Yɛn nyinaa nim sɛnea calcium ho hia ma nipadua no, titiriw ma yɛn nnompe. Efi mmofraase no, yɛn maamenom aka akyerɛ yɛn sɛ "nufusu a yɛnom hyɛ nnompe mu den." Nanso so woasusuw nea ɛba sɛ nea wɔfrɛ no calcium pa yi dɔɔso dodo wɔ yɛn mogya mu no ho pɛn? Ɛno ne nea yɛfrɛ no hypercalcemia wɔ nnuruyɛ mu. Ɛnnɛ, yɛbɛka eyi ho asɛm tiawa koraa, wɔ ɔkwan a wubetumi ate ase so.
Dɛn ankasa ne hypercalcemia?
Sɛ yɛbɛka no tiawa a, hypercalcemia yɛ bere a calcium pii wɔ wo mogya mu sen sɛnea ɛte daa no. Eyi betumi ayɛ bere tiaa mu nkɔanim ketewaa bi, anaasɛ ebetumi ayɛ tebea a enni sabea, a ɛtra hɔ ne nkwa nna nyinaa.
Afei ebia woresusuw nea ɛba bere a calcium a ɛwɔ wo nnompe mu no kɔ wo mogya mu no ho. Nokwarem no, calcium a ɛwɔ wo nipadua mu no mu dodow no ara wɔ wo nnompe mu. Nanso sɛ wubetumi ayɛ adwuma yiye a, ɛsɛ sɛ wunya calcium bi nso wɔ wo mogya mu.
Nneɛma a calcium a ɛwɔ mogya mu yɛ yɛn nipadua ni:
- Ntini a ɛma nipadua no yɛ adwuma yiye: Eyi boa wɔ biribiara a yesusuw, yɛte nka, ne ahyɛde biara mu.
- Ntini a ɛtwetwe: Calcium a ɛwɔ mogya mu no boa ma ntini no tu, nantew, na ɛyɛ kankyee biara.
- Mogya a ɛtwetwe: Ɛboa ma mogya tu bere a obi apira no.
- Koma no dwumadi a ɛfata: Eyi ho hia na ama koma no bɔ denneennen.
Yɛn nipadua no hwɛ calcium dodow yi so wɔ ɔkwan a ɛyɛ nwonwa yiye so. Nkwammoaa abien boa wɔ eyi mu. Baako ne parathyroid hormone, na biako nso ne calcitonin. Vitamin D nso di dwuma kɛse wɔ ha, efisɛ vitamin D boa nipadua no ma ɛtwe calcium fi nnuan a yedi mu.
Nanso, esiane nyarewa, nnuru, ne nneɛma afoforo bi nti, saa nhyehyɛe a wɔde siw ano yi betumi asɛe na calcium dodow a ɛwɔ mogya no mu no betumi akɔ soro. Eyi ne bere a hypercalcemia ba.
Nsonsonoe a ɛda hypercalcemia ne hypocalcemia ntam
Ɛwom sɛ nsɛmfua abien yi nnyigyei yɛ pɛ de, nanso ɛsono nea ɛkyerɛ koraa.
- Hyper: Borɔfo asɛmfua "Hyper" kyerɛ "dodow." Ɛno kyerɛ sɛ hypercalcemia yɛ calcium a ɛkɔ soro wɔ mogya mu.
- Hypo: Asɛmfua "Hypo" kyerɛ "ba fam." Ɛno kyerɛ sɛ hypocalcemia yɛ calcium a ɛba fam wɔ mogya no mu.
Hena na ɛda adi kɛse sɛ obenya saa tebea yi?
Hypercalcemia betumi aba wɔ mfe biara mu, wɔ obiara mu. Nanso, ɛtaa ba mmea a wɔadi boro mfe 50 so .Saa tebea yi taa ba, titiriw bere a obi agyae brayɛ akyi. Nea ɛde eyi ba titiriw ne parathyroid ntini a ɛyɛ adwuma boro so.
Wobu akontaa sɛ nnipa dodow no ara mu 1% kosi 2% na wɔwɔ saa tebea yi. Nanso, eyinom mu 90% fi ɔhaw a yɛadi kan aka ho asɛm wɔ parathyroid ntini (primary hyperparathyroidism) anaa kokoram ho.
