Une zviratidzo izvi here? Ngatitaurei nezveCushing Syndrome!

Wakambonzwa nezveCushing Syndrome here? Zita iri ringave idzva kwauri. Zvichitaurwa zviri nyore, idambudziko rinoitika kana miviri yedu ichigadzira hormone inonzi cortisol yakawandisa. Vamwe vanhu vanotiwo hypercortisolism. "Syndrome" muunganidzwa wezviratidzo zvinosangana. Vamwe vanhu vanogona kunge vakamboiona ichinzi Cushing's syndrome.

Saka cortisol iyi chii?

Cortisol ihormone inonzi steroid mumiviri yedu. Tinowanzoidaidza kuti "hormone yekushushikana" nekuti patinenge tiri pasi pekushushikana, miviri yedu inoburitsa cortisol yakawanda. Munguva idzi, cortisol inotibatsira:

• Kurova kwemoyo wako kunowedzera.
• Kumanikidzwa kweropa rako kuri kuwedzera.
• Inodzora huwandu hweshuga muropa.
• Inodzora kufema.
• Inowedzera kushushikana kwemhasuru.

Kwete izvozvo chete, asi kana tashungurudzika, cortisol inobatsirawo kudzima kwenguva pfupi masisitimu asina kukosha mumuviri wedu panguva iyoyo, semuenzaniso, sisitimu yekugaya chikafu uye sisitimu yekubereka.

Cortisol ihormone inokosha kumiviri yedu. Cortisol inokosha pazvinhu izvi:

• Chengetedza BP.
• Gadzirisa huwandu hweshuga muropa.
• Deredza kuzvimba.
• Vaka ndangariro.
• Dzora kufema kwako.
• Chengetedza munyu wakaringana mumuviri.
• Shandura chikafu chatinodya kuita simba.

Mazinga eCortisol anodzorwa nematumbu maviri madiki ari pamusoro peitsvo dzedu, matumbu eadrenal, pituitary gland muuropi, uye hypothalamus, iri pamusoro petumbu yepituitary.

Chirwere cheCushing chinowanzo kukonzerwa nebundu . Izvi zvinogona kuitika nenzira mbiri huru:

• Endogenous: Izvi zvinoreva kuti chirwere chinokonzerwa ne cortisol, iyo inogadzirwa mumiviri yedu.
• Kubuda Kwekunze: Izvi zvinoreva kuti chirwere chinokonzerwa nezvikonzero zvekunze semhedzisiro yemimwe mishonga inotorwa kurapa mamwe mamiriro ehutano.

Ndiani anonyanya kubatwa neCushing Syndrome?

Chirwere cheCushing chinowanzoonekwa muvana, vechidiki, nevakuru. Chinowanzoonekwa muvanhu vane makore ari pakati pe25 ne50. Vanhu vanotora mishonga ine cortisol (semuenzaniso, mishonga yeasthma nerheumatoid arthritis) vari panjodzi huru yekuva nechirwere ichi. Vanhu vanosvika 70% vane chirwere cheCushing vakadzi uye 30% varume.

Mamiriro ezvinhu aya akajairika zvakadii?

Chirwere cheCushing chirwere chisingawanzoitiki , chinobata vanhu vari pakati pe40 ne70 pavanhu vane miriyoni imwe pagore.

Musiyano uripo pakati peCushing Syndrome neCushing Disease ndeupi?

Chirwere cheCushing rudzi rwechirwere cheCushing. Chinokonzerwa nebundu risina njodzi mugland repituitary. Bundu iri rinoburitsa hormone yakawandisa yeACTH (adrenocorticotropic hormone) . Izvi zvinoita kuti magland eadrenal abudise cortisol yakawandisa.

Pavanhu vane chirwere cheCushing's syndrome, vanhu vakuru vanopfuura 70% uye vana nevechidiki vane chirwere ichi cheCushing's.

Vanachiremba verudzii vanorapa chirwere cheCushing Syndrome?

Chiremba wako achakutumira kuna chiremba anonzi endocrinologist kuti aongorore uye arape chirwere ichi.

