Konke mayelana ne-ACTH Stimulation Test, ekala ama-hormone omzimba wakho!

Ngezinye izikhathi uma izinto ezithile emzimbeni wethu zingasebenzi kahle, singaba nezinkinga zempilo ezahlukahlukene, akunjalo? Ikakhulukazi uma kukhona ukungalingani ohlelweni lwe-hormone lomzimba wethu, kungaba nomthelela omkhulu. Esimweni esinjalo, udokotela wakho angakutusa ukuthi wenze isivivinyo esikhethekile. Leso yi-'ACTH Stimulation Test'. Ake sixoxe ngalokhu kalula.

Kuyini ukuhlolwa kwe-ACTH (ACTH Stimulation Test)?

Kalula nje, lokhu ukuhlolwa okukhethekile okubheka indlela izindlala ze-adrenal emzimbeni wethu ezisabela ngayo ku-hormone ebizwa ngokuthi i-ACTH. Ngezinye izikhathi lokhu kubizwa nangokuthi i-Cosyntropin Stimulation Test (CST). Lokhu ukuhlolwa okuyinhloko ukuthola ukuthi kukhona yini isimo esibizwa ngokuthi i-adrenal insufficiency, okuwukwehla kokusebenza kwezindlala ze-adrenal. Lokhu kungaba okuyinhloko, okwesibili noma okwesithathu.

Lokhu kuhlolwa kuhilela ukufaka i-hormone ye-ACTH yokwenziwa (i-Synthetic ACTH - i-Cosyntropin) emisipheni yakho. Bese kuthi njalo ngemva kwesigamu sehora noma ngaphezulu, igazi lakho lithathwe bese kuhlolwa izinga le-hormone ebizwa ngokuthi i-cortisol. Lokhu kwenzelwa ukubona ukuthi izindlala zakho ze-adrenal zisebenza kahle kangakanani.

Yini i-ACTH ne-Cortisol?

I-'ACTH', emele i-'Adrenocorticotropic Hormone', iyi-hormone ekhiqizwa yi-'Pituitary Gland' ebuchosheni bethu. Inomthelela omkhulu endleleni umzimba wethu osabela ngayo ekucindezelekeni. Lapho i-'ACTH' ikhishwa, ivuselela izindlala ze-adrenal ukuthi zikhiqize i-'Cortisol', eyaziwa nangokuthi i-'stress hormone' . I-Cortisol iyi-hormone ebalulekile ethinta cishe zonke izitho nezicubu emzimbeni wethu.

Izinhlobo Zokuntuleka Kwe-Adrenal

Lokhu kungenzeka ngezindlela ezintathu eziyinhloko:

1. Ukuntuleka Okuyinhloko Kwezinso: Lokhu kwenzeka lapho izindlala zakho ze-adrenal zonakele futhi zingakwazi ukukhiqiza i-cortisol kahle. Imbangela eyinhloko yalokhu yisifo sika-Addison. Kuyisifo esibangelwa ukuzivikela komzimba.

2. Ukuntuleka Kwesibili Kwezinso: Lokhu kwenzeka lapho i-pituitary gland yakho ingakhiqizi i-ACTH eyanele. Khona-ke izinso ze-adrenal azivuselelwa ngokwanele ukwenza i-cortisol.

3. Ukuntuleka Kwezinso Eziphakeme: Lokhu kwenzeka lapho i-hypothalamus ebuchosheni ingakhiqizi i-hormone ethi `CRH (Corticotropin-Releasing Hormone)` ngendlela efanele. I-`CRH` yilokho okutshela i-pituitary gland ukuthi ikhiqize `ACTH`.

Kunini lapho kudingeka khona ukuhlolwa kwe-ACTH?

Lokhu kuhlolwa kunganquma ukuthi izindlala zakho ze-adrenal kanye ne-pituitary gland zisebenza kahle yini maqondana nokukhiqiza i-cortisol. Udokotela wakho angase aku-ode lokhu kuhlolwa ngezizathu ezilandelayo:

• Uma olunye ukuhlolwa kuthola ukuthi amazinga akho e-cortisol aphansi.
• Uma unezimpawu zokungasebenzi kahle kwe-adrenal (isib. ukukhathala njalo, ukwehla kwesisindo, ubuhlungu besisu, isicanucanu, isiyezi, isikhumba esimnyama ).
• Ngemva kokuyeka ukusebenzisa imithi ye-glucocorticoid, njenge-prednisone, isikhathi esithile, hlola ukuze ubone ukuthi izindlala zakho ze-pituitary neze-adrenal zibuyele esimweni esijwayelekile.

Ubani owenza lolu vivinyo?

Ngokuvamile, umjovo we-ACTH wenziwa ngumhlengikazi. Ukukhishwa kwegazi, okungukuthi, isampula yegazi, kwenziwa ngudokotela we-phlebotomist, okungukuthi, umuntu othole ukuqeqeshwa okukhethekile ngale njongo. Bese lawa masampula athunyelwa elabhorethri. Lapho, usosayensi welabhorethri yezokwelapha uhlola lawa masampula.

