Adrenal hyperplasia isiri yekenza - chii? Zviratidzo uye nokurapa chirwere

Endocrinologists zvavo tsika rinowanzoshandiswa atarisana abnormalities vari neitsvo. Adrenal hyperplasia isiri yekenza - chii? Itsvo - aiwanzopiwa wokushanda nyere, asi adrenal mumasero dziri chete pamusoro vane glandular chimiro. Kune vari akaumba zvakakodzera kuti munhu mahormone muviri (adrenaline, noradrenaline, glucocorticoids, uye pabonde). Hyperplasia isiri yekenza anotyora kodzero hormone, uye izvi achiperekedzwa zviratidzo zvakasiyana.

Adrenal hyperplasia isiri yekenza - chii?

Kana adrenal hyperplasia isiri yekenza sero rinenge aiwanzopiwa wokushanda mumasero zvishoma anowedzera, muviri kwazvo kukura, kunyange zvazvo anoramba yayo chimiro. Adrenal medullary fuma ine uye kuhukura.

Kazhinji kunokanganisa adrenal cortex hyperplasia isiri yekenza, pane nezvechinhu chimwe pathological kwacho. Various bundu kazhinji chirwere ari medulla.

Kunoratidza kuti chirwere chero zera vakadzi, varume uye vana.

Vachiberekwa adrenal hyperplasia isiri yekenza chinowanikwa mushonga unowanzosangana. Kazhinji anotakura nhaka, asi kunogonawo kuitika mune nhamba zvimwe yaivhuvhuta wechipfuwo kana zvimwewo zvinoitika. Sezvo kufanana zvokurwara iri dzakaonekwa mu varwere Cushing kwakaita syndrome (40% nyaya) syndrome. chirwere ichi Kazhinji chirwere mu pakati uye kukwegura.

Izvi zvokurwara chakakomba hazvigoni kuregeredzwa. Kana hyperplasia isiri yekenza iri kwakakanganiswa kugadzirwa mahormone zvakakodzera. In vakadzi, kazhinji kwahunokonzera kushaya mbereko. Kune mhando dzakawanda chirwere: nodular hyperplasia isiri yekenza of adrenal shwanu, nodular, diffuse, vachiberekwa uye micronodular, uye hyperplasia isiri yekenza makumbo medial. Kakawanda chirwere ichi rinowanikwa pavakadzi.

Zvinokonzera chirwere

Inokonzera zviratidzo kuoneka apo adrenal hyperplasia isiri yekenza nevana, varume kana vakadzi vachava zvakasiyana. Zvose achavaponesa zvaimirirwa chirwere. Hyperplasia isiri yekenza rinoreva mumwe mhando, kungava idiopathic, solteryayuschey, virility.

Kana pane chinoshingaira mhando vane chirwere cheBP kugadzirwa androgens uye mineralocorticoids, yakadai muitiro kukanganisa pamusoro renal midziyo uye fundus, kazhinji kunotungamirira neBP syndrome.

Kana solteryayuschem mhando hyperplasia isiri yekenza wakawedzera androgen kugadzirwa, saka pane kushayikwa mamwe mahormone neve adrenal cortex. Kunobva hyperkalemia kana yomuropa. The ngozi iri kuti muviri tasara tisina mvura, uremu.

Kana virilnoe mhando hyperplasia isiri yekenza pachivande androgen superaktiven. External nhengo dzokubereka nadzo ndakawedzera kukura, pane mburwa, wakawedzera muviri bvudzi, musculature yakatanga chaizvo akawanda.

Chekutanga zvokurwara zvose anotanga mberi nokuda wakawedzera secretion pamusoro steroid mahormone. The vawana chimiro chirwere ane zvikonzero kiyi sei akasimuka:

• metabolic nyonganyonga;
• mupfungwa simba;
• Cushing nehosha;

Vachiberekwa adrenal hyperplasia isiri yekenza nokuti kunyange panguva pamuviri, panguva gestation, dzichipfekeka kuchinja kuva. Rimwezve zano - kwemashoko chirwere panguva majini chechetere. Zvinhu Nokumukira kuratidzwa zviratidzo chirwere: a atadze kushanda zvakanaka pamusoro hypothalamus uye pituitary abnormalities panguva nemagene vanochiva tinozvarwa kuzvionera cortex aiwanzopiwa wokushanda omumuviri, nhaka kubva kumadzitateguru avo.

nodular hyperplasia isiri yekenza

Doctors vagovere kuchiita adrenal hyperplasia isiri yekenza mumapoka akawanda maererano kunotoda mufananidzo, uyewo mhando kuyerera.

