ʻAʻole anei e iho mai kou koko me ka lāʻau lapaʻau? E aʻo kākou e pili ana i ka hyperaldosteronism.

Ke noʻonoʻo nei paha ʻoe i kekahi manawa, 'No ke aha lā ʻaʻole e iho koʻu koko me ka lāʻau lapaʻau?'? Loaʻa i kekahi poʻe ka pilikia like. Aia kekahi mau manawa he paʻakikī ke kāohi i ko lākou koko, ʻoiai ma hope o ka lawe ʻana i ka lāʻau lapaʻau. I nā manawa e like me kēia, pono mākou e noʻonoʻo inā paha he kumu kumu. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana i paʻakikī ke ʻike i kekahi manawa, akā hiki ke ho'ōla ʻia inā mālama pono ʻia. ʻO ia ka hyperaldosteronism .

He aha ka Hyperaldosteronism?

I ka ʻōlelo maʻalahi, ʻo ka hyperaldosteronism ka wā e hana nui ai kāu mau kelepa adrenal i kahi hormone i kapa ʻia ʻo aldosterone . E noʻonoʻo i kēia ʻano, ua like ʻo aldosterone me kahi ʻenekinia liʻiliʻi e kaohi ana i ko mākou koko. Kōkua ia i ka mālama ʻana i ko mākou koko ma ka pae kūpono ma ka hoʻoponopono ʻana i nā pae o ka potassium a me ka sodium i loko o ko mākou kino.

I kēia manawa, ke noʻonoʻo nei paha ʻoe, 'He aha kēia mau kelepa adrenal?' He ʻāpana kēia o kā mākou ʻōnaehana endocrine . Ua like lākou me nā hale hana liʻiliʻi e hana ana i nā hormones like ʻole e pono ai ko mākou kino e hana i kēlā me kēia lā. Loaʻa iā mākou ʻelua o kēia mau kelepa adrenal, aia ma luna o ko mākou mau puʻupaʻa, e like me ka pāpale.

He aha nā ʻano o ka hyperaldosteronism?

ʻElua mau ʻano nui o ka hyperaldosteronism.

1. ʻO ka Hyperaldosteronism mua: I kekahi manawa ua kapa ʻia kēia ʻo Conn's syndrome . ʻO ka mea e hana ʻia ma ʻaneʻi, aia kekahi mea hewa me kāu mau kelepa adrenal ponoʻī, e hoʻoulu ana iā lākou e hana i ka aldosterone nui loa. E noʻonoʻo e like me he pilikia i loko o kahi hale hana a ke hana nei lākou i nā mea he nui loa.

2. ʻO ka Hyperaldosteronism Lua: ʻAʻole kēia he pilikia me nā kelepa adrenal. He pilikia ia ma kahi ʻē aʻe o kou kino e hoʻoulu ai i nā kelepa adrenal a hoʻomaka e hana i ka aldosterone hou aku. ʻO ke ʻano kēia e hana ana ka hale hana i ka manawa keu ma muli o ka mana o waho.

ʻO kēlā me kēia ʻano, ʻo ka hopena hope loa, ʻo ia ka piʻi ʻana o nā pae aldosterone o kou koko, e hoʻoulu ai i ke koko kiʻekiʻe (hypertension) a me ka emi ʻana o nā pae potassium o kou koko. Ua kapa ʻia kēia emi ʻana o ka potassium he hypokalemia .

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi? Pehea ka maʻamau o ia mea?

ʻO ka Hyperaldosteronism ka mea i ʻike pinepine ʻia i nā kānaka ma waena o 30 a me 50 mau makahiki.Eia kekahi, ʻoi aku ka maʻamau o kēia maʻi i waena o nā wahine ma mua o nā kāne.

He mea paʻakikī i nā kānaka noiʻi ke ʻōlelo pololei i ke ʻano maʻamau o kēia, no ka mea, ua kuhihewa ʻia i kekahi manawa. Akā, ua hōʻike kekahi mau noiʻi 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 kēia ʻano. No laila, ʻaʻole ia he mea maʻamau ʻole, ʻeā?

He aha nā hōʻailona o ka Hyperaldosteronism?

Hiki ke ʻokoʻa nā hōʻailona o ka hyperaldosteronism mai kēlā kanaka a kēia kanaka, ma muli o ke koʻikoʻi o ke kūlana. ʻAʻole paha i loaʻa i kekahi poʻe kekahi mau hōʻailona , ​​ʻoiai inā ʻaʻole koʻikoʻi loa ke kūlana.

Eia nō naʻe, ʻo ka hōʻailona nui a maʻamau o kēia ʻano, ʻo ia ke koko kiʻekiʻe (hypertension) , ʻoiai ke koko kiʻekiʻe hiki ʻole ke hoʻomalu maʻalahi ʻia me ka lāʻau lapaʻau.

Eia kekahi, inā ʻike ʻoe i nā hōʻailona ʻē aʻe, hoʻoulu pinepine ʻia lākou e ke koko kiʻekiʻe a koʻikoʻi a me/a i ʻole nā ​​​​pae potassium haʻahaʻa i loko o ke koko (hypokalemia).

Nā hōʻailona e hiki mai ana ma muli o ke koko kiʻekiʻe (hypertension):

• Nā ʻeha poʻo
• Pōʻino
• Nā loli o ka ʻike
• Paʻakikī ka hanu ʻana

Nā hōʻailona e hiki mai ana ma muli o ka haʻahaʻa o ka potassium i ke koko (hypokalemia):

• Nāwaliwali o nā ʻiʻo - I kekahi mau hihia koʻikoʻi, hiki ke loaʻa kahi ʻano like me ka maʻi lolo pōkole.
• Ka ʻūlū ʻana a i ʻole ka ʻūlū ʻana o nā ʻiʻo (nā ʻūlū ʻiʻo)
• ʻUʻu a me ka mae ʻana
• Luhi
• makewai nui (ua kapa ʻia kēia he polydipsia)
• Mimi pinepine

I kēia manawa ua maopopo iā ʻoe, no ka mea, he mea maʻamau kekahi o kēia mau hōʻailona i nā maʻi ʻē aʻe, hiki i kekahi manawa ke lohi ka ʻike ʻana i kēia.

He aha ke kumu o kēia?

ʻOkoʻa nā kumu o ka hyperaldosteronism ma muli o ke kumu mua a i ʻole ka lua. E nānā kākou pehea.

Nā kumu o ka Hyperaldosteronism mua

E like me kaʻu i ʻōlelo ai ma mua, ʻo ka Primary Hyperaldosteronism kahi pilikia me kāu mau kelepa adrenal ponoʻī, e koi ana iā lākou e hana i ka nui o ka aldosterone.

ʻO ke kumu maʻamau o kēia, ʻo ia nā puʻupuʻu ʻaʻole kanesa i kapa ʻia ʻo adrenal adenomas e hana ʻia ana i loko o nā kelepa adrenal . He mau puʻupuʻu liʻiliʻi kēia, ʻino ʻole, akā hiki iā lākou ke hoʻoulu i ka hoʻokuʻu nui ʻana o ka hormone aldosterone.

Eia kekahi, aia kekahi mau kumu ʻē aʻe i loaʻa pinepine ʻole :

• ʻO ka hyperplasia adrenal unilateral - ʻO ke ʻano kēia, hoʻokahi wale nō kelepa adrenal ma kekahi ʻaoʻao e pehu, hoʻonui ʻia, a hana i nā hormones hou aʻe.
• Nā carcinoma adrenocortical e hana ana i ka aldosterone - He mau puʻupuʻu kanesa kēia. Eia nō naʻe, he mea kakaikahi loa lākou.
• ʻO ka hyperaldosteronism ʻano 1 - He kūlana kēia i hoʻoilina ʻia mai nā mākua a i nā keiki.

Nā kumu o ka Hyperaldosteronism Lua

ʻO ke kumu nui o ka hyperaldosteronism lua ka emi ʻana o ka nui o ke koko e hiki aku i kou mau puʻupaʻa .

