathintwa ngu okuvela isifo.

Izimpawu kubantu besifazane

izimpawu Bright yengane esindayo isikhathi - kungukuphula ukuya esikhathini noma itlhogeko.

Izinga eliphansi hormone zesifazane kuholela nokungathuthuki ka ubulili izitho, nezindlala mammary, ukwephulwa kwamalungelo sebethule fat and mafutha zonke iziboya emzimbeni.

Uma lesi sifo azalwa naso ngokwemvelo, izici ngokobulili yesibili ayiveli. Abesifazane kuphawulwe khona ukhalo ewumngcingo nezinqe flat.

Uma lesi sifo zenzeke ngaphambili ukuthomba, izici ngokobulili ebonakale izohlala ukulondolozwa, kodwa njalo ngenyanga sinqanyuliwe zangasese izicubu yoma.

isevisi kuyinto

Hypogonadism uma kukhona ukwehla kwamazinga estrogen namazinga nesanda gonadotropins. Ngokusebenzisa ultrasound wembulani encishisiwe ngobukhulu kwesibeletho kutholakala ukuthi uphethwe yini ostepoporoz futhi ukubambezeleka ukwakheka skeleton.

ukuphathwa isifo abesifazane

iqedwe kanjani hypogonadotropic hypogonadism besifazane? Ukwelashwa kuhilela replacement therapy. Abesifazane eyabelwe ukuze bathole imishanguzo engabasiza futhi hormone ocansini (ethinyl estradiol).

Endabeni ukuqala kokuya esikhathini linqume zokuvimbela inzalo temlomo equkethe estrogens futhi progestins, futhi amalungiselelo "Triziston", "Trikvilar".

Kusho "Klimov", "Trisekvens", "klimonorma" okunqunyiwe iziguli ngemva kweminyaka engu-40.

ukwelashwa ngama-hormone is contraindicated ku kwale mibandela elandelayo:

• isimila esinomdlavuza ebeleni nesitho sangasese;
• inhliziyo futhi semithambo izifo;
• ukwehluleka kwezinso nesibindi;
• thrombophlebitis.

zokuvimbela

izifo ezifana hypogonadotropic hypogonadism, has a Izibikezelo evumayo. Ukuvimbela imfundo impilo yabantu kanye nokuqapha kwabesifazane abakhulelwe, kanye emisebenzini yezempilo.