Koj puas xav tias koj nkees tas li, xav tias koj tsis muaj sia nyob, thiab koj cov xim tawv nqaij maj mam hloov pauv? Tej zaum koj muaj kev ntshaw ntsev txawv txawv. Peb feem ntau tsis quav ntsej cov tsos mob no li ib txwm muaj. Txawm li cas los xij, cov no tuaj yeem yog cov cim qhia txog kab mob hauv peb lub cev uas tsis tshua muaj, tab sis nws yog ib qho tseem ceeb heev uas yuav tsum txheeb xyuas nws kom raug. Niaj hnub no peb tab tom tham txog kab mob tsis tshua muaj, tab sis yog tias tswj hwm kom zoo, koj tuaj yeem ua neej nyob ib txwm muaj. Ntawd yog Addison's Disease .
Hais yooj yim xwb, kab mob Addison yog dab tsi?
Zoo, cia peb piav qhia qhov no yooj yim. Peb muaj ob lub qog me me, zoo li lub kaus mom, saum peb lub raum. Peb hu cov no ua cov qog adrenal . Cov no yog ib feem tseem ceeb heev ntawm peb lub cev endocrine.
Kab mob Addison yog ib qho mob uas cov qog adrenal tsis tsim txaus ob hom tshuaj hormones tseem ceeb, cortisol thiab aldosterone .
Peb xav tau ob hom tshuaj hormones no ua dab tsi?
- Cortisol: Qhov no yog ib yam tshuaj hormones uas tseem ceeb rau lub neej. Nws pab peb lub cev daws teeb meem kev ntxhov siab, xws li thaum peb mob, muaj xwm txheej, lossis phais mob. Nws kuj pab tswj cov ntshav siab, lub plawv dhia, kev ua haujlwm ntawm lub cev tiv thaiv kab mob, thiab cov ntshav qab zib.
- Aldosterone: Cov tshuaj hormone no pab kom cov zaub mov sodium (ntsev) thiab potassium sib npaug hauv peb lub cev. Nws kuj tswj cov kua dej uas peb lub raum tso tawm ua zis. Qhov no kuj cuam tshuam ncaj qha rau peb cov ntshav siab.
Kab mob Addison kuj hu ua primary adrenal insufficiency . Muaj lwm yam mob zoo sib xws, hu ua secondary adrenal insufficiency . Hauv qhov mob no, lub qog pituitary hauv lub hlwb tsis tso tawm cov tshuaj hormone ACTH txaus, uas ua rau cov qog adrenal tsim cortisol. Tab sis hnub no peb feem ntau tham txog qhov teeb meem uas tshwm sim hauv cov qog adrenal lawv tus kheej.
Qhov sib txawv ntawm tus kab mob Addison thiab Cushing's syndrome
Tej zaum koj yuav tsis nkag siab ob lub npe no. Ob lub npe no yog cov xwm txheej sib txawv kiag li.
| Yam ntxwv | Kab mob Addison | Cushing's Syndrome |
|---|---|---|
| Qhov teeb meem tseem ceeb | Tsis txaus cortisol (thiab aldosterone) hauv lub cev. | Kev nce cortisol hauv lub cev (Hypercortisolism). |
| Cov yam ntxwv feem ntau | Poob phaus, tawv nqaij dub, ntshav siab qis. | Qhov hnyav nce, lub ntsej muag puag ncig, ntshav siab. |
Leej twg yuav muaj feem yuav kis tau tus kab mob no ntau tshaj? Nws kis tau ntau npaum li cas?
Txawm hais tias tus kab mob Addison tuaj yeem cuam tshuam rau cov neeg txhua lub hnub nyoog, nws feem ntau tshwm sim rau cov neeg hnub nyoog ntawm 30 thiab 50 xyoo .
Qhov no yog ib qho mob tsis tshua muaj . Piv txwv li, hauv Asmeskas, tus kab mob no cuam tshuam txog li ib ntawm ib puas txhiab tus neeg. Tab sis kuj muaj cov neeg uas muaj tus kab mob no hauv peb lub tebchaws thiab.
