He toto toto tiketike tōu, he " pēhanga " rānei e mōhiotia ana e tātou katoa? Tērā pea kei te tango koe i tētahi, i ētahi atu rānei rongoā kua tohua e tō tākuta. Engari he uaua ki a koe te whakahaere i tō toto toto ahakoa kua tangohia e koe te maha o ngā rongoā? Mena koinā, ko te take o tēnei pea ehara i te mea e whakaarohia ana e te katoa. I tēnei rā ka kōrero tātou mō tētahi āhuatanga hauora motuhake ka puta ai te toto toto tiketike, kāore e ngāwari te whakahaere mā te rongoā. Ko te Hyperaldosteronism tēnā. Ahakoa he uaua te ingoa, kia mārama noa tātou.
He aha te Hyperaldosteronism?
Ki te kī ngāwari, ko te Hyperaldosteronism te whakaputanga nui rawa o te homoni "Aldosterone" e ngā repe adrenal i roto i te tinana.
Inaianei kei te whakaaro pea koe, he aha ēnei repe adrenal? He aha tēnei homoni aldosterone?
Whakaarohia, i runga ake i ngā whatukuhu e rua o tō tātou tinana, e rua ngā repe iti, he rite ki ngā taupoki iti e rua. Koinei te mea e kiia nei e tātou ko ngā repe adrenal. He wāhanga tino nui ēnei o tō tātou pūnaha endocrine . Ka hangaia e ēnei repe iti e rua ētahi momo homoni e tika ana mō ngā mahi o ia rā o tō tātou tinana.
Ko te aldosterone te ingoa o tētahi homoni motuhake e whakaputaina ana e ēnei repe. Ko te mahi matua o tēnei homoni he whakahaere i te toto toto . Mā te whakahaere i ngā taumata o te konutai me te pāhare pāporo i roto i ō tātou toto ka mahi. Ka rite te mahi a tēnei homoni i roto i tō tātou tinana ki te pirihimana waka e whakahaere ana i ngā waka i runga i te rori.
Nō reira, i roto i te take o te Hyperaldosteronism, ko te mea ka tupu ko te nui rawa o te whakaputanga o tēnei homoni aldosterone. Kātahi ka piki te nui o te konutai i roto i tō tātou tinana, ka heke te nui o te pāhare pāporo. Ko te mutunga iho o tēnei ko te toto toto tiketike (hypertension) me te iti o ngā taumata pāhare pāporo i roto i te toto (hypokalemia) .
E rua ngā momo matua o tēnei.
E rua ngā momo matua o tēnei mate e wehea ana e ngā tākuta, i runga i te pūtake.
1. Te Hiperaldosteronism Tuatahi:E kiia ana hoki tēnei ko te "Conn's syndrome." Nā te raruraru o ngā repe adrenal i puta ai tēnei, ka nui rawa te homoni aldosterone i whakaputaina e rātou. Kei roto i te repe tonu te take.
2. Te Hyperaldosteronism Tuarua: Kāore he raruraru ki ngā repe adrenal i konei. Engari nā te mea he raruraru kei tētahi atu wāhi o te tinana, ka whakaohohia ngā repe adrenal hei whakautu, ā, ka nui ake te aldosterone e whakaputaina ana.
Ko wai te hunga e tino pāngia ana e tēnei mate?
Ko te tikanga ka pāngia te hunga i waenga i te 30 me te 50 tau te pakeke e tēnei mate. Kua whakaatuhia hoki e ngā rangahau he paku noa ake tēnei mate i roto i ngā wāhine i ngā tāne.
E ai ki ētahi rangahau, kei waenganui i te 5% me te 10% o te hunga he toto toto tiketike te mate pea i te hyperaldosteronism tuatahi. E whakapono ana ngā tohunga tae atu ki te 25% o te hunga he toto toto tiketike ātete ki te rongoā ka pāngia pea e te mate.
He aha ngā tohu o tēnei?
I ētahi wā, ki te tino ngawari te āhua, kāore pea he tohu e kitea. Heoi, he maha ngā tāngata ka puta he tohu.
Ko te tohu matua, ko te tohu tino kitea i tēnei mate ko te toto toto tiketike (hypertension) , inā koa te toto toto tiketike e uaua ana ki te whakahaere ahakoa te whakamahi i ētahi rongoā.
E rua ngā mea e puta ai ētahi atu tohu: te toto toto tiketike me te iti o te pāhare pāporo i roto i te toto (Hypokalemia). Me wehewehe mārama ēnei tohu.
| Take | Ngā tohu pea |
|---|---|
| Ngā Tohu o te Toto Toto Nui |
|
| Ngā Tohu o te Iti o te Pāhare Pāhare i roto i te Toto |
|
Kia maumahara, ehara i te katoa ēnei āhuatanga. Tērā pea kotahi, e rua rānei ngā āhuatanga o ētahi tāngata.
He aha i puta ai tēnei āhuatanga o te Hyperaldosteronism?
