Ingabe uvame ukuzizwa ukhathele, ukhathele, noma wehlisa isisindo? Uma ubona udokotela, angase anqume ukuhlola ama-hormone akho. Ikakhulukazi, i-hormone i-cortisol. Ngakho-ke, ukuhlolwa okuyinhloko okwenziwa ukuhlola ukuthi amazinga akho e-cortisol ajwayelekile yini yi-ACTH Stimulation Test. Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, empeleni lilula impela. Ake sixoxe ngakho konke namuhla.
Kalula nje, iyini le ACTH Stimulation Test?
Lokhu ukuhlolwa kwezokwelapha. Ukuze kube sobala, kubheka indlela izitho zakho ezimbili ezibizwa ngokuthi ama-adrenal glands ezisabela ngayo ku-hormone ebizwa ngokuthi i-ACTH (i-Adrenocorticotropic hormone) evela ebuchosheni bethu. Ingabe lokhu kuzwakala kudida kancane? Kulungile, ake sicabange ngakho ngale ndlela.
Cabanga ukuthi i-pituitary gland ebuchosheni bakho ifana nomphathi wenkampani enkulu. Ama-adrenal gland amabili amancane ngaphezu kwezinso zakho afana nabasebenzi ababili abasebenza kuleyo nkampani.
Uma umphathi (i-pituitary gland) efuna ukwenza okuthile, uthumela umlayezo obizwa ngokuthi 'ACTH' kubasebenzi (ama-adrenal glands). Uma lo myalezo umukelwa, abasebenzi (ama-adrenal glands) benza i-hormone ebizwa ngokuthi 'i-cortisol' bese beyikhipha emzimbeni. Le cortisol iyi-hormone ebaluleke kakhulu emzimbeni wethu. Isiza ezintweni eziningi njengokulawula ukucindezeleka, ukulawula amazinga kashukela egazini, kanye nokulawula umfutho wegazi.
Ngakho-ke, okwenziwa yi-ACTH Stimulation Test ukuthi sifake i-hormone ye-ACTH eyenziwe ngaphandle (ebizwa ngokuthi i-cosyntropin) emzimbeni wakho bese sibona ukuthi izindlala zakho ze-adrenal (izisebenzi) ziyasabela yini kuyo futhi zikhiqize i-cortisol ngendlela efanele.
Lokhu kuhlolwa kusetshenziselwa kakhulu ukuthola isimo esibizwa ngokuthi 'ukungasebenzi kahle kwe-adrenal' . Lokhu kusho ukuthi izindlala ze-adrenal azikhiqizi i-cortisol eyanele. Lokhu kuhlukaniswe ngezinhlobo ezintathu.
| Uhlobo lokungakwazi ukusebenza kahle kwe-adrenal | Kalula nje, kwenzekani? |
|---|---|
| Ukuntuleka Okuyinhloko Kwezinso | Inkinga lapha imayelana 'nesisebenzi'. Okusho ukuthi, ngezindlala ze-adrenal.Kukhona umonakalo othile. Kungakhathaliseki ukuthi umphathi (i-pituitary) uthumela imiyalezo emingaki (ACTH), isisebenzi (i-adrenal) asikwazi ukusebenza. I-Cortisol ayikhiqizwa. Isibonelo esihle kakhulu salokhu yisifo sika-Addison . |
| Ukuntuleka Kwesibili Kwe-Adrenal | Inkinga lapha 'ngomphathi'. Okusho ukuthi, indlala ye-pituitary ayithumeli imiyalezo eyanele (ACTH). Ngisho noma isisebenzi (i-adrenal) siphilile, asisebenzi ngoba akukho myalezo. I-Cortisol ayikhiqizwa. |
| Ukuntuleka Kwezinso Eziphakeme | Inkinga lapha imayelana 'nomphathi ongaphezu komphathi'. Okusho ukuthi, ngengxenye yobuchopho ebizwa ngokuthi 'i-hypothalamus'. Yilapho umlayezo uvela khona uye kumphathi (i-pituitary) ukuze usebenze. Uma lowo myalezo ungafiki, umphathi ngeke asebenze, ngakho-ke nesisebenzi ngeke sisebenze. |
Kukuziphi izimo lapho udokotela ekutshela khona ukuthi wenze lolu vivinyo?
Kungase kube nezizathu eziningana zokuthi kungani udokotela wakho engase ancome lokhu kuhlolwa.
- Uma ukuhlolwa kwegazi kwangaphambilini kubonise amazinga aphansi e-cortisol: Uma uke wahlolwa igazi ngesinye isizathu esibonisa amazinga aphansi e-cortisol, ungase ucelwe ukuthi wenze lokhu kuhlolwa ukuze kuqinisekiswe.
- Uma unezimpawu zokungakwazi ukusebenza kahle kwe-adrenal: Njengoba sixoxile ngaphambili, uma unezimpawu ezifana nokukhathala okuqhubekayo, ukwehla kwesisindo, ubuhlungu besisu, isicanucanu, isiyezi, kanye nomfutho wegazi ophansi, lokhu kuhlolwa kwenziwa ukuze kutholakale ukuthi lesi simo siyimbangela yini.
- Uma usuthathe ama-steroid isikhathi eside: Uma usebenzisa imithi ye-glucocorticoid efana ne-prednisone isikhathi eside, izindlala zakho ze-pituitary kanye ne-adrenal zingase ziyeke ukusebenza okwesikhashana. Ngakho-ke, ngemva kokuyeka ukuthatha imithi, lokhu kuhlolwa kwenziwa futhi ukuze kubonakale ukuthi izindlala zisebenza kahle futhi.
Kufanele uzilungiselele kanjani ngaphambi kokuhlolwa?
Lokhu kubaluleke kakhulu. Kufanele ulandele imiyalelo kadokotela wakho ngqo. Ngokuvamile, ungasho izinto ezinjengalezi:
- Ukuzila Ukudla: Ungase ucelwe ukuthi ungadli noma uphuze lutho cishe amahora ayisithupha ngaphambi kokuhlolwa. Kuvunyelwe amanzi kuphela.
- Imikhawulo Yemisebenzi: Ungase ucelwe ukuthi ugweme imisebenzi efana nokuzivocavoca okunzima amahora angu-12-24 ngaphambi kokuhlolwa.
- Ukudla: Ngezinye izikhathi ungase ucelwe ukuba udle ukudla okunama-carbohydrate amaningi.
- Ukuyeka imithi: Eminye imithi oyithathayo (ikakhulukazi ama-steroid creams, amaphilisi, noma ama-inhaler) ingathinta imiphumela yokuhlolwa. Ngakho-ke, udokotela wakho angakucela ukuthi uyeke ukuyithatha okwesikhashana. Ungalokothi uyeke ukuthatha imithi yakho ngaphandle kokubuza udokotela wakho kuqala.
Amazinga e-cortisol emzimbeni wethu awafani usuku lonke. Avame ukuba phezulu ekuseni. Ngakho-ke, lokhu kuhlolwa kuvame ukwenziwa ekuseni ukuze kugwenywe imiphumela engamanga.
Kulungile, manje ake sibone ukuthi kuzokwenzekani ngosuku lokuhlolwa.
Lokhu akwesabisi njengoba ungase ucabange. Ngokuvamile kwenziwa esibhedlela noma emtholampilo we-endocrinologist. Nakhu okwenzekayo isinyathelo ngesinyathelo.
1. Ukuthatha isampula yegazi lokuqala: Okokuqala, umhlengikazi uzothatha isampula yegazi emthanjeni osengalweni yakho. Lokhu kuzohlola izinga lakho lokuqala le-cortisol ngaphambi kokuqala kokuhlolwa.
2. Ukujova: Okulandelayo, umhlengikazi uzokunika umjovo oqukethe i-ACTH yokwenziwa (i-cosyntropin). Lokhu kuvame ukunikezwa emisipheni yengalo yakho. Kuzozwakala sengathi intuthwane encane ikuhlaba, kodwa izophela ngemizuzwana embalwa.
3. Amasampula egazi lesibili nelesithathu: Uzothathwa elinye isampula legazi ngemva kwemizuzu engama-30 ngemva komjovo. Bese kuthathwa elinye isampula legazi ngemva kwemizuzu engama-60 . Lokhu kuzokala ukuthi ingakanani i-cortisol ekhiqizwe yizindlala zakho ze-adrenal kusukela emjovweni.
4. Ukuthumela elabhorethri: Amasampula egazi athathwe athunyelwa elabhorethri.
Uma ukhishwa igazi lakho, uzwa umuzwa omncane wokuhlaba. Lokho kuyaphela ngemva kwesikhashana. Ungase uzwe inxeba elincane lapho igazi likhishwe khona, okuyinto evamile.
Imiphumela izotholakala nini futhi izothini?
Kungathatha cishe isonto ukuthi imiphumela yalolu vivinyo ibuye. Lokhu kungenxa yokuthi uma imiphumela isitholiwe, udokotela wakho uzoyihlola ngokucophelela futhi ayiqhathanise nezimpawu zakho ukuze afinyelele esiphethweni.
Uyini umphumela ojwayelekile?
Kumuntu ophilile, ngemva komjovo we-ACTH, izindlala ze-adrenal kufanele zikhuthazwe kahle futhi izinga le-cortisol egazini kufanele lenyuke kakhulu. Udokotela wakho uzokuchazela amanani embikweni wakho webhubhu kanye nobubanzi obujwayelekile.
Uyini Umphumela Ongavamile?
Khumbula, udokotela wakho ungumuntu ongcono kakhulu wokukuchazela imiphumela yokuhlolwa kwakho. Ngakho-ke ungesabi ukucabanga ngemiphumela.
- Ukuntuleka Okuyinhloko Kwezindlala Ze-adrenal (uma kunenkinga ngezindlala ze-adrenal): Kumuntu onalesi simo, noma ngabe kunikezwe umjovo we-ACTH, izinga le-cortisol alikhuphuki nhlobo noma likhuphuke ngenani elincane kakhulu. Lokhu kungenxa yokuthi inkinga isezindlaleni ze-adrenal, futhi kungakhathaliseki ukuthi kukhushulwa kangakanani ngaphandle, azikwazi ukukhiqiza i-cortisol.
- Ukuntuleka Kwesibili Kwezinso Ze-adrenal (uma kunenkinga nge-pituitary gland): Uma i-pituitary gland ingakhiphi i-ACTH isikhathi eside, izinso ze-adrenal ziyancipha kancane kancane bese ziqala ukungasebenzi (ukuphelelwa amandla). Uma umuntu onjalo enikwa umjovo we-ACTH, izinso ze-adrenal ezingasebenzi azikwazi ukusabela ngokushesha. Ngakho-ke, amazinga azo e-cortisol anda kancane kakhulu noma awakhuli nhlobo.
Ngezinye izikhathi, uma inkinga yendlala ye-pituitary isanda kwenzeka noma ithinteke kancane, amazinga e-cortisol angase akhuphuke kancane. Udokotela wakho ungumuntu ongcono kakhulu ukwenza isinqumo ngakho konke lokhu.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlolwa Kokukhuthaza I-ACTH kuwukuhlolwa okubheka indlela izindlala zakho ze-adrenal ezisabela ngayo emibhalweni evela ebuchosheni bakho.
- Lokhu kusetshenziselwa kakhulu ukuxilonga isimo esibizwa ngokuthi ukungasebenzi kahle kwe-adrenal.
- Landela imiyalelo kadokotela ngokucophelela ngaphambi kokuhlolwa (njengokuzila ukudla nokuyeka imithi).
- Lokhu kuhlolwa kuhilela ukuthatha isampula yegazi, ukujova, kanye nokuthatha amasampula egazi engeziwe.
- Ungakhathazeki ngemiphumela. Udokotela wakho uzoyichaza kahle futhi akwazise ngezinyathelo ezilandelayo kanye nokwelashwa, uma kudingeka. Ungesabi ukubuza udokotela wakho noma yimiphi imibuzo ongase ube nayo.
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