Ingabe unomfutho wegazi ophakeme , owaziwa ngokuthi "umfutho wegazi ophakeme"? Cishe usuvele uthatha umuthi owodwa, emibili, noma ngisho nangaphezulu owunikezwe udokotela wakho. Kodwa-ke, naphezu kokwelashwa, usazizwa sengathi umfutho wegazi wakho kunzima ukuwulawula? Uma kunjalo, imbangela ingase ingabi yilokho okulindele. Namuhla, sifuna ukukhuluma ngesimo esithile sezokwelapha esingabangela umfutho wegazi ophakeme okunzima ukuwulawula, ongamelana nemithi: I-Hyperaldosteronism. Nakuba igama lingase lizwakale liyinkimbinkimbi, ake silihlukanise ngamagama alula.
Kuyini i-Hyperaldosteronism?
Kalula nje, i-hyperaldosteronism yenzeka lapho izindlala zakho ze-adrenal zikhiqiza inani elikhulu kakhulu le-hormone ebizwa ngokuthi "i-aldosterone."
Ungase uzibuze: ziyini lezi zindlala ze-adrenal, futhi iyini i-aldosterone?
Cabanga ngezindlala ezimbili ezincane, ezimile njengezigqoko ezincane, ezihleli phezu kwezinso zakho. Lezi yizindlala zakho ze-adrenal. Ziyingxenye ebalulekile yesistimu yakho ye-endocrine . Lezi zindlala ezincane zikhiqiza amahomoni amaningana abalulekile emisebenzini yansuku zonke yomzimba wakho.
I-hormone eyodwa ethize ekhiqizwa yizindlala yi- aldosterone . Umsebenzi wayo oyinhloko ukulawula umfutho wegazi lakho ngokulinganisela amazinga e-sodium ne-potassium egazini lakho. Ungacabanga ngale hormone njengephoyisa lomgwaqo eliqondisa ukuhamba kwezimoto emgwaqweni omatasa.
Ngakho-ke, ku-hyperaldosteronism, kukhiqizwa i-aldosterone eningi kakhulu. Lokhu kubangela amazinga e-sodium emzimbeni wakho ukuthi akhuphuke kuyilapho amazinga e-potassium ehla. Umphumela wokugcina uba umfutho wegazi ophakeme (umfutho wegazi ophezulu) kanye ne -hypokalemia (i-potassium ephansi egazini) .
Kunezinhlobo ezimbili eziyinhloko
Odokotela bahlukanisa lesi simo ngezinhlobo ezimbili ngokusekelwe embangela eyinhloko.
1. I-Primary Hyperaldosteronism: Eyaziwa nangokuthi "i-Conn's syndrome," lokhu kwenzeka lapho inkinga ingaphakathi ngqo kwezindlala ze-adrenal, okubangela ukuthi zikhiqize i-aldosterone ngokweqile.
2. I-Secondary Hyperaldosteronism: Kulesi simo, izindlala ze-adrenal ziphilile. Esikhundleni salokho, zikhuthazwa ukuba zikhiqize i-aldosterone eningi ngenxa yenkinga evela kwenye indawo emzimbeni.
Ubani othinteka kakhulu?
Lesi simo sivame ukubonakala kubantu abaneminyaka ephakathi kuka-30 no-50. Ucwaningo luphinde luveze ukuthi sivame kakhulu kwabesifazane kunakwabesilisa.
Izifundo zibonisa ukuthi u-5% kuya ku-10% wabo bonke abantu abanomfutho wegazi ophakeme bangase babe ne-primary hyperaldosteronism. Okubaluleke kakhulu, ochwepheshe bakholelwa ukuthi phakathi kwalabo abanomfutho wegazi ophakeme omelana nemithi , iphesenti lingaba phezulu lifike ku-25%.
Ziyini izimpawu?
Ngezinye izikhathi, uma isimo sincane, ungase ungabi nazimpawu nhlobo. Kodwa-ke, abantu abaningi babonisa izimpawu.
Uphawu oluvame kakhulu umfutho wegazi ophakeme , ikakhulukazi uma luhlala luqinile naphezu kokusetshenziswa kwemithi eminingi yomfutho wegazi.
Ezinye izimpawu zivela ngenxa yokuhlanganiswa komfutho wegazi ophezulu kanye ne-potassium ephansi (i-hypokalemia). Ake sizichaze ngokucacile.
| Imbangela | Izimpawu Ezingaba Khona |
|---|---|
| Izimpawu ezibangelwa umfutho wegazi ophezulu |
|
| Izimpawu ezibangelwa yi-Potassium Ephansi |
|
Khumbula, akudingeki ukuthi ubhekane nazo zonke lezi zimpawu. Abanye abantu bangase babe nezimpawu ezilodwa noma ezimbili kuphela.
Kungani kwenzeka i-Hyperaldosteronism?
Njengoba kushiwo ngaphambili, izimbangela ziyahlukahluka ngokusekelwe ezinhlotsheni ezimbili.
Izimbangela ze-Hyperaldosteronism Eyinhloko
Lapha, inkinga iqala endlaleni ye-adrenal uqobo.
- Imbangela evame kakhulu: Ngokuvamile isimila esingesona umdlavuza (i-adrenal adenoma) endlaleni ye-adrenal. Lokhu akuwona umdlavuza, ngakho-ke asikho isidingo sokukhathazeka. Lesi simila simane sikhiqiza i-aldosterone eningi kakhulu.
- Ezinye izimbangela ezingavamile:
- Ukwanda kwendlala eyodwa ye-adrenal (i-unilateral adrenal hyperplasia).
- Ukukhiqizwa kwe-aldosterone ngesimila somdlavuza (i-adrenocortical carcinoma) - lokhu akuvamile kakhulu.
- Isifo sofuzo (i-familial hyperaldosteronism).
Izimbangela ze-Secondary Hyperaldosteronism
Lapha, izindlala ze-adrenal ziphilile, kodwa zivuselelwa okunye. Isizathu esiyinhloko ukuncipha kokunikezwa kwegazi ezinso .
Ukuze uqonde lokhu, kuyasiza ukwazi ngesistimu yomzimba emangalisayo yokulawula umfutho wegazi: i -Renin-Angiotensin-Aldosterone System .
Cabanga ngakho njengokusabela kochungechunge:
1. Uma umfutho wegazi wakho wehla noma amazinga e-sodium egazini lakho ephansi, izinso zakho ziyakubona lokho.
2. Izinso bese zikhipha i-enzyme ebizwa ngokuthi "i-renin" egazini.
3. I-Renin isebenza kuphrotheni ekhiqizwa yisibindi ebizwa ngokuthi "i-angiotensinogen," iyiguqula ibe "i-angiotensin I."
4. Okulandelayo, le Angiotensin I iguqulwa ibe “yi-Angiotensin II.”
5. Ekugcineni, yi-Angiotensin II ekhulisa umfutho wegazi lakho ngokucindezela imithambo yegazi lakho nokukhuthaza izindlala zakho ze-adrenal ukuthi zikhiqize i-aldosterone.
Ezimweni ze-Hyperaldosteronism yesibili, isimo sezokwelapha esiyisisekelo sinciphisa ukugeleza kwegazi ezinso zakho. Ngenxa yalokho, izinso zakho zicabanga ngephutha ukuthi umfutho wegazi womzimba wakho uphansi kakhulu. Ngenxa yalokho, izinso zakho ziqala ukusabela kochungechunge ukuze zicele usizo. Ngenxa yalokho, i-hormone i-aldosterone ikhiqizwa ngokweqile, yize umzimba wakho ungayidingi ngempela.
Izimo ezinciphisa ukugeleza kwegazi ezinso futhi zibangele i-hyperaldosteronism yesibili zifaka:
- Ukuncishiswa kwemithambo yegazi ehambisa igazi ezinso (isifo semithambo yegazi yezinso esivimbayo).
- Izimo lapho uketshezi luqongelela khona emzimbeni, njengokwehluleka kwenhliziyo.
- I-cirrhosis yesibindi.
- I-Nephrotic syndrome, uhlobo lokuphazamiseka kwezinso.
Udokotela usithola kanjani lesi simo?
Uma uxoxa ngezimpawu zakho nodokotela wakho—ikakhulukazi uma usho ukuthi umfutho wegazi wakho ophezulu awuphenduli emithini ejwayelekile—bangase basole lesi simo. Udokotela wakho uzobe eseyala ukuhlolwa okuningana ukuqinisekisa ukuxilongwa.
1. Ukuhlolwa Kwegazi:
- Kuphaneli yegazi elijwayelekile le-electrolyte, amazinga aphezulu kancane e-sodium (i-Hypernatremia) kanye namazinga aphansi e-potassium (i-Hypokalemia) avame ukuphakamisa izinsolo.
- Okulandelayo, kunezivivinyo ezimbili zegazi ezikhethekile ezisetshenziswa ngqo ukuhlonza lesi simo: ukuhlolwa kwe -Plasma Renin Concentration (PRC) noma ukuhlolwa kwe-Plasma Renin Activity (PRA) .
- Uma une-Hyperaldosteronism eyinhloko , amazinga akho e-renin (i-PRC ne-PRA) ngokuvamile azoba ngaphansi kunokujwayelekile.
- Uma une-Hyperaldosteronism yesibili , amazinga akho e-renin azoba phezulu kunokuvamile.
2. Ukuhlolwa Kokucindezela i-Aldosterone:
- Kulesi sivivinyo, unikezwa inani elikhuphukile le-sodium (usawoti) esikhathini esithile, kungaba ngomlomo noma nge-intravenous (IV) saline drip.
- Ngemva kwalokhu, umchamo wakho uqoqwa emahoreni angama-24 ukuze kulinganiswe izinga le-aldosterone elikhona.