Nodular adrenal hyperplasia isiri yekenza. Iri fomu nhaka. Most kazhinji chirwere vakwegura, uri kuwedzerwa nguva. Pakuitisa chirwere kwakaratidza anozivikanwa chepfungwa - pamusoro omuti kuti adrenal nodules kuumbwa. Vanogona kuva akawanda (lobed Chimiro) uye imwe, kusvikira 4-5 cm. Kunotanga Cushing kuti syndrome. The zvokurwara imhaka simba kweiyi adrenocorticotropic kemikari, iri synthesized mune pituitary shwanu. The chikuru zviri nodular hyperplasia isiri yekenza pamwe Cushing kuti urwere zvinosanganisira:

• kurwadziwa nemusoro;
• "Nhunzi" pamberi;
• nokugwinha;
• dzungu;
• mukuru zvakawanda zvive;
• kufuta (chikuru mudumbu, mutsipa, chiso);
• zvakawedzera havi;
• utambanudzire mucherechedzo ganda;
• mburwa;
• hirsutism (vakadzi);
• murombo patsva;
• hyperpigmentation;
• cheBP;
• kakawanda mitswe;
• kuora mwoyo.

diffuse hyperplasia isiri yekenza

In chimiro ichi prostate hyperplasia isiri yekenza haana kuchinja chimiro chayo, kuwedzera zvishoma nezvishoma. Asi panguva imwe chete vanoumba nodules. Ziva mhando chirwere chakaoma. In mureza nzira diagnosing Ultrasound hapana mugumisiro. Kuchinja mumuviri zvinowanikwa chete MRI kana CT. Kazhinji kuva vakaberekwa siyana, izvo kuitika kana zvinotevera zviratidzo: adrenal hyperplasia isiri yekenza vakadzi kazhinji kunotungamirira kune kuwedzera bvudzi muviri, akaratidza vhunduka, BP, kufutisa. Mune dzimwe nzvimbo pane kukuvara glomerular uye kukudziridza bilateral hyperplasia isiri yekenza.

The zvokurwara pamusoro idiopathic aldosteronism inobva kuwedzera aldosterone secretion. Kana hyperplasia isiri yekenza glomerular mapazi rinoratidza zvinotevera zviratidzo: BP, kugwinha, tsandanyama simba, kukamurwa kufamba, kuomarara kusvika muviri, nyota, wakawedzera weti goho, usiku weti. Kutyora kunokonzera kuwedzera potassium ropa, acidosis. Inosimudzira BP iri kuchengetwa nguva dzose.

Nodular uye vachiberekwa siyana

Kazhinji Nodular chimiro mberi mune vana uye kuyaruka. Kungazviratidza nokuti hadzina kufambiswa zvakanaka kana adrenal kushanda nokuda ovhadhozi pamusoro glucocorticoids. Key zviri nodular chimiro: mugari mafuta deposits, tsandanyama atrophy, pigmentation ganda, zviratidzo cheshuga, kukuvara tsinga uye zvemwoyo, osteoporosis. Kana vana Zviratidzo chirwere aonekwa munguva, akaita hormone kurapwa, asi fungidziro akanaka. Hyperplasia isiri yekenza pamusoro kuruboshwe adrenal shwanu - chii? Muchiitiko chino, hyperplasia isiri yekenza hakutsamiri kuitwa mahormone. Kana kumera mapundu kupfuura 3 masendimita kushanda kunodiwa. Laparoscopy rinoshandiswa kana maererano Fedorov nzira lyumbotomicheskim kuwana peritoneum kurutivi rworuboshwe.

Vachiberekwa adrenal hyperplasia isiri yekenza (VDKN) kunokwanisa kuonekwa kakawanda kupfuura dzimwe mhuka. In vacheche pana imwe kakawanda 1 kusvika 12 zviuru. Mumamiriro ezvinhu ichi, mwana kuoneka metabolic uye chitarisiko. Pane chikuru matatu enguva (non-chekare, nyore dzenhoroondo, virility uye solteryayuschaya.

The inonyanya muchimiro solteryayuschaya. Richiratidzwa vasikana nayo germofroditizm chenhema, vakomana rima ganda vakakomba scrotum, mboro kunowedzera ukuru. Varwere dzinoratidzwa pasi kukura uye zviratidzo zvakadai hope, kuda kurutsa, lethargy, pasi BP, kupera muviri, murombo kudya. The chirwere inofanira kubatwa mazuva chokuvapo, kana zvichibvira rufu wokutanga.