Chirwere cheCushing chinogona kuuraya here?

Ehe, chirwere cheCushing's Syndrome chinogona kuuraya kana chikarapwa nemazvo. Kana chikasarapwa, huwandu hwakakwira hwe cortisol (hypercortisolism) hunogona kukonzera matambudziko akasiyana-siyana ehutano. Semuenzaniso:

• Utachiona
• Kugwamba kweropa, kunyanya mumapapu nemakumbo
• Kuora mwoyo
• Kumira kurova kwemoyo
• Kuwedzera huremu
• Matambudziko ekurangarira kana kuoma kwekuisa pfungwa pachinhu chimwe chete
• Kukwira kweropa kana cholesterol yakakwira
• Mapfupa akatyoka
• Rudzi rwechipiri rwechirwere cheshuga, prediabetes, kana kusashanda zvakanaka kweglucose yekutsanya

Kana chirwere cheCushing chikasarapwa, chinogona kutokonzera rufu.

Ndezvipi zvikonzero zveCushing Syndrome?

Chirwere cheCushing chinokonzerwa nehuwandu hwakawanda hwe cortisol mumuviri. Pane zvikonzero zvakawanda zvinogona kunge zviri:

• Kushandisa Mishonga yeGlucocorticoid: Mishonga yeGlucocorticoid (semuenzaniso, prednisone) inoshandiswa kurapa asthma isingaperi, rheumatoid arthritis, lupus, sarcoidosis, nezvimwe zvirwere zvakawanda zve autoimmune zvinokonzera kuzvimba kusingaperi. Kutora mishonga iyi kwenguva yakareba kunogona kukonzera "iatrogenic" kana exogenous Cushing syndrome. Izwi rekuti "iatrogenic" rinoreva kuti chimwe chinhu chinokonzerwa nekurapwa.
• Matumbu epituitary: Cushing syndrome ( kunze kweiatrogenic Cushing syndrome) inokonzerwa nematumbu epituitary anogadzira ACTH yakawandisa, hormone inoudza adrenal glands kuti igadzire cortisol, uye inobata vanhu 8 pa10. Rudzi urwu runonzi chirwere cheCushing.
• Matumbu eAdrenal cortical: Bundu rinokura pamusoro peadrenal gland rinogona kuburitsa cortisol yakawandisa. Aya anowanzova matumbu asina njodzi. Zvisinei, dzimwe nguva bundu iri rinogona kunge riri adrenal cortical carcinoma, rudzi rusingawanzoitiki rwekenza yeadrenal.
• Matumbu emapapu, epancreas, ethyroid uye ethymus: Kana ACTH ikagadzirwa nematumbu ari kunze kwepituitary gland, inonzi ectopic ACTH syndrome. Matumbu aya anowanzova akaipa. Anonyanya kuwanikwa ikenza yemapapu yemasero madiki.

Chirwere cheCushing chinogara nhaka here?

Kazhinji, kwete . Zviitiko zvakawanda zveCushing's syndrome hazvigamuchirwi nhaka.

Ndezvipi zviratidzo zveCushing Syndrome?

Kuwedzera kune zviratidzo zvakanangana neCushing's syndrome, kunewo zviratidzo zvinogona kufanana nezvimwe zvirwere zvakawanda. Havasi vese vane zviratidzo zvakafanana. Izvi ndizvo zviratidzo zvinogona kuitika:

• Kuwedzera uremu nekukurumidza pachiso (vamwe vanoti izvi "chiso chemwedzi"), nzvimbo yedumbu, kumashure kwemutsipa (vamwe vanoti izvi "hump yenyati"), uye chipfuva.
• Chiso chitsvuku, chakatenderera.
• Maronda anotora nguva kuti apore.
• Kukwira kweropa (BP).
• Kukura kwebvudzi zvakanyanya pachiso, pamutsipa, pachipfuva, mudumbu, pamazamu, uye pazvidya, kana kubvaruka kwebvudzi (mhanza).
• Chirwere cheshuga.

Zvimwe zviratidzo zvinogona kusanganisira:

• Kuonekwa kwemavara ekutambanudza epepuru munzvimbo yedumbu.
• Kukuvara kuri nyore kwemaoko netsoka.
• Kushaya simba uye kuneta.
• Kuona zvisipo uye dzungu.
• Kushaya simba kwetsandanyama uye kupera simba kwemakumbo.
• Kuchinja kwesimba remuviri uye kusashanda zvakanaka kwenhengo dzekubereka muvarume.
• Kusakura zvakanaka kwevana.

Chirwere cheCushing chinotora nguva yakareba sei?

Kuti chirwere cheCushing's syndrome chinotora nguva yakareba sei zvichienderana nekuti unopindura sei kana warapwa. Vanhu vazhinji vane cortisol yakawanda (hypercortisolism) vanopora mushure memavhiki mashoma ekurapwa.

Chirwere cheCushing chinokonzera matambudziko ekufema here?

Aihwa.Kushaya mweya zvakanaka hachisi chiratidzo chinozivikanwa chechirwere cheCushing.

Ko Cushing Syndrome inokonzera osteoporosis here?

Ehe. Chirwere cheCushing chinogona kukonzera mapfupa asina simba. Izvi zvinogona kukonzera kutyoka, kunyanya kana wagara uine chirwere ichi kwenguva yakareba. Mapfupa asina simba anogonawo kukonzera kurwadziwa.

Ko Cushing Syndrome inokonzera hypokalemia here?

Hypokalemia chirwere chinokonzerwa ne potassium shoma muropa. Chirwere ichi chinogona kuitika kana uine chirwere cheCushing's.

Chirwere cheCushing chinoonekwa sei?

Kana chiremba wako achifungidzira kuti cortisol yakawanda (hypercortisolism), pane mamwe matipi avanozotevera. Vachakubvunza mibvunzo, vonyora nhoroondo yako yezvekurapa, voita bvunzo yemuviri, vozoraira mimwe miedzo yemurabhoritari. Vanogonawo kukutarisa kwenguva yakati.

Chirwere cheCushing dzimwe nguva chingave chakaoma kuzviongorora. Kana ukaudza chiremba wako kuti waneta uye wawedzera uremu, vangasafunga nezvechirwere cheCushing nekukasika. Izvi zvinodaro nekuti zviratidzo izvi zvinowanikwa muzvirwere zvakasiyana-siyana.

Uyewo, chirwere cheCushing dzimwe nguva chinogona kuvhiringidzwa nechirwere chepolycystic ovary syndrome kana chirwere chemetabolic . Chiremba wako anofanira kubvisa zvimwe zvirwere kuti aongorore chirwere chacho.

Ndezvipi zviedzo zvinoitwa kuti zviongororwe chirwere cheCushing?

Chiremba wako anogona kuita mimwe yemiedzo iyi:

• Kuongororwa kwecortisol yemuweti kwemaawa makumi maviri nemana: Kuongororwa uku kunoyera huwandu hwecortisol muweti yako muma micrograms (mcg). Chiremba wako achakukumbira kuti utore weti yako kwemaawa makumi maviri nemana.
• Kuongororwa kwecortisol yemate pakati pehusiku: Kazhinji, huwandu hwecortisol hunenge hwakaderera zvikuru husiku. Kuongororwa uku kunoongorora huwandu hwecortisol pakati pa11 na12 mangwanani. Kana uine chirwere cheCushing's, huwandu hwecortisol yako hunenge hwakakwira zvisingawanzoitiki panguva iyoyo.
• Kuongororwa kwekudzvinyirirwa kwe dexamethasone ine dose shoma:Dexamethasone mushonga wakafanana ne cortisol. Pamuedzo uyu, unotora imwe milligram (mg) yemushonga uyu nemuromo husiku, uye huwandu hwe cortisol yako hunoyerwa pakati pa8 na9 mangwanani. Kuongororwa kweropa uku kunoongorora kana adrenal glands yako yapindura ku dexamethasone nekuderedza huwandu hwe cortisol yainoburitsa. Kana uine Cushing's syndrome, huwandu hwe cortisol yako huchava hwakakwira.
• Kuongororwa kweropa: Kuongororwa kweropa kunoyera huwandu hweACTH muropa rako. Kana huwandu hweACTH hwakaderera, ungave uine bundu muadrenal cortex. Kana huwandu hwacho hwakajairwa kana kuti hwakakwira, ungave uine bundu repituitary kana bundu re ectopic.
• Bvunzo rekudzvanya dexamethasone rine mwero wakakwira: Izvi zvakafanana nebvunzo rekudzvanya dexamethasone rine mwero wakaderera, asi mwero wacho i8 milligrams pachinzvimbo che1. Bvunzo iyi inowanzoitwa mushure mekunge bvunzo yekudzvanya dexamethasone ine mwero wakakwira mangwanani uye bvunzo dzeropa dzichiratidza mwero wakakwira weACTH muropa. Bvunzo iyi inogona kubatsira kuwana chikonzero cheCushing's syndrome. Inogona kubatsira kusiyanisa pakati pepituitary adenoma (inozivikanwawo sechirwere cheCushing) nebundu riri kune imwe nzvimbo mumuviri wako (senge mumapapu).

Kana chiremba wako angosimbisa kuti une chirwere cheCushing's syndrome, danho rinotevera nderekuona kuti chii chiri kukonzera chirwere ichi. Kazhinji, chinogona kunge chiri mushonga kana bundu. Kana uri kutora glucocorticoids, ndicho chikonzero chacho, saka chiremba wako anogona kuderedza dose yako. Kana usiri kutora glucocorticoids, zvinogona kuratidza bundu muadrenal glands ako, pituitary gland, kana kumwewo. Chiremba wako anogona kukurudzira zvidzidzo zvemifananidzo zvakaita seizvi kuti zvibatsire kuwana bundu:

• Kuongororwa kweCAT (CT scan) kana MRI mudumbu: Chiremba wako anogona kuita CT scan kana MRI kuti aone kana une bundu muadrenal glands ako. Kuongororwa uku kunogona kuitwa ne intravenous contrast (IV contrast) kana pasina. Kuongororwa uku kunonyanya kunzwisisika pakuona bundu readrenal.
• Kufungidzira kwemagnetic resonance (MRI) yepituitary:MRI inotora mifananidzo yegland rako repituitary kuti ione kana paine bundu. Mune zvimwe zviitiko, MRI haisi kuongororwa kwakakwana. Vanhu vanosvika 50% vane Cushing's syndrome vane MRI "yakajairika", nepo 10% vangave nemabundu asina chekuita nechirwere ichi.
• Kuongororwa kweBilateral inferior petrosal sinus sampling (BIPPS): Kuongororwa uku kunoona kwakabva ACTH secretion. ACTH nemamwe mahormone epituitary anoburitswa kubva mupituitary gland achipinda muropa. Nyanzvi ye radiation ine ruzivo inoita bvunzo iyi kuburikidza nemitsipa miviri inonzi inferior petrosal sinuses. Mwero wekunyatsojeka kwebvunzo iyi uri pakati pe95% ne98%.
• Chifuva cheCT scan: Kana chiremba wako achifungidzira kuti une bundu remudumbu, anogona kuraira kuti chipfuva chiongororwe kuti vaone kana paine kenza yemapapu.

Chirwere cheCushing chinorapwa sei?

Rudzi rwekurapwa runoenderana nechikonzero chikuru chekuwedzera kwe cortisol mumuviri. Kana uri kutora glucocorticoids, chiremba wako angangoderedza mushonga wako kana kunyora mushonga usiri weglucocorticoid.

Kana chirwere cheCushing chichikonzerwa nebundu, chiremba wako anogona kukukurudzira kuti uvhiyiwe kana kuti upiwe mushonga wemwaranzi.