I mea e maopopo ai pehea e hana ai kēia, pono ʻoe e ʻike he ʻāpana ka hormone aldosterone o kahi kaulahao paʻakikī o nā hormones e kaohi ana i ko mākou koko koko. E noʻonoʻo iā ia e like me kahi hopena kaulahao.

Ua kapa ʻia kēia ʻōnaehana ʻo ka ʻōnaehana renin-angiotensin-aldosterone . Hana ia penei:

1. Ke ʻike kou kino i ke koko haʻahaʻa a i ʻole nā ​​pae sodium haʻahaʻa i loko o kou koko, hoʻokuʻu kou mau puʻupaʻa i kahi enzyme i kapa ʻia ʻo renin .

2. Hoʻololi kēia renin i kahi mea i kapa ʻia ʻo angiotensinogen (kahi mea mua i ka angiotensin) i hana ʻia e kou akepaʻa i angiotensin I. (ʻO Angiotensin kahi hormone e hoʻopaʻa ana i ko mākou mau kīʻaha koko.)

3. A laila, lilo kēia angiotensin I i angiotensin II .

4. ʻO ka mea hope loa, ʻo kēia angiotensin II ka mea e hoʻopaʻa hou aku i nā kīʻaha koko a hoʻoulu i nā kelepa adrenal e hoʻokuʻu i ka hormone aldosterone .

I kēia manawa, e noʻonoʻo, inā no kekahi kumu e emi ana ka nui o ke koko e hele ana i nā puʻupaʻa, manaʻo nā puʻupaʻa, 'Auē, ua hāʻule koʻu koko.' A laila hoʻāla hewa lākou i kēia ʻōnaehana renin-angiotensin-aldosterone. ʻO ka hopena, ʻo ka piʻi ʻana o ka pae o ka aldosterone i loko o ke kino, ʻoiai ʻaʻole pono maoli.

Nā kumu e hiki ai ke hōʻemi i ke kahe koko i nā puʻupaʻa a hoʻoulu i ka hyperaldosteronism luaEia kekahi mau mea:

• ʻO ka maʻi o ke aʻa renal obstructive - e like me ka paipu wai i paʻa.
• Ke koko kiʻekiʻe o ka puʻupaʻa
• Nā kūlana kahi e hōʻiliʻili ai ka wai i loko o ke kino (edema) , no ka laʻana:
• Ka hāʻule ʻana o ka puʻuwai
• ʻO ka Cirrhosis o ke akepaʻa
• He maʻi puʻupaʻa ka maʻi Nephrotic .

Pehea ʻoe e ʻike ai i kēia?

ʻO ka maʻamau, ʻike ke kauka i ka hyperaldosteronism ma o nā hoʻāʻo koko . Eia nō naʻe, ʻaʻole i ʻike ʻia ka nui o ka poʻe me ke ʻano no ka mea he nui nā kumu ʻē aʻe a me nā mea pilikia no ke koko kiʻekiʻe.

ʻO kekahi mau hōʻailona maʻamau e loaʻa paha iā ʻoe ka hyperaldosteronism:

• Ke koko kiʻekiʻe kūʻē i ka lāʻau lapaʻau.
• Eia nā hopena mai kāu hōʻike hoʻāʻo koko electrolyte :
• Kiʻekiʻe iki ka pae sodium (hypernatremia) .
• Haʻahaʻa iki ka pae magnesium (hypomagnesemia) .
• Eia kekahi, haʻahaʻa ka pae potassium (hypokalemia) .

Inā kānalua kāu kauka he hyperaldosteronism paha kāu ma muli o kēia mau hōʻailona a me nā ʻōuli, e kauoha paha ʻo ia i ʻelua mau hoʻāʻo koko kūikawā: Plasma Renin Concentration (PRC) a i ʻole Plasma Renin Activity (PRA) .

• Inā loaʻa iā ʻoe ka Primary Hyperaldosteronism , e haʻahaʻa ana kāu mau pae PRC a me PRA ma mua o ka maʻamau.
• Inā loaʻa iā ʻoe ka hyperaldosteronism lua , e ʻoi aku ke kiʻekiʻe o kēia mau pae ma mua o ka maʻamau.

Eia kekahi, pono paha ʻoe e loaʻa i kahi hoʻāʻo hoʻopau aldosterone . ʻO kēia hoʻāʻo e pili ana i ka hāʻawi ʻana iā ʻoe i kahi nui o ka sodium (paʻakai) ma ka waha a i ʻole ma o ka inikini saline (IV) ma luna o kekahi manawa. A laila, hōʻiliʻili ʻia kāu mau laʻana mimi ma luna o 24 mau hola a ana ʻia ka nui o ka aldosterone i loko o kēlā mimi ma kahi keʻena hoʻokolohua.

Inā hōʻoia kēia mau hoʻokolohua he hyperaldosteronism kou, hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aʻe e ʻike i ke kumu. No ka laʻana, he CT scan (computed tomography scan) e ʻike inā he puʻupuʻu noncancerous ke kumu o ka hyperaldosteronism.E noi ʻia paha ʻoe e hana i kahi hoʻokolohua kiʻi .

He aha nā lāʻau lapaʻau no kēia?

ʻO ka mālama ʻana no ka hyperaldosteronism e pili ana i ke kumu, akā ʻo ka pahuhopu nui ka kaohi ʻana i kou koko koko .

• No ka hyperaldosteronism mua, kahi kūlana i hoʻokumu ʻia e kahi puʻupuʻu kelepa adrenal, ʻōlelo pinepine nā kauka i ka wehe ʻana i ka puʻupuʻu . Eia nō naʻe, i kekahi mau hihia, hiki ke mālama ʻia kēia mau puʻupuʻu me ka lāʻau lapaʻau wale nō. ʻOiai ma hope o ke ʻoki ʻana, hiki nō iā ʻoe ke loaʻa ke koko kiʻekiʻe, no laila pono paha ʻoe e lawe i ka lāʻau lapaʻau e kāohi iā ia.

• Hoʻōla ʻia ka hyperaldosteronism lua ma ke kaohi ʻana i kou koko me nā lāʻau lapaʻau, me ka mālama ʻana i ke kumu kumu (e.g., maʻi puʻuwai) .

Aia kekahi mau ʻano lāʻau lapaʻau e hiki ke kōkua me ka hyperaldosteronism:

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

ʻO kahi mea e hoʻomanaʻo ai, ʻo ka hoʻohana lōʻihi ʻana i nā lāʻau pale aldosterone, e like me Spironolactone , hiki ke hana i kekahi mau hopena ʻaoʻao i nā kāne. No ka laʻana, hiki ke loaʻa ka erectile dysfunction a me ka gynecomastia . No laila, he mea nui e kamaʻilio me kāu kauka e pili ana i ka lāʻau lapaʻau maikaʻi loa iā ʻoe, pehea ka lōʻihi o kou lawe ʻana, a me nā hopena ʻaoʻao.

Hiki ke pale ʻia kēia?

ʻO kaʻoiaʻiʻo, i ka hapa nui o ka manawa, ʻaʻohe mea hiki iā ʻoe ke hana e pale aku i kēia kūlana o ka hyperaldosteronism. No ka mea, ua hoʻokumu ʻia e nā loli i nā kaʻina hana o loko o ko mākou kino. Eia nō naʻe, hiki iā ʻoe ke mālama i kou olakino holoʻokoʻa ma ka hahai ʻana i kahi nohona olakino, ka ʻai ʻana i ka meaʻai kaulike, a me ka hoʻoikaika kino.

He aha ka wānana no kēia kūlana?

ʻO ke ʻano o ka hyperaldosteronism e pili ana i ke kumu.

