Kodi muli ndi zizindikiro izi? Tiyeni tikambirane za Cushing Syndrome!

Kodi munamvapo za Cushing Syndrome? Dzinali likhoza kukhala latsopano kwa inu. Mwachidule, ndi vuto lomwe limachitika pamene matupi athu amatulutsa mahomoni ambiri a cortisol . Anthu ena amatchanso hypercortisolism. "Syndrome" ndi gulu la zizindikiro zomwe zimabwera pamodzi. Mwina munawonapo anthu ena akuitcha Cushing's syndrome.

Ndiye kodi cortisol iyi ndi chiyani?

Cortisol ndi mahomoni otchedwa steroid omwe amapezeka m'matupi athu. Nthawi zambiri timawatcha kuti "hormone ya nkhawa" chifukwa tikakhala ndi nkhawa, matupi athu amatulutsa cortisol yambiri. Munthawi zimenezi, cortisol imatithandiza:

• Kugunda kwa mtima wanu kumawonjezeka.
• Kuthamanga kwa magazi anu kukukwera.
• Amalamulira kuchuluka kwa shuga m'magazi.
• Amalamulira kupuma.
• Kumawonjezera kukanika kwa minofu.

Si zokhazo, komanso tikakhala ndi nkhawa, cortisol imathandizanso kutseka kwakanthawi machitidwe omwe si ofunikira m'thupi lathu panthawiyo, mwachitsanzo, dongosolo logaya chakudya ndi dongosolo loberekera.

Cortisol ndi mahomoni ofunikira kwambiri m'thupi lathu. Cortisol ndi yofunika kwambiri pazinthu izi:

• Sungani kuthamanga kwa magazi.
• Lamulirani kuchuluka kwa shuga m'magazi.
• Chepetsani kutupa.
• Pangani zokumbukira.
• Lamulirani kupuma kwanu.
• Sungani mchere m'thupi.
• Sinthani chakudya chomwe timadya kukhala mphamvu.

Milingo ya Cortisol imayendetsedwa ndi tiziwalo tiwiri tating'ono pamwamba pa impso zathu, tiziwalo ta adrenal, chiwalo cha pituitary muubongo, ndi hypothalamus, yomwe ili pamwamba pa chiwalo cha pituitary.

Matenda a Cushing nthawi zambiri amayamba chifukwa cha chotupa . Izi zitha kuchitika m'njira ziwiri zazikulu:

• Zachilengedwe: Izi zikutanthauza kuti ndi vuto lomwe limayamba chifukwa cha cortisol, yomwe imapangidwa m'matupi athu.
• Zakunja: Izi zikutanthauza kuti vuto limayamba chifukwa cha zinthu zina monga zotsatira zoyipa za mankhwala ena omwe amatengedwa pochiza matenda ena.

Ndani amene ali ndi mwayi waukulu wopeza matenda a Cushing?

Matenda a Cushing amapezeka kwambiri mwa ana, achinyamata, komanso akuluakulu. Amafala kwambiri mwa anthu azaka zapakati pa 25 ndi 50. Anthu omwe amamwa mankhwala okhala ndi cortisol (monga mankhwala a mphumu ndi nyamakazi) ali pachiwopsezo chachikulu chotenga matendawa. Pafupifupi 70% ya anthu omwe ali ndi matenda a Cushing ndi akazi ndipo 30% ndi amuna.

Kodi vutoli ndi lofala bwanji?

Matenda a Cushing ndi matenda osowa kwambiri , omwe amakhudza anthu pakati pa 40 ndi 70 mwa anthu miliyoni imodzi pachaka.

Kodi kusiyana pakati pa Cushing Syndrome ndi Cushing Disease ndi kotani?

Matenda a Cushing ndi mtundu wa matenda a Cushing. Amayambitsidwa ndi chotupa chosaopsa mu pituitary gland. Chotupachi chimatulutsa mahomoni ambiri a ACTH (adrenocorticotropic hormone) . Izi zimapangitsa kuti ma adrenal glands atulutse cortisol yambiri.

Mwa anthu omwe ali ndi matenda a Cushing's, akuluakulu opitilira 70% komanso pakati pa 60% ndi 70% ya ana ndi achinyamata ali ndi matenda a Cushing's.

