E aʻo kākou e pili ana i ka haku hana huna e kaohi ana i ka calcium i loko o kou kino: ʻo ka Parathyroid Hormone (PTH).

Loaʻa iā kākou āpau nā ʻelele kemika liʻiliʻi e hana ana i loko o ko kākou kino, me ka ʻike ʻole ʻia, e mālama iā kākou i ke olakino. ʻO kekahi o ia mau ʻelele, ʻo ia ka hormone parathyroid. I ka ʻōlelo maʻalahi, hoʻomalu kēia hormone i ka nui o ka calcium i loko o ko kākou koko. No ke aha he mea nui loa ia? No ka mea, he mea nui ka calcium no ko kākou mau aʻalolo, nā ʻiʻo, a me ka puʻuwai e hana pono ai.

Hana ʻia kēia hormone parathyroid (Parathyroid Hormone - PTH) e ko kākou mau kelepa parathyroid. Aia kēia mau mea ma ko kākou ʻāʻī, ma hope o ke kelepa thyroid. He ʻehā mau kelepa liʻiliʻi loa lākou. ʻO kā lākou hana nui ka hoʻomalu ʻana i ka nui o ka calcium i loko o ko kākou koko . E hoʻomanaʻo, ʻaʻole ia ka calcium i loko o nā iwi, akā, ʻo ka calcium i loko o ke koko. Eia kekahi, kōkua pū kēia PTH i ka hoʻomalu ʻana i ka mineral phosphorus a me ka hormone vitamin D i loko o ke koko a me nā iwi.

Pehea e hana ai ka hormone parathyroid (PTH)?

ʻAe, i kēia manawa e nānā kākou pehea e hana ai kēia hormone parathyroid (PTH). Ke hāʻule kou pae calcium i ke koko, hoʻokuʻu nā kelepa parathyroid i ka PTH. Ua like ia me kahi sensor. A laila hele kēia PTH a hoʻopilikia i kekahi mau ʻāpana o ko mākou kino e hoʻihoʻi i nā pae calcium i luna.

• Nā Iwi: ʻO ka mea mua, hāʻawi ʻia ko kākou mau iwi i kahi hōʻailona liʻiliʻi, e ʻōlelo ana, 'E hoʻokuʻu i kahi calcium i loko o ke koko.' A laila hoʻohui ʻia kahi liʻiliʻi o ka calcium mai nā iwi i ke koko. ʻAʻole kēia e hoʻonāwaliwali i nā iwi, no ka mea, he hana i kāohi ʻia kēia.
• Nā puʻupaʻa: ʻO ka lua, hoʻopilikia ia i ko kākou mau puʻupaʻa. ʻO kekahi, kōkua nā puʻupaʻa i ka hana ʻana i ka huaora D ikaika, i kapa ʻia ʻo calcitriol. Kōkua kēia calcitriol i ke kino e omo i ka calcium mai ka meaʻai a kākou e ʻai ai. ʻO kekahi mea, ʻo ia ke haʻi aku nei i nā puʻupaʻa e 'mālama i ka calcium i loko o ke kino, mai hoʻokuʻu iā ia i loko o ka mimi'. A laila, ʻaʻole e hoʻonele ʻia ka calcium.
• ʻŌpū liʻiliʻi: ʻO ke kolu, e like me ka mea i ʻōlelo ʻia ma mua, hoʻouna ka huaora D (Calcitriol) i kahi hōʻailona i ko mākou ʻōpū liʻiliʻi e omo i ka calcium hou aʻe mai nā meaʻai a mākou e ʻai ai.

Pēlā ka hana a PTH e mālama ai i ka pae calcium i loko o ke koko ma ka pae kūpono ma o ka hoʻohuli ʻana i nā ʻāpana like ʻole o ke kino. ʻAʻole anei kēia he ʻano hana kupaianaha?

Pehea e kāohi ai ko mākou kino i nā pae PTH?

