Hypercalcemia: Zizindikiro, Zizindikiro, ndi Chithandizo

Tonsefe tikudziwa kufunika kwa calcium m'thupi, makamaka m'mafupa athu. Kuyambira tili ana, amayi athu akhala akutiuza kuti "kumwa mkaka kumalimbitsa mafupa." Koma kodi munayamba mwaganizapo za zomwe zimachitika ngati calcium yabwino iyi ikachuluka kwambiri m'magazi mwathu? Ndicho chimene timachitcha hypercalcemia mu zamankhwala. Lero, tikambirana za izi mosavuta, m'njira yomwe mungamvetse.

Kodi hypercalcemia ndi chiyani kwenikweni?

Mwachidule, hypercalcemia imachitika pamene muli ndi calcium yambiri m'magazi mwanu kuposa momwe imakhalira nthawi zonse. Izi zitha kukhala kuwonjezeka kwakanthawi, pang'ono, kapena kungakhale matenda osatha, a moyo wonse.

Tsopano mwina mukudabwa kuti chimachitika n’chiyani calcium yomwe ili m’mafupa anu ikalowa m’magazi mwanu. Ndipotu, calcium yambiri m’thupi mwanu imakhala m’mafupa mwanu. Koma kuti thupi lizigwira ntchito bwino, muyeneranso kukhala ndi calcium m’magazi mwanu.

Nazi zinthu zomwe calcium m'magazi imachita m'thupi lathu:

• Kugwira ntchito bwino kwa dongosolo la mitsempha: Izi zimathandiza pa chilichonse chomwe timaganiza, kumva, ndi kulamula.
• Kuchepa kwa minofu: Calcium m'magazi imathandiza minofu kuyenda, kuyenda, ndi kuchita chilichonse.
• Magazi amaundana: Amathandiza kuletsa kutuluka magazi pakavulala.
• Kugwira ntchito bwino kwa mtima: Izi ndizofunikira kuti mtima ugwire bwino ntchito.

Thupi lathu limalamulira kuchuluka kwa calcium m'njira yodabwitsa kwambiri. Mahomoni awiri amathandiza pa izi. Limodzi ndi parathyroid hormone, ndipo lina ndi calcitonin. Vitamini D imagwiranso ntchito yofunika kwambiri pano, chifukwa vitamini D imathandiza thupi kuyamwa calcium kuchokera muzakudya zomwe timadya.

Komabe, chifukwa cha matenda ena, mankhwala, ndi zina, njira yowongolera iyi ikhoza kusokonekera ndipo kuchuluka kwa calcium m'magazi kumatha kukwera. Apa ndi pamene hypercalcemia imachitika.

Kusiyana pakati pa hypercalcemia ndi hypocalcemia

Ngakhale kuti mawu awiriwa amamveka chimodzimodzi, matanthauzo awo ndi osiyana kwambiri.

• Hyper: Mawu achingerezi akuti "Hyper" amatanthauza "kuchuluka kwambiri." Izi zikutanthauza kuti hypercalcemia ndi kuchuluka kwa calcium m'magazi.
• Hypo: Mawu oti "Hypo" amatanthauza "otsika." Izi zikutanthauza kuti hypocalcemia ndi calcium yochepa m'magazi.

Ndani amene ali ndi mwayi waukulu wopeza vutoli?

Hypercalcemia imatha kuchitika pa msinkhu uliwonse, mwa aliyense. Komabe, imapezeka kwambiri mwa akazi opitirira zaka 50 .Vutoli limapezeka kwambiri, makamaka akamaliza kusamba. Chifukwa chachikulu cha izi ndi kugwira ntchito mopitirira muyeso kwa parathyroid gland.

Akuti pakati pa 1% ndi 2% ya anthu onse ali ndi vutoli. Komabe, 90% ya izi zimachitika chifukwa cha vuto lomwe latchulidwa kale la parathyroid glands (primary hyperparathyroidism) kapena khansa.

Komabe, ngati calcium m'magazi ikwera kwambiri, ingayambitse mavuto aakulu.

• Kulephera kwa impso
• Kugunda kwa mtima kosazolowereka (Arrhythmia)
• Kusokonezeka kwa kukumbukira ndi chikumbumtima (Kusokonezeka)
• Kupita ku coma

Kodi zizindikiro za hypercalcemia ndi ziti?

Popeza vutoli nthawi zambiri limapezeka msanga, anthu ambiri saona zizindikiro zilizonse. Komabe, ngati calcium ili ndi kuchuluka pang'ono kapena ngati vutoli lakhalapo kwa nthawi yayitali, zizindikiro zotsatirazi zingachitike.

Nchifukwa chiyani calcium m'magazi imawonjezeka chonchi?

Pali matenda opitilira 25 omwe angayambitse hypercalcemia. Mankhwala ena ndi kutaya madzi m'thupi kungayambitsenso vutoli. Koma monga tanenera kale, zifukwa ziwiri zazikulu ndi hyperparathyroidism ndi khansa.

1. Vuto la parathyroid gland (Primary Hyperparathyroidism)

Pali tinthu tinayi tating'onoting'ono m'khosi mwathu, kumbuyo kwa tinthu ta chithokomiro. Tinthuti timatchedwa kuti parathyroid glands. Tinthuti timatulutsa parathyroid hormone (PTH). Tinthuti ndi timene timalamulira kuchuluka kwa calcium m'magazi.

Tangoganizirani, pamene calcium m'magazi mwathu imatsika, tiziwalo timeneti timatulutsa hormone ya PTH. Homoni imeneyo imapita ndi kutulutsa calcium kuchokera m'mafupa kupita m'magazi, imaletsa impso kutulutsa calcium, ndipo imathandiza matumbo kuyamwa calcium. Mwanjira imeneyi, calcium imabwerera m'malo abwinobwino.

Komabe, ngati gland imodzi kapena zingapo mwa zinayizi zikugwira ntchito mopitirira muyeso , ngakhale calcium m'magazi itabwerera mwakale, hormone ya PTH sidzasiya kutulutsidwa. Kenako calcium kuchokera m'mafupa idzapitirira kuwonjezeredwa m'magazi, zomwe zimapangitsa kuti calcium m'magazi ikwere.

2. Khansa

Pafupifupi 2% ya khansa imagwirizanitsidwa ndi hypercalcemia. Hypercalcemia ya khansa nthawi zambiri imachitika mwachangu ndipo imatha kukhala yoopsa. Izi zili choncho chifukwa maselo ena a khansa amapanga puloteni (PTHrP) yomwe imagwira ntchito ngati hormone ya PTH kapena kutulutsa calcium powononga mafupa.

Mitundu ya khansa yomwe ingayambitse vutoli:

• Khansa ya m'mapapo
• Khansa ya m'mawere
• Multiple myeloma (khansa ya maselo oyera a magazi)
• Khansa ya maselo a impso
• Khansa ya m'magazi (Leukemia)
• Lymphoma (khansa ya dongosolo la lymphatic)

3. Mankhwala ena

Mankhwala ndi mavitamini ena omwe timamwa angayambitsenso izi.

• Mankhwala ochepetsa kuthamanga kwa magazi otchedwa Thiazide diuretics (mankhwala ochizira kuthamanga kwa magazi), monga hydrochlorothiazide .
• Lithium ( mankhwala omwe amagwiritsidwa ntchito pochiza matenda ena amisala).
• Kumwa vitamini D wambiri, vitamini A, kapena calcium supplements .

4. Zifukwa zina

Kuwonjezera pa izi, palinso zifukwa zina zosazolowereka:

• Matenda a m'mapapo monga sarcoidosis ndi chifuwa chachikulu.
• Kulephera kwa impso.
• Hyperthyroidism (thyrotoxicosis).
• Kulephera kuyenda.
• Matenda a mafupa monga matenda a Paget a mafupa.

Kodi mungazindikire bwanji vutoli?

Izi nthawi zambiri zimapezeka poyesa magazi mosavuta. Dokotala wanu adzayesa kuchuluka kwa calcium m'magazi anu panthawi yoyezetsa magazi a basic metabolic panel (BMP) kapena comprehensive metabolic panel (CMP).