Muaj cov neeg uas muaj feem yuav mob no ntau dua. Cov neeg ntawd yog cov neeg uas muaj lwm yam kab mob autoimmune . Uas yog, cov kab mob uas peb lub cev tiv thaiv kab mob tawm tsam peb cov hlwb. Yog tias peb muaj cov kab mob zoo li no, qhov kev pheej hmoo ntawm kev mob Addison's yog siab dua.
- Kab mob ntshav qab zib hom I
- Kev mob ntshav tsis txaus
- Kab mob Graves
- Mob thyroiditis ntev
- Vitiligo - cov pob dawb ntawm daim tawv nqaij
- Myasthenia gravis
Cov tsos mob ntawm tus kab mob Addison yog dab tsi?
Hauv tus kab mob Addison, kev puas tsuaj rau cov qog adrenal feem ntau tshwm sim qeeb heev, dhau sijhawm. Yog li ntawd, cov tsos mob tshwm sim maj mam. Cov tsos mob no tuaj yeem sib txawv ntawm ib tus neeg mus rau ib tus neeg.
| Cov tsos mob uas feem ntau tshwm sim maj mam | |
|---|---|
| Qhov tshwj xeeb tshaj plaws | Maj mam zuj zus tuaj, qaug zog thiab qaug zog tsis paub ua li cas. |
| Kev hloov pauv ntawm daim tawv nqaij | Xim av/dub ntawm daim tawv nqaij, tshwj xeeb tshaj yog nyob rau thaj chaw uas muaj cov qhov txhab, cov tawv nqaij quav (xws li qhov tsoob, qhov ncauj), thiab cov pos hniav (Hyperpigmentation). |
| Kev zom zaub mov | Mob plab, xeev siab, ntuav, raws plab, tsis xav noj mov, thiab poob phaus. |
| Lwm yam nta | Mob nqaij thiab mob pob qij txha, lub cev qhuav dej, kiv taub hau thaum sawv (vim yog ntshav siab qis), chim siab, nyuaj siab, ntshaw ntsev ntau dhau, thiab ntshav qab zib tsawg (hypoglycemia). |
Cov poj niam kuj tseem yuav muaj cov tsos mob xws li kev coj khaub ncaws tsis tu ncua, cov plaub hau poob ntawm lub cev, thiab kev xav sib deev tsawg dua.
Qhov xwm txheej ceev uas yuav tsum tau saib xyuas: Addisonian Crisis
Qee zaum, tshwj xeeb tshaj yog tom qab muaj kev kis kab mob hnyav, raug xwm txheej, lossis kev ntxhov siab heev, cov tsos mob no tuaj yeem hloov pauv mus ua mob hnyav heev. Qhov no hu ua Addisonian Crisis lossis mob adrenal tsis ua haujlwm . Qhov no yog xwm txheej ceev uas xav tau kev kho mob tam sim ntawd thiab tuaj yeem ua rau tuag taus!
Cov tsos mob ntawm Addisonian crisis:
- Ib qho tsis muaj zog uas tsis tuaj yeem tiv taus, tsis zoo li lwm tus.
- Mob tam sim ntawd, mob hnyav rau sab nraub qaum qis, plab, lossis ob txhais ceg.
- Kev hloov pauv ntawm lub hlwb xws li tsis nyob twj ywm, tsis meej pem, thiab kev ntshai.
- ntuav thiab raws plab hnyav heev (qhov no tuaj yeem ua rau lub cev qhuav dej sai).
- Ntshav siab poob qis dhau.
- Poob siab.
Yog koj lossis ib tus neeg koj paub muaj cov tsos mob no, tam sim ntawd coj lawv mus rau Chav Kho Mob Ceev (ETU) ze tshaj plaws.
Dab tsi yog cov ua rau muaj tus kab mob Addison?
Qhov ua rau mob Addison's yog vim muaj cov tshuaj tiv thaiv kab mob autoimmune.Hais yooj yim xwb, peb lub cev tiv thaiv kab mob (lub cev tiv thaiv kab mob) ua yuam kev tawm tsam thiab rhuav tshem sab nraud ntawm peb cov qog adrenal (adrenal cortex). Qhov laj thawj tseeb vim li cas qhov no tshwm sim tseem tsis tau paub. Cov tsos mob pib tshwm sim tom qab kwv yees li 90% ntawm cov qog no tau raug rhuav tshem. Qhov no tuaj yeem siv sijhawm ntau lub hlis, lossis txawm tias ntau xyoo.