Pehea e kaohi ai ko kākou kino i kēia pae PTH? Hana ʻia nō hoʻi ia ma ke ʻano ʻē loa. Ua kapa ʻia ʻo ia he feedback loop . I ka ʻōlelo maʻalahi, ke emi ka calcium i loko o ke koko, hoʻoulu ʻia nā kelepa parathyroid a hoʻokuʻu i ka PTH. Ke piʻi ka calcium i loko o ke koko, hōʻailona ia i nā kelepa e 'hoʻōki i ka hana ʻana i ka PTH i kēia manawa, ua lawa'. No laila pēlā ke kaohi ʻia ʻana. Ua like ia me kahi motika i loko o kahi hale e hoʻā i ka wā e haʻahaʻa ai ka wai i loko o ka pahu wai a pio i ka wā e piha ai ka pahu.

Eia nō naʻe, i kekahi manawa inā he pilikia me kā mākou mau kelepa parathyroid, ʻaʻole paha e hana pono kēia loop feedback, e hana ana i ka nui a i ʻole ka liʻiliʻi o ka PTH e hana ʻia. ʻO ia ka manawa e hoʻomaka ai nā pilikia.

He aha nā maʻi e hiki ke hana inā hoʻopilikia ʻia nā pae PTH?

I kēia manawa, e nānā kākou i nā kūlana olakino e hiki mai ana inā hoʻopilikia ʻia nā pae o ka hormone parathyroid (PTH).

He aha ka mea e hana ai inā piʻi aʻe nā pae PTH? (Hyperparathyroidism)

Inā kiʻekiʻe loa nā pae PTH, kapa mākou ia he hyperparathyroidism . A laila ʻelua mau mea nui e hana ʻia:

• Piʻi ka nui o ka calcium i loko o ke koko. Ua kapa ʻia kēia he hypercalcemia.
• Hoʻemi ʻia ka pae o ka phosphorus i loko o ke koko. Ua kapa ʻia kēia he hypophosphatemia.

E noʻonoʻo, hoʻomau ka PTH i ka hoʻokuʻu ʻana i ka calcium mai nā iwi i loko o ke koko, e kāohi ana i nā puʻupaʻa mai ka hoʻokuʻu ʻana i ka calcium, a omo hou aku mai ka meaʻai ... a laila piha ke koko i ka calcium, ʻeā? Ua like kēia me ka paipu e paʻa ana a piha ka wai.

Hiki i kekahi mau kumu no kēia ʻano, e like me:

• Parathyroid Adenoma: ʻAʻole kēia he maʻi kanesa, akā ʻo kēia puʻupuʻu ke kumu o ka hana ʻana o ka gland i ka nui o ka PTH. ʻO kēia ke kumu maʻamau.
• Parathyroid Hyperplasia: Hoʻonui ʻia nā ʻāpana ʻehā a hana i nā hormones hou aku.
• Maʻi Puʻupaʻa: Hiki ke loaʻa kēia ʻano maʻi i nā poʻe me ka maʻi puʻupaʻa lōʻihi. No ka mea, i ka wā e hana pono ʻole ai nā puʻupaʻa, emi iho ka hana ʻana o ka huaora D a emi iho ka hoʻokuʻu ʻana o ka phosphorus. Hoʻoulu kēia i nā kelepa parathyroid e hana i ka PTH hou aku.
• Ka maʻi ʻaʻai Parathyroid: He mea kakaikahi loa kēia, akā hiki ke hana.

He aha ka mea e hana ai inā emi nā pae PTH? (Hypoparathyroidism)

Inā haʻahaʻa nā pae PTH, ua kapa ʻia ʻo ia he hypoparathyroidism . A laila hana ʻia ka mea ʻē aʻe:

• Haʻahaʻa nā pae kalipuna koko. Ua kapa ʻia kēia he hypocalcemia.
• Piʻi ka pae o ka phosphorus i loko o ke koko. Ua kapa ʻia kēia he hyperphosphatemia.

