Matenda a shuga

Matenda a shuga insipidus (DI) ndichinthu chachilendo pomwe impso zimalephera kutulutsa madzi.

DI siyofanana ndi matenda ashuga amtundu 1 ndi 2. Komabe, osachiritsidwa, onse a DI ndi matenda a shuga amayambitsa ludzu komanso kukodza pafupipafupi. Anthu omwe ali ndi matenda a shuga amakhala ndi shuga wambiri m'magazi (glucose) chifukwa thupi silitha kugwiritsa ntchito shuga wamagazi ngati mphamvu. Omwe ali ndi DI ali ndi shuga wabwinobwino wamagazi, koma impso zawo sizimatha kuyeza madzi m'thupi.

Masana, impso zanu zimasefa magazi anu nthawi zambiri. Nthawi zambiri, madzi ambiri amabwezeretsedwanso, ndipo ndimkodzo wochepa chabe womwe umatulutsidwa. DI imachitika pamene impso sizingayang'ane mkodzo mwachizolowezi, ndipo mkodzo wambiri wambiri umatulutsidwa.

Kuchuluka kwa madzi omwe amasungidwa mumkodzo kumayendetsedwa ndi antidiuretic hormone (ADH). ADH imatchedwanso vasopressin. ADH imapangidwa mu gawo lina la ubongo lotchedwa hypothalamus. Kenako amasungidwa ndikutulutsidwa ku gland gland. Ili ndi kansalu kakang'ono kamunsi pansi pamunsi paubongo.

DI yoyambitsidwa ndi kusowa kwa ADH amatchedwa central diabetes insipidus. DI ikayambitsidwa chifukwa cha kulephera kwa impso kuyankha ku ADH, vutoli limatchedwa nephrogenic diabetes insipidus. Njira za Nephrogenic zokhudzana ndi impso.

Central DI imatha kuyambitsidwa ndi kuwonongeka kwa hypothalamus kapena pituitary gland chifukwa cha:

• Mavuto amtundu
• Kuvulala pamutu
• Matenda
• Vuto ndimaselo opanga ADH chifukwa cha matenda omwe amadzichotsera okha
  
• Kuchepa kwa magazi kumtundu wa pituitary
• