Kodi muli ndi kuthamanga kwa magazi , komwe kumadziwika kuti "kuthamanga kwa magazi"? Mwina mukumwa kale mankhwala amodzi, awiri, kapena angapo omwe dokotala wanu wakupatsani. Komabe, ngakhale kuti mukumwa mankhwala, kodi mumamvabe kuti kuthamanga kwa magazi kwanu n'kovuta kulamulira? Ngati ndi choncho, chifukwa chake sichingakhale chomwe mumayembekezera nthawi zambiri. Lero, tikufuna kukambirana za matenda enaake omwe angayambitse kuthamanga kwa magazi kovuta kuchiza, komwe sikungalandire mankhwala: Hyperaldosteronism. Ngakhale dzinalo lingamveke lovuta, tiyeni tiligaŵanitse m'mawu osavuta.
Kodi Hyperaldosteronism ndi chiyani?
Mwachidule, hyperaldosteronism imachitika pamene adrenal glands yanu imapanga mahomoni ambiri otchedwa "aldosterone."
Mwina mukudzifunsa kuti: kodi ma adrenal glands awa ndi chiyani, ndipo aldosterone ndi chiyani?
Tangoganizirani tinthu tating'onoting'ono tiwiri, tooneka ngati zipewa zazing'ono, tomwe tili pamwamba pa impso zanu. Izi ndi tinthu ta adrenal glands. Ndi gawo lofunika kwambiri la dongosolo lanu la endocrine . Tinthu tating'onoting'onoti timatulutsa mahomoni angapo ofunikira pa zochita za tsiku ndi tsiku za thupi lanu.
Homoni imodzi yapadera yomwe ma gland amenewa amapanga ndi aldosterone . Ntchito yake yayikulu ndikulamulira kuthamanga kwa magazi mwa kugawa kuchuluka kwa sodium ndi potaziyamu m'magazi mwanu. Mutha kuganiza za homoni iyi ngati wapolisi wa pamsewu akutsogolera kuchuluka kwa magalimoto pamsewu wotanganidwa.
Chifukwa chake, mu hyperaldosteronism, aldosterone yochuluka imapangidwa. Izi zimapangitsa kuti sodium m'thupi lanu ikwere pomwe potaziyamu imatsika. Zotsatira zake zazikulu ndi kuthamanga kwa magazi (kuthamanga kwa magazi) ndi hypokalemia (kutsika kwa potaziyamu m'magazi) .
Pali mitundu iwiri ikuluikulu
Madokotala amagawa vutoli m'magulu awiri kutengera chomwe chimayambitsa.
1. Matenda oyamba a Hyperaldosteronism: Amatchedwanso "Conn's syndrome," izi zimachitika pamene vutoli lili mkati mwa adrenal glands, zomwe zimapangitsa kuti azipanga aldosterone mopitirira muyeso.
2. Secondary Hyperaldosteronism: Pankhaniyi, ma adrenal glands amakhala athanzi. M'malo mwake, amalimbikitsidwa kuti apange aldosterone yochulukirapo poyankha vuto lomwe limachokera kwina m'thupi.
Ndani amene amakhudzidwa kwambiri?
Matendawa amapezeka kwambiri mwa anthu azaka zapakati pa 30 ndi 50. Kafukufuku akusonyezanso kuti amapezeka kwambiri mwa akazi kuposa amuna.
Kafukufuku akusonyeza kuti 5% mpaka 10% ya anthu onse omwe ali ndi kuthamanga kwa magazi akhoza kukhala ndi vuto lalikulu la hyperaldosteronism. Chofunika kwambiri, akatswiri amakhulupirira kuti pakati pa anthu omwe ali ndi kuthamanga kwa magazi kosamva mankhwala , chiwerengerochi chikhoza kukhala chokwera kufika pa 25%.
Kodi zizindikiro zake ndi ziti?
Nthawi zina, ngati vutoli ndi lochepa, simungaone zizindikiro zilizonse. Komabe, anthu ambiri amasonyeza zizindikiro.
Chizindikiro chofala kwambiri ndi kuthamanga kwa magazi , makamaka ngati chikupitirirabe ngakhale mutagwiritsa ntchito mankhwala ambiri ochepetsa kuthamanga kwa magazi.
Zizindikiro zina zimayamba chifukwa cha kuphatikiza kwa kuthamanga kwa magazi ndi kuchepa kwa potaziyamu (hypokalemia). Tiyeni tifotokoze momveka bwino izi.
| Chifukwa | Zizindikiro Zomwe Zingatheke |
|---|---|
| Zizindikiro za Kuthamanga kwa Magazi |
|
| Zizindikiro za kuchepa kwa potaziyamu m'thupi |
|
Kumbukirani, simuyenera kukumana ndi zizindikiro zonsezi. Anthu ena akhoza kukhala ndi chimodzi kapena ziwiri zokha.
Chifukwa chiyani Hyperaldosteronism imachitika?
