Thaum peb hnov lo lus "qog" hauv peb lub taub hau, txhua tus neeg tam sim ntawd ntshai, puas yog? Qhov ntawd yog ib txwm muaj. Tab sis qhov tseem ceeb tshaj plaws uas peb yuav tsum nkag siab yog tias tsis yog txhua qhov qog uas loj hlob hauv lub taub hau yog mob qog noj ntshav. Hnub no peb yuav tham txog ib qho qog uas loj hlob hauv ib lub qog me me hauv qab peb lub hlwb, tab sis feem ntau tsis yog mob qog noj ntshav. Qhov no hu ua pituitary adenoma hauv kev kho mob. Yog li cia peb tham txog qhov no kom meej, yooj yim heev.
Ua ntej, cia peb saib, Pituitary Adenoma yog dab tsi?
Hais yooj yim xwb, tus kab mob pituitary adenoma yog ib qho mob qog uas loj hlob ntawm koj lub qog pituitary. Tab sis nws yog ib qho mob qog tsis muaj teeb meem . Qhov ntawd txhais tau tias nws tsis kis mus rau lwm qhov ntawm lub cev xws li mob qog noj ntshav. Tab sis thaum cov qog no loj hlob tuaj, lawv tuaj yeem nias rau ntawm cov nqaij thiab cov hlab ntsha ib puag ncig. Thaum ntawd ntau yam tsos mob pib tshwm sim.
Yog li, qhov no yog dab tsi pituitary caj pas?
Lub qog pituitary yog ib lub qog me me, zoo li pob txha nyob hauv qab lub hlwb, tom qab lub qhov ntswg. Nws txuas nrog hypothalamus hauv lub hlwb. Lub qog me me no muaj ob ntu, lub lobe pem hauv ntej thiab lub lobe tom qab. Ob qho tib si no tsim ntau yam tshuaj hormones uas tseem ceeb rau peb lub cev.
Cov tshuaj hormones zoo li cov neeg xa xov hauv peb lub cev. Lawv taug kev hla cov ntshav thiab qhia peb cov kabmob, cov leeg, thiab lwm cov nqaij kom ua ntau yam haujlwm.
Nov yog qee cov tshuaj hormones tseem ceeb uas tsim los ntawm lub qog pituitary:
- Adrenocorticotropic hormone (ACTH)
- Cov tshuaj hormones tiv thaiv diuretic (ADH)
- Cov tshuaj hormones txhawb nqa follicle (FSH)
- Cov tshuaj hormones loj hlob (GH)
- Cov tshuaj hormones Luteinizing (LH)
- Oxytocin
- Prolactin
- Cov tshuaj hormones txhawb nqa thyroid (TSH)
Tsis tas li ntawd xwb, lub qog pituitary ua rau lwm cov qog endocrine hauv peb lub cev tsim cov tshuaj hormones. Nws zoo li lub chaw ua haujlwm loj. Yog li thaum muaj qog tsim nyob rau hauv lub qog no, kev ua haujlwm ntawm ib lossis ntau dua ntawm cov tshuaj hormones no yeej tuaj yeem hloov pauv.
Yuav ua li cas cais cov pituitary adenomas?
Cov kws kho mob faib cov qog no ua ob hom loj: raws li seb lawv puas tsim cov tshuaj hormones ntxiv lossis tsis tsim, thiab raws li lawv qhov loj.
| Kev faib tawm raws li kev tsim cov tshuaj hormones | |
|---|---|
| Hom qog nqaij hlav | Piav qhia yooj yim |
| Kev ua haujlwm (kev tso tawm) adenomas (cov qog tsim cov tshuaj hormones) | Cov qog no tsim cov tshuaj hormones ntau dhau ntawm lub qog pituitary. Nyob ntawm seb cov tshuaj hormones ntau dhau los ua li cas, ntau yam tsos mob thiab mob tuaj yeem tshwm sim. |
| Cov adenoma uas tsis ua haujlwm (tsis tso tawm) (Cov qog nqaij hlav uas tsis yog hormonal) | Cov qog no tsis tsim cov tshuaj hormones. Txawm li cas los xij, thaum lawv loj hlob tuaj, lawv tuaj yeem ua rau muaj cov tsos mob los ntawm kev nias rau ntawm cov hlab ntsha thiab cov nqaij nyob ib puag ncig. Qhov no yog hom qog uas feem ntau tshwm sim. |
| Cais raws li qhov loj me | |
|---|---|
| Hom qog nqaij hlav | Piav qhia yooj yim |
| Microadenomas (Microadenoma) | Cov no yog cov txiv ntoo me dua 10 millimeters, lossis 1 centimeter. |
| Macroadenomas (Adenoma loj) | Cov no yog cov qog nqaij hlav loj dua 10 millimeters. Lawv muaj li ob npaug ntawm cov microadenomas. Cov qog nqaij hlav loj no tuaj yeem ua rau lub qog pituitary puas tsuaj, ua rau cov tshuaj hormones poob qis dua li qub. Qhov mob no hu ua hypopituitarism . |
Qhov no puas suav tias yog qog hauv hlwb?
