ʻAʻole anei i kaohi ʻia kou koko koko ʻoiai ua lawe ʻoe i ka lāʻau lapaʻau? ʻO Hyperaldosteronism paha ke kumu!

Loaʻa iā ʻoe ke koko kiʻekiʻe , a i ʻole ke " kaomi " e like me kā mākou e ʻike nei? Malia paha ke lawe nei ʻoe i hoʻokahi, ʻelua, a ʻoi aku paha nā lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka. Akā, ke paʻakikī nei iā ʻoe ke kāohi i kou koko ma hope o ka lawe ʻana i nā lāʻau lapaʻau he nui? Inā pēlā, ʻo ke kumu o kēia ʻaʻole paha he mea a ka poʻe a pau e noʻonoʻo mau ai. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana olakino kūikawā e hiki ai ke hoʻoulu i ke koko kiʻekiʻe ʻaʻole hiki ke kāohi maʻalahi ʻia e nā lāʻau lapaʻau. ʻO ia ka Hyperaldosteronism. ʻOiai he paʻakikī iki ka inoa, e hoʻomaopopo maʻalahi kākou.

He aha ka Hyperaldosteronism?

I ka ʻōlelo maʻalahi, ʻo ka Hyperaldosteronism ka hana ʻana o ka nui o ka hormone "Aldosterone" e nā kelepa adrenal i loko o ko mākou kino.

I kēia manawa ke noʻonoʻo nei paha ʻoe, he aha kēia mau kelepa adrenal? He aha kēia hormone aldosterone?

E noʻonoʻo, ma luna o nā puʻupaʻa ʻelua i loko o ko kākou kino, aia ʻelua mau kelepa liʻiliʻi, e like me ʻelua mau pāpale liʻiliʻi. ʻO ia ka mea a kākou e kapa nei he mau kelepa adrenal. He ʻāpana koʻikoʻi loa kēia o kā kākou ʻōnaehana endocrine . Hana kēia mau kelepa liʻiliʻi ʻelua i kekahi mau ʻano hormones e pono ai no nā hana o kēlā me kēia lā o ko kākou kino.

ʻO ka aldosterone kahi hormone kūikawā i hana ʻia e kēia mau glands. ʻO ka hana nui o kēia hormone ka hoʻoponopono ʻana i ko mākou koko . Hana ia i kēia ma ke kāohi ʻana i nā pae o ka sodium a me ka potassium i loko o ko mākou koko. Hana kēia hormone i loko o ko mākou kino e like me ka mākaʻi kaʻa e kāohi ana i ke kaʻa ma ke alanui.

No laila, i ke ʻano o ka Hyperaldosteronism, ʻo ka mea e hana ʻia nei, ʻo ia ka hana ʻia ʻana o kēia hormone aldosterone i ka nui. A laila piʻi ka nui o ka sodium i loko o ko mākou kino a emi ka nui o ka potassium. ʻO ka hopena hope loa o kēia, ʻo ke koko kiʻekiʻe (Hypertension) a me nā pae potassium haʻahaʻa i loko o ke koko (Hypokalemia) .

ʻElua ʻano nui o kēia.

Ua hoʻokaʻawale nā ​​​​kauka i kēia ʻano i ʻelua mau ʻano nui, ma muli o ke kumu.

1. ʻO ka Hyperaldosteronism mua:Ua kapa ʻia hoʻi kēia ʻo "Conn's syndrome." Hoʻokumu ʻia kēia e kahi pilikia i loko o nā kelepa adrenal ponoʻī, kahi e hana ai lākou i ka nui o ka hormone aldosterone. Aia ke kumu i loko o ka kelepa ponoʻī.

2. ʻO ka Hyperaldosteronism Lua: ʻAʻohe pilikia me nā kelepa adrenal ma aneʻi. Akā ma muli o kahi pilikia ma kahi ʻē aʻe o ke kino, hoʻoulu ʻia nā kelepa adrenal i ka pane ʻana a hana i ka aldosterone hou aʻe.

ʻO wai ka mea i hoʻopilikia pinepine ʻia e kēia maʻi?

ʻO ka maʻamau, hoʻopilikia kēia maʻi i nā kānaka ma waena o 30 a me 50 mau makahiki. Ua hōʻike pū ʻia ka noiʻi ʻana he ʻoi aku ka maʻamau o kēia maʻi i nā wahine ma mua o nā kāne.

Manaʻo kekahi mau noiʻi aia ma waena o 5% a me 10% o ka poʻe me ke koko kiʻekiʻe e loaʻa paha ka hyperaldosteronism mua. Manaʻo nā loea he 25% o ka poʻe me ke koko kiʻekiʻe kūʻē i ka lāʻau lapaʻau e loaʻa paha i ke ʻano.

He aha nā hōʻailona o kēia?

I kekahi manawa, inā he akahai loa ke ʻano, ʻaʻohe paha he mau hōʻailona iki. Eia nō naʻe, nui ka poʻe e loaʻa nā hōʻailona.