- Kumuntu ophilile, ukwanda kokungenisa i-sodium kubangela ukuthi umzimba unciphise ngokwemvelo ukukhiqizwa kwe-aldosterone. Kodwa-ke, kumuntu one-Hyperaldosteronism, lokhu akwenzeki.
3. Ukuhlolwa Kwezithombe:
- Uma ukuhlolwa kwegazi kuqinisekisa ukuthi une-Hyperaldosteronism eyinhloko, udokotela wakho angase akucele ukuthi kwenziwe i -CT scan (i-Computed Tomography scan) ukuze kutholakale imbangela eyinhloko, njengokuhlola isimila se-adrenal gland.
Yiziphi izindlela zokwelapha ezitholakalayo?
Izinhlelo zokwelapha zincike ngokuphelele embangela eyinhloko. Kodwa-ke, umgomo oyinhloko ukuphatha umfutho wegazi lakho ngempumelelo.
- Nge-Hyperaldosteronism eyinhloko ebangelwa yi-tumor:
Odokotela bavame ukuncoma ukususwa kwesimila kanye nendlala ethintekile ngokuhlinzwa . Ngemva kokuhlinzwa, iziguli eziningi zibona umfutho wazo wegazi kanye namazinga azo e-potassium ebuyela esimweni esijwayelekile. Abanye abantu bangase basadinga imithi eqhubekayo yomfutho wegazi ngemva kwenqubo.
- Ngezinye izimbangela kanye ne-Hyperaldosteronism yesibili:
Kulezi zimo, ukwelashwa kuhilela imithi . Ngaphezu kwalokho, uma kuyisimo sesibili, ukubhekana nesifo esiyimbangela (isib. ukwehluleka kwenhliziyo) kubalulekile.
Imithi evame ukunqunywa ihlanganisa:
- I-Spironolactone (Aldactone®)
- I-Eplerenone (Inspra®)
- I-Amiloride (i-Midamor®)
Sicela uqaphele ukuthi ukusetshenziswa isikhathi eside kwemithi evimba umsebenzi we-aldosterone, njenge-Spironolactone, kungabangela imiphumela emibi emadodeni, njengokungasebenzi kahle kokuya esikhathini noma ukukhulisa amabele (i-Gynecomastia). Uma uzwa ukungakhululeki noma imiphumela emibi, ungalokothi unqikaze ukukhuluma nodokotela wakho ngayo.
Iyini inhloso kanye nezinkinga ezingaba khona?
Isibikezelo sakho, noma umbono wesikhathi eside, sincike kakhulu embangela eyinhloko.
Uma i-Hyperaldosteronism eyinhloko itholakala kusenesikhathi futhi yelashwa ngendlela efanele, imiphumela ngokuvamile iba mihle kakhulu.. Nge-Hyperaldosteronism yesibili, umphumela uncike ekutheni isimo sezokwelapha esiyisisekelo singaphathwa kahle kangakanani.
Izinkinga ezinkulu zalesi simo zivela ekucindezelekeni kwegazi okwandayo isikhathi eside, okungaholela ezinkingeni ezinkulu zenhliziyo.
| Izinkinga Ezinkulu Ezingaba Khona |
|---|
| I-fibrillation ye-atrial (ukushaya kwenhliziyo okungajwayelekile) |
| Ukwanda kwe-ventricle yesobunxele (ukwanda kwegumbi eliyinhloko lenhliziyo) |
| Isifo senhliziyo |
| Isifo sohlangothi |
Ngenxa yalesi sizathu, ukulawula ngokuqinile umfutho wegazi lakho kubalulekile.
Ingabe lesi simo singavinjelwa?
Ezimweni eziningi, lesi simo asikwazi ukuvinjelwa njengoba sivame ukubangelwa yizinqubo zangaphakathi zomzimba. Kodwa-ke, izindaba ezinhle ukuthi uma sekutholakele, ukwelashwa okuphumelelayo kungavimbela izinkinga ezinkulu zesikhathi eside.
Umlayezo Wokuya Nawe Ekhaya
- Uma ukucindezeleka kwegazi lakho kusalokhu kunzima ukukulawula naphezu kokusebenzisa imithi eminingana, qiniseka ukuthi ukhuluma nodokotela wakho.
- I-Hyperaldosteronism yisimo esibangelwa ukukhiqizwa ngokweqile kwe-hormone i-aldosterone.
- Kungaba okuyinhloko (okuvela endlaleni) noma okwesibili (okubangelwa esinye isimo sezokwelapha).
- Kungahlolwa ngokunembile ngokuhlolwa kwegazi okukhethekile kanye nokuthwebula izithombe.
- Kungelashwa ngempumelelo ngokuhlinzwa noma ngemithi, kuye ngokuthi imbangela ikuphi.
- Into ebaluleke kakhulu okufanele uyazi ukuthi lesi yisimo esingelapheka; uma unenkinga, funa iseluleko sezokwelapha ngokushesha.
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
