ʻO kahi pilikia i loaʻa i nā poʻe he nui ma Sri Lanka, ʻo ia ke koko kiʻekiʻe. No kekahi poʻe, he mea paʻakikī loa ke kāohi i kēia ma hope o ka lawe ʻana i ka lāʻau lapaʻau. Akā, aia kekahi kanaka i loko o ko kākou kino a kākou e kamaʻilio nui ʻole ai, akā, hoʻohuli malū ʻo ia i ke koko. ʻO ia ka mea a kākou e kamaʻilio ai i kēia lā. ʻO Aldosterone kona inoa.
I ka ʻōlelo maʻalahi, ʻo wai kēia aldosterone?
He hormone ʻo Aldosterone i loko o ko kākou kino. Ua like nā hormones me nā mea lawe leka i loko o ko kākou kino. Lawe lākou i nā leka i kēlā me kēia ʻōkana, e haʻi ana iā ia e hana i kēia, e hoʻōki i kēlā.
No laila, hana ʻia kēia hormone i kapa ʻia ʻo aldosterone e nā ʻāpana liʻiliʻi ʻelua e like me ka pāpale ma luna o ko mākou mau puʻupaʻa. Kāhea mākou i kēia mau mea he mau ʻāpana adrenal. ʻO kēia mau ʻāpana he ʻāpana o kā mākou ʻōnaehana endocrine.
ʻO ka hana nui o kēia hormone ka mālama ʻana i ko mākou koko i ka pae kūpono . Hana ia i kēia ma ke kāohi ʻana i nā pae o nā minelala i loko o ko mākou koko i kapa ʻia ʻo sodium (ʻo ia ka paʻakai) a me ka potassium. ʻO kēia sodium a me ka potassium ʻelua ʻano electrolytes . ʻO lākou nā mea e mālama ai i nā pae wai o ke kino i kaulike a kōkua i nā aʻalolo a me nā ʻiʻo e hana pono.
E noʻonoʻo i ka aldosterone ma ke ʻano he mea hoʻokele e kaohi ana i ka paʻakai a me ka wai i loko o ko kākou kino. Inā piʻi kiʻekiʻe loa ia, aia nā pilikia, a inā haʻahaʻa loa ia, aia nā pilikia.
Pehea e kāohi ai ʻo aldosterone i ke koko?
He hana hoihoi loa kēia. Hoʻopilikia nui ʻo Aldosterone i ke koko ma nā ʻano penei:
1. Ka Paʻa ʻana o ka Sodium: Hōʻailona ʻo Aldosterone i ko mākou mau puʻupaʻa a me ka colon e "hoʻohui i ka sodium (paʻakai) i ke koko a hoʻonui i ka nui o ka potassium i hoʻokuʻu ʻia i loko o ka mimi."
2. Ka paʻa ʻana o ka wai: Ke hoʻohui ʻia ka sodium i ke koko, e paʻa pū ka wai i loko o ke kino. Ua like ia me ka wai e huki ʻia ana i ka paʻakai.
3. Hoʻonui ʻia ka nui o ke koko: Ke mālama mākou i ka wai i loko o ko mākou kino, piʻi aʻe ka nui o ko mākou koko holoʻokoʻa. E like me ka hoʻopiha ʻana i kahi paipu wai me ka wai hou aku e hoʻonui ai i kona kaomi, ke piʻi aʻe ka nui o ke koko, piʻi pū ke kaomi koko.
Ma kēia ʻano, ke hāʻule ko mākou koko, komo mai ka aldosterone a kōkua i ka hoʻihoʻi ʻana i kahi pae olakino. Kōkua pū kēia hormone i ka hoʻoponopono ʻana i ka pH (ʻo ia hoʻi, ke kaulike acid-base) a me nā pae electrolyte o ke koko.
Pehea e kāohi ʻia ai kēia mau pae aldosterone? - He hana kupaianaha!
ʻAʻole hana hoʻokahi ʻo Aldosterone. He ʻāpana ia o kahi hui e hana pū ana. Kāhea mākou i kēia ʻōnaehana ʻo ka Renin-Angiotensin-Aldosterone System (RAAS) . Ua like ia me kahi heihei relay.
E noʻonoʻo e pili ana i kēia ʻano.
