Loaʻa iā ʻoe ke koko kiʻekiʻe , i ʻike nui ʻia ʻo "hypertension"? Ke lawe nei paha ʻoe i hoʻokahi, ʻelua, a ʻoi aku paha nā lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka. Eia naʻe, ʻoiai ke mālama ʻia nei ʻoe, ke manaʻo nei anei ʻoe he paʻakikī ke kāohi i kou koko ? Inā pēlā, ʻaʻole paha ke kumu o ka mea āu e manaʻo ai. I kēia lā, makemake mākou e kamaʻilio e pili ana i kahi kūlana olakino kikoʻī e hiki ai ke hoʻoulu i ka hypertension paʻakikī e mālama, kūʻē i ka lāʻau: Hyperaldosteronism. ʻOiai paha he paʻakikī ke kani ʻana o ka inoa, e hoʻokaʻawale kākou i nā huaʻōlelo maʻalahi.
He aha ka Hyperaldosteronism?
I ka ʻōlelo maʻalahi, hana ʻia ka hyperaldosteronism ke hana nui kāu mau kelepa adrenal i kahi hormone i kapa ʻia ʻo "aldosterone."
E noʻonoʻo paha ʻoe: he aha kēia mau kelepa adrenal, a he aha ka aldosterone?
E noʻonoʻo i ʻelua mau kelepa liʻiliʻi, i ke ʻano o nā pāpale liʻiliʻi, e noho ana ma luna pono o kou mau puʻupaʻa . ʻO kēia kou mau kelepa adrenal. He ʻāpana koʻikoʻi lākou o kāu ʻōnaehana endocrine . Hoʻopuka kēia mau kelepa liʻiliʻi i kekahi mau hormones e pono ai no nā hana o kēlā me kēia lā o kou kino.
ʻO kahi hormone kikoʻī a kēia mau glands e hana ai ʻo aldosterone . ʻO kāna hana nui ka hoʻoponopono ʻana i kou koko ma ke kaulike ʻana i nā pae sodium a me potassium i loko o kou koko. Hiki iā ʻoe ke noʻonoʻo i kēia hormone e like me kahi mākaʻi kaʻa e kuhikuhi ana i ke kahe o ke kaʻa ma ke alanui paʻahana.
No laila, i ka hyperaldosteronism, nui loa ka aldosterone i hana ʻia. Hoʻonui kēia i nā pae sodium i loko o kou kino ʻoiai e emi ana nā pae potassium. ʻO ka hopena hope loa, ʻo ia ka hypertension (ke koko kiʻekiʻe) a me ka hypokalemia (ka potassium koko haʻahaʻa) .
ʻElua ʻano nui
Hoʻokaʻawale nā kauka i kēia ʻano i ʻelua mau ʻano ma muli o ke kumu kumu.
1. ʻO ka Hyperaldosteronism Mua: ʻIke ʻia hoʻi ʻo "Conn's syndrome," hana ʻia kēia ke waiho pololei ka pilikia i loko o nā kelepa adrenal, e hoʻoulu ai iā lākou e hana nui i ka aldosterone.
2. ʻO ka Hyperaldosteronism Lua: I kēia hihia, olakino nā kelepa adrenal. Akā, ke hoʻoulu ʻia nei lākou e hana i ka aldosterone keu ma ke ʻano he pane i kahi pilikia e puka mai ana ma kahi ʻē aʻe o ke kino.
ʻO wai ka mea i hoʻopilikia nui ʻia?
ʻIke pinepine ʻia kēia ʻano i nā poʻe ma waena o 30 a me 50 mau makahiki. Hōʻike pū ka noiʻi he ʻoi aku ka maʻamau o ia i nā wahine ma mua o nā kāne.
Ua hōʻike ʻia nā noiʻi he 5% a 10% o nā kānaka a pau me ke koko kiʻekiʻe e loaʻa paha ka hyperaldosteronism mua. ʻOi aku ka mea nui, manaʻoʻiʻo nā loea i waena o ka poʻe me ke koko kiʻekiʻe kūʻē i ka lāʻau lapaʻau , hiki i ka pakeneka ke kiʻekiʻe a hiki i ka 25%.