Imwe nzira ndeyekuti chiremba wako akunyorere mushonga unoderedza kugadzirwa kwecortisol, wakaita seketoconazole. Ungangoda kushanda navanachiremba vakasiyana-siyana kuti uvabatsire kurapa bundu nezviratidzo zveCushing's syndrome.

• Kurapa nemakemikari: Kana bundu riri rekenza uye rapararira kune dzimwe nhengo dzemuviri, chemotherapy inogona kudiwa. Iva nechokwadi chekutaura nachiremba wako nezve chero migumisiro yakaipa.
• Mishonga: Kuwedzera mishonga inoderedza cortisol kana kubvisa mishonga inogona kukonzera Cushing's Syndrome.
• Kushandiswa kwemwaranzi: Bundu repituitary rinogona kusabviswa nekuvhiyiwa. Muzviitiko zvakadaro, ungangofanira kurapwa nemwaranzi kwemavhiki matanhatu. Zvinogona kutora makore kuti huwandu hwecortisol hudzokere pahwakajairika. Taura nachiremba wako nezve chero migumisiro yakaipa.
• Kuvhiyiwa:Kuvhiyiwa kubvisa bundu repituitary, adrenal bundu, uye ectopic bundu kunobudirira, asi uchafanira kugadzirisa huwandu hutsva hwe cortisol hwakaderera. Munguva iyi, ungangoda kutora mushonga we cortisol uri muchimiro chemapiritsi e hydrocortisone. Uchakwanisa kurega kutora mushonga uyu mushure memwedzi 6 kusvika ku18. Kazhinji, mushure mekuvhiyiwa kwe laparoscopic, unokwanisa kubuda muchipatara mukati mezuva rimwe kana maviri.

Kana chirwere cheCushing chikarapwa nemazvo, zvinogona kutora mwedzi miviri kusvika gumi nemisere kuti chidzoke. Ramba uri pedyo nachiremba wako munguva iyi uye mushure mezvo.

Chii chandingatarisira kana ndine Cushing Syndrome?

Chiremba wako anogona uye anofanira kurapa chirwere cheCushing's syndrome. Kana chikasarapwa, chinogona kuuraya. Enda kuna chiremba nekukurumidza kuti mukurukure zviratidzo zvako nachiremba wako.

Chirwere cheCushing chingatowedzera kuipa here?

Chirwere cheCushing chinogona kutowedzera kuipa kana chikasarapwa zvakanaka. Gara uchitaurirana nachiremba wako uye umuudze nezvezviratidzo zvitsva, zviratidzo zviri kuramba zvichiwedzera, kana chero mamwe matambudziko.

Ndingaderedza kana kudzivirira sei njodzi yeCushing Syndrome?

Muviri wako unoda cortisol nguva dzese. Unoida kuti urambe uchishanda. Inodzora kufema kwako, inoshandura chikafu chaunodya kuita simba, inodzora huwandu hweshuga muropa rako, inokubatsira kugadzirisa kushushikana, uye inoita zvimwe zvakawanda. Cortisol haisi muvengi wemuviri wako, asi yakawandisa haina kunaka. Zvisinei, haugone kurarama usina cortisol.

Kana uri kutora glucocorticoids kana steroids, bvunza chiremba wako kuti anyatsoongorora huwandu hwe cortisol yako. Zvinosuwisa kuti hapana nzira yekudzivirira bundu kuti risakonzere chirwere cheCushing's Syndrome (hypercortisolism).

Zvakaita sei kurarama neCushing Syndrome?

Kurarama neCushing's syndrome kunogona kuoma, asi hazvifanirwe kunge kuri chirwere chinoisa hupenyu panjodzi. Kune vanachiremba vakadzidziswa kukubatsira, uye kune mishonga. Mishonga iyi inowanzo rapa Cushing's syndrome uye kugadzirisa zviratidzo zve cortisol yakakwira (hypercortisolism).

Chirwere cheCushing chinogona kukonzera kuti uve nematambudziko emanzwiro uye emagariro evanhu. Vamwe vanhu vanogona kunyara nekudonha kwebvudzi, kukura kwebvudzi zvakanyanya, uye/kana kuwedzera uremu pachiso nekumashure kwemutsipa. "Chiso chemwedzi" uye "hump yenyati" zvinogona kukuita kuti ufunge kaviri nezvekupinda muzviitiko zvekushamwaridzana. Nekufamba kwenguva, kurapwa kunogona kubatsira kugadzirisa zviratidzo izvi. Chirwere cheCushing chinogonawo kukonzera kuora mwoyo nezvimwe zvirwere zvepfungwa. Kana zvichidikanwa, ona chiremba wepfungwa kuti akupe mazano uye chiremba wepfungwa kuti akubatsire kugadzirisa migumisiro yemanzwiro emazinga ecortisol akakwira (hypercortisolism).

Ndinofanira kuona chiremba rini?

Ona chiremba kana uine chimwe chezviratidzo izvi zveCushing's syndrome:

Zviratidzo zvinonyanya kubata vakadzi:

• Kukura kwebvudzi idzva kana kuti rakawandisa pachiso.
• Kuchinja kwekuda zvepabonde.
• Kuchinja kwekufamba kwemwedzi.

Zviratidzo zvinobata munhu wese:

• Kuwedzera uremu nekukurumidza pachiso (vamwe vanoti izvi "chiso chemwedzi"), nzvimbo yedumbu, kumashure kwemutsipa (vamwe vanoti izvi "hump yenyati"), uye chipfuva.
• Chiso chitsvuku, chakatenderera.
• Kukwira kweropa (BP).
• Kukura kwebvudzi zvakanyanya pachiso, pamutsipa, pachipfuva, mudumbu, uye pazvidya.
• Chirwere cheshuga.
• Mapundu matsva kana akawandisa.
• Kuonekwa kwemavara ekutambanudza epepuru munzvimbo yedumbu.
• Kukuvara kuri nyore kwemaoko netsoka.
• Kushaya simba uye kuneta.
• Kuona zvisipo uye dzungu.
• Maronda anotora nguva kuti apore.
• Kushaya simba kwetsandanyama.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

• Mishonga ipi yandingatora kuti ndibatsire neCushing's syndrome yangu?
• Pane maekisesaizi andingaita here kuti ndibatsire tsandanyama dzangu dzisina simba?
• Pane mishonga inogona kushandiswa kubatsira ne stretch marks here?
• Ndinofanira kuona nyanzvi yeCushing Syndrome here?
• Ndinofanira kurega kushandisa mimwe mishonga yandiri kutora parizvino here?
• Ndeipi nzira yakanakisisa yekurapa?
• Pane mamwe matanho ekudzivirira andinofanira kutora here?

Chirwere cheCushing chinogona kuva chirwere chakaoma kubata nacho. Chinogona kukonzera kushaya simba, BP, uye kuneta. Kurapa kwakadai sekuvhiyiwa, mishonga, kurapwa nemwaranzi, uye chemotherapy kunogona kuoma. Asi zvakakosha, nekuti nekurapwa kwakakodzera, chirwere cheCushing chinogona kurapwa.

Pfupiso (Mharidzo Yekuenda Nayo Kumba)

Chirwere cheCushing chirwere chinokonzerwa nekuwedzera kwehomoni inonzi cortisol mumuviri wedu. Izvi hazviwanzoitiki, asiKana ikaonekwa uye ikarapwa nemazvo, inogona kurapwa . Zvakakosha kutsvaga rubatsiro rwechiremba kana uine zviratidzo zvakaita sekuzvimba kwechiso, kuwedzera huremu, kukura kwebvudzi zvakanyanya, kana BP. Nzira dzekurapa dzinosiyana zvichienderana nechikonzero. Saka taura nachiremba wako nezvese uye tevera mazano avo. Yeuka, hausi wega, uye rubatsiro ruripo.

Chirwere cheCushing, cortisol, mahormone, adrenal glands , pituitary gland, ACTH, zviratidzo, kurapwa, endocrinologist