- Ka hana mua: Hāʻule kou koko (BP). ʻIke ko mākou mau puʻupaʻa i kēia. A laila hoʻokuʻu nā puʻupaʻa i kahi enzyme i kapa ʻia ʻo renin i loko o ke koko.
- Kaʻanuʻu ʻelua: Hele kēia renin a wāwahi i kahi protein i kapa ʻia ʻo angiotensinogen, i hana ʻia e ko kākou ake, i loko o kahi ʻāpana i kapa ʻia ʻo angiotensin I. Akā ua hiamoe nō ia, ʻo ia hoʻi, ʻaʻohe ona mana nui.
- KaʻAnuʻu Hana ʻEkolu: I kēia manawa, ʻoiai kēia angiotensin I e hele ana ma ke kahe koko, ua wāwahi ʻia e ka angiotensin-converting enzyme (ACE) mai ko mākou mau māmā, e hana ana i kahi hormone ikaika loa i kapa ʻia ʻo angiotensin II . ʻO kēia ke koa maoli.
- KaʻAnuʻu Hana ʻEhā: Hana kēia angiotensin II i ʻelua mau mea nui.
1. Hoʻopili kēia i nā kīʻaha koko liʻiliʻi (arterioles). Hoʻonui koke kēia i ke koko.
2. Hele ia i nā kelepa adrenal a haʻi iā lākou, "Pōpilikia! E hana koke i ka aldosterone!"
- ʻO ka hana hope loa: I kēia manawa, hele mai ka aldosterone a haʻi aku i nā puʻupaʻa e mālama i ka paʻakai (sodium) a me ka wai a hoʻokuʻu i kekahi potassium. Hoʻonui kēia i ka nui o ke koko a hoʻihoʻi i ke kaomi koko i ka maʻamau.
Ke pau kēia kaʻina holoʻokoʻa, a hoʻi ke koko i ka maʻamau, e pani koke kēia ʻōnaehana. He ʻōnaehana hoʻomalu paʻakikī loa kēia, akā he ʻōnaehana hoʻomalu kupaianaha loa.
Pehea e ana ʻia ai nā pae aldosterone?
Inā pilikia kāu kauka i ka kaohi ʻana i kou koko, a inā he mau loli i kou pae potassium koko, manaʻo paha ʻo ia he aldosterone. ʻO ka hoʻāʻo nui no kēia ka hoʻāʻo ratio aldosterone:renin .
Ma muli o ka hana pū ʻana o ka aldosterone a me ka renin, hiki i ke ana ʻana i nā pae o nā mea ʻelua ke kōkua i ka ʻike pololei ʻana i kahi o ka pilikia. Hana pinepine ʻia kēia ma ka lawe ʻana i kahi koko liʻiliʻi mai kahi aʻa koko ma kou lima.
Eia kekahi, hiki ke ana ʻia nā pae aldosterone ma ke koko a i ʻole ka mimi i hōʻiliʻili ʻia ma luna o 24 mau hola.
He aha ka mea e hana ai inā piʻi aʻe ka pae o ka aldosterone?
Ke kiʻekiʻe aʻe ka pae o ka aldosterone i loko o ke kino ma mua o ka maʻamau, kapa mākou ia he hyperaldosteronism . ʻO ke kumu nui o kēia he kūlana i kapa ʻia ʻo primary aldosteronism . ʻO kēiaUa kapa ʻia hoʻi ʻo Conn's syndrome.
Hoʻokumu pinepine ʻia kēia ʻano e kahi puʻupuʻu liʻiliʻi, ʻaʻole maʻi kanesa (benign) e ulu ana i loko o kahi kelepa adrenal. Hoʻoulu kēia puʻupuʻu i ka gland e hana i ka aldosterone nui loa. Hoʻonui kēia i ka sodium (paʻakai) i loko o ke koko, ka emi ʻana o ka potassium, a me kahi kaulike ʻole electrolyte.
| Nā hōʻailona o ka Hyperaldosteronism | |
|---|---|
| Ke koko kiʻekiʻe (Hypertension) | Ke koko kiʻekiʻe i paʻakikī ke kaohi ʻana me ka lāʻau lapaʻau. |
| ʻEha poʻo | ʻEha pinepine ka ʻeha. |
| Nāwaliwali o nā ʻiʻo | Ke nāwaliwali nei, ʻoiai ke haʻahaʻa loa nā pae potassium. |
| Ka makewai nui a me ka mimi pinepine | ʻO ka makewai e nalo ʻole ana me ka nui o ka wai āu e inu ai a me ka pono e mimi pinepine. |
Inā loaʻa iā ʻoe kēia mau hōʻailona, ʻoiai inā pilikia ʻoe i ka kaohi ʻana i kou koko koko, e kamaʻilio pono me kāu kauka e pili ana i kēia.