ʻO ka hōʻailona nui a maʻamau i ʻike ʻia ma kēia ʻano, ʻo ia ke koko kiʻekiʻe (Hypertension) , ʻoiai ke koko kiʻekiʻe i paʻakikī ke kaohi ʻia me ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau.

ʻElua mau mea i hoʻokumu ʻia ai nā hōʻailona ʻē aʻe: ke koko kiʻekiʻe a me nā pae potassium haʻahaʻa o ke koko (Hypokalemia). E hoʻokaʻawale pono kākou i kēia mau hōʻailona.

No ke aha e kū mai ai kēia ʻano o Hyperaldosteronism?

E like me kā mākou i kūkākūkā ai ma mua, ʻokoʻa nā kumu o kēia ma muli o nā ʻano nui ʻelua.

Nā kumu o ka Hyperaldosteronism mua

ʻO ka pilikia ma aneʻi e waiho ana i loko o ka kelepa adrenal ponoʻī.

• ʻO ke kumu maʻamau: ʻO ka hapa nui, ua hana ʻia kēia e kahi puʻupuʻu ʻaʻole kanesa (adrenal adenoma) e ulu ana i loko o ke kelepa adrenal. ʻAʻole kēia he kanesa, no laila ʻaʻohe mea e hopohopo ai. Hoʻopuka kēia puʻupuʻu i ka nui o ka hormone aldosterone.
• Nā kumu kakaikahi ʻē aʻe:
• Ka hoʻonui ʻia ʻana o hoʻokahi wale nō kelepa adrenal (unilateral adrenal hyperplasia).
• Ka hana ʻana o Aldosterone e kahi puʻupuʻu maʻi kanesa (adrenocortical carcinoma) (he mea kākaʻikahi loa kēia).
• He ʻano maʻi hoʻoilina i hoʻoili ʻia ma o nā hanauna (Familial hyperaldosteronism).

Nā kumu o ka Hyperaldosteronism Lua

Maanei, ua olakino nā kelepa adrenal. Akā, ua hoʻoulu ʻia lākou no kekahi kumu ʻē aʻe. ʻO ke kumu nui, ʻo ia ka emi ʻana o ke kahe koko i nā puʻupaʻa .

I mea e hoʻomaopopo ai i kēia, pono kākou e ʻike iki e pili ana i kahi ʻōnaehana hoihoi loa i loko o ko kākou kino e kaohi ana i ke koko. Ua kapa ʻia ʻo ia ʻo ka ʻōnaehana Renin-Angiotensin-Aldosterone .

E noʻonoʻo i kēia me he hopena kaulahao lā:

1. Ke hāʻule ko kākou koko a i ʻole ka emi ʻana o ka nui o ka sodium i loko o ke koko, ʻike ko kākou mau puʻupaʻa.

2. A laila hoʻokuʻu nā puʻupaʻa i kahi enzyme i kapa ʻia ʻo "renin" i loko o ke koko.

3. Hoʻololi kēia renin i kahi protein i kapa ʻia ʻo "Angiotensinogen", ka mea i hana ʻia e ke akepaʻa, i "Angiotensin I".

4. A laila, lilo kēia angiotensin I i “Angiotensin II”.

5. ʻO ka mea hope loa, ʻo kēia angiotensin II ka mea e hoʻonui ai i ke koko ma o ka hoʻopaʻa ʻana i nā kīʻaha koko a me ka hoʻoulu ʻana i nā kelepa adrenal e hana i ka aldosterone.

I kēia manawa, i ka hyperaldosteronism lua, ʻo ka mea e hana ʻia ana, ma muli o kekahi kūlana olakino, emi ka nui o ke koko e hele ana i nā puʻupaʻa. A laila manaʻo kuhihewa nā puʻupaʻa he haʻahaʻa ke kaomi i loko o ke kino. No laila, kāhea nā puʻupaʻa no ke kōkua a hoʻomaka kēlā hopena kaulahao. ʻO ka hopena, hana lākou i ka nui o ka hormone aldosterone, i ka wā ʻaʻohe pono maoli no ia mea.

Nā kūlana e hōʻemi ai i ke kahe koko i nā puʻupaʻa a hoʻoulu i ka hyperaldosteronism lua:

• Ka maʻi ʻaʻa renal ālai.
• Nā kūlana e hōʻiliʻili ai ka wai i loko o ke kino, e like me ka hāʻule ʻana o ka puʻuwai.
• ʻO ka Cirrhosis o ke akepaʻa.
• ʻO ka maʻi Nephrotic, kahi maʻi puʻupaʻa.

Pehea e ʻike ai ke kauka i kēia maʻi?

Ke haʻi aku ʻoe i kāu kauka e pili ana i kāu mau hōʻailona, ​​ʻoiai ke koko kiʻekiʻe i kāohi ʻole ʻia e ka lāʻau lapaʻau, hiki iā ia ke kānalua i kēia kūlana. A laila, hiki iā lākou ke kauoha i kekahi mau hoʻokolohua e hōʻoia i kēia.