E ai ki tā tātou i kōrero ai i mua ake nei, he rerekē ngā take mō tēnei i runga i ngā momo matua e rua.
Ngā Take o te Hyperaldosteronism Tuatahi
Ko te raru i konei kei roto i te repe adrenal tonu.
- Te tino take: I te nuinga o te wā, ka puta mai tēnei i tētahi pukupuku ehara i te matepukupuku (adrenal adenoma) e whanake ana i roto i te repe adrenal. Ehara tēnei i te matepukupuku, nō reira kāore he mea hei manukanuka. He nui rawa te homoni aldosterone e whakaputaina ana e tēnei pukupuku.
- Ētahi atu take onge:
- Te whakanui ake i te kotahi anake o te repe adrenal (unilateral adrenal hyperplasia).
- Te whakaputanga o te aldosterone e te pukupuku matepukupuku (adrenocortical carcinoma) (he tino onge tēnei).
- He mate ira ka tukuna iho i roto i ngā whakatipuranga (Familial hyperaldosteronism).
Ngā Take o te Hyperaldosteronism Tuarua
I konei, he hauora ngā repe adrenal. Engari he take anō kei te whakaohokia rātou. Ko te take matua ko te iti o te rere o te toto ki ngā whatukuhu .
Hei mārama ki tēnei, me mōhio tātou ki tētahi pūnaha tino whakamere i roto i tō tātou tinana e whakahaere ana i te toto toto. Ko te Pūnaha Renin-Angiotensin-Aldosterone te ingoa.
Whakaarohia tēnei hei tauhohenga mekameka:
1. Ina heke te toto toto, ina heke rānei te konutai i roto i te toto, ka rongohia e ō tātou whatukuhu.
2. Kātahi ka tukuna e ngā whatukuhu tētahi whākōkī e kīia nei ko "Renin" ki roto i te toto.
3. Ka hurihia e tēnei renin tētahi pūmua e kiia nei ko te "Angiotensinogen" i hangaia e te ate hei "Angiotensin I".
4. Muri iho, ka huri tēnei angiotensin I hei "Angiotensin II".
5. Hei whakamutunga, ko te angiotensin II tēnei e whakapiki ake ana i te toto toto mā te whakawhāiti i ngā oko toto me te whakaoho i ngā repe adrenal ki te whakaputa i te aldosterone.
I roto i te hyperaldosteronism tuarua, ko te mea ka tupu, nā tētahi āhuatanga hauora, ka heke te nui o te toto e haere ana ki ngā whatukuhu. Kātahi ka whakaaro hē ngā whatukuhu he iti te pēhanga i roto i te tinana. Nō reira, ka karanga ngā whatukuhu mō te āwhina, ā, ka tīmata te tauhohenga mekameka. Nō reira, ka nui ake te homoni aldosterone e whakaputaina ana e rātou, i te mea kāore e hiahiatia ana.
Ngā āhuatanga e whakaiti ana i te rere o te toto ki ngā whatukuhu, ā, e hua ai te hyperaldosteronism tuarua:
- Te mate ārai uaua whatukuhu.
- Ngā āhuatanga e kohikohi ai te wai i roto i te tinana, pērā i te ngoikore o te ngakau.
- Te mate ate.
- Te mate nephrotic, he mate tākihi.
Me pēhea te tātaritanga a te tākuta i tēnei mate?
Ina kōrero koe ki tō tākuta mō ō tohumate, inā koa te toto toto tiketike kāore e taea te whakahaere e te rongoā, tera pea ka whakapae ia mō tēnei āhuatanga. Kātahi ka tonoa pea e rātou ētahi whakamātautau hei whakaū i tēnei.
1. Ngā whakamātautau toto:
- Mena ka whakaatuhia e te whakamātautau toto electrolyte auau he paku teitei ake ngā taumata konutai (Hypernatremia) me ngā taumata pāhare pāporo iti (Hypokalemia) , ka piki ake te whakapae.
- Muri iho, e rua ngā whakamātautau toto motuhake ka taea te whakamahi hei tautuhi i tēnei mate: te Plasma Renin Concentration (PRC) te Plasma Renin Activity (PRA) rānei.
- Mena kei a koe te Primary Hyperaldosteronism, ka iti iho ō taumata renin (PRC me PRA) i te tikanga.
- Mena he hyperaldosteronism tuarua tōu, ka teitei ake ō taumata renin i te mea noa.
2. Whakamātautau Pehi Aldosterone:
- Ko tā te whakamātautau nei he hoatu i te tote (konutai) tāpiri ki a koe mō tētahi wā. He wai ka tangohia mā te waha, he wai tote rānei ka hoatu ki roto i te uaua.
- Kātahi ka kohia tō mimi mō ngā haora 24, ā, ka inehia te nui o te aldosterone i roto i taua mimi.
