Nusianu si ku ɖe ACTH Stimulation Test, si dzidzea wò ŋutilã ƒe lãmetsiŋusẽwo ŋu!

Ɣeaɖewoɣi ne nu aɖewo le míaƒe ŋutilã me mewɔa dɔ nyuie o la, lãmesẽkuxi vovovowo ate ŋu ado mo ɖa, alo? Vevietɔ ne míaƒe ŋutilã ƒe lãmetsiŋusẽ ƒe dɔwɔwɔ mesɔ o la, ate ŋu akpɔ ŋusẽ gã aɖe ɖe mía dzi. Le nɔnɔme sia tɔgbe me la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàwɔ dodokpɔ tɔxɛ aɖe. Emae nye `ACTH Stimulation Test`. Mina míaƒo nu tso esia ŋu bɔbɔe.

Nukae nye ACTH dodokpɔ (ACTH Stimulation Test)?

Kpuie ko la, dodokpɔ tɔxɛ aɖee nye esia si léa ŋku ɖe alesi míaƒe ŋutilã ƒe adrenal glands wɔa nu ɖe ​​lãmetsi aɖe si woyɔna be ACTH ŋui ŋu. Ɣeaɖewoɣi la, wogayɔa esia be Cosyntropin Stimulation Test (CST). Esiae nye dodokpɔ vevitɔ si woawɔ atsɔ anya ne nɔnɔme aɖe li si woyɔna be adrenal insufficiency, si nye adrenal glands ƒe dɔwɔwɔ dzi ɖeɖe kpɔtɔ. Esia ate ŋu anye gbãtɔ, evelia alo etɔ̃lia.

Dodokpɔ sia bia be woado ACTH lãmetsi aɖe si wowɔ (Synthetic ACTH - Cosyntropin) ɖe wò lãmeka me. Emegbe le gaƒoƒo afã ɖesiaɖe alo esi wu nenema me la, woɖea wò ʋu eye wodoa lãmetsi aɖe si woyɔna be cortisol ƒe agbɔsɔsɔ kpɔna. Esia nye be nàkpɔ alesi wò adrenal glands le dɔ wɔm nyuie.

Nukae nye ACTH kple Cortisol?

`ACTH`, si tsi tre ɖi na `Adrenocorticotropic Hormone`, nye lãmetsi si `Pituitary Gland` si le míaƒe ahɔhɔ̃ me wɔ. Ekpɔa ŋusẽ gã aɖe ɖe alesi míaƒe ŋutilã wɔa nu ɖe ​​nuteɖeamedzi ŋui dzi. Ne `ACTH` do la, eʋãa adrenal glands be woawɔ `Cortisol`, si woyɔna hã be `stress hormone` . Cortisol nye lãmetsi vevi aɖe si gblẽa nu le míaƒe ŋutilã ƒe ŋutinu kple lãkusi ɖesiaɖe kloe ŋu.

Adrenal Insufficiency Ƒomeviwo

Esia ate ŋu adzɔ le mɔ vevi etɔ̃ nu:

1. Adrenal Insufficiency Gbãtɔ: Esia dzɔna ne wò adrenal glands gblẽ eye mete ŋu wɔa cortisol nyuie o. Nusi koŋ gbɔ esia tsonae nye Addison ƒe dɔlélea. Enye dɔléle si dɔlélenutsiŋutete ŋutɔ hena vɛ.

2. Secondary Adrenal Insufficiency: Esia dzɔna ne wò pituitary gland mewɔ ACTH si sɔ o. Emegbe womeʋãa adrenal glands ale gbegbe be woawɔ cortisol o.

3. Tertiary Adrenal Insufficiency: Esia dzɔna ne hypothalamus si le ahɔhɔ̃a me mewɔ lãmetsi si nye `CRH (Corticotropin-Releasing Hormone)` nyuie o. `CRH` nye nusi gblɔna na pituitary gland be wòawɔ `ACTH`.

Ɣekaɣie wòhiã be woawɔ ACTH dodokpɔ?