Lokhu kuhlolwa kuvame ukwenziwa esibhedlela noma ehhovisi likadokotela we-endocrinologist, udokotela ogxile ezifweni ezihlobene nama-hormone. Lokhu kuhilela ukujova imithi nokuthatha amasampula egazi. I-endocrinologist udokotela ogxile ezifweni ezihlobene nama-hormone.

Ingabe kukhona engikudingayo ukulungiselela ngaphambi kokuhlolwa?

Yebo, kunezinto ezithile.

• Ungase ucelwe ukuthi unciphise umsebenzi wakho futhi udle ukudla okunama-carbohydrate amaningi emahoreni angu-12-24 ngaphambi kokuhlolwa.
• Ungasho futhi ukuthi uzozila ukudla cishe amahora ayisithupha. Lokho kusho ukuthi awukwazi ukudla noma ukuphuza lutho ngaphandle kwamanzi.
• Uma uthatha imithi ethile engathinta ukuhlolwa kwe-cortisol, ungase ucelwe ukuthi uyeke ukuyithatha okwesikhashana.
• Njengoba amazinga e-cortisol ehluka phakathi nosuku (aphezulu kakhulu ekuseni), lokhu kuhlolwa kungcono kwenziwe ekuseni ukuze kuncishiswe ingozi yemiphumela engamanga.

Kodwa-ke, udokotela wakho uzokunikeza imiyalelo eqondile yokuthi ungalungiselela kanjani lolu vivinyo. Kufanele ulandele leyo miyalelo ngqo.

Ukuhlolwa kwe-ACTH kwenziwa kanjani?

Lezi yizinyathelo eziyisisekelo:

1. Okokuqala, kuthathwa isampula yegazi emthanjeni osengalweni yakho. Lokhu kuzohlola amazinga akho okuqala e-cortisol. Kungenziwa nezinye izivivinyo.

2. Ngemuva kwalokho, umhlengikazi uzofaka i-hormone yokwenziwa ebizwa ngokuthi i-`ACTH (Cosyntropin)` emisipheni yakho. Le `ACTH` yokwenziwa isebenza njenge-`ACTH` ekhiqizwa yimizimba yethu, ivuselela izindlala ze-adrenal ukuthi zikhiqize i-cortisol.

3. Ngemuva kwemizuzu engama-30 nemizuzu engama-60 (ngokuvamile), amasampula egazi ayathathwa emthanjeni wakho futhi bese kuhlolwa amazinga e-cortisol.

4. Lawa masampula egazi athunyelwa elabhorethri.

Hlobo luni lolwazi olutholayo ngesikhathi sokuhlolwa?

Nazi ezinye izinto ongazilindela uma ukhishwa igazi lakho:

• Uzohlaliswa esihlalweni futhi kuzotholakala umthambo omncane engalweni yakho. Ngokuvamile, uzoba ngaphakathi kwengalo yakho, ngemuva nje kwendololwane yakho.
• Uma sekutholakale umthambo, indawo iyahlanzwa futhi ihlanzwe ngamagciwane.
• Bese kufakwa inaliti encane emthanjeni bese kuthathwa isampula yegazi. Lokhu kungase kuzwakale njengokugwazwa okuncane.
• Ngemva kokufaka inaliti, igazi elincane lizoqongelela epayipini lokuhlola.
• Ngemva kokuba igazi elanele seliqoqiwe ukuze kuhlolwe, inaliti iyasuswa bese kubekwa ucezu lukakotini noma i-gauze endaweni bese lucindezelwa ukuze kumiswe ukopha.
• Bese kufakwa iplasta endaweni.

Uma uthola i-Cosyntropin, ivame ukufakwa engalweni yakho engenhla, ngaphezu nje kwehlombe lakho. Ungase uzizwe ubuhlungu noma ukushisa okuncane uma uthola umjovo, kodwa kungokwesikhashana.

Kwenzekani ngemva kokuhlolwa?

Ngemva kokuthathwa kwamasampula egazi, athunyelwa elabhorethri. Uma imiphumela isifikile, udokotela wakho uzokutshela ngawo.

Ingabe zikhona izingozi ngalolu vivinyo?

Ukuhlolwa kwegazi kuyinto evamile kakhulu kwezokwelapha. Izingozi ziphansi kakhulu. Ungase uzizwe unamanxeba noma ubuhlungu lapho igazi likhishwe khona, kodwa lokho kuzophela ngokushesha. Akukho okufanele ukhathazeke ngakho.

Kuthatha isikhathi esingakanani ukwazi imiphumela?

Kungathatha isonto elilodwa ukuthi imiphumela yokuhlolwa kwe-ACTH ibuye, ngoba uma imiphumela yelabhorethri isibuyile, udokotela kudingeka ayifunde ngokucophelela futhi afinyelele esiphethweni.

Iyini imiphumela?

Imibiko yokuhlolwa kwegazi, okuhlanganisa nemibiko ye-cortisol evela ekuhlolweni kwe-ACTH, imvamisa iqukethe ulwazi olufana nalolu:

• Igama lokuhlolwa kwegazi, noma lokho okulinganiswe egazini.
• Inombolo noma isilinganiso somphumela wokuhlolwa kwegazi lakho.
• Lelo ibanga lokulinganisa elijwayelekile lokuhlolwa.
• Ulwazi mayelana nokuthi imiphumela yakho ijwayelekile, ayijwayelekile, iphezulu, noma iphansi.

Imiphumela ejwayelekile kufanele ibe njani?

Ngaphansi kwezimo ezijwayelekile, amazinga akho e-cortisol kufanele akhuphuke ngemva kokukhuthazwa kwe-ACTH okwenziwa. Ngomphumela ojwayelekile, amazinga akho e-cortisol kufanele abe ngaphezu kuka-12.6 mcg/dL (ama-microgram nge-deciliter) ngemva kokukhuthazwa kwe-ACTH.

Khumbula, la mazinga ajwayelekile angahluka kusukela elabhorethri kuya elebhu, ukuhlolwa kuya ekuhlolweni, kanye nomuntu nomuntu. Hlola njalo ububanzi obujwayelekile obunikezwe embikweni wakho.

Uma kwenzeka ukuhlolwa kwe-ACTH, udokotela wakho noma isazi se-endocrinologist kuzodingeka aqonde kahle imiphumela ngaphambi kokuba uyibone. Uma unemibuzo mayelana nemiphumela, qiniseka ukuthi ubuza udokotela wakho.

Isho ukuthini imiphumela engavamile?

Udokotela wakho noma isazi se-endocrinologist uzohlaziya ngokucophelela imiphumela yakho yokuhlolwa kwe-ACTH. Kunezici eziningi ezingathinta ukunemba kokuhlolwa. Imbangela evame kakhulu yomphumela ongalungile ukusetshenziswa kwamuva kwama-corticosteroids.

Imiphumela yokuhlolwa kwe-ACTH engajwayelekile ivame ukukhombisa ukungasebenzi kahle kwe-adrenal okuyinhloko nokwesibili.

Ukuntuleka Okuyinhloko Kwezinso

Uma unalesi simo, izindlala zakho ze-adrenal azikwazi ukukhiqiza i-cortisol noma aziphenduli kahle ku-ACTH. Ngakho-ke, ungase ungaboni ukwanda okukhulu noma ukwanda kwamazinga akho e-cortisol ngemva kokuhlolwa kwe-ACTH. Lokhu kungenxa yokuthi i-ACTH yokwenziwa ayithinti izindlala zakho ze-adrenal.

Ukuntuleka Kwesibili Kwe-Adrenal

Uma i-pituitary gland ingasebenzi kahle isikhathi eside (hypopituitarism), futhi ukukhiqizwa kwe-ACTH kuphazamiseka, lokhu kuholela ekunganele kwesibili kwe-adrenal. Ngenxa yalokho, amaseli avame ukukhiqiza i-ACTH awashukunyiswa, futhi izindlala ze-adrenal ziqala ukuwohloka, okungukuthi, ziqala ukuba buthaka .

Ngakho-ke, uma ubune-hypopituitarism kanye nokuntuleka kwe-adrenal okwesibili isikhathi eside, ungase ubone ukwanda okuncane noma ungaboni nhlobo amazinga akho e-cortisol ngemva kokuhlolwa kwe-ACTH.

Kodwa-ke, uma i-hypopituitarism iyingxenye (okusho ukuthi indlala ye-pituitary isakhiqiza i-ACTH ethile), noma uma lesi simo sisanda kwenzeka, ukwanda kwamazinga e-cortisol, okusho izinga "elijwayelekile", kungabonakala ngemva kokuhlolwa kwe-ACTH.

Umyalezo Wokugcina Wokuya Nasekhaya

Ukuhlolwa Kokukhuthaza I-ACTH kuyindlela ebaluleke kakhulu futhi ethembekile yokuhlola ukungasebenzi kahle kwe-adrenal. Ukulinda imiphumela yokuhlolwa kokuxilonga kungaba yinto ekhathazayo kancane. Kodwa khumbula, kungakhathaliseki ukuthi imiphumela ithini, ithimba lakho lezokwelapha likhona ukukusiza. Ungesabi ukubuza udokotela wakho mayelana nokuhlolwa kwakho noma imiphumela. Kubalulekile ukwaziswa ngempilo yakho.

Ukuhlolwa kwe- ACTH, i-cortisol, izindlala ze-adrenal, indlala ye-pituitary, ama-hormone, ukungasebenzi kahle kwe-adrenal, ukuhlolwa kwezokwelapha