Mpɛn pii no, tebea yi nyɛ aniberesɛm saa. Wohu sɛ nnipa pii anya bi wɔ akwanhyia mu bere a wɔreyɛ mogya mu nhwehwɛmu a wɔyɛ no daa esiane biribi foforo nti. Enti ɛho nhia sɛ wohaw wo ho.
Nanso, sɛ calcium dodow a ɛwɔ mogya no mu kɔ soro paa a, ebetumi de ɔhaw a emu yɛ den aba.
- Asaabo a entumi nyɛ adwuma yiye
- Koma a ɛbɔ a ɛnteɛ (Arrhythmia) .
- Nkae ne nhumu a ɛhaw adwene (Adwene mu naayɛ) .
- Sɛ́ wobɛkɔ coma mu
Dɛn ne hypercalcemia ho sɛnkyerɛnne ahorow?
Esiane sɛ wɔtaa nya saa tebea yi ntɛm nti, nnipa pii nhu yare no ho sɛnkyerɛnne biara. Nanso, sɛ calcium dodow kɔ soro kakra anaasɛ sɛ tebea no atra hɔ akyɛ a, sɛnkyerɛnne ahorow a edidi so yi betumi aba.
| Nipadua nhyehyɛe | Nsɛnkyerɛnne a ebetumi aba |
|---|---|
| Asaabo ne nsu a wɔde gu nipadua mu | Nsu a wɔtaa tow ne sukɔm a ɛboro so. |
| Nnuan a wɔyam | Akisikuru ne ɔfe, akisikuru, aduan ho akɔnnɔ a ɛyera. |
| Amemene ne adwene mu tebea | Wo werɛ fi, adwenemhaw, abufuw a ɛtaa ba. |
| Nnompe ne ntini ahorow | Nnompe mu yaw, ntini mu yaw, nipadua mu yaw, ntini a ɛtwetwe. |
| Su ahorow a ɛwɔ hɔ nyinaa | Ɔbrɛ ne tiyɛ a ɛkɔ so daa. |
Dɛn nti na calcium a ɛwɔ mogya no mu no kɔ soro saa?
Nyarewa bɛboro 25 na ebetumi ama obi anya hypercalcemia. Nnuru bi ne nsu a ɛho ntew nso betumi de aba. Nanso sɛnea yɛadi kan aka no, nneɛma atitiriw abien a ɛde ba ne hyperparathyroidism ne kokoram.
1. Parathyroid ntini ho haw (Primary Hyperparathyroidism) .
Ntini nketewa anan na ɛwɔ yɛn kɔn mu, wɔ thyroid ntini no akyi. Wɔfrɛ eyinom sɛ parathyroid ntini ahorow. Eyinom ma wonya parathyroid hormone (PTH) a wɔfrɛ no parathyroid hormone. Saa hormone yi ne nea ɛhwɛ calcium dodow a ɛwɔ mogya no mu so titiriw.
Fa no sɛ, sɛ calcium dodow a ɛwɔ yɛn mogya mu no so tew a, saa ntini ahorow yi yi hormone PTH fi mu. Saa hormone no kɔ na ɛma calcium bi fi nnompe no mu kɔ mogya no mu, na ɛmma asaabo no ntumi nyi calcium, na ɛboa ma dwensɔtwaa no twe calcium. Wɔ saa kwan yi so no, wɔma calcium dodow san ba sɛnea na ɛte kan no.
Nanso, sɛ ntini anan yi mu biako anaa nea ɛboro saa yɛ adwuma boro so a , sɛ mogya mu calcium dodow san ba sɛnea na ɛte kan mpo a, PTH hormone no rennyae sɛ ɛbɛyi. Afei calcium a efi nnompe no mu bɛkɔ so de aka mogya no ho, na ama calcium dodow a ɛwɔ mogya mu no akɔ soro.
2. Kokoram ahorow
Kokoram bɛyɛ 2% ne hypercalcemia wɔ abusuabɔ. Hypercalcemia of malignancy taa ba ntɛmntɛm na ebetumi ayɛ kɛse. Nea enti a ɛte saa ne sɛ kokoram nkwammoaa bi yɛ protein (PTHrP) a ɛyɛ adwuma te sɛ hormone PTH anaasɛ ɛma calcium fi mu denam dompe a ɛsɛe so.
