Txawm koj noj tshuaj lawm los koj cov ntshav siab tseem tsis tau tswj? Tej zaum qhov ua rau muaj qhov teeb meem no yog vim muaj teeb meem ntawm lub siab (Hyperaldosteronism).

Koj puas muaj ntshav siab , lossis " ntshav siab " raws li peb txhua tus paub? Tej zaum koj tab tom noj ib, ob, lossis ntau dua cov tshuaj uas koj tus kws kho mob tau sau tseg. Tab sis koj puas pom tias nws nyuaj rau tswj koj cov ntshav siab txawm tias tom qab noj ntau yam tshuaj lawm? Yog tias yog, qhov laj thawj rau qhov no yuav tsis yog ib yam dab tsi uas txhua tus neeg feem ntau xav txog. Hnub no peb yuav tham txog ib qho mob tshwj xeeb uas tuaj yeem ua rau ntshav siab uas tsis yooj yim tswj los ntawm cov tshuaj. Ntawd yog Hyperaldosteronism. Txawm hais tias lub npe nyuaj me ntsis, cia peb nkag siab nws yooj yim heev.

Hyperaldosteronism yog dab tsi?

Hais yooj yim xwb, Hyperaldosteronism yog qhov tsim cov tshuaj hormone "Aldosterone" ntau dhau los ntawm cov qog adrenal hauv peb lub cev.

Tam sim no tej zaum koj yuav xav tias, cov qog adrenal no yog dab tsi? Cov tshuaj hormones aldosterone no yog dab tsi?

Xav txog seb, saum ob lub raum hauv peb lub cev, muaj ob lub qog me me, zoo li ob lub hau me me. Qhov ntawd yog qhov peb hu ua cov qog adrenal. Cov no yog ib feem tseem ceeb ntawm peb lub cev endocrine . Ob lub qog me me no tsim ntau hom tshuaj hormones uas tseem ceeb rau peb lub cev ua ub ua no txhua hnub .

Ib yam tshuaj hormone tshwj xeeb uas cov qog no tsim tawm hu ua aldosterone . Lub luag haujlwm tseem ceeb ntawm cov tshuaj hormone no yog los tswj peb cov ntshav siab . Nws ua qhov no los ntawm kev tswj cov sodium thiab potassium hauv peb cov ntshav. Cov tshuaj hormone no ua haujlwm hauv peb lub cev zoo li tus tub ceev xwm tsheb khiav uas tswj tsheb khiav ntawm txoj kev.

Yog li, nyob rau hauv rooj plaub ntawm Hyperaldosteronism, qhov tshwm sim yog tias cov tshuaj hormone aldosterone no raug tsim ntau dhau. Tom qab ntawd qhov ntau ntawm sodium hauv peb lub cev nce thiab qhov ntau ntawm potassium txo qis. Qhov kawg ntawm qhov no yog ntshav siab (Hypertension) thiab cov potassium qis hauv cov ntshav (Hypokalemia) .

Muaj ob hom tseem ceeb ntawm qhov no.

Cov kws kho mob faib qhov mob no ua ob hom tseem ceeb, nyob ntawm seb ua rau muaj li cas.

1. Kev mob hyperaldosteronism thawj zaug:Qhov no kuj hu ua "Conn's syndrome." Qhov no yog tshwm sim los ntawm teeb meem hauv cov qog adrenal lawv tus kheej, uas ua rau lawv tsim cov tshuaj hormone aldosterone ntau dhau. Qhov ua rau yog nyob rau hauv cov qog nws tus kheej.

2. Mob Aldosteronism Thib Ob: Hauv qhov no tsis muaj teeb meem nrog cov qog adrenal. Tab sis vim muaj teeb meem nyob rau lwm qhov hauv lub cev, cov qog adrenal raug txhawb kom teb thiab tsim cov aldosterone ntau dua.

Leej twg feem ntau raug tus mob no?

Feem ntau tus mob no tshwm sim rau cov neeg hnub nyoog ntawm 30 thiab 50 xyoo. Kev tshawb fawb kuj qhia tau tias tus mob no tshwm sim ntau dua rau cov poj niam dua li cov txiv neej.

Qee qhov kev tshawb fawb qhia tias ntawm 5% thiab 10% ntawm cov neeg uas muaj ntshav siab yuav muaj tus mob hyperaldosteronism thawj zaug. Cov kws tshaj lij ntseeg tias muaj txog li 25% ntawm cov neeg uas muaj ntshav siab uas tsis kam noj tshuaj yuav muaj tus mob no.

Cov tsos mob ntawm qhov no yog dab tsi?

Qee zaum, yog tias qhov mob tsis hnyav heev, tej zaum yuav tsis muaj tsos mob li. Txawm li cas los xij, ntau tus neeg muaj tsos mob.