Dodokpɔ sia ate ŋu anya ne wò adrenal glands kple pituitary gland le dɔ wɔm nyuie le cortisol wɔwɔ gome. Wò ɖɔkta ate ŋu adɔ dodokpɔ sia le susu siwo gbɔna ta:

• Ne dodokpɔ bubu aɖe kpɔe be wò cortisol ƒe agbɔsɔsɔ le sue.
• Ne adrenal insufficiency ƒe dzesiwo le ŋuwò (e.g., ɖeɖiteameŋu enuenu, lolo dzi ɖeɖe kpɔtɔ, dɔgbo ƒe veve, ʋuʋudedi, taɖuame, ŋutigbalẽ si do viviti ).
• Ne èdzudzɔ glucocorticoid-tikewo, abe prednisone ene, zazã hena ɣeyiɣi aɖe la, lé ŋku ɖe eŋu be wò pituitary kple adrenal glands gatrɔ va nɔ nɔnɔme nyui me hã.

Amekae le dodokpɔ sia wɔm?

Zi geɖe la, dɔnɔdzikpɔlae doa ACTH la. Ʋu si woɖena, si nye ʋu si woɖena la, nyea ʋukawo ŋuti nunyala, si fia be ame aɖe si xɔ hehe tɔxɛ ɖe taɖodzinua ta. Emegbe woɖoa kpɔɖeŋu siawo ɖe dodokpɔxɔ aɖe. Afimae atikewɔƒe ƒe dzɔdzɔmeŋutinunyala aɖe doa kpɔɖeŋu siawo kpɔna.

Zi geɖe la, wowɔa dodokpɔ sia le kɔdzi alo le lãmenugbagbeviwo ƒe dɔwɔwɔ ŋuti nunyala, si nye ɖɔkta si bi ɖe dɔléle siwo do ƒome kple lãmetsiŋusẽ me ƒe dɔwɔƒe. Esia bia be woado atike ɖe lãme na ame ahaɖe ʋu. Lãmetsiŋutinunyala nye ɖɔkta si bi ɖe dɔléle siwo do ƒome kple lãmetsiŋusẽ me.

Ðe wòhiã be madzra nane ɖo hafi adoe kpɔa?

Ẽ, nanewo li.

• Woate ŋu abia tso asiwò be nàɖe wò dɔwɔnawo dzi akpɔtɔ eye nàɖu nuɖuɖu si me carbohydrate sɔ gbɔ ɖo gaƒoƒo 12-24 do ŋgɔ na dodokpɔa.
• Àte ŋu agblɔ hã be yeatsi nu adɔ abe gaƒoƒo ade ene. Ema fia be màte ŋu aɖu nu alo ano naneke o negbe tsi ko.
• Ne èle atike aɖewo zãm siwo ate ŋu akpɔ ŋusẽ ɖe cortisol dodokpɔa dzi la, woate ŋu abia tso asiwò be nàdzudzɔ wo nono hena ɣeyiɣi aɖe.
• Esi wònye be cortisol ƒe agbɔsɔsɔ toa vovo le ŋkekea me katã (si sɔa gbɔ wu le ŋdi me) ta la, anyo wu be woawɔ dodokpɔ sia le ŋdi me be wòaɖe afɔku si le alakpa dodokpɔ me tsonu nyuiwo me dzi akpɔtɔ.

Gake wò ɖɔkta ana mɔfiame tɔxɛwo wò le alesi nàdzra ɖo ɖe dodokpɔ sia ŋui ŋu. Ele be nàwɔ ɖe mɔfiame mawo dzi pɛpɛpɛ.

Aleke wowɔa ACTH dodokpɔae?

Esiawoe nye afɔɖeɖe veviawo:

1. Gbã la, woɖea ʋu tso ʋuka aɖe si le wò alɔnu me. Esia alé ŋku ɖe wò cortisol ƒe agbɔsɔsɔ le gɔmedzedzea me ŋu. Woate ŋu awɔ dodokpɔ bubuwo hã.

2. Emegbe, dɔnɔdzikpɔla aɖe ado lãmetsi aɖe si wowɔ si woyɔna be `ACTH (Cosyntropin)` ɖe wò lãmeka me. `ACTH` sia si wowɔ la wɔa dɔ abe `ACTH` si míaƒe ŋutilã wɔna ene, si doa ŋusẽ adrenal glands be woawɔ cortisol.