Kokoram ahorow a ebetumi de tebea yi aba:
- Ahurututu mu kokoram
- Nufu mu kokoram
- Multiple myeloma (mogya mu nkwammoaa fitaa mu kokoram) .
- Adwene mu nkwammoaa mu kokoram
- Mogya mu kokoram (Leukemia) .
- Lymphoma (kokoram a ɛba nipadua no mu) .
3. Nnuru bi
Nnuru ne vitamin ahorow bi a yɛnom nso betumi de eyi aba.
- Thiazide diuretics (nnuru a wɔde sa mogya mmoroso), te sɛ hydrochlorothiazide .
- Lithium ( aduru bi a wɔde sa adwenemyare bi).
- Vitamin D, vitamin A, anaa calcium a wɔnom pii .
Nnipa binom taa nom calcium carbonate aduru te sɛ Tums® ma yafunu mu yare. Sɛ obi nom eyinom pii a, ebetumi ama calcium dodow a ɛwɔ mogya no mu akɔ soro bere tiaa bi.
4. Nneɛma afoforo nti
Nea ɛka eyi ho no, nneɛma afoforo pii wɔ hɔ a ɛntaa nsi:
- Ahurututu mu nyarewa te sɛ sarcoidosis ne nsamanwaw.
- Asaabo a entumi nyɛ adwuma yiye.
- Ntini a ɛma mogya tu a ɛboro so (Thyrotoxicosis).
- Nneɛma a ɛma obi ntumi nkɔ baabiara.
- Nnompe mu nyarewa te sɛ Paget yare a ɛwɔ dompe mu.
Ɔkwan bɛn so na wobehu tebea yi?
Wɔtaa de mogya mu nhwehwɛmu a ɛnyɛ den na ehu eyi. Wo duruyɛfo bɛsusuw wo calcium dodow bere a wɔreyɛ basic metabolic panel (BMP) anaa comprehensive metabolic panel (CMP) mogya mu nhwehwɛmu no.
Wɔkyekyɛ tebea no mu den mu sɛnea calcium dodow a ɛwɔ mogya no mu te.
| Gyinabea | Mogya mu calcium dodow (mg/dL) . |
|---|---|
| Calcemia a ɛboro so a ɛnyɛ den | 10.5 kosi 11.9 mg/dL |
| Hypercalcemia a ɛkɔ soro a ɛkɔ fam | 12.0 kosi 13.9 mg/dL |
| Tebea a emu yɛ den/egye ntɛmpɛ (Hypercalcemic crisis) . | 14.0 kosi 16.0 mg/dL |
Sɛ wo duruyɛfo hu sɛ calcium dodow a ɛwɔ wo mogya mu no dɔɔso a, obebisa wo nnuru a wode di dwuma, w’abusua aduruyɛ ho abakɔsɛm, ne nneɛma afoforo ho asɛm. Afei, wɔbɛhyɛ sɛ wɔnyɛ nhwehwɛmu kakraa bi bio na wɔahu nea ɛde ba.
- Mogya mu nhwehwɛmu a ɛkyerɛ sɛnea parathyroid hormone (PTH) dodow te.
- Mogya mu nhwehwɛmu a wɔyɛ de hwɛ vitamin D dodow.
- Sɔhwɛ a ɛkyerɛ sɛnea calcium dodow a wɔayi afi nsu mu no.
Sɛ adwenem naayɛ bi wɔ hɔ sɛ nea ɛde ba no yɛ ɔhaw bi a ɛwɔ parathyroid ntini no mu a, wobetumi ahyɛ sɛ wɔnyɛ ultrasound scan anaa CT scan mfa nhwɛ sɛ akisikuru anaasɛ ntini no mu ahonhon anaa.
Dɛn ne ayaresa ahorow a wɔde sa hypercalcemia?
Ayaresa no gyina nea ɛde tebea no ba ne sɛnea emu yɛ den so.
Wɔ nsɛm a emu nyɛ den ho
Sɛ wo calcium dodow kɔ soro kakra a, ebia wo duruyɛfo betu wo fo sɛ:
- Nom nsu pii: Eyi boa ma calcium a ɛboro so no bi fa asaabo no mu.