He maʻi laha ʻole ka Hypoparathyroidism. ʻO ka hapa nui o nā hihia (ma kahi o 75%) i hana ʻia e ka hōʻino ʻia ʻana a i ʻole ka wehe ʻia ʻana o nā kelepa parathyroid i ka wā o ke ʻoki ʻāʻī, ʻoiai ke ʻoki thyroid. Hiki ke hana ʻia e kekahi mau kūlana genetic a me nā kūlana autoimmune - nā maʻi i hoʻouka ai ka ʻōnaehana pale o ke kino i kāna mau cell ponoʻī.

Pehea ʻoe e ʻike ai inā he ʻano ʻē kou pae PTH? He aha nā hōʻailona?

E like me kā mākou i kūkākūkā ai ma mua, ʻo ka PTH ke kāohi nui i ka nui o ka calcium i loko o ke koko. No laila, ʻo nā hōʻailona e kū mai ana i ka wā e haʻahaʻa a kiʻekiʻe paha nā pae PTH he mau hōʻailona maoli ia o nā pae calcium haʻahaʻa a kiʻekiʻe paha i loko o ke koko. E nānā kākou i ke ʻano o lākou.

Nā hōʻailona o ka haʻahaʻa o ka calcium koko (Hypocalcemia):

Hiki iā ʻoe ke manaʻo i nā mea e like me kēia:

• Noe lolo a huikau paha. Hiki ke manaʻo ʻia ua uhi ʻia kou poʻo i ka noe.
• Maloʻo ka ʻili, haki maʻalahi nā kui, a hāʻule ka lauoho.
• ʻO nā ʻehaʻeha o nā ʻiʻo, ʻoiai ma nā wāwae a me nā lima.
• Ke kani ʻana ma kou mau lehelehe, nā manamana lima a i ʻole nā ​​​​wāwae.
• Hiki nō hoʻi ke ʻano o nā mea e like me ka hopohopo a me ke kaumaha .
• I nā hihia koʻikoʻi, hiki ke loaʻa nā maʻi ʻeha.

E noʻonoʻo, ua manaʻo koke ʻo Niluka i ka mae ʻana o kona mau manamana lima, me ka ʻūlū a puni kona waha, a ua hoʻomaka ka ʻiʻo ma kona mau wāwae e lilo i ʻulaʻula. Ua manaʻo ʻo ia he ʻoluʻolu ʻole loa. I kona hele ʻana e ʻike i ke kauka, ua ʻike ʻo ia ua emi ka pae calcium o kona koko, a ʻo ke kumu, ʻo ia ka hypoparathyroidism.

Nā hōʻailona o ke kiʻekiʻe o ka calcium koko (Hypercalcemia):

ʻO nā hōʻailona e like me kēia e hōʻike ana i ke kiʻekiʻe o ka calcium koko:

• Ua luhi loa au, me he mea lā ʻaʻohe oʻu ikaika (Luhi). ʻOiai pehea ka nui o koʻu hiamoe ʻana, ʻaʻole like me ka nalowale ʻana o ka luhi.
• ʻEha poʻo.
• ʻEha hui a me ka ʻeha iwi.
• Pono e mimi pinepine a makewai.
• Nā mea e like me ka ʻeha o ka ʻōpū, ka nausea, ka luaʻi ʻana, a me ka diarrhea.
• He paʻakikī ke kau ʻana i ka manaʻo, nalowale ka hoʻomanaʻo, a me ka huikau o ka noʻonoʻo.
• I nā hihia koʻikoʻi, hiki ke loaʻa nā pōhaku puʻupaʻa a me nā puʻuwai puʻuwai kūpono ʻole.

Eia kekahi laʻana, ua luhi loa ʻo ʻAnakala Saman no kekahi mau lā, a ua ʻeha kona mau hono. Ua makewai mau ʻo ia a pono e hele i ka lua. I ka nānā ʻana o ke kauka iā ia, ua haʻi ʻia iā ia ua kiʻekiʻe iki ka calcium o kona koko. He hyperparathyroidism kona.

