He toto toto tiketike tōu, e mōhiotia whānuitia ana ko te "hypertension"? Tērā pea kua tangohia e koe tētahi, e rua, neke atu rānei ngā rongoā kua tohua e tō tākuta. Heoi, ahakoa kei te rongoatia koe, kei te whakaaro tonu koe he uaua ki te whakahaere i tō toto toto ? Mēnā koinā, kāore pea te take i rite ki tāu e tumanako ai. I tēnei rā, e hiahia ana mātou ki te kōrero mō tētahi āhuatanga hauora motuhake ka puta ai te toto toto tiketike uaua ki te whakahaere, ātete ki te rongoā: Hyperaldosteronism. Ahakoa he uaua te ahua o te ingoa, me wehewehe kia māmā noa iho.
He aha te Hyperaldosteronism?
Ki te kī ngāwari, ka puta te hyperaldosteronism ina nui rawa te homoni e whakaputaina ana e ō repe adrenal e kiia nei ko te "aldosterone".
Tērā pea koe e whakaaro ana: he aha ēnei repe adrenal, ā, he aha te aldosterone?
Whakaarohia kia rua ngā repe iti, he rite te āhua ki ngā taupoki iti, e noho ana i runga tonu i ō whatukuhu . Ko ō repe adrenal ēnei. He wāhanga nui ēnei o tō pūnaha endocrine . Ka whakaputahia e ēnei repe iti ētahi homoni e tika ana mō ngā mahi o ia rā a tō tinana.
Ko tētahi homoni motuhake e whakaputaina ana e ēnei repe ko te aldosterone . Ko tana mahi matua he whakahaere i tō toto toto mā te whakataurite i ngā taumata konutai me te pāhare pāporo i roto i ō toto. Ka taea e koe te whakaaro ki tēnei homoni he rite ki tētahi pirihimana waka e whakahaere ana i te rere o ngā waka i runga i tētahi rori pukumahi.
Nō reira, i roto i te hyperaldosteronism, ka nui rawa te aldosterone ka puta. Ka piki ake ngā taumata konutai i roto i tō tinana, ka heke hoki ngā taumata pāhare pāporo. Ko te mutunga iho ko te toto toto tiketike (te toto toto tiketike) me te hypokalemia (te pāhare pāporo iti i roto i te toto) .
E rua ngā momo matua
E rua ngā momo o tēnei mate e whakarōpūtia ana e ngā tākuta, i runga i te pūtake o te mate.
1. Te Hyperaldosteronism Tuatahi: E mōhiotia ana ko te "syndrome a Conn," ka puta tēnei ina kei roto tonu i ngā repe adrenal te raruraru, ka nui rawa te aldosterone e whakaputaina ana e rātou.
2. Te Hyperaldosteronism Tuarua: I tēnei wā, he hauora ngā repe adrenal. Engari, kei te whakaohokia rātou ki te whakaputa i te aldosterone nui rawa hei whakautu ki tētahi raruraru e ahu mai ana i tētahi atu wāhanga o te tinana.
Ko wai te mea tino pāngia?
Ko te nuinga o te wā ka kitea tēnei mate i waenga i te 30 me te 50 tau te pakeke. E ai ki ngā rangahau he paku noa ake te kitea i roto i ngā wāhine i ngā tāne.
E whakaatu ana ngā rangahau e 5% ki te 10% o ngā tāngata katoa e pāngia ana e te toto toto tiketike, tera pea he hyperaldosteronism tuatahi. Ko te mea nui ake, e whakapono ana ngā tohunga, i roto i te hunga e ātete ana ki te rongoā ki te toto toto tiketike , ka eke pea te ōrau ki te 25%.
He aha ngā tohu?
I ētahi wā, ki te ngawari te āhua, kāore pea koe e kite i tētahi tohu. Heoi, he maha ngā tāngata e whakaatu ana i ngā tohu.
Ko te tohu tino kitea ko te toto toto tiketike , ina koa ka mau tonu te toto ahakoa te maha o ngā rongoā toto toto tiketike e whakamahia ana.
Ka puta ake ētahi atu tohu i te whakakotahitanga o te toto toto tiketike me te pāhare pāporo iti (hypokalemia). Me wehewehe mārama tātou i ēnei.
| Take | Ngā Tohu Tūpono |
|---|---|
| Ngā tohu e pā ana ki te toto toto tiketike |
|
| Ngā tohu nā te iti o te pāhare pāporo |
|
Kia maumahara, kāore koe e hiahia kia pāngia e ēnei tohu katoa. Tērā pea kotahi, e rua rānei ngā tohu o ētahi tāngata.
He aha te take ka puta ai te Hyperaldosteronism?
Ka rite ki te kōrero i mua ake nei, he rerekē ngā take i runga i ngā momo e rua.
Ngā Take o te Hyperaldosteronism Tuatahi
I konei, ka tīmata te raruraru i te repe adrenal tonu.
- Te tino take: He pukupuku kore-matepukupuku (adrenal adenoma) i runga i te repe adrenal. Ehara tēnei i te matepukupuku, nō reira kāore he take e mataku ai. He nui rawa te aldosterone e whakaputaina ana e tēnei pukupuku.
- Ētahi atu take onge:
- Te whakanui ake i te repe adrenal kotahi (unilateral adrenal hyperplasia).
- Te whakaputanga o te aldosterone e te pukupuku matepukupuku (adrenocortical carcinoma) - he tino onge tēnei.
- He āhuatanga ira (familial hyperaldosteronism).
Ngā Take o te Hyperaldosteronism Tuarua
I konei, he ora ngā repe adrenal, engari he mea anō kei te whakaohokia e rātou. Ko te take matua ko te iti o te rere o te toto ki ngā whatukuhu .
Hei mārama ki tēnei, he mea āwhina te mōhio ki te pūnaha whakamiharo o te tinana mō te whakahaere i te toto toto: te Pūnaha Renin-Angiotensin-Aldosterone .
Whakaarohia he tauhohenga mekameka:
1. Ina heke tō toto toto, ina iti rānei te taumata konutai i roto i tō toto, ka kitea e ō whatukuhu.
2. Kātahi ka tukuna e ngā whatukuhu tētahi whākōkī e kīia nei ko te "renin" ki roto i te toto.
3. Ka mahi te renin ki tētahi pūmua i hangaia e te ate e kiia nei ko te "angiotensinogen", ka hurihia hei "angiotensin I".
4. Muri iho, ka hurihia tēnei Angiotensin I hei “Angiotensin II.”
5. Hei whakamutunga, ko tēnei Angiotensin II te mea e whakanui ana i tō toto toto mā te whakawhāiti i ō uaua toto me te whakaoho i ō repe adrenal ki te whakaputa i te aldosterone.
Mēnā he Hyperaldosteronism tuarua, ka whakaitihia te rere o te toto ki ō whatukuhu e tētahi mate hauora kei raro iho. Nō reira, ka whakaaro hē ō whatukuhu he iti rawa te toto toto o tō tinana. Hei whakautu, ka whakaohohia e ō whatukuhu he tauhohenga mekameka ki te tono āwhina. Nō reira, ka nui rawa te hanga o te homoni aldosterone, ahakoa kāore tō tinana e hiahia ana.
Ko ngā āhuatanga e whakaiti ana i te rere o te toto ki ngā whatukuhu, e whakaoho ana hoki i te Hyperaldosteronism tuarua ko:
- Te whaiti o ngā uaua e tuku toto ana ki ngā whatukuhu (Te mate aukati o te uaua whatukuhu).
- Ngā āhuatanga e kohia ai te wai i roto i te tinana, pērā i te ngoikore o te ngākau.
- Te mate ate.
- Te mate nephrotic, he momo mate tākihi.
Me pēhea te tātaritanga a te tākuta i tēnei mate?
Ina kōrero koe ki tō tākuta mō ō tohumate—ina koa mēnā ka kī koe kāore tō toto toto tiketike e pai ake ana ki ngā rongoā noa—tērā pea ka whakapae rātou i tēnei mate. Kātahi ka whakahau tō tākuta i ētahi whakamātautau hei whakaū i te mate.
1. Ngā Whakamātautau Toto:
- I roto i tētahi whakamātautau toto electrolyte auau, ka ara ake te whakapae mēnā he paku teitei ngā taumata konutai (Hypernatremia) me te iti o ngā taumata pāhare pāporo (Hypokalemia) .
- Muri iho, e rua ngā whakamātautau toto motuhake e whakamahia ana hei tautuhi i tēnei āhuatanga: ko ngā whakamātautau Plasma Renin Concentration (PRC) me te Plasma Renin Activity (PRA) .
- Mena he Hyperaldosteronism tuatahi tōu, ko ngā taumata renin (PRC me PRA) ka iti iho i te tikanga noa.
- Mena he Hyperaldosteronism tuarua tōu, ka teitei ake ō taumata renin i te mea noa.
2. Whakamātautau Pehi Aldosterone:
- I tēnei whakamātautau, ka nui ake te tote (konutai) ka hoatu ki a koe mō tētahi wā motuhake, mā te waha, mā te maturuturu tote rānei i roto i te uaua (IV).