3. Emegbe le miniti 30 kple aɖabaƒoƒo 60 (zi geɖe) megbe la , wogaɖea ʋu le wò ʋuka me eye wokpɔa cortisol ƒe agbɔsɔsɔ.

4. Woɖoa ʋu siawo ɖe nudokpɔƒe.

Nuteƒekpɔkpɔ ka ƒomevie nèkpɔna le dodokpɔa wɔɣi?

Nusiwo nàte ŋu akpɔ mɔ na ne wole wò ʋu ɖem la dometɔ aɖewoe nye esi:

• Ànɔ zikpui dzi eye woakpɔ ʋuka bɔbɔe aɖe le wò alɔnu. Zi geɖe la, anɔ wò abɔ ƒe eme, le wò abɔta megbe tututu.
• Ne wonya ke ɖe ʋuka aɖe ŋu ko la, wokɔa teƒea hewua dɔlékuiwo.
• Emegbe wotsɔa aŋe sue aɖe dea ʋukaa me eye woɖea ʋu. Esia ate ŋu ase le eɖokui me abe ƒoƒoe vi aɖe ene.
• Ne wotsɔ aŋea de eme vɔ la, ʋu vi aɖe aƒo ƒu ɖe dodokpɔmɔ̃ aɖe me.
• Ne wofɔ ʋu si sɔ na dodokpɔa vɔ la, woɖea aŋea ɖa eye wotsɔa kotoku alo gaze kakɛ aɖe dana ɖe teƒea hezinɛ be ʋua natɔ te.
• Emegbe wotsɔa aŋɔ ƒoa teƒea.

Ne èxɔ Cosyntropin la, zi geɖe la, wodonɛ ɖe wò abɔta, le wò abɔta tame tututu. Àte ŋu ase veve vie alo dzobibi ne wodo atikea na wò, gake ɣeyiɣi kpui aɖe koe wòxɔna.

Nukae dzɔna le dodokpɔa megbe?

Ne woɖe ʋuawo vɔ la, woɖoa wo ɖe dodokpɔxɔa me. Ne emetsonuwo va ɖo la, wò ɖɔkta agblɔ wo ŋu nya na wò.

Ðe afɔku aɖewo le dodokpɔ sia mea?

Ʋudodokpɔ nye nusi bɔ ŋutɔ le atikewɔwɔ me. Afɔkuawo le sue ŋutɔ. Ðewohĩ àse le ɖokuiwò me be yevuvu alo abi vie le afisi woɖe ʋua le, gake ema nu ayi kaba. Naneke meli si ŋu woatsi dzi ɖo o.

Ɣeyiɣi didi kae wòxɔna hafi míenyaa emetsonuwo?

Ate ŋu axɔ kwasiɖa ɖeka hafi ACTH dodokpɔa me tsonu nagatrɔ ava, elabena ne dodokpɔ me tsonu siwo le dodokpɔxɔa me gatrɔ gbɔ ko la, ele be ɖɔktaa nasrɔ̃ nu tso wo ŋu nyuie eye wòaƒo nya ta.

Nukawoe dona tso eme?

Zi geɖe la, nyatakaka siwo le abe esia ene nɔa ʋudodokpɔ ŋuti nyatakakawo me, siwo dome cortisol ŋuti nyatakakawo tso ACTH dodokpɔa me hã le:

• Ʋudodokpɔa ƒe ŋkɔ, alo nusi wodzidze le ʋua me.
• Wò ʋudodokpɔ me tsonu ƒe xexlẽme alo dzidzenu.
• Emae nye dzidzenu si sɔ na dodokpɔa.
• Nyatakaka siwo ku ɖe nenye be wò dodokpɔa me tsonu sɔ, mesɔ o, lolo, alo le sue ŋu.

Aleke wòle be emetsonuwo nanɔ le mama dedie nu?

Le nɔnɔme siwo sɔ me la, ele be wò cortisol ƒe agbɔsɔsɔ nadzi ɖe edzi le ACTH ƒe dɔwɔwɔ si wowɔ kple asi megbe. Le emetsonu si sɔ me la, ele be wò cortisol ƒe agbɔsɔsɔ nasɔ gbɔ wu 12.6 mcg/dL (micrograms per deciliter) le ACTH ƒe dzodzo megbe.