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​ʻo ia hoʻi ke manaʻo nei ʻoe ua haʻahaʻa a kiʻekiʻe paha kou pae calcium i loko o ke koko, pono ʻoe e ʻike i ke kauka . Mai poina i kēlā. ʻAʻole kēia he mau hōʻailona maikaʻi e hoʻowahāwahā ʻia.

Pehea e nānā ai i ka pae o ka PTH?

Hiki i kāu kauka ke nānā i kāu mau pae hormone parathyroid me kahi hoʻāʻo koko maʻalahi . Kāhea nā kauka a me nā labs i kēia hoʻāʻo "PTH, intact." Nānā pinepine lākou i kou mau pae koko o ka calcium, phosphorus, a me ka huaora D e kiʻi i kahi kiʻi piha.

He aha nā waiwai maʻamau no nā pae PTH?

I loko o kahi hoʻāʻo koko PTH maʻamau, ʻo kahi pae olakino ma waena o 15 a me 65 picograms no ka milliliter (pg/mL) . ʻO ka picogram hoʻokahi trillion o ka gram. ʻO ia hoʻi, he liʻiliʻi loa ka nui e hana i kēia hana koʻikoʻi i loko o ko mākou kino.

Akā, hoʻokahi mea e hoʻomanaʻo ai, hiki ke ʻokoʻa iki kēia mau waiwai maʻamau mai kēlā me kēia keʻena hoʻokolohua. No laila, pono ʻoe e nānā mau i ka pae maʻamau no kēlā keʻena hoʻokolohua ma kāu hōʻike hoʻāʻo koko.

Inā loaʻa iā ʻoe kahi hoʻāʻo PTH, ʻo kāu kauka ka mea nāna e wehewehe pololei i nā hopena. E hoʻohālikelike ʻo ia iā ia me kou pae calcium a haʻi iā ʻoe inā pono ka hoʻāʻo hou ʻana.

No laila, he aha nā mea e pono ai kākou e hoʻomanaʻo mai kēia mau mea a pau?

He hormone koʻikoʻi loa ka Parathyroid Hormone (PTH) e kaohi pono ana i ka pae o ka calcium i loko o ko kākou koko. He mea nui kēia pae calcium no ka hana olakino o ko kākou ʻōnaehana nerve, nā ʻiʻo, a me ka puʻuwai.

Inā loaʻa iā ʻoe nā hōʻailona o ka hypercalcemia (calcium koko kiʻekiʻe) a i ʻole hypocalcemia (calcium koko haʻahaʻa), e like me nā pilikia ʻiʻo, nā loli i ka hana noʻonoʻo, ka luhi nui, a me ka ʻeha o ka iwi, he mea nui e ʻimi koke i ke aʻo lapaʻau. Inā hoʻomau kēia mau kūlana, hiki iā lākou ke hōʻino i nā puʻupaʻa, ka puʻuwai, a me nā iwi.

Hiki i kāu kauka ke holo i kekahi mau hoʻokolohua maʻalahi e hoʻoholo ai inā ʻo kāu mau pae hormone parathyroid ke kumu. Inā pēlā, hiki iā lākou ke hoʻomaka koke i ka mālama ʻana. I kekahi manawa hiki ke mālama ʻia kēia mau pilikia me ka lāʻau lapaʻau, i kekahi manawa me ke ʻoki liʻiliʻi. No laila, ʻo ka mālama ʻana i kou kino, ka hoʻomaopopo ʻana i nā hōʻailona āna e hāʻawi ai, a me ka hana ʻana ma luna o lākou ke ala maikaʻi loa e noho olakino ai.

ʻO ka hormone parathyroid, PTH, calcium, hyperparathyroidism, hypoparathyroidism, hypercalcemia, hypocalcemia