Koj puas muaj ntshav siab , feem ntau hu ua "hypertension"? Tej zaum koj twb noj ib, ob, lossis ntau dua cov tshuaj uas koj tus kws kho mob tau sau tseg lawm. Txawm hais tias koj tau kho mob lawm los, koj puas tseem xav tias koj cov ntshav siab nyuaj rau tswj? Yog tias yog, qhov ua rau tej zaum yuav tsis yog qhov koj xav tau. Niaj hnub no, peb xav tham txog ib qho mob tshwj xeeb uas ua rau muaj ntshav siab nyuaj rau tswj, tsis kam noj tshuaj: Hyperaldosteronism. Txawm hais tias lub npe yuav zoo li nyuaj, cia peb muab nws faib ua cov lus yooj yim.
Hyperaldosteronism yog dab tsi?
Hais yooj yim xwb, hyperaldosteronism tshwm sim thaum koj cov qog adrenal tsim cov tshuaj hormones hu ua "aldosterone" ntau dhau.
Tej zaum koj yuav xav paub: cov qog adrenal no yog dab tsi, thiab aldosterone yog dab tsi?
Xav txog ob lub qog me me, zoo li lub kaus mom me me, zaum saum koj lub raum . Cov no yog koj cov qog adrenal. Lawv yog ib feem tseem ceeb ntawm koj lub endocrine system . Cov qog me me no tsim ntau yam tshuaj hormones uas tseem ceeb rau koj lub cev cov dej num txhua hnub .
Muaj ib hom tshuaj hormones uas cov qog no tsim tawm yog aldosterone . Nws txoj haujlwm tseem ceeb yog tswj koj cov ntshav siab los ntawm kev sib npaug ntawm cov sodium thiab potassium hauv koj cov ntshav. Koj tuaj yeem xav txog cov tshuaj hormones no zoo li ib tug tub ceev xwm tsheb khiav uas coj kev khiav tsheb ntawm txoj kev uas muaj neeg coob coob.
Yog li ntawd, hauv hyperaldosteronism, aldosterone ntau dhau raug tsim tawm. Qhov no ua rau cov sodium hauv koj lub cev nce siab thaum cov potassium poob qis. Qhov tshwm sim kawg yog ntshav siab (ntshav siab) thiab hypokalemia (ntshav potassium qis) .
Muaj ob hom tseem ceeb
Cov kws kho mob faib cov mob no ua ob hom raws li qhov ua rau muaj mob.
1. Mob aldosteronism thawj zaug: Kuj hu ua "Conn's syndrome," qhov no tshwm sim thaum qhov teeb meem nyob hauv cov qog adrenal, ua rau lawv tsim cov aldosterone ntau dhau.
2. Mob Aldosteronism Thib Ob: Hauv qhov no, cov qog adrenal tseem noj qab nyob zoo. Hloov chaw, lawv raug txhawb kom tsim cov aldosterone ntau dhau los teb rau qhov teeb meem uas tshwm sim lwm qhov hauv lub cev.
Leej twg raug kev cuam tshuam ntau tshaj?
Feem ntau cov neeg uas muaj hnub nyoog 30 txog 50 xyoo no feem ntau yuav mob li no. Kev tshawb fawb kuj qhia tias cov poj niam feem ntau mob li cov txiv neej.
Cov kev tshawb fawb qhia tau tias 5% txog 10% ntawm cov neeg uas muaj ntshav siab yuav muaj thawj hyperaldosteronism. Qhov tseem ceeb tshaj, cov kws tshaj lij ntseeg tias ntawm cov neeg uas muaj ntshav siab tsis kam siv tshuaj , feem pua yuav siab txog 25%.
Cov tsos mob yog dab tsi?
Qee zaum, yog tias qhov mob tsis hnyav heev, koj yuav tsis muaj tsos mob dab tsi li. Txawm li cas los xij, ntau tus neeg yeej muaj cov tsos mob.
Cov tsos mob feem ntau yog ntshav siab , tshwj xeeb tshaj yog thaum nws tseem tawv ncauj txawm tias siv ntau yam tshuaj ntshav siab los xij.
Lwm cov tsos mob tshwm sim los ntawm kev sib xyaw ua ke ntawm ntshav siab thiab potassium qis (hypokalemia). Cia peb piav qhia txog cov no kom meej.
| Ua rau | Cov tsos mob uas yuav tshwm sim |
|---|---|
| Cov tsos mob vim yog ntshav siab |
|
| Cov tsos mob vim yog Potassium qis |
|
Nco ntsoov, koj tsis tas yuav muaj tag nrho cov tsos mob no. Tej zaum ib txhia neeg tsuas muaj ib lossis ob xwb.
Vim li cas thiaj muaj Hyperaldosteronism?
Raws li tau hais ua ntej lawm, cov ua rau txawv raws li ob hom.