Ndi madokotala otani omwe amachiritsa matenda a Cushing?

Dokotala wanu adzakutumizani kwa katswiri wotchedwa endocrinologist kuti akapeze matenda ndi kuchiza vutoli.

Kodi matenda a Cushing angakhale oopsa?

Inde, Cushing's Syndrome ikhoza kupha ngati sichithandizidwe bwino. Ngati sichichiritsidwa, kuchuluka kwa cortisol (hypercortisolism) kumeneku kungayambitse mavuto osiyanasiyana azaumoyo. Mwachitsanzo:

• Matenda
• Magazi amaundana, makamaka m'mapapo ndi miyendo
• Kuvutika maganizo
• Matenda amtima
• Kulemera
• Mavuto okumbukira kapena kuvutika kuganizira
• Kuthamanga kwa magazi kapena cholesterol yambiri
• Mafupa osweka
• Matenda a shuga amtundu wa 2, prediabetes, kapena kusala kudya kwa glucose

Ngati sichichiritsidwa, matenda a Cushing angayambitse imfa.

Kodi ndi zinthu ziti zomwe zimayambitsa matenda a Cushing?

Matenda a Cushing amayamba chifukwa cha kuchuluka kwa cortisol m'thupi. Pali zifukwa zingapo zomwe zingayambitse izi:

• Kugwiritsa Ntchito Mankhwala a Glucocorticoid: Mankhwala a Glucocorticoid (monga prednisone) amagwiritsidwa ntchito pochiza mphumu yosatha, nyamakazi ya m'mafupa, lupus, sarcoidosis, ndi matenda ena ambiri a autoimmune omwe amayambitsa kutupa kosatha. Kumwa mankhwalawa kwa nthawi yayitali kungayambitse "iatrogenic" kapena exogenous Cushing syndrome. Mawu oti "iatrogenic" amatanthauza kuti china chake chimachitika chifukwa cha chithandizo chamankhwala.
• Ziphuphu za pituitary: Matenda a Cushing ( kupatula matenda a Cushing a iatrogenic) amayamba chifukwa cha ziphuphu za pituitary zomwe zimapanga ACTH yochuluka, mahomoni omwe amauza ma adrenal glands kuti atulutse cortisol, ndipo amakhudza anthu 8 mwa 10. Mtundu uwu umatchedwa matenda a Cushing.
• Zilonda za m'mimba mwa adrenal: Chotupa chomwe chimakula pamwamba pa adrenal gland chingapangitse cortisol yochuluka kwambiri. Izi nthawi zambiri zimakhala zotupa zopanda vuto. Komabe, nthawi zina chotupachi chingakhale khansa ya m'mimba mwa adrenal, mtundu wosowa kwambiri wa khansa ya m'mimba mwa adrenal.
• Zotupa za m'mapapo, kapamba, chithokomiro ndi thymus: Pamene ACTH imapangidwa ndi zotupa kunja kwa pituitary gland, imatchedwa ectopic ACTH syndrome. Zotupa zimenezi nthawi zambiri zimakhala zoopsa. Chofala kwambiri mwa izi ndi khansa ya m'mapapo ya maselo ang'onoang'ono.

Kodi matenda a Cushing ndi obadwa nawo?

Kawirikawiri, ayi . Matenda ambiri a Cushing's syndrome si obadwa nawo.

Kodi zizindikiro za matenda a Cushing ndi ziti?

Kuwonjezera pa zizindikiro zomwe zimayenderana ndi matenda a Cushing, palinso zizindikiro zomwe zingakhale zofanana ndi matenda ena ambiri. Si aliyense amene ali ndi zizindikiro zomwezo. Zizindikiro zomwe zingachitike ndi izi:

• Kunenepa mofulumira pankhope (ena amati izi ndi "nkhope ya mwezi"), m'mimba, kumbuyo kwa khosi (ena amati izi ndi "buffalo hump"), ndi pachifuwa.
• Nkhope yofiira, yozungulira.
• Mabala amatenga nthawi kuti achire.
• Kuthamanga kwa magazi (kuthamanga kwa magazi).
• Kumera kwambiri tsitsi pankhope, pakhosi, pachifuwa, m'mimba, m'mabere, ndi m'ntchafu, kapena kutayika tsitsi (dazi).
• Matenda a shuga.

Zizindikiro zina zingaphatikizepo:

• Kuwoneka kwa mabala ofiirira m'mimba.
• Kuvulala kosavuta m'manja ndi m'mapazi.
• Kufooka ndi kutopa konse.
• Kusawona bwino komanso chizungulire.
• Kufooka kwa minofu ndi kufooka kwa miyendo.
• Kusintha kwa chilakolako cha kugonana ndi kulephera kugwira ntchito bwino kwa erectile mwa amuna.
• Kukula kolakwika kwa ana.

Kodi matenda a Cushing amatenga nthawi yayitali bwanji?

Kutalika kwa nthawi yomwe matenda a Cushing's syndrome amatha kumadalira momwe mumayankhira chithandizo. Anthu ambiri omwe ali ndi cortisol yambiri (hypercortisolism) amachira atatha milungu ingapo ya chithandizo.

Kodi matenda a Cushing amayambitsa mavuto opuma?

Ayi.Kupuma movutikira si chizindikiro chodziwika bwino cha matenda a Cushing.

Kodi Cushing Syndrome imayambitsa matenda a osteoporosis?

Inde. Matenda a Cushing angayambitse mafupa ofooka. Izi zingayambitse kusweka kwa mafupa, makamaka ngati mwakhala ndi vutoli kwa nthawi yayitali. Mafupa ofooka angayambitsenso ululu.

Kodi Cushing Syndrome imayambitsa hypokalemia?

Hypokalemia ndi vuto lomwe potaziyamu m'magazi mwanu ndi wochepa. Vutoli lingachitike ngati muli ndi matenda a Cushing.

Kodi matenda a Cushing amawapeza bwanji?

Ngati dokotala wanu akukayikira kuti muli ndi cortisol yambiri (hypercortisolism), pali malangizo ena omwe angatsatire. Adzakufunsani mafunso, adzalemba mbiri yanu yachipatala, adzakuyesani thupi, kenako adzayitanitsa mayeso ena a labu. Akhozanso kukuyang'anirani kwa nthawi ndithu.

Matenda a Cushing nthawi zina amakhala ovuta kuwazindikira. Ngati muuza dokotala wanu kuti mwatopa ndipo mukulemera, sangaganizepo nthawi yomweyo za matenda a Cushing. Izi zili choncho chifukwa zizindikirozi ndizofala m'matenda osiyanasiyana.

Komanso, matenda a Cushing nthawi zina amatha kusokonezedwa ndi matenda a polycystic ovary syndrome kapena metabolic syndrome . Dokotala wanu ayenera kuchotsa matenda ena kuti adziwe ngati ali ndi matendawa.

Kodi ndi mayeso ati omwe amachitidwa kuti adziwe matenda a Cushing?

Dokotala wanu akhoza kuchita mayeso ena mwa awa:

• Mayeso a mkodzo a cortisol a maola 24: Mayesowa amayesa kuchuluka kwa cortisol mu mkodzo wanu mu ma microgram (mcg). Dokotala wanu adzakufunsani kuti mutenge mkodzo wanu kwa maola 24.
• Kuyesa kwa cortisol ya m'malovu pakati pa usiku: Kawirikawiri, kuchuluka kwa cortisol kumakhala kochepa kwambiri usiku. Kuyesaku kumayesa kuchuluka kwa cortisol pakati pa 11 ndi 12 koloko m'mawa. Ngati muli ndi matenda a Cushing, kuchuluka kwa cortisol yanu kudzakhala kwakukulu kwambiri panthawiyo.
• Kuyesa kwa dexamethasone kocheperako:Dexamethasone ndi mankhwala ofanana ndi cortisol. Pa mayeso awa, mumatenga miligramu imodzi (mg) ya mankhwalawa pakamwa usiku, kenako kuchuluka kwa cortisol yanu kumayesedwa pakati pa 8 ndi 9 koloko m'mawa. Kuyesa magazi kumeneku kumayang'ana ngati ma adrenal glands anu ayankha ku dexamethasone pochepetsa kuchuluka kwa cortisol komwe amatulutsa. Ngati muli ndi matenda a Cushing, kuchuluka kwa cortisol yanu kudzakhala kwakukulu.
• Kuyezetsa magazi: Kuyezetsa magazi kumayesa kuchuluka kwa ACTH m'magazi mwanu. Ngati kuchuluka kwa ACTH kuli kochepa, mungakhale ndi chotupa cha adrenal. Ngati kuchuluka kwake kuli bwino kapena kokwera, mungakhale ndi chotupa cha pituitary kapena chotupa cha ectopic.
• Kuyesa kwa dexamethasone yochuluka: Izi zikufanana ndi kuyesa kwa dexamethasone yocheperako, koma mlingo wake ndi mamiligalamu 8 m'malo mwa 1. Kuyesaku nthawi zambiri kumachitika pambuyo poti mayeso a mlingo wotsika awonetsa kuchuluka kwa cortisol m'mawa ndipo mayeso amagazi akuwonetsa kuchuluka kwa ACTH m'magazi. Kuyesaku kungathandize kupeza chomwe chimayambitsa matenda a Cushing. Kungathandize kusiyanitsa pakati pa pituitary adenoma (yomwe imadziwikanso kuti matenda a Cushing) ndi chotupa china m'thupi lanu (monga m'mapapo).

Dokotala wanu akatsimikizira kuti muli ndi matenda a Cushing, sitepe yotsatira ndikupeza chomwe chikuyambitsa matendawa. Nthawi zambiri, akhoza kukhala mankhwala kapena chotupa. Ngati mukumwa glucocorticoids, ndiye chifukwa chake, kotero dokotala wanu angachepetse mlingo wanu. Ngati simukumwa glucocorticoids, izi zitha kusonyeza chotupa mu adrenal glands yanu, pituitary gland, kapena kwina kulikonse. Dokotala wanu angakulangizeni kuti mufufuze zithunzi ngati izi kuti mupeze chotupacho:

• Kujambula kwa CAT (CT scan) kapena MRI m'mimba: Dokotala wanu angachite CT scan kapena MRI kuti aone ngati muli ndi chotupa m'matenda anu a adrenal. Kujambula kumeneku kungachitike ndi kapena popanda intravenous contrast (IV contrast). Mayeso awa ndi ofunikira kwambiri pozindikira zotupa za adrenal.
• Kujambula kwa maginito (MRI) kwa pituitary:MRI imajambula zithunzi za pituitary gland yanu kuti ione ngati pali chotupa. Nthawi zina, MRI si matenda odziwikiratu. Pafupifupi 50% ya anthu omwe ali ndi matenda a Cushing ali ndi MRI "yabwinobwino", pomwe 10% akhoza kukhala ndi zotupa zomwe sizikugwirizana ndi matendawa.
• Kuyesa kwa Bilateral inferior petrosal sinus sampling (BIPPS): Kuyesa kumeneku kumapeza komwe kumachokera kutulutsa kwa ACTH. ACTH ndi mahomoni ena a pituitary amatulutsidwa kuchokera ku pituitary gland kupita m'magazi. Katswiri wodziwa bwino ntchito ya radiation amachita mayesowa kudzera m'mitsempha iwiri yotchedwa inferior petrosal sinuses. Kulondola kwa mayesowa kuli pakati pa 95% ndi 98%.
• Chifuwa cha CT scan: Ngati dokotala wanu akukayikira kuti muli ndi chotupa cha ectopic, angakupatseni CT scan pachifuwa kuti aone ngati pali khansa ya m'mapapo.

Kodi matenda a Cushing amachiritsidwa bwanji?

Mtundu wa chithandizo umadalira chifukwa chachikulu cha kuchuluka kwa cortisol m'magazi. Ngati mukumwa glucocorticoids, dokotala wanu mwina angachepetse mlingo wanu kapena kukupatsani mankhwala osakhala a glucocorticoid.

Ngati matenda a Cushing amayamba chifukwa cha chotupa, dokotala wanu angakulangizeni opaleshoni kapena chithandizo cha radiation.

Njira ina ndi yakuti dokotala wanu akupatseni mankhwala omwe amachepetsa kupanga kwa cortisol, monga ketoconazole. Mungafunike kugwira ntchito ndi madokotala osiyanasiyana kuti muchiritse chotupa ndi zizindikiro za matenda a Cushing.

• Chemotherapy: Ngati chotupa chili ndi khansa ndipo chafalikira mbali zina za thupi, chemotherapy ingakhale yofunikira. Onetsetsani kuti mwalankhula ndi dokotala wanu za zotsatirapo zilizonse zoyipa.
• Mankhwala: Kuwonjezera mankhwala omwe amachepetsa cortisol kapena kuchotsa mankhwala omwe angayambitse Cushing's Syndrome.
• Kutulutsa kwa radiation: Chotupa cha pituitary sichingachotsedwe mwa opaleshoni. Pazochitika zotere, mungafunike kuchitidwa chithandizo cha radiation kwa milungu isanu ndi umodzi. Zingatenge zaka kuti milingo ya cortisol ibwerere mwakale. Lankhulani ndi dokotala wanu za zotsatirapo zilizonse zoyipa.
• Opaleshoni:Kuchotsa zotupa za pituitary, adrenal tumors, ndi ectopic tumors opaleshoni ya opaleshoni yapambana, koma muyenera kuzolowera kuchuluka kwa cortisol komwe kulipo, komwe kumachepa. Panthawiyi, mungafunike kumwa mankhwala a cortisol mu mawonekedwe a mapiritsi a hydrocortisone. Mudzatha kusiya kumwa mankhwalawa patatha miyezi 6 mpaka 18. Nthawi zambiri, mutatha opaleshoni ya laparoscopic, mudzatha kutuluka kuchipatala patatha tsiku limodzi kapena awiri.

Ngati matenda a Cushing athandizidwa bwino, zingatenge miyezi iwiri mpaka 18 kuti achire. Khalani pafupi ndi dokotala wanu panthawiyi komanso kupitirira apo.

Kodi ndingayembekezere chiyani ngati ndili ndi Cushing Syndrome?

Dokotala wanu akhoza ndipo ayenera kuchiza matenda a Cushing. Ngati sanalandire chithandizo, akhoza kupha. Pitani kwa dokotala mwamsanga kuti mukambirane za zizindikiro zanu ndi dokotala wanu.

Kodi matenda a Cushing angakule kwambiri?

Matenda a Cushing amatha kukulirakulira ngati sakulandira chithandizo choyenera. Lumikizanani ndi dokotala wanu ndipo muwadziwitse za zizindikiro zatsopano, zizindikiro zomwe zikuipiraipira, kapena mavuto ena aliwonse.

Kodi ndingachepetse kapena kupewa bwanji chiopsezo cha matenda a Cushing Syndrome?

Thupi lanu limafunikira cortisol nthawi zonse. Mumaifuna kuti ikhale yogwira ntchito. Imalamulira kupuma kwanu, imasintha chakudya chomwe mumadya kukhala mphamvu, imayang'anira shuga m'magazi mwanu, imakuthandizani kuthana ndi kupsinjika maganizo, komanso imachita zambiri. Cortisol si mdani wa thupi lanu, koma yochuluka kwambiri si yabwino. Komabe, simungakhale popanda cortisol.

Ngati mukumwa glucocorticoids kapena steroids, funsani dokotala wanu kuti aziyang'anira kuchuluka kwa cortisol m'thupi lanu. Mwatsoka, palibe njira yopewera chotupa kuti chisayambitse matenda a Cushing's Syndrome (hypercortisolism).

Kodi zimakhala bwanji kukhala ndi matenda a Cushing?

Kukhala ndi matenda a Cushing kungakhale kovuta, koma sikuyenera kukhala vuto lomwe lingawononge moyo. Pali madokotala ophunzitsidwa kukuthandizani, ndipo palinso mankhwala. Mankhwalawa nthawi zambiri amatha kuchiza matenda a Cushing ndikuwonjezera zizindikiro za kuchuluka kwa cortisol m'thupi (hypercortisolism).

