Ingabe umfutho wegazi lakho awukalawuleki naphezu kokuthatha imithi? Imbangela ingaba yi-Hyperaldosteronism!

Ingabe unomfutho wegazi ophakeme , noma " umfutho wegazi " njengoba sonke sazi? Mhlawumbe uthatha umuthi owodwa, emibili, noma ngaphezulu onikezwe udokotela wakho. Kodwa ingabe ukuthola kunzima ukulawula umfutho wegazi lakho ngisho nangemva kokuthatha imithi eminingi kangaka? Uma kunjalo, isizathu salokhu kungenzeka kungabi yinto wonke umuntu avame ukuyicabanga. Namuhla sizokhuluma ngesimo esikhethekile sezokwelapha esingabangela umfutho wegazi ophakeme ongalawulwa kalula yimithi. Leyo yi-Hyperaldosteronism. Nakuba igama liyinkimbinkimbi kancane, masiliqonde kalula.

Kuyini i-Hyperaldosteronism?

Kalula nje, i-Hyperaldosteronism ukukhiqizwa kwe-hormone eningi kakhulu ethi "Aldosterone" yizindlala ze-adrenal emzimbeni wethu.

Manje cishe ucabanga ukuthi, ziyini lezi zindlala ze-adrenal? Iyini le hormone ye-aldosterone?

Cabanga nje, ngaphezu kwezinso ezimbili emzimbeni wethu, kunezindlala ezimbili ezincane, njengezivalo ezimbili ezincane. Yilokho esikubiza ngokuthi izindlala ze-adrenal. Lezi ziyingxenye ebaluleke kakhulu yesistimu yethu ye-endocrine . Lezi zindlala ezimbili ezincane zenza izinhlobo eziningana zama-hormone ezibalulekile emisebenzini yansuku zonke yomzimba wethu.

I-hormone ekhethekile ekhiqizwa yilezi zindlala ibizwa ngokuthi i-aldosterone . Umsebenzi oyinhloko wale hormone ukulawula umfutho wegazi lethu. Lokhu ikwenza ngokulawula amazinga e-sodium ne-potassium egazini lethu. Le hormone isebenza emizimbeni yethu njengephoyisa lomgwaqo elilawula ithrafikhi emgwaqweni.

Ngakho-ke, uma kwenzeka i-Hyperaldosteronism, okwenzekayo ukuthi le hormone ye-aldosterone ikhiqizwa ngokweqile. Bese inani le-sodium emzimbeni wethu liyakhuphuka bese inani le-potassium liyancipha. Umphumela walokhu umfutho wegazi ophakeme (i-Hypertension) kanye namazinga aphansi e-potassium egazini (i-Hypokalemia) .

Kunezinhlobo ezimbili eziyinhloko zalokhu.

Odokotela bahlukanisa lesi simo sibe izinhlobo ezimbili eziyinhloko, kuye ngokuthi sibangelwa yini.

1. I-Hyperaldosteronism Eyinhloko:Lokhu kubizwa nangokuthi "i-Conn's syndrome." Lokhu kubangelwa inkinga ezindlaleni ze-adrenal ngokwazo, okubangela ukuthi zikhiqize i-aldosterone eningi kakhulu. Imbangela ingaphakathi kwendlala ngokwayo.

2. I-Secondary Hyperaldosteronism: Lapha akukho nkinga ngezindlala ze-adrenal. Kodwa ngenxa yenkinga kwenye indawo emzimbeni, izindlala ze-adrenal ziyavuselelwa ekuphenduleni futhi zikhiqize i-aldosterone eyengeziwe.

Ubani ovame ukuthinteka kakhulu yilesi simo?

Lesi simo sivame ukuthinta abantu abaneminyaka ephakathi kuka-30 no-50. Ucwaningo luye lwabonisa nokuthi lesi simo sivame kakhulu kwabesifazane kunakwabesilisa.

Ezinye izifundo zisikisela ukuthi phakathi kuka-5% no-10% wabantu abanomfutho wegazi ophakeme bangase babe ne-primary hyperaldosteronism. Ochwepheshe bakholelwa ukuthi abantu abangafika ku-25% abanomfutho wegazi ophakeme omelana nemithi bangase babe nalesi simo.

Ziyini izimpawu zalokhu?

Ngezinye izikhathi, uma isimo sincane kakhulu, kungase kungabi nazimpawu nhlobo. Kodwa-ke, abantu abaningi baba nezimpawu.

Uphawu oluyinhloko noluvame kakhulu olubonakala kulesi simo umfutho wegazi ophakeme (i-Hypertension) , ikakhulukazi umfutho wegazi ophakeme okunzima ukuwulawula ngisho nokusebenzisa imithi eminingana.

Ezinye izimpawu zibangelwa izinto ezimbili: umfutho wegazi ophakeme kanye namazinga aphansi e-potassium egazini (i-Hypokalemia). Ake sihlukanise lezi zimpawu ngokucacile.

Kungani lesi simo se-Hyperaldosteronism senzeka?

Njengoba sixoxile ngaphambili, izizathu zalokhu ziyahlukahluka ngokuya ngezinhlobo ezimbili eziyinhloko.

Izimbangela ze-Hyperaldosteronism Eyinhloko

Inkinga lapha isesigabeni se-adrenal uqobo.

• Imbangela evame kakhulu: Ngokuvamile, lokhu kubangelwa isimila esingesona umdlavuza (i-adrenal adenoma) esikhula endlaleni ye-adrenal. Lokhu akuwona umdlavuza, ngakho-ke akukho okufanele ukhathazeke ngakho. Lesi simila sikhiqiza i-hormone aldosterone eningi kakhulu.
• Ezinye izimbangela ezingavamile:
• Ukwanda kwendlala eyodwa ye-adrenal (i-unilateral adrenal hyperplasia).
• Ukukhiqizwa kwe-aldosterone ngesimila esinomdlavuza (i-adrenocortical carcinoma) (lokhu akuvamile kakhulu).
• Isifo sofuzo esidluliselwa ezizukulwaneni ngezizukulwane (i-Familial hyperaldosteronism).

Izimbangela ze-Secondary Hyperaldosteronism

Lapha izindlala ze-adrenal ziphilile. Kodwa zivuselelwa ngesinye isizathu. Isizathu esiyinhloko ukuncipha kokunikezwa kwegazi ezinso .

Ukuze siqonde lokhu, sidinga ukwazi okuncane ngohlelo oluthakazelisayo kakhulu emzimbeni wethu olulawula umfutho wegazi. Lubizwa ngokuthi i-Renin-Angiotensin-Aldosterone System .

Cabanga ngalokhu njengokusabela kochungechunge:

1. Lapho umfutho wegazi wethu wehla noma lapho i-sodium egazini lethu yehla, izinso zethu ziyakuzwa lokho.

2. Izinso zikhipha i-enzyme ebizwa ngokuthi "i-Renin" egazini.

3. Le renin iguqula iphrotheni ebizwa ngokuthi "i-Angiotensinogen" ekhiqizwa yisibindi ibe "i-Angiotensin I".

4. Okulandelayo, le angiotensin I iba “yi-Angiotensin II”.

5. Ekugcineni, yi-angiotensin II ekhulisa umfutho wegazi ngokucindezela imithambo yegazi nokukhuthaza izindlala ze-adrenal ukuthi zikhiqize i-aldosterone.

Manje, ku-hyperaldosteronism yesibili, okwenzekayo ukuthi ngenxa yesimo esithile sezokwelapha, inani legazi eliya ezinso liyancipha. Bese izinso zicabanga ngephutha ukuthi ingcindezi emzimbeni iphansi. Ngakho-ke, izinso zifuna usizo bese kuqala ukusabela kweketanga. Ngenxa yalokho, zikhiqiza i-hormone i-aldosterone eningi, lapho kungekho sidingo salokho.

Izimo ezinciphisa ukuphakelwa kwegazi ezinso futhi zibangele i-hyperaldosteronism yesibili:

• Isifo somthambo wezinso ovimbayo.
• Izimo ezibangela uketshezi ukuthi luqongelelane emzimbeni, njengokwehluleka kwenhliziyo.
• I-cirrhosis yesibindi.
• I-Nephrotic syndrome, isifo sezinso.

Udokotela usithola kanjani lesi simo?

Uma utshela udokotela wakho ngezimpawu zakho, ikakhulukazi umfutho wegazi ophakeme ongalawulwa ngemithi, angase asole lesi simo. Bese, bangase bacele ukuhlolwa okuningana ukuqinisekisa lokhu.