He aha ka mea e hana ai inā e emi iho ka pae o ka aldosterone?
Eia kekahi, ke haʻahaʻa ka pae o ka aldosterone i loko o ke kino ma mua o ka maʻamau, kapa mākou ia he hypoaldosteronism . ʻO kēia ka wā e hana ʻia ai ka hormone aldosterone me ka liʻiliʻi a i ʻole ua hoʻopilikia ʻia kāna hana. Hiki i kēia ke hana i ka emi ʻana o ka sodium (paʻakai) i loko o ke koko, ka piʻi ʻana o ka potassium, a me kahi kūlana i kapa ʻia ʻo metabolic acidosis ( hoʻonui ʻia ka acidity i loko o ke koko).
He aha nā kumu no kēia?
- ʻO ka maʻi o Addison:He maʻi autoimmune laha ʻole kēia. ʻO ke ʻano kēia, huli ka ʻōnaehana pale ponoʻī o ke kino iā ia iho a hōʻino i nā kelepa adrenal. Hoʻemi kēia i ka hana ʻana o nā hormones aldosterone a me cortisol.
- ʻO Congenital Adrenal Hyperplasia (CAH): He kūlana genetic kēia i loaʻa i ka wā hānau. Hoʻopilikia ia i nā hemahema o kekahi mau enzymes e pono ai e hana i nā hormones i loko o nā kelepa adrenal.
- Nā kūlana olakino ʻē aʻe: Hiki ke loaʻa kēia ʻano i nā poʻe me ka maʻi diabetes, nā maʻi puʻupaʻa, a me ka poʻe maʻi nui.
- Kekahi mau lāʻau lapaʻau: Hiki ke hana ʻia kēia ʻano e nā lāʻau ʻeha (NSAID) , nā lāʻau hoʻokahe koko e like me ka heparin, a me kekahi mau lāʻau lapaʻau puʻuwai.
| Nā hōʻailona o ka Hypoaldosteronism | |
|---|---|
| Ke koko haʻahaʻa (Hypotension) | Ke haʻahaʻa mau nei ke koko, a me ka manaʻo nāwaliwali. |
| Nāwaliwali o nā ʻiʻo | Kino ola ʻole, ʻūlū nā ʻiʻo. |
| Ka luaʻi | Manaʻo e luaʻi ana. |
| Nā Palpitations | Ke ʻike nei i ke kuʻi ʻana o kou puʻuwai nou iho. |
| Puʻuwai puʻuwai kūpono ʻole (Arrhythmia) | Puʻuwai kūpono ʻole. |
Inā loaʻa iā ʻoe kēia mau hōʻailona, he mea nui loa e hoʻonohonoho i kahi manawa e ʻike ai i kāu kauka a kamaʻilio e pili ana i kēia.
Leka Lawe-Home
- He hormone koʻikoʻi ʻo Aldosterone no ka kaohi ʻana i ko mākou koko.
- Hoʻokele nui ia i ka paʻakai (sodium) a me ka potassium o ke kino.
- ʻO ka nui o (Hyperaldosteronism) a i ʻole ka emi ʻana (Hypoaldosteronism) o kēia hormone hiki ke hoʻoulu i nā pilikia olakino like ʻole.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ke koko kiʻekiʻe e paʻakikī ke kaohi, nāwaliwali o nā ʻiʻo, ka make wai nui, a i ʻole ka nāwaliwali, e kamaʻilio me ke kauka e pili ana i ia mea.
- Hiki i kahi hoʻāʻo koko a mimi paha ke haʻi iā ʻoe i kāu mau pae aldosterone.
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