He aha nā hōʻailona?
I kekahi manawa, inā he akahai ke ʻano, ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona. Eia nō naʻe, hōʻike ka nui o ka poʻe i nā hōʻailona.
ʻO ka hōʻailona maʻamau ka hypertension , ʻoiai ke paʻakikī mau nei ʻoiai ke hoʻohana ʻia nā lāʻau lapaʻau he nui.
Kū mai nā hōʻailona ʻē aʻe ma muli o ka hui pū ʻana o ke koko kiʻekiʻe a me ka potassium haʻahaʻa (hypokalemia). E wehewehe pono kākou i kēia mau mea.
| Kumu | Nā Hōʻailona Kūpono |
|---|---|
| Nā hōʻailona ma muli o ke koko kiʻekiʻe |
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| Nā hōʻailona ma muli o ka Potassium Haʻahaʻa |
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E hoʻomanaʻo, ʻaʻole pono ʻoe e ʻike i kēia mau hōʻailona āpau. Loaʻa paha i kekahi poʻe hoʻokahi a ʻelua paha.
No ke aha e kū ai ka Hyperaldosteronism?
E like me ka mea i ʻōlelo ʻia ma luna nei, ʻokoʻa nā kumu ma muli o nā ʻano ʻelua.
Nā kumu o ka Hyperaldosteronism mua
Maanei, hoʻomaka ka pilikia ma ka ʻōpū adrenal ponoʻī.
- ʻO ke kumu maʻamau: ʻO ka maʻamau he puʻupuʻu ʻaʻole kanesa (adrenal adenoma) ma ka adrenal gland. ʻAʻole kēia he kanesa, no laila ʻaʻohe pono e hopohopo. Hoʻopuka wale kēia puʻupuʻu i ka aldosterone nui loa.
- Nā kumu kakaikahi ʻē aʻe:
- Ka hoʻonui ʻia ʻana o hoʻokahi kelepa adrenal (unilateral adrenal hyperplasia).
- ʻO ka hana ʻana o ka aldosterone e kahi maʻi kanesa (adrenocortical carcinoma) - he mea laha ʻole kēia.
- He kūlana hoʻoilina (familial hyperaldosteronism).
Nā kumu o ka Hyperaldosteronism Lua
Maanei, ua olakino nā kelepa adrenal, akā ua hoʻoulu ʻia lākou e kekahi mea ʻē aʻe. ʻO ke kumu nui, ʻo ia ka emi ʻana o ke kahe koko i nā puʻupaʻa .
No ka hoʻomaopopo ʻana i kēia, he mea kōkua ka ʻike e pili ana i ka ʻōnaehana kupaianaha o ke kino no ka hoʻoponopono ʻana i ke koko: ʻo ka ʻōnaehana Renin-Angiotensin-Aldosterone .
E noʻonoʻo iā ia me he hopena kaulahao lā:
1. Ke hāʻule kou koko a i ʻole haʻahaʻa nā pae sodium i loko o kou koko, ʻike kou mau puʻupaʻa iā ia.
2. A laila hoʻokuʻu nā puʻupaʻa i kahi enzyme i kapa ʻia ʻo "renin" i loko o ke kahe koko.
3. Hana ʻo Renin ma luna o kahi protein i hana ʻia e ke akepaʻa i kapa ʻia ʻo "angiotensinogen," e hoʻololi ana iā ia i "angiotensin I."
4. A laila, ua hoʻololi ʻia kēia Angiotensin I i “Angiotensin II.”
5. ʻO ka mea hope loa, ʻo kēia Angiotensin II ka mea e hoʻonui ai i kou koko ma ka hoʻopaʻa ʻana i kou mau kīʻaha koko a me ka hoʻoulu ʻana i kāu mau kelepa adrenal e hana i ka aldosterone.