- Mō te tangata hauora, ka whakaitihia te hanga aldosterone e te tinana mēnā ka nui rawa te konutai e kainga ana. Heoi, mō te tangata e pāngia ana e te hyperaldosteronism, kāore tēnei e tupu.
3. Ngā Whakamātautau Whakaahua:
- Ki te whakaūtia e ngā whakamātautau toto kei a koe te hyperaldosteronism tuatahi, ka whakahau tō tākuta i tētahi whakamātautau pēnei i te matawai CT (matawai Tomography Rorohiko) hei kimi i te pūtake. Mā tēnei ka taea te tirotiro mō tētahi pukupuku i te repe adrenal.
He aha ngā maimoatanga mō tēnei?
Ko te maimoatanga e whakawhirinaki ana ki te pūtake o te mate. Heoi, ko te whāinga matua ko te whakahaere i tō toto toto.
- Mō te hyperaldosteronism tuatahi i puta mai i te pukupuku:
He maha ngā wā, ka tūtohu ngā tākuta kia tangohia te pukupuku me te repe e pā ana ki tēnei mate mā te pokanga.Ka hoki te toto toto me te pāhare pāporo o te nuinga o te tangata ki te āhua noa i muri i tēnei pokanga. Heoi anō, ka piki tonu pea te toto toto o ētahi tāngata i muri i te pokanga, ā, me haere tonu tā rātou tango rongoā.
- Mō ētahi atu take me te hyperaldosteronism tuarua:
I ēnei āhuatanga, ka rongoāhia . Waihoki, ki te mea he mate tuarua, he mea nui kia rongoāhia te mate pūtake (hei tauira, te mate ngākau).
Ko ētahi o ngā rongoā e whakamahia whānuitia ana mō tēnei kaupapa ko:
- Spironolactone (Spironolactone – Aldactone®)
- Eplerenone (Eplerenone – Inspra®)
- Amiloride (Amiloride – Midamor®)
Ka pā mai pea ētahi pānga taha ki ngā tāne i ēnei rongoā, inā koa ko ērā e aukati ana i te mahi aldosterone, pērā i te Spironolactone, ina whakamahia mō te wā roa. Hei tauira, ko te ngoikore o te ure me te whakanui i te ū (gynecomastia). Ki te pāngia koe e tētahi o ēnei tohu, kaua e mangere ki te kōrero ki tō tākuta mō tēnei mea.
He aha ngā mea ka puta i muri i te maimoatanga? Ā, he aha ngā raruraru ka pā mai?
Ko te matapae mō tēnei āhuatanga, arā, te āhua ā muri ake nei, e whakawhirinaki ana ki te take.
Ko te hyperaldosteronism tuatahi he tino pai te manawanui mēnā ka kitea wawetia, ā, ka rongoatia tika . I te hyperaldosteronism tuarua, ko te putanga ka whakawhirinaki ki te taea te whakahaere i te mate taketake.
Ko ngā raruraru matua ka puta i tēnei āhuatanga ko te toto toto tiketike kāore i te whakahaeretia mō te wā roa. He raruraru nui ēnei e pā ana ki te pūnaha manawa.
| Ngā raruraru matua pea |
|---|
| Te fibrillation atrial (te ngakau ohorere) |
| Te whakanui ake i te ventricle maui o te ngākau (te whakanui ake i te ventricle maui o te ngākau) |
| Te whakaekenga o te ngakau |
| Whiu |
Nō reira, he mea tino nui kia tika te whakahaere i te toto toto.
Ka taea te ārai i tēnei āhuatanga?
I te nuinga o te wā, kāore he mea e taea e tātou te mahi hei ārai i tēnei mate. Nā te mea i puta mai i ngā huringa e puta ana i roto i tō tātou tinana. Engari ko te mea pai rawa atu, ina kitea te mate, ka taea te rongoā, ā, ka taea hoki te ārai i ngā raruraru.
Karere Tangohia ki te Kāinga
- Mena kei te uaua koe ki te whakahaere i tō toto toto ahakoa te maha o ngā rongoā kua whakamahia, me kōrero ki tō tākuta .
- Ko te Hyperaldosteronism he mate e hua mai ana i te nui rawa o te hanga o te homoni aldosterone.
- Ka taea tēnei te noho tuatahi (he raruraru ki te repe tonu) te noho tuarua rānei (nā tētahi atu mate).
- Ka taea te tautuhi tika i tēnei mate mā roto i ngā whakamātautau toto me ngā karapa motuhake.
- I runga i te pūtake, ka taea te rongoā angitu mā te pokanga, te rongoā rānei.
- Ko te mea pai rawa atu, he mate tēnei ka taea te rongoā. Nō reira, ki te mea he ruarua āu mō tēnei, kāore e roa rawa ki te rapu tohutohu hauora.
Hyperaldosteronism, aldosterone, repe adrenal, te mate a Conn, te toto toto tiketike, te toto toto tiketike, te pēhanga, te pāhare pāporo, te konutai, ngā whatukuhu, ngā homoni
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