- Nnuru a wobɛsesa: Sɛ worenom nnuru a ɛte sɛ thiazide a wɔde sa mogya mmoroso a, ebia wɔbɛka akyerɛ wo sɛ sesa.
- Gyae nnuru a wɔde ka aduan ho nom: Sɛ worenom nnuru a ɛma calcium, vitamin D, anaa yafunu mu yare a, gyae nom anaasɛ tew dodow so sɛnea wo duruyɛfo kyerɛ no .
Sɛ ɔhaw bi wɔ parathyroid ntini no ho a
Sɛ nea ɛde ba ne parathyroid ntini a ɛyɛ adwuma boro so a, mpɛn pii no ayaresa a eye sen biara ne oprehyɛn a wɔde yi ntini anaa ntini a ɛyɛ adwuma boro so no.
Sɛ kokoram na ɛde tebea no ba a
Saa bere yi de, wɔde nnuru titiriw bi ma de hwɛ calcium dodow so bere a wɔresa kokoram no.
- Bisphosphonates: Eyinom brɛ calcium a efi nnompe mu no ase.
- Denosumab: Wɔde saa aduru yi ma nnipa a wɔnyɛ bisphosphonates ho adwuma.
Wɔ nsɛm a emu yɛ den ho
Sɛ calcium dodow dɔɔso yiye na yare no ho sɛnkyerɛnne a emu yɛ den da adi a, ɛsɛ sɛ wɔde ɔyarefo no kɔ ayaresabea ntɛm ara ma wɔsa no yare. Eyi hwehwɛ sɛ wɔde nkyene fa ntini mu (IV nsu) na ama calcium a ɛboro so no afi nipadua no mu ntɛmntɛm.
Dɛn ne nea efi tebea yi mu ba bere tenten?
Sɛ wɔanhu hypercalcemia na wɔansa no ntɛm a, ebetumi de nsɛnnennen a ɛtra hɔ kyɛ aba.
- Asaabo mu abo .
- Asaabo a entumi nyɛ adwuma yiye esiane calcium a ɛwɔ asaabo mu nti.
- Mogya mmoroso (Hypertension) .
- Nnompe mu yare ne asiane a ɛkɔ soro sɛ nnompe bɛpaapae.
- Nnompe mu akisikuru.
- Hahaahayɔ.
So wobetumi asiw tebea yi ano?
Wontumi nsiw hypercalcemia ano mfi nneɛma nyinaa mu. Nanso wubetumi atew asiane a ɛwɔ hɔ no so akodu baabi denam calcium a wobɛkwati dodo ne nnuru a ekum acid a calcium wom a wunni aduruyɛfo afotu so .
Sɛ obi a ɔwɔ w’abusua mu a ɔwɔ mogya mu calcium pii, asaabo mu abo, anaa parathyroid yare a, wo ne wo duruyɛfo nka ho asɛm.
Nkrasɛm a Wɔde Kɔ Fie
- Hypercalcemia yɛ calcium dodow a ɛwɔ mogya no mu a ɛkɔ soro sen dodow a ɛfata ara kwa.
- Mpɛn pii no, nsɛm a emu nyɛ den no nkyerɛ yare no ho sɛnkyerɛnne biara. Wɔnam mogya mu nhwehwɛmu a wɔyɛ no kwa so na ehu.
- Nneɛma atitiriw abien a ɛde eyi ba ne parathyroid ntini a ɛyɛ adwuma boro so ne kokoram ahorow bi.
- Ayaresa a wobetumi apaw no gyina nea ɛde tebea no ba ne sɛnea emu yɛ den so, enti ɛho hia yiye sɛ wobehu yare no pɛpɛɛpɛ.
- Sɛ wowɔ sɛnkyerɛnne ahorow a wɔaka ho asɛm wɔ asɛm yi mu no bi anaasɛ sɛ obi a ɔwɔ w’abusua mu anya saa yare yi a, hwɛ hu sɛ wobɛkɔ wo duruyɛfo nkyɛn akɔhwehwɛ afotu.
- Mfa calcium anaa vitamin afoforo a wɔde ma da a wunni aduruyɛfo afotu.
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