So wowɔ mogya mmoroso , a wɔtaa frɛ no "hypertension"? Ɛbɛyɛ sɛ worenom nnuru biako, abien, anaa ebia nea ɛboro saa mpo a wo duruyɛfo akyerɛw ama wo no dedaw. Nanso, ɛmfa ho sɛ wowɔ ayaresa so no, so woda so ara te nka sɛ ɛyɛ den sɛ wubedi wo mogya so? Sɛ saa a, ebia nea ɛde ba no nyɛ nea wotaa hwɛ kwan no. Ɛnnɛ, yɛpɛ sɛ yɛka aduruyɛ mu tebea pɔtee bi a ebetumi ama mogya mmoroso a ɛyɛ den sɛ wobedi ho dwuma, a nnuru ntumi nkɔ so ho asɛm: Hyperaldosteronism. Bere a ebia edin no bɛyɛ te sɛ nea ɛyɛ den no, momma yɛnkyekyɛ mu nyɛ no nsɛmfua a ɛnyɛ den.
Dɛn ne Hyperaldosteronism?
Sɛ yɛbɛka no tiawa a, hyperaldosteronism ba bere a wo adrenal ntini ahorow no yɛ hormone bi a wɔfrɛ no "aldosterone" dodow a ɛboro so no.
Ebia woresusuw ho sɛ: dɛn ne saa adrenal glands yi , na dɛn ne aldosterone?
Fa no sɛ ntini nketenkete abien a ne nsɛso te sɛ kyɛw nketewa te w’asaabo atifi pɛɛ . Eyinom ne wo adrenal ntini ahorow. Wɔyɛ wo endocrine nhyehyɛe no fã titiriw . Saa ntini nketenkete yi ma nkwaadɔm pii a ɛho hia ma wo nipadua no da biara da dwumadi ahorow .
Hormone pɔtee biako a saa ntini ahorow yi yɛ ne aldosterone . N’adwuma titiriw ne sɛ ɛbɛma wo mogya mmoroso ayɛ yiye denam sodium ne potassium dodow a ɛbɛkari pɛ wɔ wo mogya mu no so. Wubetumi asusuw saa hormone yi ho te sɛ kar polisini bi a ɔrekyerɛ kar akwan kwan wɔ ɔkwan a nnipa pii fa so so.
Enti, wɔ hyperaldosteronism mu no, wɔyɛ aldosterone pii dodo. Eyi ma sodium dodow a ɛwɔ wo nipadua mu no kɔ soro bere a potassium dodow so tew. Nea efi mu ba awiei koraa ne mogya mmoroso (mogya mmoroso) ne hypokalemia (mogya mu potassium a ɛba fam) .
Nneɛma atitiriw abien na ɛwɔ hɔ
Nnuruyɛfo gyina nea ɛde ba no so kyekyɛ tebea yi mu abien.
1. Primary Hyperaldosteronism: Wɔsan frɛ no "Conn's syndrome," eyi ba bere a asɛm no da adrenal ntini no mu tẽẽ, na ɛma wɔyɛ aldosterone boro so no.
2. Secondary Hyperaldosteronism: Wɔ eyi mu no, adrenal ntini no wɔ apɔwmuden. Mmom no, wɔrekanyan wɔn ma wɔayɛ aldosterone a ɛboro so de abua ɔhaw bi a efi nipadua no mmeae afoforo.
Henanom na ɛka wɔn kɛse?
Wɔtaa hu saa tebea yi wɔ nnipa a wɔadi fi mfe 30 kosi 50. Nhwehwɛmu nso kyerɛ sɛ ɛtaa ba mmea so kakra sen mmarima.
Nhwehwɛmu kyerɛ sɛ nnipa a wɔwɔ mogya mmoroso nyinaa mu 5% kosi 10% betumi anya hyperaldosteronism titiriw. Nea ɛho hia kɛse no, abenfo gye di sɛ wɔ wɔn a wɔwɔ mogya mmoroso a nnuru ntumi nnom mu no , ɔha biara mu nkyem no betumi akɔ soro akodu 25%.
Dɛn ne sɛnkyerɛnne ahorow no?
Ɛtɔ da bi a, sɛ tebea no nyɛ den a, ebia worenhu sɛnkyerɛnne biara koraa. Nanso, nnipa pii da nsɛnkyerɛnne adi.
Nsɛnkyerɛnne a ɛtaa ba ne mogya mmoroso , titiriw bere a ɛkɔ so yɛ den ɛmfa ho sɛ wɔde mogya mmoroso nnuru pii di dwuma no.
Nsɛnkyerɛnne afoforo sɔre esiane mogya mmoroso ne potassium a ɛba fam (hypokalemia) a wɔaka abom nti. Momma yɛnkyekyɛ eyinom mu pefee.
| Sɛnti | Nsɛnkyerɛnne a Ebetumi Ahu |
|---|---|
| Nsɛnkyerɛnne a efi Mogya Mmoa a Ɛkɔ Anim mu ba |
|
| Nsɛnkyerɛnne a efi Potassium a ɛba fam mu ba |
|
Kae sɛ ɛnsɛ sɛ wuhu saa sɛnkyerɛnne ahorow yi nyinaa. Ebia nnipa binom wɔ biako anaa baanu pɛ.
Dɛn nti na Hyperaldosteronism ba?
Sɛnea yɛadi kan aka no, ɛsono nea ɛde ba no gyina ahorow abien no so.
Nneɛma a Ɛde Hyperaldosteronism a Ɛho Hia Mfitiase Ba
Ɛha yi, ɔhaw no fi adrenal gland no ankasa mu.
- Nea ɛtaa de ba: Mpɛn pii no, ɛyɛ akisikuru a ɛnyɛ kokoram (adrenal adenoma) wɔ adrenal gland no so. Eyi nyɛ kokoram, enti ɛho nhia sɛ wɔbɔ kɔkɔ. Saa akisikuru yi ma aldosterone pii ba kɛkɛ.
- Nneɛma afoforo a ɛntaa nsi:
- Adrenal gland biako a ɛtrɛw (unilateral adrenal hyperplasia).
- Aldosterone a kokoram akisikuru (adrenocortical carcinoma) na ɛyɛ - eyi ho yɛ na yiye.
- Awosu mu tebea bi (abusua mu hyperaldosteronism).
Nneɛma a Ɛde Hyperaldosteronism a Ɛto so Abien Ba
Ɛha yi, adrenal ntini no wɔ apɔwmuden, nanso biribi foforo na ɛkanyan no. Ade titiriw nti a ɛte saa ne mogya a ɛkɔ asaabo no mu a ɛso tew .
Sɛnea ɛbɛyɛ na yɛate eyi ase no, ɛboa sɛ yebehu nipadua no nhyehyɛe a ɛyɛ nwonwa a ɛma mogya mmoroso yɛ yiye no ho asɛm: Renin-Angiotensin-Aldosterone Nhyehyɛe .
Fa no sɛ nkɔnsɔnkɔnsɔn mu adeyɛ:
1. Sɛ wo mogya so tew anaasɛ sodium dodow a ɛwɔ wo mogya mu no so tew a, w’asaabo hu.
2. Afei asaabo no gyae enzyme bi a wɔfrɛ no "renin" kɔ mogya no mu.
3. Renin yɛ adwuma wɔ protein bi a mmerɛbo no yɛ a wɔfrɛ no "angiotensinogen" so, na ɛdan no "angiotensin I."
4. Nea edi hɔ no, wɔdan Angiotensin I yi ma ɛbɛyɛ “Angiotensin II.”
5. Awiei koraa no, ɛyɛ Angiotensin II yi na ɛma wo mogya mmoroso kɔ soro denam wo mogya ntini a ɛtwetwe na ɛkanyan wo adrenal glands ma ɛyɛ aldosterone no so.
Wɔ Hyperaldosteronism a ɛto so abien ho no, aduruyɛ mu tebea bi a ɛda adi no ma mogya a ɛkɔ w’asaabo mu no so tew. Ne saa nti, w’asaabo di mfomso fa no sɛ wo nipadua no mogya so atew dodo. Nea ɛbɛyɛ na wɔabua no, w’asaabo no kanyan nkɔnsɔnkɔnsɔn a wɔde srɛ mmoa. Ne saa nti, wɔyɛ hormone aldosterone no boro so, ɛwom mpo sɛ wo nipadua no nhia no ankasa de.
Tebea horow a ɛtew mogya a ɛkɔ asaabo mu no so na ɛkanyan Hyperaldosteronism a ɛto so abien no bi ne:
- Ntini a ɛde mogya kɔ asaabo no mu a ɛyɛ teateaa (Obstructive renal artery disease).
- Tebea horow a nsu boaboa ano wɔ nipadua no mu, te sɛ Koma a entumi nyɛ adwuma yiye.
- Cirrhosis a ɛwɔ mmerɛbo mu.
- Nephrotic syndrome, asaabo mu yare bi.
Ɔkwan bɛn so na oduruyɛfo hu saa tebea yi?
Sɛ wo ne wo duruyɛfo susuw wo sɛnkyerɛnne ahorow ho—titiriw sɛ woka sɛ wo mogya mmoroso ntumi nyɛ nnuru a wɔtaa de di dwuma no ho dwuma a—ebia wobesusuw sɛ tebea yi wɔ hɔ. Afei wo duruyɛfo bɛhyɛ sɛ wɔnyɛ nhwehwɛmu pii mfa nkyerɛ sɛ woahu sɛ wowɔ yare no.
1. Mogya mu Nhwehwɛmu:
- Wɔ electrolyte mogya a wɔtaa de di dwuma mu no, sodium dodow a ɛkɔ soro kakra (Hypernatremia) ne potassium dodow a ɛba fam (Hypokalemia) taa ma adwenem naayɛ sɔre.
- Afei, mogya mu nhwehwɛmu titiriw abien wɔ hɔ a wɔde di dwuma titiriw de hu tebea yi: Plasma Renin Concentration (PRC) anaa Plasma Renin Activity (PRA) nhwehwɛmu.
- Sɛ wowɔ Hyperaldosteronism titiriw a, mpɛn pii no wo renin dodow (PRC ne PRA) bɛba fam sen sɛnea ɛte daa.
- Sɛ wowɔ Hyperaldosteronism a ɛto so abien a, wo renin dodow bɛkɔ soro asen sɛnea ɛte daa.
2. Aldosterone a Wɔde Siw Ano Sɔhwɛ:
- Wɔ sɔhwɛ yi mu no, wɔma wo sodium (nkyene) dodow a ɛkɔ soro wɔ bere pɔtee bi mu, wɔ anom anaasɛ wɔde nkyene a wɔde fa ntini mu (IV) so.
- Eyi akyi no, wɔboaboa wo nsu ano wɔ nnɔnhwerew 24 mu de susuw aldosterone dodow a ɛwɔ mu no.
- Wɔ obi a ɔwɔ apɔwmuden mu no, sodium a wɔnom kɔ soro no ma nipadua no tew aldosterone a ɛba no so fi awosu mu. Nanso, wɔ obi a ɔwɔ Hyperaldosteronism mu no, eyi nsi.
3. Mfoninitwa Sɔhwɛ ahorow:
- Sɛ mogya mu nhwehwɛmu kyerɛ sɛ wowɔ Hyperaldosteronism titiriw a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ CT scan (Computed Tomography scan) na ama wɔahu nea ɛde ba, te sɛ sɛ wɔbɛhwɛ sɛ adrenal gland tumor bi wɔ hɔ anaa.
Dɛn ne ayaresa ahorow a ɛwɔ hɔ?
Ayaresa nhyehyɛe ahorow gyina nea ɛde ba no so koraa. Nanso, botae titiriw ne sɛ wobɛhwɛ wo mogya so yiye.
- Wɔ Hyperaldosteronism titiriw a akisikuru de ba no ho no:
Nnuruyɛfo taa kamfo kyerɛ sɛ wɔnyɛ oprehyɛn yi akisikuru no ne ntini a asɛe no . Wɔ oprehyɛn akyi no, ayarefo pii hu sɛ wɔn mogya mmoroso ne potassium dodow asan aba sɛnea na ɛte kan no. Ebia ankorankoro binom da so ara hia mogya mmoroso nnuru a ɛkɔ so wɔ oprehyɛn no akyi.
- Wɔ nneɛma afoforo a ɛde ba ne Hyperaldosteronism a ɛto so abien nti:
Wɔ nsɛm yi mu no, ayaresa hwehwɛ sɛ wɔde nnuru di dwuma . Bio nso, sɛ ɛyɛ tebea a ɛto so abien a, yare a ɛde ba no ho dwuma a wobedi (sɛ nhwɛso no, komayare) ho hia.
Nnuru a wɔtaa kyerɛw ma no bi ne:
- Spironolactone (Aldactone®) a wɔde yɛ aduru a wɔfrɛ no Spironolactone (Aldactone®) .
- Eplerenone (Inspra®) a ɛwɔ nipadua no mu.
- Amiloride (Midamor®) a ɛwɔ nipadua no mu.
Yɛsrɛ sɛ hyɛ no nsow sɛ nnuru a esiw aldosterone dwumadi kwan te sɛ Spironolactone a wɔde di dwuma bere tenten no betumi de ɔhaw ahorow aba mmarima so, te sɛ ɔbarima ne ɔbea nna a ɛnyɛ den anaasɛ nufu a ɛtrɛw (Gynecomastia). Sɛ wunya ɔhaw biara anaa ɔhaw bi a, ntwentwɛn wo nan ase da sɛ wo ne wo duruyɛfo bɛka ho asɛm.
Dɛn ne adwene a ɛwɔ hɔ ne nsɛnnennen a ebetumi de aba?
Wo nkɔmhyɛ, anaa bere tenten mu nsusuwii gyina nea ɛde ba no so kɛse.
Sɛ wohu Hyperaldosteronism titiriw no ntɛm na wɔsa no yiye a, nea efi mu ba no taa yɛ nea eye sen biara. Wɔ Hyperaldosteronism a ɛto so abien ho no, nea ebefi mu aba no gyina sɛnea wobetumi adi aduruyɛ tebea a ɛwɔ ase no ho dwuma yiye so.
Nsɛnnennen atitiriw a ɛba tebea yi mu no fi mogya mmoroso a ɛtra hɔ kyɛ a wontumi nni so, a ebetumi de koma ne ntini mu nsɛm a emu yɛ den aba.
| Nsɛnnennen Titiriw a Ebetumi Ayɛ |
|---|
| Atrial fibrillation (koma a ɛbɔ a ɛnteɛ) . |
| Benkum so ventricular hypertrophy (koma no dan titiriw a ɛtrɛw) . |
| Koma mu yare |
| Nnwodwoɔ |
Esiane eyi nti, wo mogya mmoroso a wobɛhwɛ so denneennen no ho hia.
So wobetumi asiw tebea yi ano?
Mpɛn pii no, wontumi nsiw tebea yi ano efisɛ ɛtaa gyina nipadua no mu nneɛma so. Nanso, asɛmpa no ne sɛ, sɛ wohu a, ayaresa a etu mpɔn betumi asiw ɔhaw ahorow a emu yɛ den a ɛtra hɔ kyɛ ano.
Nkrasɛm a Wɔde Kɔ Fie
- Sɛ ɛda so ara yɛ den sɛ wubedi wo mogya mmoroso so ɛmfa ho sɛ wonom nnuru pii a, hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa .
- Hyperaldosteronism yɛ tebea a efi hormone aldosterone a ɛdɔɔso dodo mu ba.
- Ebetumi ayɛ nea edi kan (efi ase wɔ ntini no mu) anaa nea ɛto so abien (a aduruyɛ mu tebea foforo na ɛde ba).
- Wobetumi afa mogya mu nhwehwɛmu titiriw ne mfoninitwa so ahu no pɛpɛɛpɛ.
- Wobetumi de oprehyɛn anaa nnuru asa no yiye, a egyina nea ɛde ba no so.
- Ade a ɛho hia sen biara a ɛsɛ sɛ wuhu ne sɛ eyi yɛ tebea a wobetumi asa; sɛ wowɔ nsɛm bi a ɛhaw wo a, hwehwɛ aduruyɛfo afotu ntɛm ara.
Hyperaldosteronism, aldosterone, adrenal glands, Conn’s syndrome, mogya mmoroso, mogya mmoroso, nhyɛso, potassium, sodium, asaabo, hormone ahorow
