Ese imisemburo yose ya pituitary yawe iri hasi? Reka tuvuge kuri panhypopituitarism!

Hari igihe ibintu mu mibiri yacu bidakora nk'uko byari byitezwe, si byo se? Imisemburo ni itsinda ry'intumwa z'ingenzi cyane zigira uruhare muri buri gikorwa cyose mu mibiri yacu. Iyo hari ikibazo kuri iyi misemburo, gishobora kugira ingaruka ku buzima bwacu bwose. Uyu munsi tugiye kuvuga ku ndwara idasanzwe buri wese agomba kumenya. Iyo ni panhypopituitarism.

Panhypopituitarism ni iki?

Mu magambo make, panhypopituitarism ni indwara idakunze kugaragara aho agahu k'ubwonko, ari ko gahu gato ko mu bwonko bwacu, kadakora neza cyangwa kakabura imisemburo yose gatanga. Igice cya "pan" bivuze "byose." Iyi ndwara ishobora kwibasira abana bato, abana n'abantu bakuru.

Noneho ushobora kuba wibaza uti "Izi misemburo ni iki? Kuki ari ingenzi cyane?" Reka turebere hamwe.

Imisemburo ni nk'intumwa mu mibiri yacu. Ni imiti idasanzwe. Inyura mu maraso yacu kandi igatanga ubutumwa ku ngingo zitandukanye, imitsi, n'izindi ngingo. Ihuza, ni ukuvuga, igenzura kandi igahuza ibikorwa bitandukanye by'umubiri wacu, ikababwira ngo "kora ibi, bikore muri iki gihe, bikore muri ubu buryo."

Ingirabuzimafatizo yacu ya pituitari ingana n'iy'ishaza. Iherereye mu nsi y'ubwonko bwacu, munsi gato ya hypothalamus. (Hypothalamus ni ikigo gikomeye mu bwonko kigenzura ibintu byinshi by'ingenzi, harimo n'imitsi yacu yigenga.) Nubwo ari nto, ingirabuzimafatizo ya pituitari igira uruhare runini mu mikorere yacu ya endocrine. Ni ukuvuga ko iyi misemburo ya pituitari ari yo igenzura ibintu byinshi mu mubiri wacu, nko gukora imisemburo, gukura no kororoka.

Ubusanzwe, imibiri yacu igenzura neza urugero rw'iyi misemburo. Ariko, iyo imwe muri iyo misemburo ibaye mike cyane, ishobora gutera ibimenyetso bitandukanye n'ibibazo by'ubuzima. Panhypopituitarism ni igihe imisemburo yose ikorwa n'agace ka pituitary iba iri hasi cyane, bigatera ibimenyetso bitandukanye.

Ni irihe tandukaniro riri hagati ya Panhypopituitarism na Hypopituitarism?

Aya mazina yombi asa gato, bityo ashobora gutera urujijo. Tekereza kuri ibi, hypopituitarisme ni indwara aho imisemburo imwe cyangwa myinshi ikorwa n'agace ka pituitary. Panhypopituitarisme ni ikibazo cyihariye kandi cyuzuye. Ni ukuvuga ko panhypopituitarisme ari ibura ry'imisemburo yose ikorwa n'agace ka pituitary. Ijambo "pan" risobanura "byose", bityo risobanura iyi ndwara.

Ni iyihe misemburo ikorwa n'agace ka pituitary?

Hari ubwoko bwinshi bw'imisemburo ikorwa kandi igasohoka (igasohorwa) n'ingirabuzimafatizo yacu ya pituitary. Buri imwe muri zo ifite akazi kayo. Reka turebere hamwe ibyo ari byo:

• Imisemburo ya Adrenocorticotropic (ACTH cyangwa corticotropin): Iyi ikangura imiterere y'uturemangingo tw'impyiko (adrenal glands) kugira ngo ikore imisemburo yitwa cortisol. Iyi cortisol yitwa kandi 'imisemburo y'stress'. Ni ingenzi cyane mu kugenzura umuvuduko w'amaraso n'urugero rw'isukari mu maraso.
• Umusemburo utera imbaraga mu gutera intanga (FSH): Uyu musemburo ufasha mu gutera intanga mu bagabo no mu gutera intanga mu bagore gukora umusemburo wa estrogen no gukura kw'intanga.
• Imisemburo yo gukura (GH): Nk'uko izina ribigaragaza, ni ingenzi mu mikurire y'abana. Ifasha kandi kubungabunga imitsi n'amagufwa mu bantu bakuru, kandi igira ingaruka ku ikwirakwizwa ry'ibinure mu mubiri. GH kandi igira uruhare mu mikorere yacu ya 'metabolism'.
• Umusemburo wa Luteinizing (LH): LH irakenewe kugira ngo itere imbere intanga mu bagore kandi itere imbere ikorwa rya testosterone mu bagabo.
• Prolactine: Iyi misemburo ituma amashereka akorwa nyuma yo kuvuka k'umwana. Ishobora kandi kugira ingaruka ku mihango y'abagore ndetse no ku burumbuke ndetse n'imikorere y'imibonano mpuzabitsina ku bantu bakuru.
• Hormone itera imbaraga mu mikorere ya tiroyide (TSH): Iyi itera imbaraga mu mikorere ya tiroyide kugira ngo ikore imisemburo ya tiroyide, iyobora imikorere y’umubiri, ingufu n’imikorere y’imitsi.

Uretse ibi, ingirabuzimafatizo ya pituitary ibika kandi ikarekura izindi misemburo ibiri iyo bikenewe. Ariko, izi zikorwa na hypothalamus:

• Umusemburo urwanya diuretike (ADH cyangwa vasopressin): Uyu musemburo ugenzura ingano y'amazi na sodiyumu (umunyu) mu mubiri wacu.
• Oxytocin: Ifasha abagore gufunga nyababyeyi yabo mu gihe cyo kubyara, kandi igafasha amashereka gutembera neza. Iyi misemburo kandi bivugwa ko igira ingaruka ku mubano uri hagati y'ababyeyi n'abana.

Urabona, akazi gakomeye aka gatsiko gato ka pituitary gakora! Bityo rero, kugabanuka kw'iyi misemburo yose bishobora kugira ingaruka zikomeye.

Ni nde urebwa cyane n'iki kibazo cya panhypopituitarism?

Mu by’ukuri, iyi ndwara yitwa panhypopituitarism ishobora kubaho ku muntu uwo ari we wese, ku myaka iyo ari yo yose. Nta myaka cyangwa igice runaka cy’imyaka gihari.

Iki kibazo gikunze kugaragara gute?

Iyi ni indwara idakunze kugaragara . Ku isi yose, iyi ndwara igaragara mu bantu bane gusa mu bihumbi ijana buri mwaka. Kubwibyo, ni ibisanzwe kutayumva byinshi kuri yo.

Ese Panhypopituitarism ishobora gushyira ubuzima mu kaga?

Yego, rimwe na rimwe iyi ndwara ishobora gushyira ubuzima mu kaga. Cyane cyane iyo imisemburo ya adrenocorticotropic hormone (ACTH) iri hasi cyane, ishobora guteza akaga.

Impamvu y'ibi ni uko kubura ACTH bishobora gutera ikibazo cyihutirwa cyitwa adrenal crisis . Ibi kandi byitwa "acute cortisol insufficiency". ACTH ni yo igenzura urugero rwa cortisol yacu. Rero iyo ACTH ivuyeho, cortisol ntikorwa. Iyi adrenal crisis ni indwara isaba ubuvuzi bwihuse ndetse ishobora no gushyira ubuzima mu kaga.

Ibimenyetso by'ikibazo cy'inkende bishobora kuba birimo:

• Umuriro
• Intege nke zikomeye
• Urujijo (kutamenyekana)
• Umuvuduko w'amaraso uri hasi (hypotension)
• Umutima utera cyane (tachycardia)
• Kuruka
• Impiswi
• Isukari nke mu maraso (hypoglycemia)

Niba wowe cyangwa umwana wawe mufite kimwe muri ibi bimenyetso, jya ku bitaro biri hafi yawe vuba cyangwa uhamagare 1990. Iki ni ikibazo cyihutirwa!

Ni ibihe bimenyetso bya Panhypopituitarism?

Ibimenyetso by'iyi ndwara bishobora gutandukana cyane bitewe n'uburyo buri misemburo ya pituitary ibura ndetse n'uburyo indwara igenda yihuta cyangwa buhoro.

Dore ibimenyetso bimwe na bimwe bishobora kugaragara ku bana no ku bantu bakuru:

• Isesemi cyangwa isereri
• Umunaniro ukabije
• Ihungabana n'/cyangwa imihangayiko
• Kwandura indwara zikunze kugaragara
• Isukari nke mu maraso (hypoglycemia)
• Kudashobora kwihanganira ubukonje
• Uruhu rwumye bidasanzwe
• Kugabanya ibiro cyangwa kwiyongera nta mpamvu
• Kutameze neza kw'ibinure mu maraso na cholesterol (dyslipidemia)
• Umutima utera cyane (tachycardia)
• Inyota nyinshi no kwihagarika kenshi
• Ukwezi kw'abagore kutumvikana neza
• Ubugumba bw'abagore
• Ubugumba bw'abagabo

Hari ibindi bimenyetso byibasira cyane cyane abana bavutse, impinja, cyangwa abana bato:

• Umuhogo w'umuhondo mu gihe kirekire ku bana bavutse
• Imboro nto mu bana b'abahungu (micropenis)
• Gukura nabi (ntibikura birebire)
• Gutinda mu bugimbi

Kubera ko ibi bimenyetso bishobora gusa n'ibindi bibazo by'ubuzima, ni ngombwa gusuzuma neza niba ufite ibimenyetso bishya cyangwa bidashira nk'ibi. Kubwibyo, gana muganga kugira ngo akugire inama.

Ni izihe mpamvu zitera panhypopituitarism?

Hari impamvu nyinshi zishobora gutera iyi ndwara. Hari igihe abaganga badashobora kubona impamvu yihariye. Ibi byitwa idiopathic panhypopituitarism.

Muri rusange, impamvu nyamukuru ibitera ni uko hypothalamus yacu na/cyangwa pituitary gland byangiritse mu buryo runaka, bigatuma kimwe cyangwa byombi bidakora neza.

Kugira ngo usobanukirwe izi mpamvu, ugomba gusobanukirwa gato uburyo hypothalamus yacu na pituitary gland bikorana.

Isano y'imyanya ya hypothalamus na pituitary

Tekereza kuri hypothalamus yacu, imyakura ya pituitary, na pituitary gland nk'umuyobozi mukuru n'umuyobozi w'ikigo kinini. Ibi byombi hamwe bikora nk'ikigo cy'ingenzi cy'ubwonko bwacu (hypothalamus-pituitary complex), bigenzura imikorere y'ingenzi cyane mu mubiri.

Hypothalamus ni igice cy'ubwonko bwacu gishinzwe imirimo myinshi y'ibanze y'umubiri. Yohereza ubutumwa ku buryo bwacu bwo mu bwonko bwigenga. Ibwira kandi ingirabuzimafatizo ya pituitary "gukora iyi misemburo, ikayirekura." Iyi misemburo ya pituitary igira ingaruka ku bindi bice by'umubiri.

Ingirabuzimafatizo ya pituitary ihuzwa na hypothalamus n'igiti kirimo imiyoboro y'amaraso n'imitsi yitwa "igishishwa cya pituitary." Ni muri urwo rushishwa aho hypothalamus ivugana n'igishishwa cya pituitary.

Hypothalamus ikora imisemburo myinshi ishishikariza ingirabuzimafatizo za pituitary:

• Imisemburo isohora Corticotropin
• Dopamine
• Imisemburo isohora Gonadotropini
• Imisemburo isohora imisemburo ikura
• Somatostatin
• Imisemburo isohora thyrotropin

Kubera ko ingirabuzimafatizo ya pituitari na hypothalamus bikora neza cyane, kwangirika kwa kimwe muri byo bishobora kugira ingaruka ku mikorere y'imisemburo y'ikindi. Iyi ni yo shingiro ry'iterambere rya panhypopituitarism.

Impamvu ziterwa n'imyanya y'ubwonko

Ibintu bishobora kwangiza igitsina cya pituitary no gutera panhypopituitarism birimo:

• Adenomas y'ubwonko (izi ni ibibyimba bitari kanseri)
• Kubagwa kw'ingirabuzimafatizo z'ubwonko (akenshi kugira ngo bikureho izi adenomas)
• Uburyo bwo kuvura indwara ya pituitary adenoma hakoreshejwe imirasire
• Indwara ya pituitary (isenyuka ritunguranye ry'uturemangingo twa pituitary bitewe no kugabanuka kw'amaraso ajya mu gahu k'ubwonko cyangwa kuva amaraso)
• Ingufu ya pituitary ntikura neza cyangwa ngo ikore neza igihe umuntu avutse.

Impamvu zifitanye isano na hypothalamus

Ibintu bishobora kwangiza hypothalamus no gutera panhypopituitarism birimo:

• Ihungabana ry'ubwonko (TBI)
• Kubagwa k'ubwonko bikorerwa kuri hypothalamus cyangwa hafi yayo
• Ibibyimba bitari kanseri bikura muri hypothalamus (urugero: craniopharyngiomas)
• Kanseri yakwirakwiriye (yahindutse) ijya muri hypothalamus iturutse ahandi mu mubiri (urugero: kanseri y'ibihaha, iy'ibere)
• Hydrocephalus (umuvuduko uterwa no kwibumbira mu mazi mu bwonko)
• Igisebe cy'imitsi
• Meningite itera indwara ya TB

Panhypopituitarism ipimwa ite?

Niba ufite ibimenyetso by'iyi ndwara, muganga wawe abanza kukubaza ibimenyetso byawe n'amateka y'ubuzima bwawe, hanyuma agukorere isuzuma ry'umubiri.

Hanyuma, hasabwa ibizamini bikenewe kugira ngo hemezwe ikibazo cya panhypopituitarisme no kugira ngo hamenyekane izindi ndwara zishobora gutera ibyo bimenyetso.

Ni ibihe bipimo byo gusuzuma indwara?

Ubusanzwe abaganga bakora ibizamini byinshi kugira ngo bamenye iyi ndwara, harimo ibizamini byo gufata amashusho n'ibizamini by'urugero rw'imisemburo.

Ibizamini byo gushushanya

Panhypopituitarism iterwa no kwangirika kwa hypothalamus cyangwa pituitary gland, kandi ibizamini nk'ibi bishobora gukorwa kugira ngo hamenyekane icyabiteye:

• Isuzuma rya MRI yo mu bwonko (Magnetic Resonance Imaging): Isuzuma rya MRI rikoresha imiraba ya radiyo n'imbaraga zikomeye za rukuruzi kugira ngo ritange amashusho arambuye y'imbere mu mubiri. Isuzuma rya MRI rifatwa nk'uburyo bwiza bwo kubona ibibyimba bya pituitary. Rishobora kandi gufasha gusuzuma ibindi bibazo bya hypothalamus cyangwa pituitary gland.
• Isuzuma rya CT (Computed Tomography) ku bwonko: Isuzuma rya CT rikoresha imirasire ya X na mudasobwa kugira ngo hakorwe amashusho arambuye y'ubwonko. Iki kizamini gishobora gukoreshwa mu gusuzuma ikibyimba cyo mu bwonko cyangwa adenoma ya pituitary. Bishobora kandi gufasha mu gusuzuma ibindi bibazo biri muri hypothalamus cyangwa pituitary gland.

Ibipimo by'imisemburo

Niba ufite ibimenyetso bya panhypopituitarisme, muganga wawe azakenera gupima urugero rwa buri misemburo irekurwa n'agace ka pituitary. Ibi bizagufasha kumenya uko buri misemburo iri hasi no kumenya izindi ndwara.

Nubwo imisemburo imwe n'imwe ya pituitari isanzwe iba mu maraso yacu ku rugero ruhoraho, indi misemburo irahindagurika cyane umunsi wose. Kubwibyo, ibizamini bimwe na bimwe bya misemburo bishobora gukorwa nk'ibizamini byoroshye by'amaraso, mu gihe ibindi bisaba ibizamini byihariye byo gukangura.

Ibipimo by'urugero rw'imisemburo birimo:

• Gupima amaraso: Gupima amaraso byoroshye bishobora gupima imisemburo ya pituitary nka hormone itera tiroyide (TSH), prolactine, follicle-stimulating hormone (FSH), na luteinizing hormone (LH). Bishobora kandi gupima indi misemburo iterwa n'imisemburo ya pituitary, nka thyroxine, estrogen, na testosterone.
• Ikizamini cyo gukangura ACTH:Ibi bipima uburyo adrenal glands yawe ikora ku musemburo wa adrenocorticotropic (ACTH). Ibi bikubiyemo kuguha inshinge za ACTH zikozwe mu buryo bwa sintetiki no gufata ibizamini by'amaraso buri gihe.
• Ikizamini cyo gukangura imisemburo ikura (GH): Kuri iki kizamini, muganga wawe azagutera inshinge z'umuti. Uyu muti akenshi utera imbaraga imisemburo ya pituitary kugira ngo ikuremo imisemburo ikura. Hanyuma, amaraso yawe azafatwa hanyuma hagapimwa urugero rwa GH.
• Ikizamini cyo kwihanganira insuline: Iki kizamini gifasha kumenya imisemburo ikura (GH) na ACTH.

Panhypopituitarism ivurwa ite?

Uburyo bwo kuvura iyi ndwara buratandukanye bitewe n'umuntu ku giti cye. Biterwa n'uburyo urugero rw'imisemburo ya pituitary ruri hasi n'impamvu nyamukuru. Bityo rero, gahunda yo kuvura ni iyo ku giti cye. Itsinda ry'abaganga ni ryo rizaguhitiramo gahunda nziza yo kuvura.

Amwe mu mahitamo akunze gukoreshwa mu kuvura ni:

• Uburyo bwo kuvura imisemburo: Intego y'ibi ni ukugarura imisemburo ya pituitary yari yaragabanutse ku rwego rwiza. Abantu bafite panhypopituitarism bazakenera uburyo bwo kuvura imisemburo ubuzima bwabo bwose keretse iyo impamvu nyamukuru ishobora kuvurwa. Imiti imwe n'imwe ikoreshwa mu gusimbuza imisemburo ifatwa nk'ibinini, indi itangwa nk'inshinge.
• Kubagwa: Niba iyo ndwara iterwa na kanseri yo mu bwonko cyangwa adenoma y'ubwonko, muganga wawe ashobora kukugira inama yo kubagwa kugira ngo iki kibyimba gikureho.
• Ubuvuzi bushingiye ku mirasire: Iyo iyi ndwara iterwa na kanseri yo mu bwonko cyangwa adenoma ya pituitary, ubuvuzi bushingiye ku mirasire bushobora kuba inama yo kuvura cyangwa kugabanya iki kibyimba.
• Corticosteroids: Ushobora gukenera gufata doze nyinshi za corticosteroids mbere cyangwa mu gihe cy'ikintu icyo ari cyo cyose gitera stress ku mubiri cyangwa mu mutwe. Ibyibasira umubiri birimo indwara, kwandura, no kubagwa. Iyi corticosteroids itangwa kugira ngo isimbuze imisemburo ya adrenal idakorwa bitewe no kubura ACTH. Iyi misemburo ni ingenzi iyo umubiri uri mu stress.

Ese Panhypopituitarism ishobora gukira burundu?

Mu bihe bimwe na bimwe, panhypopituitarism ishobora guhindurwa binyuze mu kuvura impamvu nyamukuru (urugero, kubaga gukuraho adenoma ya pituitary yari irimo gukandagira ku gatsi k'umuyoboro wa pituitary, niba iyo gatsi k'umuyoboro katangiritse). Ariko, mu bihe byinshi , kubura imisemburo biterwa na panhypopituitarism bisaba kuvurwa ubuzima bwose.

Ese iki kibazo gishobora kwirindwa?

Kenshi na kenshi, nta buryo bwo kwirinda panhypopituitarism buhari. Ariko, niba uri mu kaga ko kuyirwara, hari uburyo bwo kuyimenya hakiri kare.

Niba warahuye na kimwe muri ibi bikurikira, uri mu kaga gakomeye ko kurwara panhypopituitarism:

• Niba warabazwe ubwonko cyangwa ingirabuzimafatizo ya pituitary.
• Niba warahawe ubuvuzi bw'imirasire ku bwonko cyangwa ku gasabo k'ubwonko.
• Iyo ubwonko bwagize impanuka iturutse ku mpanuka (Imvune yo mu bwonko iteye ubwoba).
• Niba urwaye indwara ya hydrocephalus (amazi yiyongera ku bwonko).