Qhov no yog qhov ua rau 75% ntawm cov neeg mob Addison.
Lwm yam ua rau tsis tshua muaj:
- Kab mob ntsws: Qhov no yog ib qho ua rau muaj kab mob loj heev yav dhau los. Nws tseem yog ib qho ua rau muaj kab mob loj heev hauv cov teb chaws uas tseem tab tom txhim kho.
- Cov kab mob rov tshwm sim dua: Cov kab mob ntsig txog HIV/AIDS thiab cov kab mob fungal.
- Mob qog noj ntshav: Kev kis ntawm cov hlwb qog noj ntshav los ntawm lwm qhov mus rau cov qog adrenal.
- Kev hemorrhage rau hauv cov qog adrenal.
- Kev phais tshem tawm cov qog adrenal.
- Amyloidosis: Ib yam kab mob uas ib hom protein tso rau hauv cov kabmob thiab ua puas rau lawv.
Yuav kuaj mob li cas? (Kev kuaj mob)
Vim tias cov tsos mob tshwm sim qeeb heev thiab yog ib qho uas tshwm sim rau ntau lwm yam kab mob, kab mob Addison tuaj yeem nyuaj rau kuaj mob thaum ntxov. Feem ntau, cov kab mob no raug tshawb pom "ua ntej." Cov kws kho mob yuav xav tias qhov no yog tias lawv pom cov ntsev tsawg thiab cov ntsev potassium ntau hauv cov ntshav thaum lub sijhawm kuaj ntshav rau lwm yam mob. Tsis tas li ntawd, hyperpigmentation ntawm daim tawv nqaij yog ib qho tsos mob tseem ceeb uas ua rau xav tias muaj kab mob no.
Yog koj tus kws kho mob xav tias qhov no yog vim koj cov tsos mob, lawv yuav xaj ntau qhov kev kuaj ntxiv kom paub meej tias muaj tus kab mob.
Kev kuaj mob:
- Kev kuaj ntshav: Kev kuaj ntshav ntsuas cov sodium, potassium, cortisol, thiab ACTH cov tshuaj hormones. Hauv tus kab mob Addison, cortisol qis thiab ACTH siab.
- Kev kuaj mob ACTH: Qhov no yog qhov kev kuaj tseem ceeb uas siv los paub meej tias muaj mob. Hauv qhov kev kuaj no, cov tshuaj hormones ACTH uas tsim los ntawm tib neeg raug muab ua ib qho kev txhaj tshuaj, thiab qib cortisol hauv koj cov ntshav raug ntsuas li ib teev tom qab. Yog tias koj cov qog adrenal noj qab nyob zoo, koj qib cortisol yuav tsum nce ntxiv. Txawm li cas los xij, yog tias nws tsis nce, nws lees paub tias koj cov qog adrenal tsis ua haujlwm zoo.
- Kev kuaj ntshav qab zib qis los ntawm insulin: Qhov kev kuaj no yog ua los nrhiav seb koj cov tsos mob puas yog los ntawm teeb meem nrog lub qog pituitary.
- CT scan: Ib qho CT scan yuav ua tau los xyuas seb koj cov qog adrenal puas lawm, kis kab mob, lossis tau me dua.
Yuav kho li cas?
Txoj kev kho mob tseem ceeb ntawm Addison's disease yog,Kev Kho Mob Hloov Tshuaj Hormone (HRT) yog txheej txheem ntawm kev hloov cov tshuaj hormones uas lub cev tsis txaus hauv daim ntawv ntawm cov tshuaj ntsiav tshuaj.
Vim qhov no yog ib qho mob ntev, koj yuav tsum noj cov tshuaj no mus tas koj lub neej .
- Ib yam tshuaj hu ua hydrocortisone raug muab hloov qhov hormone cortisol .
- Ib yam tshuaj hu ua fludrocortisone raug muab hloov qhov hormone aldosterone .
Cov tshuaj no yuav tsum tau noj ntau npaum li cas los ntawm ib tus neeg mus rau ib tus neeg. Tsis tas li ntawd, koj tus kws kho mob yuav tsum tau nce koj cov tshuaj kom tsis txhob muaj teeb meem Addisonian yog tias koj muaj kev ntxhov siab, xws li kev kis kab mob, kev sib tsoo, lossis kev phais.
Yog tias koj noj tshuaj fludrocortisone, koj tus kws kho mob yuav qhia koj kom ntxiv ntsev me ntsis rau hauv koj cov zaub mov noj, tshwj xeeb tshaj yog thaum huab cua kub, tawm hws thiab tom qab ua si nawv hnyav.
Nyob nrog tus kab mob thiab koj yuav tsum ua li cas
Yog tias kho kom zoo, ib tug neeg uas muaj tus kab mob Addison's yuav ua tau lub neej zoo li qub thiab noj qab nyob zoo . Txawm li cas los xij, nws yog ib qho tseem ceeb heev uas yuav tsum noj tshuaj kom raug.
Yog tias cov tshuaj noj ntau dhau, cov kev mob tshwm sim xws li kev rog dhau, ntshav qab zib hom 2, pob txha tawg, thiab ntshav siab tuaj yeem tshwm sim. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum mus ntsib koj tus kws kho mob tsis tu ncua (feem ntau yog tus kws kho mob endocrinologist) thiab ua qhov kev kuaj mob tsim nyog kom tswj tau qhov ntau npaum li cas ntawm cov tshuaj.
Tej yam koj yuav tsum ua rau koj tus kheej muaj kev nyab xeeb:
- Ib txwm hnav daim npav ID lossis ib txoj hlua tes/txoj hlua caj dab ceeb toom txog kev kho mob. Qhov no yuav pab cov neeg ua haujlwm kho mob paub tias koj muaj tus kab mob Addison yog tias koj tsis nco qab thaum muaj xwm txheej ceev.
- Tham nrog koj tus kws kho mob txog kev khaws ib koob tshuaj cortisol kom npaj txhij thaum muaj xwm txheej ceev. Tsis tas li ntawd, qhia ib tug neeg hauv tsev neeg lossis ib tus neeg koj hlub yuav txhaj tshuaj rau koj li cas.
- Nug koj tus kws kho mob seb yuav ua li cas thaum koj mob lossis ntxhov siab heev. Hauv cov xwm txheej zoo li no, tej zaum yuav tau hloov kho qhov ntau npaum li cas ntawm koj cov tshuaj.
- Txuas ntxiv mus ntsib koj tus kws kho mob.
Paub tias koj muaj tus mob ntev ntev tuaj yeem ua rau koj lub siab ntxhov siab. Tab sis qhov xov xwm zoo yog tias tus kab mob Addison raug tswj tau zoo heev nrog kev siv tshuaj. Qhov tseem ceeb tshaj plaws yog kom sib cuag nrog koj tus kws kho mob tsis tu ncua thiab tau txais kev kho mob uas koj xav tau.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob Addison yog ib qho mob uas cov qog adrenal tsis tsim cov tshuaj hormones cortisol thiab aldosterone txaus.
- Cov tsos mob tseem ceeb suav nrog qaug zog tas li yam tsis muaj laj thawj pom tseeb, daim tawv nqaij thiab cov pos hniav dub zuj zus, thiab ntshaw zaub mov ntsev ntau dhau.
- "Addisonian crisis" yog ib qho xwm txheej ceev uas txaus ntshai rau lub neej thiab yuav tsum tau kho tam sim ntawd.
- Kev kho mob yog noj cov tshuaj hormones tsawg tsawg mus tas li.
- Yog koj kho tau zoo, koj yuav ua neej tau zoo li qub thiab noj qab nyob zoo, tiam sis nws tseem ceeb heev uas yuav tsum nrog koj tus kws kho mob sib tham.
- Yog koj muaj tus kab mob no, nws yog ib qho tseem ceeb heev rau koj txoj kev nyab xeeb kom hnav daim npav ceeb toom kho mob lossis lub kauj tes thiab muaj phiaj xwm xwm txheej ceev.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus