Byose ku bijyanye n'ikizamini cya ACTH Stimulation Test, gipima imisemburo y'umubiri wawe!

Hari igihe iyo ibintu bimwe na bimwe mu mubiri wacu bidakora neza, dushobora kugira ibibazo bitandukanye by'ubuzima, si byo se? Cyane cyane iyo hari ubusumbane mu mikorere y'imisemburo mu mubiri wacu, bishobora kugira ingaruka zikomeye. Muri icyo gihe, muganga wawe ashobora kukugira inama yo gukora ikizamini cyihariye. Icyo ni "ACTH Stimulation Test". Reka tubiganireho mu buryo bworoshye.

Ikizamini cya ACTH (ACTH Stimulation Test) ni iki?

Mu magambo make, iki ni ikizamini cyihariye kireba uburyo impuzandengo z'impyiko mu mubiri wacu zitabira imisemburo yitwa ACTH. Hari igihe iki kizamini kitwa kandi ikizamini cyo gushishikariza abantu gutera impyiko (CST). Iki ni cyo kizamini nyamukuru cyo kumenya niba hari ikibazo cyitwa kudakora neza kw'impuzandengo, ari nacyo kigabanya imikorere y'impuzandengo z'impyiko. Ibi bishobora kuba iby'ibanze, iby'inyongera cyangwa iby'inyongera.

Iki kizamini kigamije gutera imisemburo ya ACTH (Synthetic ACTH - Cosyntropin) mu mitsi yawe. Hanyuma, buri minota 30 cyangwa irenga, amaraso yawe arafatwa hanyuma hagapimwa urugero rw'imisemburo yitwa cortisol. Ibi ni ukugira ngo harebwe uburyo imisemburo yawe y'intanga ngabo ikora neza.

ACTH na Cortisol ni iki?

`ACTH`, bisobanura `Adrenocorticotropic Hormone`, ni imisemburo ikorwa na `Pituitary Gland` mu bwonko bwacu. Igira ingaruka zikomeye ku buryo umubiri wacu witabira stress. Iyo `ACTH` irekuwe, itera imbaraga imisemburo ya adrenal gukora `Cortisol`, izwi kandi nka `stress hormone` . Cortisol ni imisemburo y'ingenzi igira ingaruka hafi ya buri ngingo n'ingingo zose z'umubiri wacu.

Ubwoko bw'indwara yo kubura impyiko z'intanga ngore

Ibi bishobora kubaho mu buryo butatu bw'ingenzi:

1. Kunanirwa kw'intanga ngore: Ibi bibaho iyo impuzandengo z'intangangore zawe zangiritse kandi ntizishobore gukora cortisol neza. Impamvu nyamukuru y'ibi ni indwara ya Addison. Ni indwara iterwa n'ubwiyongere bw'umubiri.

2. Kunanirwa kwa kabiri kwa adrenal: Ibi bibaho iyo adrenal gland yawe idakora ACTH ihagije. Hanyuma adrenal gland ntiziba zishishikajwe bihagije kugira ngo zikore cortisol.

3. Kunanirwa k'uburemere bw'intanga ngabo: Ibi bibaho iyo hypothalamus yo mu bwonko idakora imisemburo ya `CRH (Corticotropin-Releasing Hormone)` neza. `CRH` ni yo ibwira ingirabuzimafatizo ya pituitary gukora `ACTH`.

Ni ryari ikizamini cya ACTH gikenewe?

Iki kizamini gishobora kugaragaza niba imisemburo ya adrenal na pituitary gland bikora neza mu bijyanye no gukora cortisol. Muganga wawe ashobora gutegeka iki kizamini kubera impamvu zikurikira:

• Niba ikindi kizamini cyagaragaje ko urugero rwa cortisol mu mubiri wawe ruri hasi.
• Niba ufite ibimenyetso by'uko adrenal insufficiency idashobora gukora neza (urugero: umunaniro ukabije, kugabanya ibiro, kubabara mu gifu, isesemi, isereri, uruhu rwijimye ).
• Nyuma yo guhagarika gukoresha imiti ya glucocorticoid, nka prednisone, mu gihe runaka, reba niba imyakura yawe ya pituitary na adrenal glands byongeye kumera neza.

Ni nde uri gukora iki kizamini?

Ubusanzwe, urushinge rwa ACTH ruterwa n'umuforomo. Gufata amaraso, ni ukuvuga icyitegererezo cy'amaraso, bikorwa n'umuganga w'indwara z'imitsi, ni ukuvuga umuntu wahawe amahugurwa yihariye kuri iyo ntego. Hanyuma ibyo bipimo byoherezwa muri laboratwari. Aho ngaho, umuhanga mu bya laboratwari y'ubuvuzi apima ibyo bipimo.

Iki kizamini gikunze gukorerwa mu bitaro cyangwa mu biro by'umuganga w'indwara z'imitsi, umuganga wihariye mu ndwara ziterwa n'imisemburo. Ibi bikubiyemo gutera imiti no gufata ibizamini by'amaraso. Umuganga w'indwara z'imitsi ni umuganga wihariye mu ndwara ziterwa n'imisemburo.

Ese hari icyo nkeneye gutegura mbere yo gukora ikizamini?

Yego, hari ibintu bimwe na bimwe.

• Ushobora gusabwa kugabanya ibikorwa byawe no kurya indyo irimo karubohidrati nyinshi amasaha 12-24 mbere yo kwipimisha.
• Ushobora kandi kuvuga ko uziyiriza ubusa amasaha agera kuri atandatu. Ibyo bivuze ko udashobora kurya cyangwa kunywa ikindi kintu uretse amazi.
• Niba ufata imiti imwe n'imwe ishobora kugira ingaruka ku gipimo cya cortisol, ushobora gusabwa kuyihagarika by'agateganyo.
• Kubera ko urugero rwa cortisol rutandukana umunsi wose (ruri hejuru cyane mu gitondo), iki kizamini ni byiza gukorwa mu gitondo kugira ngo ugabanye ibyago byo kubona ibisubizo bitari byo.

Ariko, muganga wawe azaguha amabwiriza yihariye y'uburyo bwo kwitegura iki kizamini. Ugomba gukurikiza ayo mabwiriza neza.

Ikizamini cya ACTH gikorwa gute?

Izi ni intambwe z'ibanze:

1. Ubwa mbere, amaraso afatwa mu mutsi uri mu kuboko kwawe. Ibi bizasuzuma urugero rw'ibanze rwa cortisol yawe. Hari n'ibindi bizamini bishobora gukorwa.

2. Hanyuma, umuforomo azatera imisemburo ya sintetike yitwa `ACTH (Cosyntropin)` mu mitsi yawe. Iyi `ACTH` ya sintetike ikora nk'iyo umubiri wacu ukora, ikangura imiterere y'uturemangingo tw'inkende (adrenal glands) kugira ngo ikore cortisol.

3. Hanyuma, nyuma y'iminota 30 n'iminota 60 (ubusanzwe), amaraso afatwa mu mitsi yawe hanyuma hagasuzumwa urugero rwa cortisol.

4. Ibi bipimo by'amaraso byoherezwa muri laboratwari.

Ni ubuhe bunararibonye ubona mu gihe cy'ikizamini?

Dore bimwe mu bintu ushobora kwitega mu gihe ugiye gukururwa amaraso:

• Uzaba wicaye ku ntebe kandi uzasangamo umutsi woroshye mu kuboko kwawe. Akenshi, uzaba uri imbere mu kuboko kwawe, inyuma gato y'inkokora yawe.
• Iyo umutsi ubonetse, aho hantu hasukurwa kandi hagashyirwa imiti yica udukoko.
• Hanyuma urushinge ruto rushyirwa mu mutsi hanyuma hagafatwa ikizamini cy'amaraso. Ibi bishobora kumvikana nk'aho umuntu ashongeshejwe gato.
• Nyuma yo gushyiramo urushinge, amaraso make azaterana mu muyoboro w'isuzuma.
• Nyuma yo gukusanya amaraso ahagije yo gupima, urushinge rurakurwaho hanyuma agace k'ipamba cyangwa gaze gashyirwa aho byakorewe kagashyirwa hasi kugira ngo amaraso ahagarike.
• Hanyuma hashyirwa plaster kuri ako gace.

Iyo ufashe Cosyntropin, ikunze guterwa mu kuboko kwawe ko hejuru, hejuru gato y'urutugu rwawe. Ushobora kumva ubabara cyangwa ushyushye gato iyo ufashe urushinge, ariko ni iby'igihe gito.

Bigenda bite nyuma y'ikizamini?

Nyuma yo gufata amaraso, yoherezwa muri laboratwari. Iyo ibisubizo bibonetse, muganga wawe azakubwira ibyayo.

Ese hari ingaruka zishobora guterwa n'iki kizamini?

Gupima amaraso ni ikintu gikunze kugaragara mu buvuzi. Ingaruka ni nke cyane. Ushobora kumva ufite ibikomere cyangwa ububabare aho amaraso yakuwe, ariko ibyo bizashira vuba. Nta cyo ugomba guhangayikishwa nacyo.

Bitwara igihe kingana iki kugira ngo umenye ibisubizo?

Bishobora gufata icyumweru kimwe kugira ngo ibisubizo by'ikizamini cya ACTH bigaruke, kuko iyo ibisubizo bya laboratwari bigarutse, muganga agomba kubyigaho neza akagera ku mwanzuro.

Ibisubizo ni ibihe?

Raporo z'ibipimo by'amaraso, harimo na raporo za cortisol zo mu gipimo cya ACTH, ubusanzwe ziba zirimo amakuru nk'aya:

• Izina ry'ikizamini cy'amaraso, cyangwa icyapimwe mu maraso.
• Umubare cyangwa igipimo cy'ibyavuye mu isuzuma ry'amaraso yawe.
• Ubwo ni bwo buryo busanzwe bwo gupima ikizamini.
• Amakuru yerekeye niba ibisubizo byawe ari ibisanzwe, bidasanzwe, biri hejuru, cyangwa biri hasi.

Ibisubizo bisanzwe bigomba kumera bite?

Mu bihe bisanzwe, urugero rwa cortisol yawe rugomba kwiyongera nyuma yo gukangura ACTH mu buryo bw'ubukorano. Mu buryo busanzwe, urugero rwa cortisol yawe rugomba kuba rurenze 12.6 mcg/dL (mikorogarama kuri desilita imwe) nyuma yo gukangura ACTH.

Wibuke ko ibi byiciro bisanzwe bishobora gutandukana bitewe na laboratwari, ikizamini, n'umuntu ku wundi. Buri gihe reba urwego rusanzwe rwatanzwe kuri raporo yawe.

Mu gihe cyo gupimwa ACTH, umuganga wawe cyangwa inzobere mu by’imiti igabanya ubukana bw’indwara z’umutima (endocrinologists) azakenera gusobanukirwa neza ibisubizo mbere yuko ubibona. Niba ufite ikibazo ku bisubizo, banza ubaze muganga wawe.

Ibisubizo bidasanzwe bivuze iki?

Muganga wawe cyangwa inzobere mu by’ubuvuzi bw’indwara z’imitsi azasesengura neza ibisubizo by’ibizamini bya ACTH. Hari ibintu byinshi bishobora kugira ingaruka ku buryo ikizamini kimeze. Impamvu ikunze gutuma igisubizo cy’ibiyobyabwenge kidahuye n’ukuri ni ugukoresha imiti ya corticosteroids vuba aha.

Ibisubizo by'ibipimo bya ACTH bidasanzwe akenshi bigaragaza ko adrenal insufficiency y'ibanze n'iya kabiri.

Kubura kw'intanga ngabo by'ibanze

Iyo ufite iyi ndwara, adrenal glands yawe ntishobora gukora cortisol cyangwa ntisubize neza ACTH. Kubwibyo, ushobora kutabona ukwiyongera gukomeye cyangwa kwiyongera k'urugero rwa cortisol yawe nyuma yo gupimwa na ACTH. Ibi biterwa nuko ACTH y'ubukorano itagira ingaruka ku adrenal glands yawe.

Kubura kwa kabiri kw'intanga ngore

Iyo ingirabuzimafatizo ya pituitary idakora neza igihe kirekire (hypopituitarism), kandi umusaruro wa ACTH ukagabanuka, ibi bituma ingirabuzimafatizo z’intanga zikora ACTH zidakora neza. Kubera iyo mpamvu, uturemangingo dusanzwe dukora ACTH ntitwibagirwe, maze ingirabuzimafatizo z’intanga zigatangira gucika intege, ni ukuvuga ko zitangira gucika intege .

Bityo rero, niba umaze igihe kinini ufite hypopituitarisme no kunanirwa kwa adrenal cortex, ushobora kubona ubwiyongere buke cyangwa nta n'ubwo ufite nyuma yo gupimwa ACTH.

Ariko, niba hypopituitarisme ari igice (bivuze ko agahu k'ubwonko kagikomeza gukora ACTH), cyangwa niba indwara iherutse, kwiyongera kwa cortisol, bivuze urugero "rusanzwe", bishobora kugaragara nyuma yo gupimwa kwa ACTH.

Ubutumwa bwa nyuma bwo kujyana mu rugo

Ikizamini cya ACTH Stimulation Test ni cyo kizamini cy'ingenzi kandi cyizewe cyo gusuzuma ikibazo cy'imisemburo idakora neza. Gutegereza ibisubizo by'ikizamini cyo gusuzuma bishobora gutera ubwoba. Ariko ibuka ko uko ibisubizo byaba bimeze kose, itsinda ry'abaganga rihari kugira ngo rigufashe. Ntutinye kubaza muganga wawe ibyerekeye ikizamini cyawe cyangwa ibisubizo. Ni ngombwa kumenya amakuru yerekeye ubuzima bwawe.

Ikizamini cya ACTH , cortisol, adrenal glands, pituitary gland, imisemburo, adrenal insufficiency, ibizamini by'ubuvuzi