Cov ua rau muaj tus kab mob Hyperaldosteronism thawj zaug
Ntawm no, qhov teeb meem pib hauv lub qog adrenal nws tus kheej.
- Feem ntau ua rau: Feem ntau yog mob qog tsis yog mob qog (adrenal adenoma) ntawm lub qog adrenal. Qhov no tsis yog mob qog, yog li tsis tas yuav txhawj. Mob qog no tsuas yog tsim cov aldosterone ntau dhau.
- Lwm yam ua rau tsis tshua muaj:
- Kev loj hlob ntawm ib lub qog adrenal (unilateral adrenal hyperplasia).
- Kev tsim cov aldosterone los ntawm cov qog nqaij hlav (adrenocortical carcinoma) - qhov no tsis tshua muaj.
- Ib qho mob caj ces (tsev neeg hyperaldosteronism).
Ua rau muaj mob hyperaldosteronism theem ob
Ntawm no, cov qog adrenal noj qab nyob zoo, tab sis lawv raug txhawb los ntawm lwm yam. Qhov laj thawj tseem ceeb yog txo cov ntshav mus rau lub raum .
Yuav kom nkag siab qhov no, nws yog ib qho pab tau kom paub txog lub cev lub cev zoo kawg nkaus rau kev tswj ntshav siab: Renin-Angiotensin-Aldosterone System .
Xav txog nws ua ib qho kev sib txuas lus:
1. Thaum koj cov ntshav siab poob qis los yog cov ntsev sodium hauv koj cov ntshav qis, koj lub raum yuav pom.
2. Tom qab ntawd cov raum tso tawm ib qho enzyme hu ua "renin" mus rau hauv cov ntshav.
3. Renin ua haujlwm rau ib qho protein uas lub siab tsim tawm hu ua "angiotensinogen," hloov nws mus ua "angiotensin I."
4. Tom ntej no, Angiotensin I no raug hloov mus ua "Angiotensin II."
5. Thaum kawg, nws yog Angiotensin II no uas ua rau koj cov ntshav siab ntxiv los ntawm kev ua rau koj cov hlab ntsha nqaim thiab ua rau koj cov qog adrenal tsim cov aldosterone.
Thaum muaj mob hyperaldosteronism theem ob, muaj mob uas ua rau cov ntshav ntws mus rau koj lub raum tsis txaus. Yog li ntawd, koj lub raum yuam kev xav tias koj lub cev cov ntshav siab qis dhau. Ua li ntawd, koj lub raum ua rau muaj kev hloov pauv kom thov kev pab. Yog li ntawd, cov tshuaj hormone aldosterone raug tsim ntau dhau, txawm tias koj lub cev tsis xav tau nws tiag tiag.
Cov mob uas txo cov ntshav ntws mus rau lub raum thiab ua rau muaj Hyperaldosteronism theem ob suav nrog:
- Kev nqaim ntawm cov hlab ntsha uas mus rau lub raum (Kab mob hlab ntsha hauv lub raum).
- Cov mob uas cov kua dej sib sau ua ke hauv lub cev, xws li Lub plawv tsis ua haujlwm.
- Kab mob siab cirrhosis.
- Mob nephrotic syndrome, ib hom mob raum.
Tus kws kho mob kuaj mob li cas?
Thaum koj tham txog koj cov tsos mob nrog koj tus kws kho mob—tshwj xeeb tshaj yog tias koj hais tias koj cov ntshav siab tsis teb rau cov tshuaj ib txwm muaj—lawv yuav xav tias muaj tus mob no. Tom qab ntawd koj tus kws kho mob yuav xaj ntau qhov kev kuaj mob kom paub tseeb tias muaj mob.
1. Kev Kuaj Ntshav:
- Hauv cov ntshav electrolyte ib txwm muaj, cov sodium me ntsis nce (Hypernatremia) thiab cov potassium qis (Hypokalemia) feem ntau ua rau muaj kev tsis ntseeg.
- Tom ntej no, muaj ob txoj kev kuaj ntshav tshwj xeeb uas siv tshwj xeeb los txheeb xyuas qhov mob no: Plasma Renin Concentration (PRC) lossis Plasma Renin Activity (PRA) kev kuaj.
- Yog tias koj muaj mob thawj zaug Hyperaldosteronism, koj cov renin theem (PRC thiab PRA) feem ntau 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:
- Hauv qhov kev kuaj no, koj tau txais cov sodium (ntsev) ntau ntxiv rau ib lub sijhawm tshwj xeeb, noj los yog los ntawm kev txhaj tshuaj saline rau hauv cov hlab ntsha (IV).
- Tom qab qhov no, koj cov zis raug sau rau hauv 24 teev kom ntsuas qib aldosterone uas muaj.
- Rau ib tug neeg uas noj qab nyob zoo, kev noj sodium ntau ntxiv ua rau lub cev txo cov aldosterone ntau lawm. 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 hais kom koj ua CT scan (Computed Tomography scan) los txheeb xyuas qhov ua rau mob, xws li kuaj xyuas seb puas muaj qog adrenal gland.