Cov tsos mob tseem ceeb thiab feem ntau pom hauv tus mob no yog ntshav siab (Hypertension) , tshwj xeeb yog ntshav siab uas nyuaj rau tswj txawm tias siv ntau yam tshuaj los xij.

Lwm cov tsos mob yog tshwm sim los ntawm ob yam: ntshav siab thiab cov ntshav potassium qis (Hypokalemia). Cia peb cais cov tsos mob no kom meej meej.

Vim li cas qhov mob Hyperaldosteronism no thiaj tshwm sim?

Raws li peb tau tham ua ntej lawm, cov laj thawj rau qhov no sib txawv raws li ob hom tseem ceeb.

Cov ua rau muaj tus kab mob Hyperaldosteronism thawj zaug

Qhov teeb meem ntawm no yog nyob rau hauv lub qog adrenal nws tus kheej.

• Feem ntau ua rau muaj qhov teeb meem no: Feem ntau, qhov no yog tshwm sim los ntawm ib qho qog uas tsis yog mob qog noj ntshav (adrenal adenoma) uas loj hlob hauv cov qog adrenal. Qhov no tsis yog mob qog noj ntshav, yog li ntawd tsis muaj dab tsi yuav tsum txhawj txog. Qhov qog no tsim cov tshuaj hormones aldosterone ntau dhau.
• Lwm yam ua rau tsis tshua muaj:
• Kev loj hlob ntawm ib lub qog adrenal xwb (unilateral adrenal hyperplasia).
• Aldosterone tsim los ntawm cov qog nqaij hlav (adrenocortical carcinoma) (qhov no tsis tshua muaj).
• Ib yam mob caj ces uas kis tau los ntawm ntau tiam neeg (Familial hyperaldosteronism).

Ua rau muaj mob hyperaldosteronism theem ob

Nov cov qog adrenal noj qab nyob zoo. Tab sis lawv raug txhawb nqa rau lwm qhov laj thawj. Qhov laj thawj tseem ceeb yog cov ntshav tsis txaus rau lub raum .

Yuav kom nkag siab qhov no, peb yuav tsum paub me ntsis txog ib lub cev uas tswj cov ntshav siab hauv peb lub cev. Nws hu ua Renin-Angiotensin-Aldosterone System .

Xav txog qhov no ua ib qho kev sib txuas lus:

1. Thaum peb cov ntshav siab poob qis los yog peb cov sodium hauv cov ntshav poob qis, peb lub raum yuav hnov ​​​​​​qhov ntawd.

2. Ces cov raum tso tawm ib qho enzyme hu ua "renin" rau hauv cov ntshav.

3. Cov renin no hloov cov protein hu ua "Angiotensinogen", uas yog tsim los ntawm lub siab, mus ua "Angiotensin I".

4. Tom ntej no, qhov angiotensin I no dhau los ua "Angiotensin II".

5. Thaum kawg, nws yog qhov angiotensin II no uas ua rau cov ntshav siab ntxiv los ntawm kev txwv cov hlab ntsha thiab txhawb cov qog adrenal kom tsim cov aldosterone.

Tam sim no, nyob rau hauv hyperaldosteronism theem ob, qhov tshwm sim yog tias vim qee qhov mob, qhov ntau ntawm cov ntshav mus rau lub raum txo qis. Tom qab ntawd lub raum xav yuam kev tias lub siab hauv lub cev qis. Yog li, lub raum hu rau kev pab thiab qhov kev ua haujlwm saw hlau pib. Yog li ntawd, lawv tsim ntau cov tshuaj hormones aldosterone, thaum tsis tas yuav muaj nws.

Cov mob uas txo cov ntshav mus rau lub raum thiab ua rau muaj hyperaldosteronism theem ob:

• Kab mob ntawm cov hlab ntsha hauv lub raum.
• Cov mob uas ua rau cov kua dej sib sau ua ke hauv lub cev, xws li lub plawv tsis ua haujlwm.
• Kab mob siab cirrhosis.
• Kab mob nephrotic, ib yam kab mob raum.

Tus kws kho mob kuaj mob li cas?

Thaum koj qhia rau koj tus kws kho mob txog koj cov tsos mob, tshwj xeeb tshaj yog cov ntshav siab uas tsis tswj tau los ntawm cov tshuaj, nws yuav xav tias muaj tus mob no. Tom qab ntawd, lawv yuav xaj ntau qhov kev kuaj mob kom paub meej qhov no.

