Kei te iti katoa ō homoni pituitary? Me kōrero tātou mō te panhypopituitarism!

I ētahi wā, kāore ngā mea o roto i ō tātou tinana e mahi pērā i te mea e tumanakohia ana, tika? He rōpū karere tino nui ngā homoni e whai wāhi ana ki te nuinga o ngā tukanga o roto i ō tātou tinana. Mena he raruraru kei roto i tēnei pūnaha homoni, ka pā ki tō tātou oranga katoa. I tēnei rā ka kōrero tātou mō tētahi āhuatanga onge me mōhio te katoa. Ko te panhypopituitarism tēnā.

He aha te Panhypopituitarism?

He whakarāpopototanga noa iho, he āhuatanga onge te panhypopituitarism, e kore ai e nui te whakaputanga o te repe pituitary, he repe iti i roto i te roro, e kore rānei e nui ngā homoni katoa e whakaputaina ana e ia. Ko te tikanga o te wāhanga "pan" ko "katoa". Ka pā tēnei āhuatanga ki ngā pēpi, ki ngā tamariki, me ngā pakeke.

Inaianei kei te whakaaro pea koe, "He aha ēnei homoni? He aha i tino hira ai?" Āe, me titiro tātou ki tēnā.

He rite ngā homoni ki ngā karere i roto i ō tātou tinana. He matū motuhake ēnei. Ka haere rātou i roto i ō tātou toto, ka kawe karere ki ngā momo okana, uaua, me ētahi atu kiko. Ka whakarite, arā, ka whakahaere, ka whakarite hoki i ngā mahi rerekē a tō tātou tinana, me te kī atu ki a rātou kia "meatia tēnei, meatia i tēnei wā, meatia pēnei."

He rite te rahi o tō tātou repe pituitary ki te pī. Kei te pūtake o tō tātou roro, i raro noa i te hypothalamus. (Ko te hypothalamus te pokapū nui o te roro e whakahaere ana i ngā mea nui maha, tae atu ki tō tātou pūnaha io aunoa.) Ahakoa tōna iti, he tino nui te mahi a te repe pituitary i roto i tō tātou pūnaha endocrine. Arā, ko ēnei homoni pituitary te hunga e whakahaere ana i ngā mea maha o roto i tō tātou tinana, pērā i te pākia o te tinana, te tipu, me te whakaputa uri.

I te nuinga o te wā, ka āta whakahaeretia e ō tātou tinana ēnei taumata homoni. Heoi, ki te iti rawa tētahi o ēnei homoni, ka puta he maha ngā tohu me ngā raruraru hauora. Ko te panhypopituitarism te wā e iti rawa ana ngā homoni katoa e hangaia ana e te repe pituitary, ka puta he maha ngā tohu.

He aha te rerekētanga i waenga i te Panhypopituitarism me te Hypopituitarism?

He āhua ōrite ēnei ingoa e rua, nō reira ka pōhēhē pea. Whakaarohia, ko te hypopituitarism he āhuatanga e puta ai tētahi, neke atu rānei o ngā homoni e te repe pituitary. Ko te panhypopituitarism he take motuhake, whānui ake o taua mea. Arā, ko te panhypopituitarism he ngoikore o ngā homoni katoa e puta ai te repe pituitary. Ko te tikanga o te kupu "pan" ko "katoa", nō reira e whakamārama ana i tēnei āhuatanga.

He aha ngā homoni ka whakaputaina e te repe pituitary?

He maha ngā momo homoni e hangaia ana, e tukuna ana hoki e te repe pituitary. He mahi motuhake tā ia o rātou. Me titiro tātou ki ēnei:

• Te homoni adrenocorticotropic (ACTH, corticotropin rānei): Ka whakaoho tēnei i ō tātou repe adrenal ki te whakaputa i tētahi homoni e kiia nei ko te cortisol. Ka kiia hoki tēnei cortisol ko te 'hormone ahotea'. He mea tino nui mō te whakahaere i te toto toto me ngā taumata huka toto.
• Te homoni whakaoho-follicle (FSH): Ka āwhina tēnei homoni ki te whakaoho i te hanga parāoa i roto i ngā tāne, ā, ka whakaoho i ngā ovaries i roto i ngā wāhine ki te whakaputa i te homoni estrogen me te pakari i ngā hua manu.
• Homoni tipu (GH): E ai ki te ingoa, he mea nui mō te tipu o ngā tamariki. Ka āwhina hoki ki te pupuri i ngā uaua me ngā wheua hauora i roto i ngā pakeke, ā, ka pā ki te tohatoha o te ngako tinana. Kei roto hoki te GH i roto i tā tātou pākia o te tinana.
• Hormone Luteinizing (LH): E hiahiatia ana te LH hei whakaoho i te whakaputanga o te hua manu i roto i ngā wāhine, me te whakaoho i te hanga testosterone i roto i ngā tāne.
• Prolactin: Ka whakaoho tēnei homoni i te whakaputanga o te waiū ū i muri i te whānautanga o te pēpi. Ka pā anō hoki ki te huringa paheketanga o ngā wāhine me te momonatanga me te mahi ā-ira tangata o ngā pakeke.
• Te homoni whakaohooho tairoi (TSH): Ka whakaoho tēnei i te repe tairoi kia whakaputa i ngā homoni tairoi, e whakahaere ana i te pākia o te tinana, te pūngao, me te pūnaha io.

Haunga ēnei, ka rongoa, ka tukuna hoki e te repe pituitary ētahi atu homoni e rua ina hiahiatia. Heoi, ka hangaia ēnei e te hypothalamus:

• Te homoni ārai-diuretic (ADH, vasopressin rānei): Ka whakahaere tēnei homoni i te nui o te wai me te konutai (tote) i roto i tō tātou tinana.
• Oxytocin: Ka āwhina i ngā wāhine ki te whakawhāiti i ō rātou kōpū i te wā e whānau ana, ā, ka āwhina anō hoki i te rere o te waiū ū. E kiia ana hoki ka pā tēnei homoni ki te hononga i waenga i ngā mātua me ngā pēpi.

Titiro mai, he mahi nui tēnei o te repe pituitary iti nei! Nō reira, ka nui te pānga o te hekenga o ēnei homoni katoa.

Ko wai te mea tino pāngia e tēnei āhua o te panhypopituitarism?

Ina hoki, ka taea e te tangata te pā ki tēnei āhuatanga e kīia nei ko te panhypopituitarism, ahakoa te pakeke. Kāore he rohe tau, he wāhanga rānei.

E hia te auau o tēnei āhuatanga?

He tino onge tēnei mate. I te ao whānui, e whā noa iho i roto i te rau mano tāngata e pāngia ana e tēnei mate i ia tau. Nō reira, he mea noa te kore e rangona nuitia mōna.

Ka taea e te panhypopituitarism te whakararu i te ora?

Ae, i ētahi wā ka mate pea koe i tēnei āhuatanga. Ina koa mēnā he iti rawa te homoni adrenocorticotropic hormone (ACTH), ka tino morearea pea.

Ko te take o tēnei, nā te korenga o te ACTH ka puta he āhuatanga ohorere e kiia nei ko te raruraru adrenal . Ka kiia hoki tēnei ko te "koretake o te cortisol acute". Ko te ACTH te mea e whakahaere ana i ngā taumata cortisol. Nō reira, ina ngaro te ACTH, kāore te cortisol e puta. He āhuatanga tēnei raruraru adrenal e hiahia ana kia arohia tonutia e te hauora, ā, ka taea hoki te whakararu i te ora.

Ko ngā tohu o te raruraru adrenal ko:

• Kirika
• ngoikore nui
• Pōhēhē (kore mārama)
• Te toto toto iti (hypotension)
• Te tere o te manawa (tachycardia)
• Ruaki
• Korere
• Te huka toto iti (hypoglycemia)

Ki te pāngia koe, tāu tamaiti rānei e tētahi o ēnei tohu, haere tonu ki te hōhipera tata, waea atu rānei ki te 1990. He āhuatanga ohorere tēnei!

He aha ngā tohu o te Panhypopituitarism?

Ka rerekē rawa ngā tohu o tēnei mate i ia tangata, i runga i te nui o ia homoni pituitary e ngaro ana me te tere, te puhoi rānei o te whanaketanga o te mate.

Anei ētahi tohu e kitea whānuitia ana i roto i ngā tamariki me ngā pakeke:

• Whakapairuaki, whanoke rānei
• Ngenge rawa
• Te pouri me te manukanuka rānei
• Ngā mate pāwera auau
• Te huka toto iti (hypoglycemia)
• Te kore e taea te aro atu ki te makariri
• Kiri maroke rawa
• Te ngaronga, te pikinga rānei o te taumaha mō te kore take
• Ngā taumata ngako toto me te cholesterol koretake (dyslipidemia)
• Te tere o te manawa (tachycardia)
• Te matewai nui me te mimi pinepine
• Ngā huringa paheketanga koretake i roto i ngā wāhine
• Te kore tamarikitanga o te wahine
• Te kore tamarikitanga o te tāne

Tērā atu anō ētahi atu tohu e pā ana ki ngā pēpi hou, ngā pēpi, me/ngā tamariki nohinohi:

• Te jaundice roa i roto i ngā pēpi hou
• Ure iti i roto i ngā pēpi tāne (micropenis)
• Te tipu pōturi (kāore e tipu teitei)
• Te pakeketanga kua roa

Nā te mea he rite tonu ēnei tohu ki ētahi atu mate hauora, he mea nui kia tika te tātaritanga mēnā he tohu hou, he tohu pumau rānei ōu. Nō reira, tirohia he tākuta mō ētahi tohutohu.

He aha ngā take o te panhypopituitarism?

He maha ngā take pea mō tēnei mate. I ētahi wā, kāore e kitea e ngā tākuta tētahi take motuhake. Ka kiia tēnei ko te idiopathic panhypopituitarism.

Ko te take matua mō tēnei, ko te pakaru o te hypothalamus me/ranei te pituitary gland, ā, kāore tetahi, tetahi rānei o rāua e mahi tika.

Hei mārama ki ēnei take, me mārama koe ki te mahi tahi a tō tātou hypothalamus me te pituitary gland.

Te whanaungatanga o te hypothalamus-pituitary repe

Whakaarohia tō tātou hypothalamus, te repe pituitary, me te repe pituitary hei Tumu Whakahaere Matua me te kaiwhakahaere o tētahi kamupene nui. Ka mahi ngātahi ēnei e rua hei pokapū whakahaere matua o tō tātou roro (te matatini hypothalamus-pituitary), e whakahaere ana i ngā tukanga tino nui o te tinana.

Ko te hypothalamus te wāhanga o tō tātou roro e kawenga ana mō ētahi mahi taketake o te tinana. Ka tukuna ngā karere ki tō tātou pūnaha io ā-roto. Ka kī atu hoki ki te repe pituitary kia "hangaia ēnei homoni, kia tukuna ēnei." Ka pāngia ēnei homoni pituitary e ētahi atu wāhanga o te tinana.

E hono ana te repe pituitary ki te hypothalamus mā te kakau kei roto ngā oko toto me ngā muka io e kiia nei ko te "kakau pituitary." Mā roto i tēnei kakau ka hono te hypothalamus ki te repe pituitary.

He maha ngā homoni ka whakaputaina e te hypothalamus hei whakaoho i te repe pituitary:

• Te homoni tuku corticotropin
• Dopamine
• Te homoni tuku gonadotropin
• Te homoni tuku-homoni
• Somatostatin
• Te homoni tuku-thyrotropin

Nā te mea he tino tata te mahi tahi a te repe pituitary me te hypothalamus, ka pā te kino ki tētahi o ngā homoni o tētahi atu. Koinei te pūtake o te whanaketanga o te panhypopituitarism.

Ngā take e pā ana ki te repe pituitary

Ko ngā āhuatanga ka kino ki te repe pituitary me te mate hypopituitarism ko:

• Ngā adenoma pituitary (he pukupuku kore-matepukupuku ēnei)
• Te pokanga o te repe pituitary (he maha ngā wā hei tango i ēnei adenomas)
• Te rongoā irahiko mō te adenoma pituitary
• Te mate puku o te pituitary (te whakangaromanga ohorere o te kiko pituitary nā te iti o te rere o te toto ki te repe pituitary, te toto rānei)
• Kāore te repe pituitary i te whanake tika, i te hanga koretake rānei i te whānautanga.

Ngā take e pā ana ki te hypothalamus

Ko ngā āhuatanga ka kino pea te hypothalamus me te mate hypopituitarism ko:

• Te whara roro whara (TBI)
• Te pokanga roro e mahia ana i runga, i te taha rānei o te hypothalamus
• Ngā pukupuku kore-matepukupuku e whanake ana i roto i te hypothalamus (hei tauira, craniopharyngiomas)
• Te mate pukupuku kua horapa (metastasized) ki te hypothalamus mai i ētahi atu wāhanga o te tinana (hei tauira, te mate pukupuku o te pukahukahu, te ū)
• Te hydrocephalus (te pēhanga i puta mai i te kohikohinga wai i roto i te roro)
• Whiu
• Te meningitis kohi

Me pēhea te tātaritanga o te panhypopituitarism?

Mena kei a koe ngā tohu o tēnei mate, ka pātai tuatahi tō tākuta ki a koe mō ō tohu me tō hītori hauora, kātahi ka whakahaere i tētahi whakamātautau tinana.

Kātahi ka whakaritea ngā whakamātautau e tika ana hei whakaū i te āhua o te panhypopituitarism me te whakakore i ētahi atu āhuatanga e hua ai ēnei tohu.

He aha ngā whakamātautau tātaritanga?

He maha ngā whakamātautau ka mahia e ngā tākuta hei tautuhi i tēnei mate, tae atu ki ngā whakamātautau whakaahua me ngā whakamātautau taumata homoni.

Ngā whakamātautau whakaahua

Ko te panhypopituitarism ka puta mai i te kino o te hypothalamus, te pituitary rānei, ā, ka taea te mahi i ngā whakamātautau whakaahua pēnei hei kimi i te take:

• Matawai MRI (Whakaahua Āhua Aukume) o te Roro: Ka whakamahia e te matawai MRI ngā ngaru reo irirangi me te papa aukume kaha hei whakaputa whakaahua taipitopito o roto o te tinana. E kiia ana ko ngā matawai MRI te huarahi pai ki te kimi i ngā pukupuku pituitary. Ka taea hoki e rātou te āwhina ki te tautuhi i ētahi atu raruraru o te hypothalamus, te repe pituitary rānei.
• Matawai CT (Tomography Rorohiko) o te roro: Ka whakamahia e te matawai CT ngā hihi-X me te rorohiko hei hanga whakaahua taipitopito o te roro. Ka taea te whakamahi i tēnei whakamātautau hei tirotiro mō te pukupuku roro, te adenoma pituitary rānei. Ka taea hoki e ia te āwhina ki te tautuhi i ētahi atu raruraru o te hypothalamus, te repe pituitary rānei.

Ngā whakamātautau homoni

Mena kei a koe ngā tohu o te panhypopituitarism, me ine e tō tākuta ngā taumata o ia homoni e tukuna ana e te repe pituitary. Mā tēnei ka āwhina ki te whakatau i te iti o ia homoni, me te whakakore i ētahi atu mate.

Ahakoa kei roto i ō tātou toto ētahi homoni pituitary i te taumata pumau, ka tino rerekē ngā taumata o ētahi atu homoni puta noa i te rā. Nō reira, ka taea te mahi i ētahi whakamātautau homoni hei whakamātautau toto noa iho, ko ētahi ia me whai whakamātautau whakaohooho motuhake.