Monga tanenera kale, zifukwa zimasiyana malinga ndi mitundu iwiriyi.
Zifukwa za Hyperaldosteronism Yoyamba
Apa, vutoli limayambira mu adrenal gland yokha.
- Choyambitsa chachikulu: Nthawi zambiri chotupa chosakhala khansa (adrenal adenoma) pa adrenal gland. Ichi si khansa, kotero palibe chifukwa chodera nkhawa. Chotupachi chimapanga aldosterone yambiri.
- Zina mwa zifukwa zachilendo:
- Kukula kwa gland imodzi ya adrenal (unilateral adrenal hyperplasia).
- Kupanga kwa aldosterone ndi chotupa cha khansa (adrenocortical carcinoma) - izi zimachitika kawirikawiri kwambiri.
- Matenda a majini (familial hyperaldosteronism).
Zifukwa za Hyperaldosteronism Yachiwiri
Apa, ma adrenal glands ndi athanzi, koma amalimbikitsidwa ndi china chake. Chifukwa chachikulu ndi kuchepa kwa magazi kupita ku impso .
Kuti mumvetse izi, ndikofunikira kudziwa za dongosolo lapadera la thupi lolamulira kuthamanga kwa magazi: Renin-Angiotensin-Aldosterone System .
Taganizirani izi ngati njira yotsatizana:
1. Kuthamanga kwa magazi anu kukatsika kapena kuchuluka kwa sodium m'magazi anu kukachepa, impso zanu zimazindikira.
2. Impso zimatulutsa enzyme yotchedwa "renin" m'magazi.
3. Renin imagwira ntchito pa puloteni yopangidwa ndi chiwindi yotchedwa "angiotensinogen," n’kuisintha kukhala "angiotensin I."
4. Kenako, Angiotensin I iyi imasinthidwa kukhala “Angiotensin II.”
5. Pomaliza pake, ndi Angiotensin II iyi yomwe imawonjezera kuthamanga kwa magazi mwa kufinya mitsempha yanu yamagazi ndikulimbikitsa ma adrenal glands anu kuti apange aldosterone.
Pankhani ya matenda ena a hyperaldosteronism, vuto linalake la matenda limachepetsa kuyenda kwa magazi kupita ku impso zanu. Chifukwa chake, impso zanu zimaganiza molakwika kuti kuthamanga kwa magazi m'thupi lanu ndi kotsika kwambiri. Poyankha, impso zanu zimayambitsa chain reaction kuti zipemphe thandizo. Zotsatira zake, hormone ya aldosterone imapangidwa mopitirira muyeso, ngakhale kuti thupi lanu silikufunikira kwenikweni.
Zinthu zomwe zimachepetsa kuyenda kwa magazi kupita ku impso ndikuyambitsa Hyperaldosteronism yachiwiri ndi izi:
- Kuchepa kwa mitsempha yopereka magazi ku impso (Obstructive renal artery disease).
- Matenda omwe madzi amasonkhana m'thupi, monga kulephera kwa mtima.
- Matenda a chiwindi (cirrhosis).
- Nephrotic syndrome, mtundu wa matenda a impso.
Kodi dokotala amazindikira bwanji vutoli?
Mukakambirana ndi dokotala wanu za zizindikiro zanu—makamaka ngati mwanena kuti kuthamanga kwa magazi anu sikukugwirizana ndi mankhwala wamba—akhoza kukayika kuti vutoli ndi lovuta. Dokotala wanu adzalamula kuti muyesedwe kangapo kuti atsimikizire kuti muli ndi matendawa.
1. Kuyezetsa Magazi:
- Mu magazi a electrolyte wamba, kuchuluka kwa sodium (Hypernatremia) ndi potassium yochepa (Hypokalemia) nthawi zambiri zimakayikitsa.
- Kenako, pali mayeso awiri apadera a magazi omwe amagwiritsidwa ntchito makamaka kuti adziwe vutoli: mayeso a Plasma Renin Concentration (PRC) kapena mayeso a Plasma Renin Activity (PRA) .
- Ngati muli ndi vuto lalikulu la Hyperaldosteronism, kuchuluka kwa renin (PRC ndi PRA) nthawi zambiri kumakhala kotsika kuposa masiku onse.
- Ngati muli ndi Hyperaldosteronism yachiwiri , kuchuluka kwa renin m'magazi anu kudzakhala kwakukulu kuposa kwachibadwa.
2. Mayeso Oletsa Aldosterone:
- Mu mayeso awa, mumapatsidwa sodium wochuluka (mchere) kwa nthawi inayake, kaya pakamwa kapena kudzera mu drip ya saline (IV).
- Pambuyo pa izi, mkodzo wanu umasonkhanitsidwa mkati mwa maola 24 kuti muyese kuchuluka kwa aldosterone komwe kulipo.
- Mwa munthu wathanzi, kuchuluka kwa sodium m'thupi kumapangitsa kuti thupi lichepetse kupanga aldosterone mwachibadwa. Komabe, mwa munthu amene ali ndi Hyperaldosteronism, izi sizichitika.
3. Mayeso Ojambula:
- Ngati mayeso a magazi atsimikizira kuti muli ndi Hyperaldosteronism yoyamba, dokotala wanu angakupatseni CT scan (Computed Tomography scan) kuti adziwe chomwe chimayambitsa, monga kuwona chotupa cha adrenal gland.
Kodi mankhwala omwe alipo ndi ati?
Mapulani a chithandizo amadalira kwathunthu chomwe chimayambitsa vutoli. Komabe, cholinga chachikulu ndikuwongolera bwino kuthamanga kwa magazi.
- Pa matenda oyamba a Hyperaldosteronism omwe amayamba chifukwa cha chotupa:
Madokotala nthawi zambiri amalimbikitsa kuti chotupacho ndi gland yomwe yakhudzidwayo zichotsedwe opaleshoni . Pambuyo pa opaleshoni, odwala ambiri amaona kuti kuthamanga kwa magazi ndi potaziyamu m'magazi awo zikubwerera mwakale. Anthu ena angafunikebe mankhwala opitilira kuthamanga kwa magazi pambuyo pa opaleshoniyo.
- Pazifukwa zina ndi Hyperaldosteronism yachiwiri:
Muzochitika izi, chithandizo chimaphatikizapo mankhwala . Kuphatikiza apo, ngati ndi vuto lachiwiri, kuthana ndi matenda omwe amayambitsa (monga kulephera kwa mtima) ndikofunikira.
Mankhwala omwe amaperekedwa nthawi zambiri ndi awa:
- Spironolactone (Aldactone®)
- Eplerenone (Inspra®)
- Amiloride (Midamor®)
Dziwani kuti kugwiritsa ntchito mankhwala omwe amaletsa ntchito ya aldosterone kwa nthawi yayitali, monga Spironolactone, kungayambitse zotsatirapo zoyipa mwa amuna, monga kulephera kugwira ntchito kwa erectile kapena kukula kwa mawere (Gynecomastia). Ngati mukumva kusasangalala kapena zotsatirapo zoyipa, musazengereze kulankhula ndi dokotala wanu za izi.
Kodi chiyembekezo ndi zovuta zomwe zingachitike ndi ziti?
Kuyembekezera kwanu, kapena chiyembekezo cha nthawi yayitali, kumadalira kwambiri chifukwa chake.
Ngati Hyperaldosteronism yoyamba yapezeka msanga ndikuchiritsidwa bwino, zotsatira zake nthawi zambiri zimakhala zabwino kwambiri.Pa matenda a hyperaldosteronism achiwiri, zotsatira zake zimadalira momwe matenda omwe ali m'thupi angathandizidwire.
Mavuto akuluakulu a vutoli amabwera chifukwa cha kuthamanga kwa magazi kwa nthawi yayitali komanso kosalamulirika, komwe kungayambitse mavuto aakulu a mtima.
| Mavuto Aakulu Omwe Angakhalepo |
|---|
| Kugunda kwa mtima kosakhazikika (kugunda kwa mtima kosasinthasintha) |
| Kuchuluka kwa magazi m'mitsempha yakumanzere (kukula kwa chipinda chachikulu cha mtima) |
| Matenda amtima |
| Stroke |
Pachifukwa ichi, kuwongolera kuthamanga kwa magazi anu ndikofunikira kwambiri.
Kodi vutoli lingapewedwe?
Nthawi zambiri, vutoli silingathe kupewedwa chifukwa nthawi zambiri limachokera ku zochitika zamkati mwa thupi. Komabe, nkhani yabwino ndi yakuti chithandizo chogwira ntchito chikapezeka, chingapewe mavuto aakulu kwa nthawi yayitali.
Uthenga Wopita Nawo Kunyumba
- Ngati kuthamanga kwa magazi anu kukuvutabe ngakhale mukumwa mankhwala angapo, onetsetsani kuti mwalankhula ndi dokotala wanu.
- Hyperaldosteronism ndi vuto lomwe limayamba chifukwa cha kupanga mopitirira muyeso kwa aldosterone.
- Ikhoza kukhala yoyamba (yochokera mu gland) kapena yachiwiri (yomwe imayamba chifukwa cha matenda ena).
- Ikhoza kupezedwa molondola kudzera mu mayeso apadera a magazi ndi kujambula zithunzi.
- Itha kuchiritsidwa bwino kudzera mu opaleshoni kapena mankhwala, kutengera chifukwa chake.
- Chofunika kwambiri kudziwa ndichakuti vutoli ndi lochiritsika; ngati muli ndi nkhawa, funsani upangiri wa dokotala mwachangu.
Hyperaldosteronism, aldosterone, adrenal glands, Conn's syndrome, kuthamanga kwa magazi, kuthamanga kwa magazi, kupanikizika, potaziyamu, sodium, impso, mahomoni