1. Kev kuaj ntshav:

• Yog tias cov ntshav electrolyte ib txwm qhia tias muaj cov sodium ntau me ntsis (Hypernatremia) thiab cov potassium tsawg (Hypokalemia) , qhov kev xav tias muaj teeb meem yuav nce ntxiv.
• Tom ntej no, muaj ob txoj kev kuaj ntshav tshwj xeeb uas siv tau los kuaj mob no: Plasma Renin Concentration (PRC) lossis Plasma Renin Activity (PRA) .
• Yog koj muaj Primary Hyperaldosteronism, koj cov renin theem (PRC thiab PRA) yuav qis dua li qub.
• Yog tias koj muaj hyperaldosteronism theem ob , koj cov renin theem yuav siab dua li qub.

2. Kev Ntsuas Aldosterone:

• Qhov kev kuaj no yuav tsum muab ntsev ntxiv rau koj rau ib lub sijhawm. Nws tuaj yeem yog cov kua uas koj haus los ntawm qhov ncauj lossis cov kua ntsev uas koj muab rau hauv cov leeg ntshav.
• Tom qab ntawd, koj cov zis raug sau rau hauv 24 teev thiab ntsuas qhov ntau ntawm aldosterone hauv cov zis ntawd.
• Rau ib tug neeg noj qab nyob zoo, kev noj ntsev ntau dhau yuav txo qhov tsim cov aldosterone hauv lub cev. Txawm li cas los xij, rau ib tug neeg uas muaj hyperaldosteronism, qhov no tsis tshwm sim.

3. Kev Ntsuas Duab:

• Yog tias cov kev kuaj ntshav lees paub tias koj muaj mob hyperaldosteronism thawj zaug, koj tus kws kho mob yuav xaj kom kuaj xws li CT scan (Computed Tomography scan) kom nrhiav tau qhov ua rau. Qhov no tuaj yeem kuaj xyuas seb puas muaj qog nqaij hlav ntawm lub qog adrenal.

Cov kev kho mob rau qhov no yog dab tsi?

Kev kho mob nyob ntawm seb ua rau muaj mob li cas. Txawm li cas los xij, lub hom phiaj tseem ceeb yog tswj koj cov ntshav siab.

• Rau cov mob hyperaldosteronism thawj zaug uas tshwm sim los ntawm qog:

Feem ntau, cov kws kho mob pom zoo kom phais tshem tawm cov qog thiab cov qog cuam tshuam.Feem ntau cov neeg cov ntshav siab thiab cov potassium rov qab mus rau qhov qub tom qab phais mob no. Txawm li cas los xij, qee tus neeg yuav tseem muaj ntshav siab tom qab phais mob, thiab lawv yuav tsum tau noj tshuaj ntxiv.

• Rau lwm yam ua rau thiab hyperaldosteronism theem ob:

Hauv cov rooj plaub no, kev kho mob yog siv tshuaj . Tsis tas li ntawd, yog tias nws yog ib qho mob thib ob, nws yog ib qho tseem ceeb uas yuav tsum kho tus kab mob tseem ceeb (piv txwv li, kab mob plawv).

Qee cov tshuaj siv feem ntau rau lub hom phiaj no yog:

• Spironolactone (Spironolactone – Aldactone®)
• Eplerenone (Eplerenone – Inspra®)
• Amiloride (Amiloride – Midamor®)

Tom qab kho mob tas lawm, yuav muaj dab tsi tshwm sim? Thiab yuav muaj teeb meem dab tsi?

Qhov kev kwv yees rau tus mob no, uas yog, lub xeev yav tom ntej, nyob ntawm qhov ua rau.

Feem ntau tus mob hyperaldosteronism thawj zaug yuav zam tau zoo yog tias kuaj pom thaum ntxov thiab kho kom zoo . Hauv tus mob hyperaldosteronism thib ob, qhov tshwm sim nyob ntawm seb tus mob hauv qab no puas tuaj yeem tswj tau.

Cov teeb meem tseem ceeb uas tuaj yeem tshwm sim hauv tus mob no yog los ntawm kev tsis tswj ntshav siab ntev. Cov no yog cov teeb meem loj ntsig txog lub plawv thiab cov hlab ntsha.

Yog li ntawd, nws tseem ceeb heev uas yuav tsum tswj cov ntshav siab kom zoo.

Puas tiv thaiv tau qhov teeb meem no?

Feem ntau, peb ua tsis tau dab tsi los tiv thaiv qhov mob no. Vim tias nws yog los ntawm kev hloov pauv uas tshwm sim hauv peb lub cev. Tab sis qhov zoo tshaj plaws yog tias thaum kuaj pom tias muaj mob, nws tuaj yeem kho tau thiab cov teeb meem tuaj yeem tiv thaiv tau.

Hyperaldosteronism, aldosterone, adrenal glands, Conn's syndrome, ntshav siab, ntshav siab, siab, potassium, sodium, raum, cov tshuaj hormones