Loaʻa iā ʻoe ke koko kiʻekiʻe, a i ʻole ka hypertension? Ke lawe nei paha ʻoe i ʻelua a ʻekolu mau lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka. Akā, he paʻakikī anei ke kāohi i kou koko? Ke manaʻo nei hoʻi ʻoe i ka luhi, nāwaliwali, a me ka maloʻo pinepine? Inā pēlā, ʻo ke kumu o kou kūlana he mea ʻē aʻe ma mua o ke koko maʻamau. I kēia lā e kamaʻilio mākou e pili ana i ia ʻano. ʻO ia ka Primary Aldosteronism, a i ʻole Conn's Syndrome.
I ka ʻōlelo maʻalahi, he aha ka Aldosteronism mua?
He mea kēia e pono ai ka wehewehe iki. I loko o ko kākou kino, aia ʻelua mau kelepa liʻiliʻi ma luna o nā puʻupaʻa. Kāhea mākou i kēia mau kelepa adrenal, a i ʻole ma ka ʻōlelo Pelekania, nā kelepa adrenal . Hoʻopuka kēia mau kelepa i kekahi mau ʻano hormones e pono ai ko kākou kino.
He hormone steroid ʻo Aldosterone i hana ʻia e kēia mau glands. ʻO ka hana nui o kēia hormone ka hoʻomalu ʻana i nā pae o ka sodium (paʻakai) a me ka potassium i loko o ko kākou koko. Ma o kēia, kōkua pū kēia hormone i ka hoʻoponopono ʻana i ke kaulike wai o ko kākou kino a me ke koko.
No laila, ʻo ka Aldosteronism mua ka wā e hana nui ai kāu mau kelepa adrenal i ka hormone aldosterone no kekahi kumu. Ke piʻi aʻe nā pae aldosterone, piʻi ka nui o ka sodium (paʻakai) i loko o kou kino a emi iho ka nui o ka potassium. ʻO ka hopena kēia i ke koko kiʻekiʻe hiki ʻole ke kāohi ʻia a me nā pae potassium haʻahaʻa o ke koko (hypokalemia).
Ua manaʻo ʻia kēia he maʻi laha ʻole ma mua, akā ua ʻike ʻia i kēia manawa ma waena o 5% a me 10% o nā pākeke me ke koko kiʻekiʻe e loaʻa paha kēia maʻi.
He aha nā hōʻailona nui o kēia maʻi?
ʻAʻole e ʻike nā kānaka a pau me kēia maʻi i nā hōʻailona like. Akā, ʻo kēia nā hōʻailona maʻamau. E nānā kākou iā lākou ma kahi papa.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| Ke koko kiʻekiʻe (Hypertension) | ʻO kēia ka hōʻailona nui, ʻoiai ke koko kiʻekiʻe e paʻakikī ke kaohi ʻia me nā lāʻau lapaʻau he nui. |
| Ka haʻahaʻa o ka potassium i loko o ke koko (Hypokalemia) | Hiki i kahi hoʻokolohua koko ke hōʻike i nā pae potassium haʻahaʻa. Hiki i kēia ke kumu o ka ʻūlū ʻana o nā ʻiʻo a me ka maneʻo. |
| Luhi pinepine | Manaʻo luhi a make ke ola i nā manawa a pau me ke kumu ʻole. |
| ʻEha poʻo | ʻEha pinepine ka ʻeha. |
| Ka makewai nui a me ka mimi pinepine | Ke make wai nei ma mua o ka maʻamau a no laila pono e mimi pinepine. |
| Ka nāwaliwali o nā ʻiʻo a me nā ʻeha ʻiʻo | Manaʻo e like me ka ʻōwili ʻana o nā ʻiʻo o nā wāwae a me nā lima, ʻoiai ma muli o ka haʻahaʻa o ka potassium. |
| ʻIke pōwehiwehi | I kekahi manawa, ua pōwehiwehi iki ka ʻike. |
No ke aha e hoʻonui ai kēia i ka hormone aldosterone?
Aia paha kekahi mau kumu no kēia.
- Nā puʻupuʻu maikaʻi ʻole o nā kelepa adrenal: ʻO kēia ke kumu o kēia ʻano i ka hapa nui o nā kānaka. Hoʻomohala ʻia kahi puʻupuʻu liʻiliʻi, ʻaʻole kanesa (adenoma) i loko o hoʻokahi a i ʻole nā kelepa adrenal ʻelua, kahi e hana nui ai i ka hormone aldosterone.
- ʻO ka hyperplasia adrenal bilateral: I kekahi manawa, me ka ʻole o ka puʻupuʻu, hiki i nā pūnaewele ma nā kelepa adrenal ʻelua ke lilo i overactive a hana i ka nui o ka hormone.
- Nā kumu hoʻoilina: Hiki ke hoʻoilina ʻia kēia maʻi i kekahi mau ʻohana. ʻO kahi laʻana ʻo `(Congenital Adrenal Hyperplasia)`.
- ʻO ke kanesa adrenal: He kumu kakaikahi loa kēia.
ʻO ka ʻokoʻa ma waena o ka Aldosteronism mua a me ke kula kiʻekiʻe
Aia kekahi mea nui ʻē aʻe e pono ai ʻoe e ʻike. ʻO ka Aldosteronism mua, a mākou i kamaʻilio ai, he pilikia ia e kū mai ana i loko o ke kelepa adrenal ponoʻī, e hoʻonui ana i ka hormone.
