Ngaba une -high blood pressure , eyaziwa ngokuba yi-"hypertension"? Kusenokwenzeka ukuba sele uthatha amayeza elinye, amabini, okanye nangaphezulu achazwe ngugqirha wakho. Nangona kunjalo, nangona uselashwa, ngaba usaziva ngathi uxinzelelo lwakho lwegazi kunzima ukululawula? Ukuba kunjalo, unobangela usenokungabi yile nto ubuyilindele. Namhlanje, sifuna ukuthetha ngemeko ethile yezonyango enokubangela ukuba kube nzima ukuyilawula, uxinzelelo lwegazi olunganyangekiyo ngamayeza: i-Hyperaldosteronism. Nangona igama lisenokuvakala linzima, masiliqhekeze libe ngamagama alula.
Yintoni iHyperaldosteronism?
Ngamafutshane, i-hyperaldosteronism yenzeka xa amadlala akho e-adrenal evelisa inani elikhulu lehomoni ebizwa ngokuba yi-"aldosterone."
Usenokuba uzibuza: zithini ezi glands ze-adrenal, kwaye yintoni i-aldosterone?
Khawucinge ngee-glands ezimbini ezincinci, ezimile okwee-caps ezincinci, ezihleli ngqo phezu kwezintso zakho. Ezi zii-adrenal glands zakho. Ziyinxalenye ebalulekileyo yenkqubo yakho ye-endocrine . Ezi glands zincinci zivelisa iihomoni ezininzi ezibalulekileyo kwimisebenzi yemihla ngemihla yomzimba wakho.
Ihomoni ethile eveliswa zezi gland yi -aldosterone . Umsebenzi wayo oyintloko kukulawula uxinzelelo lwegazi lakho ngokulinganisela amanqanaba esodium kunye ne-potassium egazini lakho. Ungacinga ngale homoni njengepolisa lendlela elilawula ukuhamba kwezithuthi kwindlela exakekileyo.
Ngoko ke, kwi-hyperaldosteronism, kuveliswa i-aldosterone eninzi kakhulu. Oku kubangela ukuba amanqanaba e-sodium emzimbeni wakho anyuke ngelixa amanqanaba e-potassium ehla. Isiphumo sokugqibela yi -hypertension (uxinzelelo lwegazi oluphezulu) kunye ne -hypokalemia (i-potassium ephantsi yegazi) .
Kukho iintlobo ezimbini eziphambili
Oogqirha bahlula le meko ibe ziintlobo ezimbini ngokusekwe kwisizathu esiyintloko.
1. I-Primary Hyperaldosteronism: Eyaziwa ngokuba yi-"Conn's syndrome," oku kwenzeka xa ingxaki ikwi-adrenal glands, nto leyo ebangela ukuba zivelise i-aldosterone ngokugqithisileyo.
2. I-Secondary Hyperaldosteronism: Kule meko, amadlala e-adrenal aphilile. Endaweni yoko, akhuthazwa ukuba avelise i-aldosterone egqithisileyo ngenxa yengxaki evela kwenye indawo emzimbeni.
Ngubani ochaphazeleka kakhulu?
Le meko ixhaphake kakhulu kubantu abaphakathi kweminyaka engama-30 ukuya kwengama-50 ubudala. Uphando lubonisa ukuba ixhaphake kancinci kubasetyhini kunakumadoda.
Izifundo zibonisa ukuba i-5% ukuya kwi-10% yabo bonke abantu abane-hypertension banokuba ne-primary hyperaldosteronism. Okubaluleke ngakumbi, iingcali zikholelwa ukuba phakathi kwabo bane -hypertension enganyangekiyo ngamayeza , ipesenti inokuba phezulu ukuya kwi-25%.
Zithini iimpawu?
Ngamanye amaxesha, ukuba imeko incinci, usenokungabi nazo naziphi na iimpawu kwaphela. Nangona kunjalo, abantu abaninzi babonisa iimpawu.
Uphawu oluqhelekileyo luxinzelelo lwegazi , ingakumbi xa luhlala luqinile nangona kusetyenziswa amayeza amaninzi oxinzelelo lwegazi.
Ezinye iimpawu zivela ngenxa yokudibana koxinzelelo lwegazi oluphezulu kunye ne-potassium ephantsi (i-hypokalemia). Masizichaze ngokucacileyo ezi mpawu.
| Unobangela | Iimpawu ezinokubakho |
|---|---|
| Iimpawu ezibangelwa luxinzelelo lwegazi oluphezulu |
|
| Iimpawu ezibangelwa yi-Potassium ephantsi |
|
Khumbula, akufuneki ukuba ube nazo zonke ezi mpawu. Abanye abantu basenokuba nenye okanye ezimbini kuphela.
Kutheni i-Hyperaldosteronism isenzeka?
Njengoko bekutshiwo ngaphambili, izizathu zahlukile ngokusekelwe kwiindidi ezimbini.
Izizathu ze-Hyperaldosteronism ephambili
Apha, ingxaki ivela kwi-adrenal gland ngokwayo.