Cov kev kho mob muaj dab tsi?
Cov phiaj xwm kho mob nyob ntawm seb qhov ua rau muaj teeb meem no yog dab tsi. Txawm li cas los xij, lub hom phiaj tseem ceeb yog kom tswj tau koj cov ntshav siab kom zoo.
- Rau thawj qhov hyperaldosteronism uas tshwm sim los ntawm qog:
Cov kws kho mob feem ntau pom zoo kom phais tshem tawm cov qog thiab cov qog uas raug mob . Tom qab phais, ntau tus neeg mob pom lawv cov ntshav siab thiab cov potassium rov qab mus rau qhov qub. Tej zaum ib txhia neeg tseem yuav tsum tau noj tshuaj ntshav siab tas mus li tom qab phais.
- Rau lwm yam ua rau thiab theem nrab Hyperaldosteronism:
Hauv cov xwm txheej no, kev kho mob suav nrog tshuaj . Ntxiv mus, yog tias nws yog ib qho mob thib ob, kev kho mob ntawm tus kab mob tseem ceeb (piv txwv li, lub plawv tsis ua haujlwm) yog qhov tseem ceeb.
Cov tshuaj uas feem ntau sau ntawv kho mob muaj xws li:
- Spironolactone (Aldactone®)
- Eplerenone (Inspra®)
- Amiloride (Midamor®)
Thov nco ntsoov tias kev siv cov tshuaj uas thaiv kev ua haujlwm ntawm aldosterone mus ntev, xws li Spironolactone, yuav ua rau muaj kev phiv rau cov txiv neej, xws li kev ua haujlwm tsis zoo lossis lub mis loj (Gynecomastia). Yog tias koj muaj kev tsis xis nyob lossis kev phiv, tsis txhob yig tham nrog koj tus kws kho mob txog lawv.
Qhov kev cia siab thiab tej teeb meem uas yuav tshwm sim yog dab tsi?
Koj qhov kev kwv yees, lossis kev xav mus sij hawm ntev, feem ntau nyob ntawm qhov ua rau muaj teeb meem.
Yog tias thawj zaug Hyperaldosteronism raug kuaj pom thaum ntxov thiab kho kom raug, cov txiaj ntsig feem ntau zoo heev.Rau qhov mob hyperaldosteronism theem ob, qhov tshwm sim nyob ntawm seb tus mob hauv qab no tuaj yeem tswj tau zoo npaum li cas.
Cov teeb meem loj ntawm tus mob no yog los ntawm kev ntshav siab mus sij hawm ntev, uas tsis tuaj yeem tswj tau, uas tuaj yeem ua rau muaj teeb meem loj rau lub plawv.
| Tej Yam Teeb Meem Tseem Ceeb Uas Yuav Muaj Tau |
|---|
| Atrial fibrillation (lub plawv dhia tsis xwm yeem) |
| Sab laug ventricular hypertrophy (kev loj hlob ntawm lub plawv lub chamber loj) |
| Mob plawv nres |
| Mob stroke |
Vim li no, kev tswj hwm koj cov ntshav siab kom zoo yog qhov tseem ceeb heev.
Puas tiv thaiv tau qhov mob no?
Feem ntau, tus mob no tsis tuaj yeem tiv thaiv tau vim nws feem ntau yog los ntawm cov txheej txheem sab hauv ntawm lub cev. Txawm li cas los xij, qhov xov xwm zoo yog tias thaum twg pom tau lawm, kev kho mob zoo tuaj yeem tiv thaiv tau cov teeb meem loj mus sij hawm ntev.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Yog tias koj cov ntshav siab tseem nyuaj rau tswj txawm tias koj noj ntau yam tshuaj los xij, nco ntsoov nrog koj tus kws kho mob tham.
- Hyperaldosteronism yog ib qho mob uas tshwm sim los ntawm kev tsim ntau dhau ntawm cov tshuaj hormones aldosterone.
- Nws tuaj yeem yog thawj zaug (los ntawm lub qog) lossis thib ob (los ntawm lwm yam mob).
- Nws tuaj yeem kuaj pom tseeb los ntawm kev kuaj ntshav tshwj xeeb thiab kev thaij duab.
- Nws kho tau zoo los ntawm kev phais lossis tshuaj, nyob ntawm seb ua rau muaj li cas.
- Qhov tseem ceeb tshaj plaws uas yuav tsum paub yog tias qhov no yog ib qho mob uas kho tau; yog tias koj muaj kev txhawj xeeb, nrhiav kev pab kho mob sai sai.
Hyperaldosteronism, aldosterone, adrenal glands, Conn's syndrome, ntshav siab, ntshav siab, siab, potassium, sodium, raum, cov tshuaj hormones