Matenda a Cushing angakuthandizeni kukhala ndi mavuto amaganizo ndi a anthu ena. Anthu ena angachite manyazi ndi kutayika kwa tsitsi, kukula kwambiri kwa tsitsi, ndi/kapena kunenepa kwambiri pankhope ndi kumbuyo kwa khosi. "Nkhope ya mwezi" ndi "buffalo hump" zingakupangitseni kuganiza kawiri za kutenga nawo mbali pazochitika za anthu ena. Pakapita nthawi, chithandizo chingathandize kuchepetsa zizindikirozi. Matenda a Cushing angayambitsenso kuvutika maganizo ndi matenda ena amisala. Ngati kuli kofunikira, pitani kwa katswiri wa zamaganizo kuti akupatseni uphungu ndi dokotala wamaganizo kuti akuthandizeni kuthana ndi mavuto amalingaliro omwe amabwera chifukwa cha kuchuluka kwa cortisol m'magazi (hypercortisolism).

Kodi ndiyenera kupita kwa dokotala liti?

Pitani kwa dokotala ngati muli ndi zizindikiro izi za matenda a Cushing:

Zizindikiro zomwe zimakhudza makamaka akazi:

• Tsitsi latsopano kapena lochuluka pankhope limakula.
• Kusintha kwa chilakolako chogonana.
• Kusintha kwa kayendedwe ka msambo.

Zizindikiro zomwe zimakhudza aliyense:

• Kunenepa mofulumira pankhope (ena amati izi ndi "nkhope ya mwezi"), m'mimba, kumbuyo kwa khosi (ena amati izi ndi "buffalo hump"), ndi pachifuwa.
• Nkhope yofiira, yozungulira.
• Kuthamanga kwa magazi (kuthamanga kwa magazi).
• Kumera kwambiri tsitsi pankhope, pakhosi, pachifuwa, m'mimba, ndi m'ntchafu.
• Matenda a shuga.
• Ziphuphu zatsopano kapena zochulukirapo.
• Kuwoneka kwa mabala ofiirira m'mimba.
• Kuvulala kosavuta m'manja ndi m'mapazi.
• Kufooka ndi kutopa konse.
• Kusawona bwino komanso chizungulire.
• Mabala amatenga nthawi kuti achire.
• Kufooka kwa minofu.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

• Ndi mankhwala ati omwe ndingatenge kuti ndithandize ndi matenda anga a Cushing's?
• Kodi pali masewera olimbitsa thupi omwe ndingachite kuti ndithandize minofu yanga yofooka?
• Kodi pali mankhwala aliwonse omwe angagwiritsidwe ntchito pochiza matenda a stretch marks?
• Kodi ndiyenera kuwona katswiri wa matenda a Cushing Syndrome?
• Kodi ndiyenera kusiya kumwa mankhwala aliwonse omwe ndikumwa panopa?
• Kodi chithandizo chabwino kwambiri kwa ine ndi chiti?
• Kodi pali njira zina zodzitetezera zomwe ndiyenera kuchita?

Matenda a Cushing's syndrome akhoza kukhala ovuta kuthana nawo. Angayambitse kufooka, kuthamanga kwa magazi, komanso kutopa. Mankhwala monga opaleshoni, mankhwala, chithandizo cha radiation, ndi chemotherapy akhoza kukhala ovuta. Koma ndi ofunika, chifukwa ndi chithandizo choyenera, matenda a Cushing's syndrome amatha kuchiritsidwa.

Chidule (Uthenga Wopita Nawo Kunyumba)

Matenda a Cushing ndi matenda omwe amayamba chifukwa cha kuchuluka kwa cortisol m'thupi lathu. Izi zimachitika kawirikawiri, komaNgati yapezeka ndi kuchiritsidwa bwino, imatha kuchiritsidwa . Ndikofunikira kwambiri kufunafuna upangiri wa dokotala ngati muli ndi zizindikiro monga kutupa pankhope, kunenepa kwambiri, kukula kwa tsitsi kwambiri, kapena kuthamanga kwa magazi. Njira zochiritsira zimasiyana malinga ndi chifukwa chake. Choncho lankhulani ndi dokotala wanu za chilichonse ndikutsatira upangiri wawo. Kumbukirani, simuli nokha, ndipo thandizo lilipo.

Matenda a Cushing, cortisol, mahomoni, adrenal glands, pituitary gland, ACTH, zizindikiro, chithandizo, endocrinologist