- Eyona nto ixhaphakileyo: Ngokwesiqhelo yi -tumor engeyomhlaza (i-adrenal adenoma) kwi-adrenal gland. Lo asingomhlaza, ngoko ke akukho mfuneko yokoyika. Le tumor ivelisa i-aldosterone eninzi kakhulu.
- Ezinye izizathu ezingaqhelekanga:
- Ukwanda kwe-adrenal gland enye (i-unilateral adrenal hyperplasia).
- Ukuveliswa kwe-aldosterone yi-tumor enomhlaza (i-adrenocortical carcinoma) - oku kunqabile kakhulu.
- Ingxaki yemfuza (i-familial hyperaldosteronism).
Izizathu ze-Hyperaldosteronism yesibini
Apha, amadlala e-adrenal aphilile, kodwa akhuthazwa yenye into. Isizathu esiphambili kukuncipha kokunikezelwa kwegazi ezintso .
Ukuze uqonde oku, kuyanceda ukwazi ngenkqubo yomzimba ephawulekayo yokulawula uxinzelelo lwegazi: iRenin-Angiotensin-Aldosterone System .
Cinga ngayo njengempendulo yetsheyini:
1. Xa uxinzelelo lwakho lwegazi luhla okanye amanqanaba esodium egazini lakho esezantsi, izintso zakho ziyayibona loo nto.
2. Emva koko izintso zikhupha i-enzyme ebizwa ngokuba yi-"renin" egazini.
3. I-Renin isebenza kwiproteni eveliswa sisibindi ebizwa ngokuba yi-"angiotensinogen," iyiguqula ibe yi-"angiotensin I."
4. Okulandelayo, le Angiotensin I iguqulwa ibe yi-“Angiotensin II.”
5. Ekugqibeleni, yi-Angiotensin II eyonyusa uxinzelelo lwegazi lakho ngokunciphisa imithambo yegazi yakho nokukhuthaza amadlala akho e-adrenal ukuba avelise i-aldosterone.
Kwimeko ye-Hyperaldosteronism yesibini, imeko yezonyango engaphantsi inciphisa ukuhamba kwegazi ukuya kwizintso zakho. Ngenxa yoko, izintso zakho zicinga ngempazamo ukuba uxinzelelo lwegazi lomzimba wakho luphantsi kakhulu. Ngenxa yoko, izintso zakho zibangela ukusabela kwetsheyini ukuze zicele uncedo. Ngenxa yoko, i-hormone i-aldosterone iveliswa ngokugqithisileyo, nangona umzimba wakho ungayidingi ngokwenene.
Iimeko ezinciphisa ukuhamba kwegazi ukuya kwizintso kwaye zibangele i-hyperaldosteronism yesibini ziquka:
- Ukuncitshiswa kwemithambo yegazi ehambisa igazi kwizintso (isifo semithambo yegazi yezintso esibizwa ngokuba yi-Obstructive renal artery disease).
- Iimeko apho ulwelo luqokelelana emzimbeni, njengokusilela kwentliziyo.
- Isifo sokuqaqamba kwesibindi.
- Isifo se-Nephrotic, uhlobo lwesifo sezintso.
Ugqirha uyixilonga njani le meko?
Xa uxoxa ngeempawu zakho nogqirha wakho—ingakumbi ukuba uthi uxinzelelo lwakho lwegazi oluphezulu aluphenduli kumayeza aqhelekileyo—basenokukrokrela ukuba le meko. Ugqirha wakho uya kuyalela iimvavanyo ezininzi ukuqinisekisa ukuba unesifo.
1. Uvavanyo lwegazi:
- Kwiphaneli yegazi ye-electrolyte eqhelekileyo, amanqanaba aphezulu e-sodium (Hypernatremia) kunye namanqanaba aphantsi e-potassium (Hypokalemia) adla ngokubangela ukurhanelwa.
- Okulandelayo, kukho iimvavanyo ezimbini zegazi ezikhethekileyo ezisetyenziselwa ngokukodwa ukuchonga le meko: uvavanyo lwePlasma Renin Concentration (PRC) okanye uvavanyo lwePlasma Renin Activity (PRA) .
- Ukuba une -primary Hyperaldosteronism, amanqanaba akho e-renin (i-PRC kunye ne-PRA) aya kuba phantsi kunesiqhelo.
- Ukuba une-Hyperaldosteronism yesibini , amanqanaba akho e-renin aya kuba phezulu kunesiqhelo.
2. Uvavanyo lokuNciphisa i-Aldosterone:
- Kolu vavanyo, unikwa isixa esongezelelweyo sesodium (ityuwa) kwixesha elithile, nokuba ngomlomo okanye nge-intravenous (IV) saline drip.
- Emva koku, umchamo wakho uqokelelwa kwiiyure ezingama-24 ukuze kulinganiswe inqanaba le-aldosterone ekhoyo.
- Kumntu ophilileyo, ukonyuka kokutya i-sodium kubangela ukuba umzimba unciphise ngokwendalo ukuveliswa kwe-aldosterone. Nangona kunjalo, kumntu one-Hyperaldosteronism, oku akwenzeki.
3. Uvavanyo lweMifanekiso:
- Ukuba uvavanyo lwegazi luqinisekisa ukuba une-Hyperaldosteronism yokuqala, ugqirha wakho unokuyalela i -CT scan (i-Computed Tomography scan) ukuze abone unobangela, njengokujonga ithumba le-adrenal gland.
Zeziphi iindlela zonyango ezikhoyo?
Izicwangciso zonyango zixhomekeke ngokupheleleyo kwisizathu esiyintloko. Nangona kunjalo, injongo ephambili kukulawula uxinzelelo lwegazi lwakho ngokufanelekileyo.
- Kwi-Hyperaldosteronism eyintloko ebangelwa sisimila:
Oogqirha badla ngokucebisa ukuba kususwe ithumba kunye nedlala elichaphazelekayo ngotyando . Emva kotyando, izigulane ezininzi zibona uxinzelelo lwegazi kunye namanqanaba e-potassium ebuyela kwisiqhelo. Abanye abantu basenokufuna unyango oluqhubekayo loxinzelelo lwegazi emva kwenkqubo.
- Kwezinye izizathu kunye ne-hyperaldosteronism yesibini:
Kwezi meko, unyango lubandakanya amayeza . Ngaphezu koko, ukuba yimeko yesibini, ukujongana nesifo esingundoqo (umz., ukusilela kwentliziyo) kubalulekile.
Amayeza aqhelekileyo aquka:
- I-Spironolactone (Aldactone®)
- I-Eplerenone (Inspra®)
- I-Amiloride (iMidamor®)
Nceda uqaphele ukuba ukusetyenziswa ixesha elide kwamayeza athintela umsebenzi we-aldosterone, njengeSpironolactone, kunokubangela iziphumo ebezingalindelekanga kumadoda, ezinje ngokungasebenzi kakuhle kwe-erectile okanye ukwanda kwamabele (iGynecomastia). Ukuba ufumana naluphi na usizi okanye iziphumo ebezingalindelekanga, ungaze ungathandabuzi ukuthetha nogqirha wakho ngazo.
Iyintoni imbonakalo kunye neengxaki ezinokubakho?
Ingqikelelo yakho, okanye umbono wakho wexesha elide, ixhomekeke kakhulu kwisizathu esiyintloko.
Ukuba i-Hyperaldosteronism yokuqala ichongiwe kwangethuba kwaye inyangwa ngokuchanekileyo, iziphumo zihlala zilungile kakhuluKwi-hyperaldosteronism yesibini, isiphumo sixhomekeke ekubeni imeko yezonyango esisiseko inokulawulwa njani.
Iingxaki ezinkulu zale meko zivela kuxinzelelo lwegazi oluphezulu olungalawulekiyo oluhlala ixesha elide, olunokukhokelela kwiingxaki ezinkulu zentliziyo.
| Iingxaki Ezinkulu Ezinokubakho |
|---|
| I-Atrial fibrillation (ukubetha kwentliziyo okungaqhelekanga) |
| I-hypertrophy ye-ventricular yasekhohlo (ukwandiswa kwegumbi eliphambili lentliziyo) |
| Ukuhlaselwa yintliziyo |
| Istroke |
Ngenxa yesi sizathu, ukulawula uxinzelelo lwegazi lakho ngokungqongqo kubalulekile.
Ngaba le meko ingathintelwa?
Kwiimeko ezininzi, le meko ayinakuthintelwa kuba idla ngokubangelwa ziinkqubo zangaphakathi zomzimba. Nangona kunjalo, iindaba ezimnandi zezokuba xa sele ifunyenwe, unyango olusebenzayo lunokuthintela iingxaki ezinkulu zexesha elide.
Umyalezo oya nawo ekhaya
- Ukuba uxinzelelo lwakho lwegazi luhlala lunzima ukulilawula nangona usebenzisa amayeza amaninzi, qiniseka ukuba uthetha nogqirha wakho.
- I-Hyperaldosteronism yimeko ebangelwa kukuveliswa kakhulu kwehomoni i-aldosterone.
- Isenokuba yi-primary (evela kwi-gland) okanye ibe yi-secondary (ebangelwa yenye imeko yezonyango).
- Ingachongwa ngokuchanekileyo ngovavanyo lwegazi olukhethekileyo kunye nemifanekiso.
- Inganyangeka ngempumelelo ngotyando okanye ngamayeza, kuxhomekeke kwisizathu.
- Eyona nto ibalulekileyo ekufuneka uyazi kukuba le yimeko enokunyangeka; ukuba uneengxaki, funa ingcebiso kagqirha ngokukhawuleza.
I-Hyperaldosteronism, i-aldosterone, ii-adrenal glands, i-Conn's syndrome, uxinzelelo lwegazi oluphezulu, uxinzelelo lwegazi oluphezulu, uxinzelelo lwegazi oluphezulu, uxinzelelo lwegazi oluphezulu, i-potassium, i-sodium, izintso, ii-hormones