Yog. Lub qog pituitary tsis yog ib feem ntawm lub hlwb, tab sis yog ib lub qog endocrine uas txuas rau lub hlwb. Txawm li cas los xij, cov kws kho mob xav tias pituitary adenoma yog qog hauv hlwb. Hom qog no tsuas yog muaj 10% ntawm cov qog uas loj hlob hauv lub taub hau.
Qhov tseem ceeb tshaj plaws uas yuav tsum nco ntsoov yog tias txawm hais tias qhov no hu ua "mob qog hauv lub hlwb," nws tsis yog mob qog noj ntshav.
Cov tsos mob ntawm tus kab mob pituitary adenoma yog dab tsi?
Cov tsos mob ntawm cov qog no tuaj yeem sib txawv heev, nyob ntawm ntau yam:
- Seb qhov mob qog nqaij hlav loj hlob thiab ua puas rau cov nqaij mos nyob ib puag ncig lossis lub qog pituitary nws tus kheej (qhov no hu ua mass effect).
- Puas yog ib qho qog ua haujlwm uas tso cov tshuaj hormones, thiab yog tias muaj, cov tshuaj hormones twg raug tso tawm ntau dhau?
Cov tsos mob ntawm kev ntxhov siab vim yog qhov mob qog loj hlob (Mass Effect)
Cov tsos mob no feem ntau tshwm sim hauv cov macroadenomas (cov qog nqaij hlav loj).
- Teeb Meem Pom Kev: Qhov no yog cov tsos mob tseem ceeb. 40% -60% ntawm cov neeg mob muaj kev tsis pom kev (pom kev tsis meej, pom ob sab). Qhov no yog vim tias thaum lub qog loj hlob, nws nias rau ntawm lub qhov muag chiasm, qhov chaw uas cov hlab ntsha ntawm peb lub qhov muag sib ntsib. Qhov no ua rau tsis pom kev, tshwj xeeb tshaj yog nyob rau hauv lub qhov muag .
- Mob taub hau: Mob taub hau tuaj yeem tshwm sim thaum lub qog nias rau ntawm cov nqaij ib puag ncig. Txawm li cas los xij, vim tias mob taub hau yog ib qho uas tshwm sim ntau heev, lawv kuj tuaj yeem tshwm sim rau lwm yam.
- Hypopituitarism: Ib qho qog loj tuaj yeem ua rau cov hlwb ntawm lub qog pituitary puas tsuaj, txo qhov tsim ib lossis ntau cov tshuaj hormones. Cov tsos mob ntawm txhua qhov tsis txaus hormone sib txawv.
- Tsis muaj LH thiab FSH hormone txaus: Qhov no ua rau cov poj niam tsis muaj estrogen thiab cov txiv neej tsis muaj testosterone. Qhov no hu ua hypogonadism . Cov tsos mob suav nrog kev coj khaub ncaws tsis xwm yeem, txo qis libido, qaug zog, thiab kev ua tsis tau haujlwm ntawm kev sib deev rau cov txiv neej.
- TSH hormone tsis txaus: Qhov no ua rau cov thyroid hormone tsawg zuj zus. Qhov no hu ua hypothyroidism . Qhov no tuaj yeem ua rau qaug zog, cem quav, tawv nqaij qhuav, thiab lub plawv dhia qeeb.
- Qhov tsis txaus ACTH hormone: Qhov no ua rau cov tshuaj cortisol tsawg zuj zus. Qhov no hu ua adrenal insufficiency . Tej zaum yuav muaj cov tsos mob xws li ntshav siab qis, xeev siab, ntuav, mob plab, thiab tsis xav noj mov.
- Tsis muaj GH hormone txaus: Cov tsos mob ntawm kev tsis muaj hormone loj hlob sib txawv raws li hnub nyoog. Cov neeg laus yuav muaj kev qaug zog thiab cov leeg tsis muaj zog.