Munguva dzekare chimiro haapfuuri zviratidzo, asi pane nokuwedzera kwetunhu pabonde varume mahormone. Kana hosha isina kurapwa, mamwe matambudziko anowanikwa mune vakadzi pabonde uye chepfungwa.

The non-dzekare chimiro anooneka vakadzi vakuru uye kuyaruka. The chikuru zvichemo kushaya mbereko, kumwedzi hadzina kufambiswa zvakanaka, hirsutism uye mburwa.

Adrenal hyperplasia isiri yekenza: mukuru zviratidzo

Kakawanda, vana, varume navakadzi vanochengeta vakadzima chimiro chirwere, kana pasina raidudzwa zviratidzo, mune zviitiko zvakadaro zvakaoma rokuongorora chirwere. Vachiberekwa chimiro chinorondedzerwa vana kare pakutanga uye rechipiri gore upenyu.

Kazhinji, adrenal hyperplasia isiri yekenza (chii, hatina kare akatsanangura) rine zvinotevera zviratidzo huru:

• kusagadzikana BP (yakaderera kana mukuru);
• kumhanya mberi cheshuga mellitus;
• uremu kuwedzera;
• Kuratidza osteoporosis;
• chiveve kuti tsandanyama, kwavakazoita atrophy;
• Vakadzi vari "mwedzi-kufanana nechiso";
• ndangariro vanotaura;
• huta breakdowns;
• pigmentation;
• utambanudzire mucherechedzo ganda;
• kuvhiringidzika nemudumbu;
• richikwidibira pamusoro kutapata;
• kuzvirotera kusunungurwa weti;
• nyota kwazvo;
• psychoses;
• kushaya mbereko;
• amenorrhea;
• kwete zera-yakakodzera yakakwirira kukura;
• ikaramba ichiserera hairline ari rwenyama nharaunda;
• hirsutism.

Varume nevakadzi vakasiyana muna zvekuchipatara zviratidzo chirwere.

kurapwa Guidelines

Hwaro marapirwo zvechokwadi kwemakemikari omuviri mishonga. Masayendisiti haasati yakasarudza sei zvakanakisisa kuita pamusoro adrenal hyperplasia isiri yekenza. Treatment rinonyanya kubatanidzwa. For kuyaruka vanotumirwa zvinoreva izvo normalize kutaura yechipiri bonde unhu, vasikana kuratidzwa estrogens uye vakomana - androgens.

Anoshandiswa pakurapa zvinotevera mubatanidzwa glucocorticoids:

• cortisone acetate;
• hydrocortisone;
• dexamethasone;
• prednisolone.

Masikati murwere anogamuchira 2 kana 3 mishonga yacho mahormone (zvienzane mari). Evoruzhinji uye 5% shuga mhinduro. Girls, kusiyana vakomana, zvose upenyu hune kuti gadziriro sezvinodiwa.

Nokuti mumwe murwere chiremba anofanira kuwana nzira chaiyo kuti ndipe ayo kurapwa nzira (zvose zvinoenderana ruzivo rwake uye ruzivo). kurapa pakurapa chirwere ichi Single haako.

Vachiberekwa hyperplasia isiri yekenza pamusoro adrenal cortex zvikuru kubatwa vanovhiya. Pane nyaya kuti sikarudzi hazvigoni kusiyaniswa sezvo mukadzi kana munhurume. For vasikana Zvinokurudzirwa mapurasitiki paunowana Maumbirwe labia. Nechekare negore upenyu rokutanga kuratidza kuvhiyiwa yakadaro, dzimwe nguva (mu zvikuru ezvinhu) voitakura kunze gare gare. Ita kuvhiyiwa uye namamota.

Kana muviri asina munyu, murwere anofanira kuwedzera zuva dose ose 1-3 magiramu. Iva vakagadzwa Pakadaro, uye mineralocorticoid.

Diffuse hyperplasia isiri yekenza zvinodhaka kurapa asina zvikuru kushanda. It chinodiwa nyaya dzakadaro adrenalectomy. Sashanda kurapwa uye aldosteroma kana zvabatanidzwa pamwe diffuse hyperplasia isiri yekenza. The kushurudzira iri zvisingafadzi.. Nyaya rwokusarudza zvinodhaka kurapa uye Zona glomerulosa bilateral hyperplasia isiri yekenza (idiopathic hyperaldosteronism). Operation muchiitiko ichi - chinhu zvakanyanyisa chiyero.

The ikure kurapwa IGA - kugamuchira spironolactone, chiri antagonist kuti aldosterone. Uyewo chinobatsira zvinodhaka eplerenone. Spironolactone zvinowanzooneka kubatwa Rakabatanidzwa pamwe karusiyamu antagonist. Kana zviratidzo chipo chirwere cheBP, kurapwa pamwe ACE FIs kwakabatana.

Kana munhu negashiro virilization nazvo zvinodhaka nguva dzose. Kana rudzi adrenal hyperplasia isiri yekenza inoreva virilizing, zvinofanira kuva kugadzwa cortisol. Rinogona kushandiswa intramuscular jekiseni. Dose akatora chiremba. Nokuti vana vakura vanogona kushandisa prednisolone.

Kana pasina kurapwa, asi hyperplasia isiri yekenza kungaita kuti kukura chirwere Kona kana Cushing chirwere. Pashure zvakakodzera chirwere kurapwa kunofanira kutanga pakarepo.

chirwere chirwere

Adrenal hyperplasia isiri yekenza - chii? How rokuongorora chirwere? Nodular uye diffuse hyperplasia isiri yekenza dzakaonekwa mukufamba richishanda uye mumarabhoritari tsvakurudzo. The Diagnostics zvinosanganisira: Murwere kuongorora, kuongorora mumuviri, chiremba kuongororwa, radiological kuongororwa kana rinobva resonance kuri, radionuclide kushanda pakuvheneka. Maererano zvabuda kuongororwa kukosha, uye chimiro adrenal mumasero vose. Radioimmunoassay akaita tsvakurudzo murabhoritari. Kutsunga ari weti uye ropa cortisol. Rokuongorora hormone chinzvimbo, bata-chokuita immunosorbent munhu akaidza. Dzimwe zvakafanira kuitisa chido ponji.

Maererano migumisiro nechirwere chiremba rinofumura chirwere uye ibasa kupfuura kukodzera nzira kurapwa.

Hyperplasia isiri yekenza vakuru: zvokuita?

Kazhinji wokusagadzikana of adrenal cortex vari panoonekwa achiri mucheche, asi zviratidzo chirwere kuonekwe nedzevakuru. adrenal hyperplasia isiri yekenza vakadzi kunoratidzwa refu kuwedzera pubic bvudzi, inzwi yakadzika, mburwa, marwadzo ari kumashure musoro, usiku nezvipusha, murombo kudyisa, wakawedzera BP, adrenal syndrome.

Kana ukava mune zviratidzo izvi, usaedza rokuongorora pachako. Muzviitiko izvi regai kubatsira, uye zvavo mishonga. Nokukurumidza kugadzirisa kuti vanachiremba. Zvakakodzera hormone kurapwa. Kazhinji, vakadzi vane chirwere chakadai hachina varumbidzwa kuronga pamuviri. Muzviitiko zvakawanda, kunyange akarambidza kuti asununguke. Dzimwe nguva yakanakisisa dambudziko - kubviswa zvachose hosha itsvo, uye zvose zvayo zvinoshandiswa.

dziviriro

Chii adrenal hyperplasia isiri yekenza - iri kunyanya kuziva vakaroorana avo vakaronga kuberekwa mwana uye mumhuri ivo (majini) vane zviitiko vachiberekwa hyperplasia isiri yekenza. Ndapota kureva nhaka kwezvinhu - unyanzvi, ruzivo nenyanzvi. Nokuti kudzivirira zvirwere vanofanira kuti chirwere kuti perinatal (nguva kana mwana achiri kukura uye ari mudumbu amai). Mune trimester pamuviri rokutanga rinoitwa chorionic villus zvakabudiswa. In yechipiri yezana zvaida kuongorora Líquido fluid iyo achasarudza pachiyero mahormone.

Option - IVF. Muchiitiko chino, unogona kugadzira rokutanga nemagene kuongorora utachiona masero vasati nourume.

Panguva gestation vakadzi nechirwere hyperplasia isiri yekenza kunofanira pasi kuramba pokudzora chiremba nguva kupfuura zvaida miedzo yose. Ko kunze upenyu zvose zvinobvira zvine chepfu uye migumisiro nemwaranzi.

Nokuti kudzivirira adrenal hyperplasia isiri yekenza inoita basa rinokosha uye kuongorora miedzo kuti kuitwa mu achangozvarwa. Nokuti kuongorora zvakafanira kutora ropa kubva rirambe richibvira (nzvimbo asarudzirwa ponji chitsitsinho mbudzana).