• ʻO ka hyperaldosteronism mua , inā ʻike mua ʻia a mālama pono ʻia, he hopena maikaʻi ka maʻamau . Inā wehe ʻia kahi puʻupuʻu, hoʻomalu pinepine ʻia ke kūlana.
• ʻO ka Hyperaldosteronism LuaʻO ka wā e hiki mai ana o ka maʻi e pili ana i ka maikaʻi o ka hoʻomalu ʻana i ke kūlana olakino ma lalo (e laʻa me ka maʻi puʻuwai, maʻi akepaʻa).

ʻO nā pilikia nui e hiki ke kū mai ma muli o ka hyperaldosteronism he mau pilikia cardiovascular i hoʻokumu ʻia e ke koko kiʻekiʻe. ʻO kēia mau mea:

• Atrial fibrillation - he puʻuwai naʻau kūpono ʻole.
• ʻO ka hypertrophy ventricular hema - ka mānoanoa o nā paia o ke keʻena hema o ka puʻuwai.
• Maʻi hohola
• Hahau

No laila he mea nui loa ka ʻike koke ʻana i kēia maʻi a loaʻa ka lāʻau kūpono.

Āhea wau e ʻike ai i ke kauka?

Inā ua ʻike ʻia ʻoe me ka hyperaldosteronism, pono ʻoe e ʻike pinepine i kāu kauka e hōʻoia i ka hana pono ʻana o ka lāʻau lapaʻau i kuhikuhi ʻia iā ʻoe . He mea nui loa hoʻi e hahai i nā ʻōlelo a kāu kauka.

Inā loaʻa iā ʻoe kekahi mau hōʻailona hou, a i ʻole e ʻike ʻoe i kahi loli i nā hōʻailona e kū nei , e hoʻomaopopo koke i kāu kauka.

ʻO ka mea nui loa, inā he koko kiʻekiʻe kou i kūʻē i ka lāʻau lapaʻau, e kamaʻilio me kāu kauka e pili ana i kou mau hopohopo, e like me, "Hiki iaʻu ke loaʻa ka hyperaldosteronism?" Hiki iā ia ke loiloi i kou kūlana a ʻōlelo i nā hoʻokolohua e pono ai.

E hoʻomanaʻo, he nui nā kumu o ke koko kiʻekiʻe. ʻO ka Hyperaldosteronism kekahi o lākou. ʻO ka nūhou maikaʻi, he maʻi hiki ke mālama ʻia kēia.

Leka Lawe-Home

ʻAe, ke lana nei koʻu manaʻo ua ʻike maikaʻi ʻoe i ka mea a mākou i kamaʻilio ai, ʻo Hyperaldosteronism. Eia kekahi mau mea e hoʻomanaʻo ai:

• ʻO ka Hyperaldosteronism ka hana nui ʻana o ka hormone aldosterone e nā kelepa adrenal.
• Hiki i kēia ke hoʻoulu i ke koko kiʻekiʻe (hypertension) a me nā pae potassium haʻahaʻa o ke koko (hypokalemia) .
• ʻElua ʻano nui: ʻO ke kumu mua ( kahi pilikia me nā kelepa adrenal ponoʻī) a me ke kumu lua (hoʻoulu ʻia ke kelepa adrenal ma muli o kahi pilikia ma kahi ʻē aʻe).
• Inā loaʻa iā ʻoe ke koko kiʻekiʻe i kāohi ʻole ʻia e ka lāʻau lapaʻau , pono ʻoe e kānalua i kēia.
• Ua ʻike ʻia kēia ma o nā hoʻokolohua koko .
• ʻO ka mālama ʻana e pili ana i ke kaohi ʻana i ke koko a me ka mālama ʻana i ke kumu .
• Inā ʻike ʻia a mālama ʻia i ka wā mua, hiki ke loaʻa nā hopena maikaʻi .

Inā he mau nīnau hou aku kāu e pili ana i kēia, e ʻoluʻolu e nīnau i kāu kauka. E noho olakino!

ʻO Hyperaldosteronism, Hyperaldosteronism, Aldosterone, Ke koko kiʻekiʻe, hypertension, Potassium, Adrenal glands, Conn's syndrome