I nā hihia o ka Hyperaldosteronism lua, hoʻemi kahi maʻi olakino ma lalo o ke kahe koko i kou mau puʻupaʻa. No laila, kuhi hewa kou mau puʻupaʻa ua haʻahaʻa loa ke koko o kou kino. I ka pane ʻana, hoʻāla kou mau puʻupaʻa i kahi hopena kaulahao e noi i ke kōkua. ʻO ka hopena, hana nui ʻia ka hormone aldosterone, ʻoiai ʻaʻole pono maoli kou kino.
ʻO nā kūlana e hōʻemi ana i ke kahe koko i nā puʻupaʻa a hoʻoulu i ka Hyperaldosteronism lua:
- Ka hāiki ʻana o nā aʻa e hoʻolako ana i ke koko i nā puʻupaʻa (Obstructive renal artery disease).
- Nā kūlana kahi 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 ʻano maʻi puʻupaʻa.
Pehea e ʻike ai ke kauka i kēia maʻi?
Ke kūkākūkā ʻoe i kāu mau hōʻailona me kāu kauka—ʻoiai inā ʻoe e ʻōlelo ʻaʻole pane kou koko kiʻekiʻe i nā lāʻau lapaʻau maʻamau—hiki paha iā lākou ke kānalua i kēia kūlana. A laila e kauoha kāu kauka i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona.
1. Nā hoʻāʻo koko:
- I loko o kahi panela koko electrolyte maʻamau, ʻo nā pae sodium kiʻekiʻe iki (Hypernatremia) a me nā pae potassium haʻahaʻa (Hypokalemia) e hoʻāla pinepine ai i ka kānalua.
- ʻO ka mea aʻe, aia ʻelua mau hoʻāʻo koko kūikawā i hoʻohana pono ʻia e ʻike i kēia ʻano: nā hoʻāʻo Plasma Renin Concentration (PRC) a i ʻole Plasma Renin Activity (PRA) .
- Inā loaʻa iā ʻoe ka Hyperaldosteronism mua , ʻoi aku ka haʻahaʻa o 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:
- Ma kēia hoʻokolohua, hāʻawi ʻia ʻoe i kahi nui o ka sodium (paʻakai) ma luna o kekahi manawa kikoʻī, ma ka waha a i ʻole ma o kahi intravenous (IV) saline drip.
- Ma hope o kēia, e hōʻiliʻili ʻia kāu mimi ma luna o 24 mau hola e ana i ka pae o ka aldosterone i loaʻa.
- I ke kanaka olakino, ʻo ka hoʻonui ʻia ʻana o ka ʻai ʻana i ka sodium e hoʻemi maoli ai ke kino i ka hana ʻana o ka aldosterone. Eia nō naʻe, i kekahi me Hyperaldosteronism, ʻaʻole kēia e hana.
3. Nā Hoʻāʻo Kiʻi:
- Inā hōʻoia nā hoʻokolohua koko he Hyperaldosteronism mua kou, hiki i kāu kauka ke kauoha i kahi CT scan (Computed Tomography scan) e ʻike i ke kumu kumu, e like me ka nānā ʻana i kahi puʻupuʻu adrenal gland.
He aha nā lāʻau lapaʻau i loaʻa?
Aia wale nō nā hoʻolālā lapaʻau i ke kumu kumu. Eia nō naʻe, ʻo ka pahuhopu nui ka mālama pono ʻana i kou koko.
- No ka Hyperaldosteronism mua i hoʻokumu ʻia e kahi ʻōpū:
Hoʻoikaika pinepine nā kauka i ka wehe ʻana i ka puʻupuʻu a me ke kelepa i hoʻopilikia ʻia . Ma hope o ke ʻoki ʻana, ʻike ka nui o nā maʻi i ko lākou koko a me nā pae potassium e hoʻi i ka maʻamau. Pono paha kekahi poʻe i ka lāʻau lapaʻau koko e hoʻomau ma hope o ke kaʻina hana.