1. Nā hoʻāʻo koko:

• Inā hōʻike kahi panela koko electrolyte maʻamau i nā pae sodium kiʻekiʻe iki (Hypernatremia) a me nā pae potassium haʻahaʻa (Hypokalemia) , piʻi aʻe ka kānalua.
• ʻO ka mea aʻe, aia ʻelua mau hoʻāʻo koko kikoʻī e hiki ke hoʻohana ʻia e ʻike i kēia kūlana: Plasma Renin Concentration (PRC) a i ʻole Plasma Renin Activity (PRA) .
• Inā loaʻa iā ʻoe ka Primary Hyperaldosteronism, e haʻahaʻa ana kāu mau pae renin (PRC a me PRA) ma mua o ka maʻamau.
• Inā loaʻa iā ʻoe ka hyperaldosteronism lua , e ʻoi aku ke kiʻekiʻe o kāu mau pae renin ma mua o ka maʻamau.

2. Hoʻāʻo Hoʻopau Aldosterone:

• ʻO kēia hoʻāʻo e pili ana i ka hāʻawi ʻana iā ʻoe i ka sodium (paʻakai) keu i loko o kekahi manawa. Hiki ke lilo i wai āu e lawe ai ma ka waha a i ʻole kahi wai saline āu e hāʻawi ai i loko o kahi aa.
• A laila, hōʻiliʻili ʻia kāu mimi ma luna o 24 mau hola a ana ʻia ka nui o ka aldosterone i loko o kēlā mimi.
• I ke kanaka olakino, hōʻemi ka nui o ka sodium i ka hana ʻana o ke kino i ka aldosterone. Eia nō naʻe, i ke kanaka me ka hyperaldosteronism, ʻaʻole kēia e hana.

3. Nā Hoʻāʻo Kiʻi:

• Inā hōʻoia nā hoʻokolohua koko he hyperaldosteronism mua kou, e kauoha kāu kauka i kahi hoʻokolohua e like me ka CT scan (Computed Tomography scan) e ʻike i ke kumu. Hiki i kēia ke nānā i kahi puʻupuʻu ma ka adrenal gland.

He aha nā lāʻau lapaʻau no kēia?

Aia ka lāʻau lapaʻau i ke kumu o ke kūlana. Eia nō naʻe, ʻo ka pahuhopu nui ka kaohi ʻana i kou koko.

• No ka hyperaldosteronism mua i hoʻokumu ʻia e kahi ʻōpū:

I ka manawa pinepine, ʻōlelo nā kauka i ka wehe ʻana i ka ʻōpū a me ke kelepa pili.Hoʻi hou ke koko a me ka pae potassium o ka hapa nui o nā kānaka i ka maʻamau ma hope o kēia ʻoki kino. Eia nō naʻe, hiki i kekahi poʻe ke hoʻomau i ke koko kiʻekiʻe ma hope o ke ʻoki kino, a pono lākou e hoʻomau i ka lawe ʻana i ka lāʻau lapaʻau.

• No nā kumu ʻē aʻe a me ka hyperaldosteronism lua:

I kēia mau hihia, ʻo ka lāʻau lapaʻau ka lāʻau lapaʻau . Eia kekahi, inā he maʻi lua ia, he mea nui e mālama i ka maʻi kumu (e.g. maʻi puʻuwai).

ʻO kekahi o nā lāʻau lapaʻau i hoʻohana pinepine ʻia no kēia kumu:

• Spironolactone (Spironolactone - Aldactone®)
• ʻEplerenone (Eplerenone - Inspra®)
• ʻAmiloride (ʻAmiloride - Midamor®)

He aha ka mea e hana ʻia ma hope o ka mālama ʻana? A he aha nā pilikia?

ʻO ka wānana no kēia kūlana, ʻo ia hoʻi, ke kūlana e hiki mai ana, e pili ana i ke kumu.

ʻO ka maʻamau, ʻae maikaʻi ʻia ka hyperaldosteronism mua inā ʻike mua ʻia a mālama pono ʻia . I ka hyperaldosteronism lua, hilinaʻi ka hopena i ka hiki ke kaohi ʻia ke kūlana kumu.

ʻO nā pilikia nui e hiki ke kū mai i kēia kūlana, ʻo ia ke kumu o ke koko kiʻekiʻe i kāohi ʻole ʻia no ka manawa lōʻihi. He mau pilikia koʻikoʻi kēia e pili ana i ka ʻōnaehana cardiovascular.

No laila, he mea nui loa ia e kaohi pono i ke koko.

Hiki ke pale ʻia kēia kūlana?

I ka hapanui o nā hihia, ʻaʻohe mea hiki iā mākou ke hana e pale aku i kēia maʻi mai ka hanana ʻana. No ka mea, ua hana ʻia ia e nā loli e kū nei i loko o ko mākou kino. Akā ʻo ka mea maikaʻi loa, ke ʻike ʻia, hiki ke mālama ʻia a hiki ke pale ʻia nā pilikia.

ʻO ka Hyperaldosteronism, aldosterone, nā kelepa adrenal, ka maʻi Conn, ke koko kiʻekiʻe, ke koko kiʻekiʻe, ke kaomi, potassium, sodium, nā puʻupaʻa, nā hormones