Kuopsa kwa vutoli kumagawidwa malinga ndi kuchuluka kwa calcium m'magazi.

Dokotala wanu akapeza kuti calcium m'magazi mwanu ndi yokwera, adzakufunsani za mankhwala anu, mbiri ya matenda a m'banja lanu, ndi zina zotero. Kenako, adzayitanitsa mayeso ena angapo kuti apeze chomwe chikuyambitsa.

• Kuyezetsa magazi komwe kumayesa kuchuluka kwa parathyroid hormone (PTH).
• Kuyezetsa magazi kuti muwone kuchuluka kwa vitamini D.
• Kuyesa komwe kumayesa kuchuluka kwa calcium yomwe imatuluka mu mkodzo.

Ngati pali kukayikira kuti chifukwa chake ndi vuto la parathyroid glands, scan ya ultrasound kapena CT scan ingapemphedwe kuti ione ngati pali chotupa kapena kutupa m'ma glands.

Kodi mankhwala a hypercalcemia ndi ati?

Chithandizo chimadalira chifukwa cha vutoli komanso kuopsa kwake.

Kwa milandu yofatsa

Ngati mulingo wa calcium m'thupi lanu wakwera pang'ono, dokotala wanu angakulangizeni kuti:

• Imwani madzi ambiri: Izi zimathandiza kutulutsa calcium yochulukirapo kudzera mu impso.
• Kusintha mankhwala anu: Ngati mukumwa mankhwala amtundu wa thiazide a kuthamanga kwa magazi, mungapemphedwe kuti muwasinthe.
• Siyani kumwa mankhwala owonjezera: Ngati mukumwa mapiritsi a calcium, vitamini D, kapena mapiritsi a gastritis, siyani kumwa kapena kuchepetsa mlingo monga momwe dokotala wanu wanenera .

Ngati pali vuto ndi parathyroid gland

Ngati chifukwa chake ndi parathyroid gland yomwe imagwira ntchito mopitirira muyeso, chithandizo chabwino kwambiri nthawi zambiri chimakhala kuchotsa opaleshoni ya gland kapena glands yomwe imagwira ntchito mopitirira muyeso.

Ngati vutoli layamba chifukwa cha khansa

Pa nthawiyi, mankhwala apadera amaperekedwa kuti achepetse kuchuluka kwa calcium m'thupi pochiza khansa.

• Ma Bisphosphonates: Izi zimachepetsa kutulutsidwa kwa calcium m'mafupa.
• Denosumab: Mankhwalawa amaperekedwa kwa anthu omwe sayankha ku bisphosphonates.

Pa milandu yoopsa

Ngati calcium ili yochuluka kwambiri ndipo pali zizindikiro zoopsa, wodwalayo ayenera kugonekedwa m'chipatala nthawi yomweyo kuti akalandire chithandizo. Izi zimaphatikizapo kupereka mankhwala amchere kudzera m'mitsempha (IV fluids) kuti atulutse calcium yochuluka m'thupi mwachangu.

Kodi zotsatira zake za nthawi yayitali ndi ziti?

Ngati hypercalcemia siipezeka ndi kuchiritsidwa msanga, ingayambitse mavuto a nthawi yayitali.

• Miyala ya impso .
• Kulephera kwa impso chifukwa cha kuchuluka kwa calcium m'mafupa.
• Kuthamanga kwa magazi (BP) .
• Matenda a mafupa ndi chiopsezo chowonjezeka cha kusweka kwa mafupa.
• Mafupa a mafupa.
• Kuvutika maganizo.

Kodi vutoli lingapewedwe?

Hypercalcemia singathe kupewedwa pazifukwa zonse. Komabe, mutha kuchepetsa chiopsezo chanu pang'ono popewa kumwa mankhwala owonjezera a calcium ndi ma antacid okhala ndi calcium popanda upangiri wa dokotala .

Ngati wina m'banja mwanu ali ndi mbiri ya calcium yambiri m'magazi, miyala ya impso, kapena matenda a parathyroid, lankhulani ndi dokotala wanu za izi.