Akā i kekahi manawa, hiki ke piʻi aʻe nā pae aldosterone ma muli o nā kūlana olakino ʻē aʻe i loko o ke kino. No ka laʻana, hiki i kēia hormone ke piʻi aʻe i nā kūlana e like me ka hāʻule ʻana o ka puʻuwai, ka maʻi akepaʻa, a i ʻole ka stenosis o ke aʻa renal. Kāhea mākou i kēia ʻo Secondary Aldosteronism . E hoʻokaʻawale pololei ke kauka ma waena o kēia mau kūlana ʻelua.
Pehea e ʻike ai i kēia?
Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna, e nānā mua kāu kauka i kou koko. A laila, inā he kānalua e pili ana i kēia kūlana, e kuhikuhi ʻo ia iā ʻoe no kekahi mau hoʻokolohua koko kūikawā.
- Nā pae hormone koko: Ke ana nui nei kēia i nā pae o nā hormones aldosterone a me renin. I ka aldosteronism mua, kiʻekiʻe nā pae aldosterone a haʻahaʻa nā pae renin.
- Ka Hoʻāʻo ʻana i ka Pae Electrolyte: Hoʻāʻo kēia i nā pae sodium a me potassium i loko o kou koko.
He mea nui: Inā ʻoe e lawe nei i nā lāʻau lapaʻau koko, hiki i kekahi o kēlā mau lāʻau ke hoʻopilikia i nā hopena o kēia mau hoʻāʻo koko. No laila, no ka hana ʻana i kahi hōʻailona pololei, hiki i kāu kauka ke aʻo aku iā ʻoe e hoʻololi a hoʻōki paha i kāu lāʻau lapaʻau no kekahi manawa.
Inā hōʻoia nā hoʻokolohua koko i kēia kūlana, ʻo ka hana aʻe e nānā i nā kelepa adrenal e ʻike i ke kumu. Hana pinepine ʻia kēia me kahi CT scan (Computed Tomography) a i ʻole MRI scan (Magnetic Resonance Imaging) .
He aha nā lāʻau lapaʻau no kēia?
ʻO ke ʻano o ka mālama ʻana i kēia maʻi e pili ana i ke kumu. ʻElua mau ʻano lapaʻau nui.
1. Ka mālama ʻana me ka lāʻau lapaʻau
Inā hana nui nā kelepa adrenal ʻelua (hyperplasia), ʻaʻole hana pinepine ʻia ke ʻoki kino. Akā, hāʻawi ʻia nā lāʻau lapaʻau e ālai ana i ka hana o ka hormone aldosterone. ʻO nā lāʻau lapaʻau i hoʻohana pinepine ʻia ʻo spironolactone a me eplerenone . Hiki i kēia mau lāʻau lapaʻau ke kāohi i ke koko a hoʻihoʻi i nā pae potassium.
2. Lapaʻau ʻana ma o ke ʻoki kino
Inā hōʻoia ka CT a i ʻole MRI scan aia kahi puʻupuʻu (adenoma) i loko o hoʻokahi wale nō kelepa adrenal, ʻo ka lāʻau lapaʻau maikaʻi loa ka wehe ʻana i kēlā kelepa ma ke ʻoki ʻana. Ua kapa ʻia kēia ʻoki ʻana he adrenalectomy . Hana pinepine ʻia kēia ma ke ʻano he ʻoki puka kī (laparoscopic surgery) i wikiwiki ai ka hoʻōla ʻana.
Ma hope o ke ʻoki ʻana, hoʻi ke koko o ka hapa nui o nā kānaka i ka maʻamau a hiki ke hoʻomalu ʻia me ka liʻiliʻi o nā lāʻau lapaʻau.
He aha ka mea e hana ʻia inā ʻaʻole mālama ʻia?
Inā waiho ʻole ʻia kēia kūlana i ka mālama ʻole ʻia, hiki ke loaʻa nā pilikia koʻikoʻi ma muli o ke koko kiʻekiʻe a me ka hoʻohālikelike electrolyte i ka wā lōʻihi.
- Ka hāʻule ʻana o ka puʻuwai a i ʻole ka hāʻule ʻana o ka puʻuwai
- Hahau
- Ka hāʻule ʻana o ka puʻupaʻa
- Puʻuwai puʻuwai kūpono ʻole (Arrhythmia)
- Ka maʻi lolo no ka manawa pōkole
No laila, inā loaʻa iā ʻoe nā hōʻailona, he mea nui loa e ʻike koke i ke kauka a ʻimi i ka lāʻau lapaʻau.
Leka Lawe-Home
- ʻO ka aldosteronism mua kahi maʻi i hoʻoulu ʻia e ka hana nui ʻana o ka hormone aldosterone e nā kelepa adrenal.
- ʻO nā hōʻailona nui, ʻo ia ke koko kiʻekiʻe a me ka haʻahaʻa o ka potassium i loko o ke koko, he mea paʻakikī ke kaohi ʻia me ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau.
- Hiki nō hoʻi ke ʻike ʻia nā hōʻailona e like me ka luhi pinepine, ka ʻeha poʻo, ka make wai nui, a me ka ʻūlū ʻana o nā ʻiʻo.
- Hiki i nā hoʻokolohua koko a me nā scan ke ʻike pololei i kēia maʻi a me kona kumu.
- Ma muli o ke kumu, hiki ke hoʻomalu pono ʻia kēia kūlana me ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana.
- 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 ia mea.
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