- Whai muri i tēnei, ka kohia tō mimi i roto i ngā haora 24 hei ine i te taumata o te aldosterone.
- Mō te tangata hauora, mā te pikinga o te kai konutai ka whakaitihia te hanga aldosterone e te tinana. Heoi, mō te tangata e pāngia ana e te Hyperaldosteronism, kāore tēnei e tupu.
3. Ngā Whakamātautau Whakaahua:
- Mena ka whakaūtia e ngā whakamātautau toto he Hyperaldosteronism tuatahi tōu, ka tonoa pea e tō tākuta he matawai CT (matawai Tomography Rorohiko) hei tautuhi i te pūtake, pēnei i te tirotiro mō te pukupuku repe adrenal.
He aha ngā maimoatanga e wātea ana?
Ko ngā mahere maimoatanga e whakawhirinaki ana ki te pūtake o te mate. Heoi, ko te whāinga matua ko te whakahaere tika i tō toto toto.
- Mō te Hyperaldosteronism tuatahi i puta mai i te pukupuku:
He maha ngā tākuta e taunaki ana kia tangohia te pukupuku me te repe e pāngia ana e te pokanga . Whai muri i te pokanga, he maha ngā tūroro ka kite i te hokinga o ō rātou toto toto me ngā taumata pāhare pāporo ki te noho noa. Tērā pea ka hiahia tonu ētahi tāngata ki te rongoā toto toto tonu i muri i te pokanga.
- Mō ētahi atu take me te Hyperaldosteronism tuarua:
I ēnei wā, ko te rongoā te rongoā hei rongoā . Hei tāpiri, ki te mea he mate tuarua, he mea nui te aro atu ki te mate pūtake (hei tauira, te ngoikore o te ngākau).
Ko ngā rongoā e tohua ana i te nuinga o te wā ko:
- Spironolactone (Aldactone®)
- Eplerenone (Inspra®)
- Amiloride (Midamor®)
Kia mōhio mai, ko te whakamahinga roa o ngā rongoā e aukati ana i te mahi aldosterone, pērā i te Spironolactone, ka pāngia pea ngā tāne e ngā pānga taha, pērā i te ngoikore o te ure, te whakanui rānei i ngā ū (Gynecomastia). Mēnā ka pāngia koe e te mamae, e ngā pānga taha rānei, kaua e mangere ki te kōrero ki tō tākuta mō ēnei mea.
He aha te tirohanga me ngā raruraru pea?
Ko tō matapae, ko tō tirohanga mō te wā roa rānei, e whakawhirinaki ana ki te take matua.
Mena ka kitea wawetia te Hyperaldosteronism tuatahi, ā, ka rongoatia tika, he tino pai ngā hua.Mō te Hyperaldosteronism tuarua, ko te hua ka whakawhirinaki ki te pai o te whakahaere i te mate hauora taketake.
Ko ngā raruraru nui o tēnei mate ka puta mai i te toto toto tiketike kāore i te whakahaeretia mō te wā roa, ka arahi pea ki ngā raruraru nui o te pūnaha manawa.
| Ngā raruraru nui pea |
|---|
| Te fibrillation atrial (te ngakau koretake) |
| Te whakanui ake i te ventricular maui (te whakanui ake i te ruma matua o te ngakau) |
| Te whakaekenga o te ngakau |
| Whiu |
Mō tēnei take, he mea nui kia mau tonu te whakahaere i tō toto toto.
Ka taea te ārai i tēnei āhuatanga?
I te nuinga o te wā, kāore e taea te ārai i tēnei mate nā te mea he maha ngā wā ka puta mai i ngā tukanga ā-roto o te tinana. Heoi, ko te rongo pai, ina kitea, ka taea e te maimoatanga whai hua te ārai i ngā raruraru nui mō te wā roa.
Karere Tangohia ki te Kāinga
- Mena he uaua tonu te whakahaere i tō toto toto ahakoa te maha o ngā rongoā e tangohia ana e koe, me kōrero koe ki tō tākuta .
- Ko te Hyperaldosteronism he mate e hua mai ana i te nui rawa o te homoni aldosterone.
- Ka taea te tuatahi (e ahu mai ana i te repe) te tuarua rānei (e puta mai ana i tētahi atu mate hauora).
- Ka taea te tautuhi tika mā roto i ngā whakamātautau toto motuhake me te whakaahua.
- Ka taea te rongoā angitu mā te pokanga, mā te rongoā rānei, kei te pūtake.
- Ko te mea nui kia mōhio koe he mate ka taea te rongoā; ki te whai āwangawanga koe, rapua wawetia he 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