Cov tsos mob tshwm sim los ntawm cov qog uas tsim cov tshuaj hormones ntxiv (Functioning Adenomas)
Cov qog no tsim tawm ntau dhau ib lossis ntau cov tshuaj hormones, uas tuaj yeem ua rau muaj ntau yam mob nkeeg.
| Hom qog nqaij hlav | Tus mob thiab cov tsos mob feem ntau |
|---|---|
| Cov qog prolactinoma (Tsim cov prolactin ntau dhau) | Cov no yog hom qog pituitary uas feem ntau pom. Kev nce ntxiv ntawm cov tshuaj hormones prolactin (hyperprolactinemia) tuaj yeem ua rau cov txiv neej thiab cov poj niam tsis muaj menyuam. Tsis tas li ntawd, cov poj niam uas tsis cev xeeb tub yuav muaj cov kua mis tawm ntawm lawv lub mis (galactorrhea). |
| Cov adenoma ntawm Somatotroph (Tsim cov tshuaj hormones loj hlob ntau dua) | Rau cov neeg laus, qhov no ua rau muaj mob hu ua acromegaly . Qhov no ua rau tes, taw, ntsej muag, thiab taub hau loj dhau. Yog tias mob no tshwm sim rau cov menyuam yaus thiab cov hluas, lawv yuav siab dhau. Qhov no hu ua gigantism . |
| Cov adenoma Corticotroph (tsim ntau ACTH) | ACTH ntau dhau ua rau muaj cov tshuaj cortisol ntau ntxiv, ua rau muaj mob hu ua Cushing's syndrome . Cov tsos mob suav nrog ntshav siab, cov leeg tsis muaj zog, yooj yim raug mob, cov cim ncab, thiab ntshav qab zib hom 2 mellitus. |
| Cov thyroid adenomas (TSH ntau dua) | Cov no tsis tshua muaj. TSH ntau dhau ua rau cov tshuaj hormones thyroid nce ntxiv, ua rau muaj mob hu ua hyperthyroidism . Cov tsos mob suav nrog lub plawv dhia ceev, poob phaus, tawm hws, tes tshee hnyo, thiab tsis so. |
Vim li cas cov pituitary adenoma thiaj tshwm sim?
Cov kws tshawb fawb tseem tsis tau paub qhov ua rau muaj qhov no, tab sis ntseeg tias feem ntau nws yog los ntawm kev hloov pauv tsis raws cai (kev hloov pauv) hauv peb cov DNA . Cov kev hloov pauv no ua rau cov hlwb hauv lub qog pituitary loj hlob tawm ntawm kev tswj hwm thiab tsim ib lub qog.
Qee zaum cov no tuaj yeem txuas nrog cov mob caj ces uas tau kis mus rau ntau tiam neeg, tab sis feem ntau lawv tshwm sim yam tsis muaj laj thawj.
Yuav kuaj mob li cas?
Koj tus kws kho mob yuav xaj kom kuaj mob raws li koj cov tsos mob. Qee zaum, cov qog no tuaj yeem pom tsis tau thaum lub sijhawm luam theej taub hau rau lwm yam laj thawj.
Yog koj tus kws kho mob xav tias muaj tus mob no, lawv yuav xaj kom kuaj cov hauv qab no:
- Kev kuaj ntshav: Nyob ntawm koj cov tsos mob, kev kuaj ntshav yuav raug txiav txim kom kuaj xyuas ntau yam tshuaj hormones.
- Kev kuaj duab: Kev kuaj MRI (Magnetic Resonance Imaging) lossis CT (Computed Tomography) ntawm lub taub hau tuaj yeem lees paub qhov muaj cov qog no.
- Kev kuaj qhov muag: Yog tias koj muaj teeb meem pom kev, yuav muaj kev kuaj qhov muag kom paub tseeb tias koj ob lub qhov muag ua haujlwm li cas.
Cov kev kho mob yog dab tsi?
Feem ntau muaj peb txoj kev kho mob rau qhov no: phais, siv tshuaj, thiab siv hluav taws xob. Koj pab neeg kho mob yuav txiav txim siab seb txoj kev kho mob twg zoo tshaj plaws rau koj raws li hom, qhov loj, thiab cov tsos mob ntawm koj lub qog.
1. Kev Phais Mob: Yog tias qhov qog ua rau muaj kev tsis sib npaug ntawm cov tshuaj hormones lossis teeb meem pom kev, tus kws kho mob yuav pom zoo kom phais mob kom tshem tawm tag nrho lossis ib feem ntawm qhov qog.
- Txoj kev phais mob feem ntau (95%) siv rau qhov no yog phais transsphenoidal , uas muab lub koob yees duab me me thiab cov cuab yeej ntxig rau hauv lub qhov ntswg kom tshem tawm cov qog.
- Yog tias qhov mob loj heev, tej zaum yuav tsim nyog siv kev phais transcranial, uas ua los ntawm lub pob txha taub hau.
2. Tshuaj: Qee hom qog nqaij hlav, tshwj xeeb tshaj yog Prolactinomas , tuaj yeem kho nrog cov tshuaj. Cov tshuaj no ua rau qog nqaij hlav me dua thiab tswj cov tsos mob. Feem ntau, cov tshuaj xws li cabergoline lossis bromocriptine raug muab rau qhov no. 80% ntawm cov neeg mob tau txais cov txiaj ntsig zoo nrog cov tshuaj no.