Ko ngā whakamātautau taumata homoni ko:

• Ngā whakamātautau toto: Mā ngā whakamātautau toto māmā ka taea te ine i ngā homoni pituitary pērā i te homoni whakaoho tairoi (TSH), te prolactin, te homoni whakaoho follicle (FSH), me te homoni luteinizing (LH). Ka taea hoki e rātou te ine i ētahi atu homoni e pāngia ana e ngā homoni pituitary, pērā i te thyroxine, te estrogen, me te testosterone.
• Whakamātautau whakaohooho ACTH:Ka whakamātautauhia e tēnei te urupare a ō repe adrenal ki te homoni adrenocorticotropic (ACTH). Kei roto i tēnei ko te werohanga o te ACTH hangai me te tango tauira toto i ngā wā auau.
• Whakamātautau whakaohooho homoni tipu (GH): Mō tēnei whakamātautau, ka werohia koe e tō tākuta ki tētahi rongoā. Ko te tikanga, ka whakaoho tēnei rongoā i te repe pituitary kia tukuna te homoni tipu. Kātahi ka tangohia tō tauira toto, ā, ka inehia ō taumata GH.
• Whakamātautau ātete ki te insulin: Ka āwhina tēnei whakamātautau ki te tautuhi i te ngoikore o te homoni tipu (GH) me te ACTH.

Me pēhea te rongoā i te panhypopituitarism?

He rerekē te maimoatanga mō tēnei āhuatanga i ia tangata, i ia tangata. Kei te iti o ngā taumata o te homoni pituitary me te take matua. Nō reira, he takitahi te mahere maimoatanga. Mā tō rōpū hauora e whakatau te mahere maimoatanga pai rawa atu māu.

Ko ētahi o ngā kōwhiringa maimoatanga e whakamahia whānuitia ana ko:

• Whakaora whakakapinga homoni: Ko te whāinga o tēnei he whakahoki mai i ngā homoni pituitary kua heke ki te taumata hauora. Me whai rongoā whakakapinga homoni mō te wā katoa te hunga e pāngia ana e te panhypopituitarism ki te kore e taea te rongoā i te take matua. Ko ētahi rongoā whakakapinga homoni ka tangohia hei pire, ko ētahi ka hoatu hei werohanga.
• Pokanga: Mena he pukupuku roro, he adenoma pituitary rānei te take o te mate, ka tūtohu pea tō tākuta kia pokangahia te tango i te pukupuku.
• Whakaora irahiko: Mena he pukupuku roro, he adenoma pituitary rānei te take o te mate, ka tūtohutia pea te rongoā irahiko hei rongoā, hei whakaiti rānei i te pukupuku.
• Corticosteroids: Me tango pea e koe he horopeta nui o te corticosteroids i mua atu, i te wā rānei o tētahi huihuinga e pāngia ai te ahotea tinana, hinengaro rānei. Ko ngā ahotea tinana ko te mate, te mate pāwera, me te pokanga. Ka hoatu ēnei corticosteroids hei whakakapi i ngā homoni adrenal kāore i hangaia nā te korenga o te ACTH. He mea nui ēnei homoni ina pāngia te tinana e te ahotea.

Ka taea te whakaora katoa i te panhypopituitarism?

I ētahi wā, ka taea te whakakore i te panhypopituitarism mā te rongoā i te pūtake (hei tauira, mā te pokanga ka tangohia he adenoma pituitary i pēhi i te repe pituitary, ki te kore te repe i pakaru). Heoi, i te nuinga o te wā , ko te ngoikore o ngā homoni i puta mai i te panhypopituitarism me rongoā mō te wā katoa.

Ka taea te ārai i tēnei āhuatanga?

I te nuinga o te wā, kāore he huarahi hei ārai i te panhypopituitarism. Heoi, ki te mea kei te tūpono koe ki tēnei mate, tera pea ētahi huarahi hei kite wawe i tēnei mate.

Mena kua pāngia koe e tētahi o ngā āhuatanga e whai ake nei, ka nui ake tō tūponotanga ki te whakawhanake i te panhypopituitarism:

• Mena kua pokangahia tō roro, tō repe pituitary rānei.
• Mena kua whiwhi koe i te maimoatanga irahiko ki te roro me/ranei te repe pituitary.
• Mena kua pāngia te roro e te ru ohorere i tētahi aituā (Whara roro whara).
• Mena kei te pāngia koe e te hydrocephalus (he wai e pupū ake ana i te roro).

Mena kei roto koe i te mōrearea, ka tūtohu tō tākuta kia tirohia te mahi me te hauora o tō repe pituitary me/ranei hypothalamus.

He aha te matapae mō te panhypopituitarism?

Ko te āhua o tēnei mate, arā, te āhua o te tūroro ā muri ake nei, e whakawhirinaki ana ki ētahi āhuatanga:

• Te iti o ia homoni pituitary.
• Tō tau i te tīmatanga o te mate.
• Ka āta haere, ka tere rānei te whanaketanga o tēnei āhuatanga?
• Kia pēhea te tere o te tautuhi i te mate me te tīmatanga o te maimoatanga?

Kua kitea te hononga o te panhypopituitarism ki te whakahekenga nui o te kounga o te oranga me te roanga o te oranga.

He maha ngā wā ka nui ake te mōrearea o te hunga whai mate pēnei ki te momona, te heke o te taumaha tinana hiroki, me te mate manawa. Tērā pea ka nui ake hoki te mōrearea o te osteoporosis (te angiangi o ngā wheua) me te whati o te wheua.

Heoi anō, mā te rongoā whakakapinga homoni tino tupato, me te aroturuki tata i ngā āhuatanga mōrearea o te ngakau ka pai ake ngā putanga. Nō reira, he mea tino nui te whai i ngā tohutohu a te rata.

Āhea koe me toro atu ki te tākuta mēnā he panhypopituitarism tōu?

Mena kei a koe ngā tohu o te panhypopituitarism, kua tautuhia rānei kei a koe te mate, me toro atu pea koe ki tētahi endocrinologist, he tākuta e tohunga ana ki te rongoā i ngā mate e pā ana ki ngā homoni.

Me toro atu koe ki tō tākuta endocrinologist i ia wā, i ia wā, kia mōhio ai koe kei te tika te mahi a tō rongoā whakakapinga homoni, kia kore ai hoki e nui rawa te whakakapinga o ngā homoni.

He mea noa te mataku ina whiwhi koe i tētahi tātaritanga hou. Engari kaua e wehi ki te pātai ki tō tākuta mō te panhypopituitarism. I te mea he maha ngā wā e hiahiatia ana he maimoatanga mō te wā katoa me te aroturukitanga homoni, he mea nui kia kite i tō tākuta i ia wā. Mena ka puta he tohu hou, he tohu āwangawanga rānei, me whakamōhio tonu atu ki tō tākuta. Kei reira rātou hei āwhina i a koe.

Ngā mea nui hei maumahara (Karere hei kawe ki te kāinga)

Āe, me whakarāpopoto e tātou ētahi o ngā mea hei maumahara māu mai i ngā mea kua kōrerohia e tātou:

• He mate onge engari he mate kino te panhypopituitarism, e heke ai ngā homoni katoa e hangaia ana e te repe pituitary.
• He maha ngā take mō tēnei, ko te nuinga he pakaru ki te repe pituitary, ki te hypothalamus rānei.
• He rerekē ngā tohu, ā, i ētahi wā ka puta mai ngā āhuatanga e morearea ana ki te ora pērā i te mate adrenal . Nō reira, rapua tonutia he tohutohu hauora mēnā ka puta he tohu.
• E hiahiatia ana ngā mahi pēnei i ngā whakamātautau toto me ngā karapa MRI/CT hei tāutu i te mate tika.
• He maha ngā wā ka uru te rongoā whakakapinga homoni ki te maimoatanga mō te wā katoa.
• Mā te mahi tahi me tō tākuta, me te whiwhi i ngā whakamātautau me ngā maimoatanga tika, ka taea e koe te noho angitu me tēnei mate.

Ko tāku tumanako he whai hua ēnei mōhiohio ki a koe. Kia maumahara, ehara i te mea ko koe anake, ā, kei reira ngā tākuta me ngā kaiwhakarato hauora hei āwhina i a koe.

` Te panhypopituitarism, te repe pituitary, te korenga o te homoni, te hypothalamus, te rongoā homoni, ngā pukupuku roro, te ACTH