1. Ukuhlolwa kwegazi:

• Uma iphaneli yegazi elijwayelekile le-electrolyte libonisa amazinga aphezulu e-sodium (i-Hypernatremia) kanye namazinga aphansi e-potassium (i-Hypokalemia) , ukusola kuyanda.
• Okulandelayo, kunezinhlobo ezimbili zokuhlolwa kwegazi ezingasetshenziswa ukuxilonga lesi simo: Ukuhlushwa kwe-Plasma Renin (PRC) noma i-Plasma Renin Activity (PRA) .
• Uma une -Primary Hyperaldosteronism, amazinga akho e-renin (i-PRC kanye ne-PRA) azoba ngaphansi kunokujwayelekile.
• Uma une-hyperaldosteronism yesibili , amazinga akho e-renin azoba phezulu kunokuvamile.

2. Ukuhlolwa Kokucindezela i-Aldosterone:

• Lokhu kuhlolwa kuhilela ukukunikeza i-sodium eyengeziwe (usawoti) ngokuhamba kwesikhathi. Kungaba yisisombululo osithatha ngomlomo noma isixazululo se-saline osifaka emthanjeni.
• Ngemuva kwalokho, umchamo wakho uqoqwa emahoreni angama-24 bese kulinganiswa inani le-aldosterone kulowo mchamo.
• Kumuntu ophilile, ukudla i-sodium eningi kunciphisa ukukhiqizwa kwe-aldosterone emzimbeni. Kodwa-ke, kumuntu one-hyperaldosteronism, lokhu akwenzeki.

3. Ukuhlolwa Kwezithombe:

• Uma ukuhlolwa kwegazi kuqinisekisa ukuthi une-primary hyperaldosteronism, udokotela wakho uzoyala ukuhlolwa okufana ne-CT scan (Computed Tomography scan) ukuthola imbangela. Lokhu kungahlola isimila esise-adrenal gland.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kuncike embangela yalesi simo. Kodwa-ke, umgomo oyinhloko ukulawula umfutho wegazi lakho.

• Nge-hyperaldosteronism eyinhloko ebangelwa yi-tumor:

Ngokuvamile, odokotela batusa ukususwa kwesimila kanye nendlala ehlobene naso ngokuhlinzwa.. Umfutho wegazi kanye namazinga e-potassium kubantu abaningi abuyela esimweni esijwayelekile ngemva kwalokhu kuhlinzwa. Kodwa-ke, abanye abantu bangase baqhubeke nokuba nomfutho wegazi ophezulu ngemva kokuhlinzwa, futhi kuzodingeka baqhubeke nokuthatha imithi.

• Ngezinye izimbangela kanye ne-hyperaldosteronism yesibili:

Kulezi zimo, ukwelashwa kwenziwa ngemithi . Futhi, uma kuyisimo sesibili, kubalulekile ukwelapha isifo esiyisisekelo (isib. isifo senhliziyo).

Eminye yemithi esetshenziswa kakhulu kule njongo yile:

• I-Spironolactone (i-Spironolactone - i-Aldactone®)
• I-Eplerenone (Eplerenone – Inspra®)
• I-Amiloride (i-Amiloride – i-Midamor®)

Kuzokwenzekani ngemva kokwelashwa? Futhi yiziphi izinkinga?

Ukubikezela kwalesi simo, okungukuthi, isimo sesikhathi esizayo, kuncike embangela.

I-hyperaldosteronism eyinhloko ivame ukubekezelelwa kahle uma itholakale kusenesikhathi futhi yelashwa ngendlela efanele . Ku-hyperaldosteronism yesibili, umphumela uncike ekutheni isimo esiyisisekelo singalawulwa yini.

Izinkinga ezinkulu ezingaba khona kulesi simo zibangelwa umfutho wegazi ophakeme ongalawuleki isikhathi eside. Lezi yizinkinga ezinkulu ezihlobene nohlelo lwenhliziyo nemithambo yegazi.

Ngakho-ke, kubaluleke kakhulu ukulawula kahle umfutho wegazi.

Ingabe lesi simo singavinjelwa?

Ezimweni eziningi, akukho esingakwenza ukuvimbela lesi simo ukuthi singenzeki. Ngoba sibangelwa izinguquko ezenzeka emzimbeni wethu. Kodwa into engcono kakhulu ukuthi uma sesitholakele, singelashwa futhi izinkinga zingavinjelwa.

I-Hyperaldosteronism, i-aldosterone, izindlala ze-adrenal, i-Conn's syndrome, umfutho wegazi ophakeme, umfutho wegazi ophakeme, ingcindezi, i-potassium, i-sodium, izinso, ama-hormone