Ðo ŋku edzi be didime siawo siwo sɔ ate ŋu ato vovo tso dodokpɔxɔ ɖeka me yi bubu gbɔ, dodokpɔ ɖesiaɖe me yi bubu gbɔ, kple ame ɖeka yi ame bubu gbɔ. Kpɔ didime si sɔ si wona le wò nyatakakaa me ɖa ɣesiaɣi.

Le ACTH dodokpɔ gome la, ahiã be wò ɖɔkta alo lãmenugbagbeviwo ƒe dɔwɔwɔ ŋuti nunyala nase emetsonuwo gɔme nyuie hafi nàte ŋu akpɔ wo. Ne nya aɖe le asiwò ku ɖe emetsonuwo ŋu la, kpɔ egbɔ be yebia wò ɖɔkta.

Nukae emetsonu siwo mesɔ o fia?

Wò ɖɔkta alo lãmenugbagbeviwo ƒe dɔwɔwɔ ŋuti nunyala adzro wò ACTH dodokpɔa me tsonu me nyuie. Nu geɖe li siwo ate ŋu akpɔ ŋusẽ ɖe dodokpɔa ƒe nyateƒetoto dzi. Nusi gbɔ wòtsona be alakpatɔe nye be corticosteroids zazã nyitsɔ laa.

Zi geɖe la, ACTH dodokpɔ me tsonu siwo mesɔ o ɖenɛ fiana be adrenal ƒe dɔmawɔmawɔ nyuie gbãtɔ kple evelia.

Adrenal ƒe Dɔmawɔmawɔ Nyuie Gbãtɔ

Ne dɔléle sia le ŋuwò la, wò adrenal glands mate ŋu awɔ cortisol o alo womewɔa nu nyuie ɖe ACTH ŋu o. Eyata ɖewohĩ màkpɔ dzidziɖedzi gã aɖeke alo dzidziɖedzi aɖeke le wò cortisol ƒe agbɔsɔsɔ me le ACTH dodokpɔ vɔ megbe o. Esia le alea elabena ACTH si wowɔ la mekpɔa ŋusẽ ɖe wò adrenal glands dzi o.

Adrenal ƒe Dɔmawɔmawɔ nyuie Evelia

Ne lãkusia mewɔa dɔ nyuie o ɣeyiɣi didi aɖe (hypopituitarism), eye ACTH ƒe wɔwɔme gblẽ la, esia hea adrenal ƒe dɔmawɔmawɔ nyuie evelia vɛ. Esia wɔnɛ be womeʋãa lãmenugbagbevi siwo wɔa ACTH le dzɔdzɔme nu o, eye adrenal glands tea vuvu, si fia be wodzea gbɔdzɔgbɔdzɔ gɔme .

Eyata ne ʋumenugbagbeviɣidɔ kple adrenal evelia ƒe dɔmawɔmawɔ nyuie le ŋuwò ɣeyiɣi didi aɖe la, àte ŋu akpɔ dzidziɖedzi boo aɖeke le wò cortisol ƒe agbɔsɔsɔ me le ACTH dodokpɔa megbe o .

Gake ne hypopituitarism nye akpa aɖe (si fia be pituitary gland gakpɔtɔ le ACTH aɖewo wɔm), alo ne nɔnɔmea nye nyitsɔ laa la, woate ŋu akpɔ cortisol ƒe agbɔsɔsɔ ƒe dzidziɖedzi, si fia be "si sɔ" le ACTH dodokpɔa megbe.

Gbedasi Mamlɛtɔ si Wotsɔ Yi Aƒeme

ACTH Stimulation Test nye dodokpɔ vevitɔ kekeake si ŋu kakaɖedzi le wu be woatsɔ anya adrenal insufficiency. Dodokpɔ si wowɔ be woatsɔ anya dɔlélea ƒe emetsonuwo lala ate ŋu agbã dzi na ame vie. Gake ɖo ŋku edzi be nuka kee ado tso eme o, wò atikewɔlawo ƒe ƒuƒoƒoa li be yewoakpe ɖe ŋuwò. Mègavɔ̃ be yeabia wò ɖɔkta tso wò dodokpɔa alo emetsonuwo ŋu o. Ele vevie be woana nànya nu tso wò lãmesẽ ŋu.

` ACTH dodokpɔ, cortisol, adrenal glands, pituitary gland, lãmetsiwo, adrenal ƒe dɔmawɔmawɔ nyuie, atikewɔwɔ dodokpɔwo