Niba uri mu kaga, muganga wawe akunze kukugira inama yo kugenzura imikorere n'ubuzima bw'agace ka pituitary yawe na/cyangwa hypothalamus.

Ni iki giteganyijwe ku ndwara ya panhypopituitarism?

Uko iyi ndwara izamera, ni ukuvuga uko umurwayi azayikurikirana mu gihe kizaza, biterwa n'ibintu byinshi:

• Ingano ya buri hormone ya pituitary ni nke.
• Imyaka yawe igihe indwara yatangiriye.
• Ese iki kibazo kizagenda buhoro buhoro cyangwa vuba?
• Ni gute indwara ishobora kumenyekana vuba kandi ubuvuzi bugatangira kuvurwa?

Panhypopituitarism byagaragaye ko ifitanye isano no kugabanuka cyane kw'ubuzima n'igihe cyo kubaho.

Abantu bafite iyi ndwara bakunze kugira ibyago byinshi byo kurwara umubyibuho ukabije, kugabanuka k'ibiro by'umubiri bidafite umubiri munini, n'indwara z'umutima n'imitsi. Bashobora kandi kugira ibyago byinshi byo kurwara osteoporosis (kugabanuka kw'amagufwa) no kuvunika amagufwa.

Ariko, ubuvuzi bwitondewe kandi bwuzuye bwo gusimbuza imisemburo no gukurikirana neza ibintu bishobora gutera indwara z’umutima n’imitsi bishobora kongera umusaruro. Kubwibyo, ni ngombwa cyane gukurikiza inama za muganga.

Ni ryari wagombye kujya kwa muganga niba ufite panhypopituitarism?

Niba ufite ibimenyetso bya panhypopituitarisme, cyangwa ukaba warapimwe iyi ndwara, birashoboka ko uzakenera kubonana n'umuganga w'indwara z'imitsi, umuganga w'inzobere mu kuvura indwara ziterwa n'imisemburo.

Uzakenera kujya kwa muganga w’indwara z’imitsi (endocrinologist) buri gihe mu buzima bwawe bwose kugira ngo umenye neza ko uburyo bwo kuvura indwara ziterwa n’imisemburo bukora neza kandi wirinde gusimbuza imisemburo cyane.

Ni ibisanzwe kumva ufite ubwoba iyo ubonye indwara nshya. Ariko ntugatinye kubaza muganga wawe ibibazo bijyanye na panhypopituitarisme. Kubera ko akenshi bisaba kuvurwa ubuzima bwose no gukurikiranwa n'imisemburo, ni ngombwa kujya kwa muganga wawe buri gihe. Niba ugaragaje ibimenyetso bishya cyangwa biteye impungenge, menyesha muganga wawe ako kanya. Barahari kugira ngo bagufashe.

Ibintu by'ingenzi ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Noneho reka tuvuge muri make bimwe mu bintu ugomba kwibuka mu byo twavuze:

• Panhypopituitarism ni indwara idasanzwe ariko ikomeye aho imisemburo yose ikorwa n'agace ka pituitary igabanuka.
• Hari impamvu nyinshi zishobora gutera ibi, cyane cyane kwangirika kwa pituitary gland cyangwa hypothalamus.
• Ibimenyetso biratandukanye, rimwe na rimwe ndetse n'indwara zishobora gushyira ubuzima mu kaga nk'ikibazo cy'intanga ngabo . Kubwibyo, shaka ubufasha kwa muganga vuba niba ufite ibimenyetso.
• Ibintu nk'ibipimo by'amaraso na MRI / CT scan birakenewe kugira ngo hamenyekane neza indwara.
• Ubuvuzi akenshi busaba uburyo bwo kuvura indwara yo gusimbuza imisemburo ubuzima bwose.
• Mu gukorana bya hafi na muganga wawe no gukorerwa ibizamini n'ubuvuzi bukwiye, ushobora kubaho neza ufite iyi ndwara.

Ndizera ko aya makuru azagufasha. Wibuke ko utari wenyine, kandi abaganga n'abashinzwe ubuvuzi bariho kugira ngo bagufashe.

Panhypopituitarism , ingirabuzimafatizo za pituitary, kubura imisemburo, hypothalamus, kuvura imisemburo, ibibyimba byo mu bwonko, ACTH