3. Kev kho mob siv hluav taws xob: Qhov no suav nrog kev siv cov duab hluav taws xob X-rays muaj zog heev los ua kom lub qog me dua lossis tiv thaiv nws txoj kev loj hlob. Qhov no ua tiav los ntawm kev siv cov txheej txheem tshwj xeeb hu ua stereotactic radiosurgery . Qhov no suav nrog kev tsom mus rau lub qog nrog cov teeb hluav taws xob thaum txo qhov kev puas tsuaj rau cov nqaij ntshiv noj qab haus huv ib puag ncig.
Tom qab kho mob tas, yuav muaj dab tsi tshwm sim? Kev kwv yees yav tom ntej
Qhov kev cia siab rau qhov no zoo heev. Tom qab lub qog raug tshem tawm tag nrog kev kho mob, feem ntau cov neeg tuaj yeem ua neej nyob zoo thiab noj qab nyob zoo.
Qee zaum, kev phais lossis kev kho mob hluav taws xob tuaj yeem ua rau lub qog pituitary puas tsuaj, ua rau cov tshuaj hormones qis (hypopituitarism). Hauv qhov no, koj yuav tsum noj cov tshuaj hormones hloov pauv rau tas koj lub neej kom hloov cov tshuaj hormones qis.
Cov qog no qee zaum tuaj yeem rov tshwm sim dua, yog li nws yog ib qho tseem ceeb heev uas yuav tsum mus kuaj mob tsis tu ncua txawm tias tom qab kho tas lawm los xij.
Yog tsis kho ces yuav muaj teeb meem dab tsi tshwm sim?
Yog tias tsis kho, tshwj xeeb tshaj yog cov qog loj (macropadenomas) thiab cov qog tsim cov tshuaj hormones (ua haujlwm adenomas) tuaj yeem ua rau muaj teeb meem kev noj qab haus huv loj.
Ib qho teeb meem uas tsis tshua muaj tab sis txaus ntshai heev yog pituitary apoplexy . Qhov no yog ib qho mob uas xav tau kev kho mob thaum muaj xwm txheej ceev.
Qhov tshwm sim ntawm no yog tias lub qog ntshav tam sim ntawd los ntshav rau hauv lossis tawm ntawm lub qog ntshav. Lub qog ntshav tam sim ntawd loj hlob thiab ua puas rau lub qog pituitary. Cov tsos mob ntawm qhov no tshwm sim tam sim ntawd.
- Mob taub hau hnyav heev, tam sim ntawd.
- Pom ob sab lossis tsis muaj peev xwm qhib qhov muag vim yog kev ua haujlwm tsis zoo ntawm cov leeg nqaij ntawm lub qhov muag.
- Tsis pom kev tam sim ntawd lossis tsis pom kev ntawm ib sab.
- Ntshav siab poob qis tam sim ntawd, xeev siab thiab ntuav.
Yog koj muaj ib lossis ntau yam ntawm cov tsos mob no, koj yuav tsum mus rau Chav Kho Mob Ceev (ETU) ze tshaj plaws hauv tsev kho mob yam tsis muaj kev ncua. Qhov no yog qhov xwm txheej ceev uas txaus ntshai rau lub neej.
Nws yog ib qho ib txwm muaj kev ntshai thaum koj raug kuaj pom tias muaj pituitary adenoma. Tab sis nco ntsoov, cov no feem ntau tsis yog mob qog noj ntshav. Thiab, nrog rau kev kho mob siab heev niaj hnub no, lawv tuaj yeem kho tau tag nrho. Tham nrog koj tus kws kho mob thiab nug tag nrho koj cov lus nug.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Pituitary adenoma feem ntau yog ib qho mob qog nqaij hlav, yog li tsis txhob ntshai tsis tas li.
- Cov tsos mob feem ntau yog tshwm sim los ntawm qhov mob loj hlob, kev nyuaj siab rau cov hlab ntsha ib puag ncig, lossis kev hloov pauv ntawm cov tshuaj hormones.
- Tsis txhob tso tseg qhov teeb meem pom kev (tshwj xeeb tshaj yog qhov muag tsis pom kev zoo) thiab mob taub hau tas li. Mus ntsib kws kho mob tam sim ntawd.
- Muaj cov kev kho mob zoo heev rau qhov no, xws li phais, tshuaj, thiab kev kho hluav taws xob.
- Yog tias koj tau kuaj pom tias muaj tus mob no, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia thiab mus ntsib kws kho mob tsis tu ncua.
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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