- No nā kumu ʻē aʻe a me ka Hyperaldosteronism lua:
I kēia mau hihia, pili ka lāʻau lapaʻau i ka lāʻau lapaʻau . Eia kekahi, inā he maʻi lua ia, he mea nui ka hoʻoponopono ʻana i ka maʻi kumu (e like me ka hāʻule ʻana o ka puʻuwai).
ʻO nā lāʻau lapaʻau i kuhikuhi pinepine ʻia:
- Spironolactone (Aldactone®)
- ʻEplerenone (Inspra®)
- ʻAmiloride (Midamor®)
E ʻoluʻolu e hoʻomaopopo ʻo ka hoʻohana lōʻihi ʻana i nā lāʻau lapaʻau e ālai ana i ka hana aldosterone, e like me Spironolactone, hiki ke hana i nā hopena ʻaoʻao i nā kāne, e like me ka erectile dysfunction a i ʻole ka hoʻonui ʻana o ka umauma (Gynecomastia). Inā loaʻa iā ʻoe kekahi ʻoluʻolu ʻole a i ʻole nā hopena ʻaoʻao, mai kānalua e kamaʻilio me kāu kauka e pili ana iā lākou.
He aha ke ʻano o ka nānā ʻana a me nā pilikia e hiki mai ana?
ʻO kāu wānana, a i ʻole ka nānā ʻana i ka wā lōʻihi, e hilinaʻi nui ʻia i ke kumu kumu.
Inā ʻike mua ʻia ka Hyperaldosteronism mua a mālama pono ʻia, maikaʻi loa nā hopenaNo ka Hyperaldosteronism lua, pili ka hopena i ka maikaʻi o ka mālama ʻana i ke kūlana olakino kumu.
ʻO nā pilikia nui o kēia ʻano e kū mai ana mai ke koko kiʻekiʻe i ka wā lōʻihi, hiki ke alakaʻi i nā pilikia koʻikoʻi o ka maʻi cardiovascular.
| Nā pilikia nui e hiki mai ana |
|---|
| ʻO ka fibrillation atrial (ka puʻuwai puʻuwai kūpono ʻole) |
| ʻO ka hypertrophy ventricular hema (ka hoʻonui ʻia ʻana o ke keʻena nui o ka puʻuwai) |
| Maʻi hohola |
| Hahau |
No kēia kumu, he mea nui ka mālama ʻana i ka kaohi paʻa o kou koko.
Hiki ke pale ʻia kēia maʻi?
I ka hapanui o nā hihia, ʻaʻole hiki ke pale ʻia kēia maʻi no ka mea ua hoʻokumu pinepine ʻia ia i nā kaʻina hana o loko o ke kino. Eia nō naʻe, ʻo ka nūhou maikaʻi, i ka wā e ʻike ʻia ai, hiki i ka lāʻau lapaʻau kūpono ke pale aku i nā pilikia koʻikoʻi lōʻihi.
Leka Lawe-Home
- Inā paʻakikī ke kaohi i kou koko koko ʻoiai ke lawe nei ʻoe i kekahi mau lāʻau lapaʻau, e kamaʻilio me kāu kauka .
- ʻO ka Hyperaldosteronism kahi maʻi i hana ʻia e ka hana nui ʻana o ka hormone aldosterone.
- Hiki ke kumu mua (hoʻomaka mai loko mai o ke gland) a i ʻole ke lua (i hoʻokumu ʻia e kekahi maʻi ʻē aʻe).
- Hiki ke ʻike pololei ʻia ma o nā hoʻokolohua koko kūikawā a me ke kiʻi ʻana.
- Hiki ke mālama pono ʻia ma o ke ʻoki kino a i ʻole ka lāʻau lapaʻau, ma muli o ke kumu.
- ʻO ka mea nui e ʻike ai, he maʻi hiki ke mālama ʻia kēia; inā he mau hopohopo kāu, e ʻimi koke i ke kōkua lapaʻau.
ʻO ka Hyperaldosteronism, aldosterone, nā kelepa adrenal, ka maʻi Conn, ke koko kiʻekiʻe, ke koko kiʻekiʻe, ke kaomi, potassium, sodium, nā puʻupaʻa, nā hormones
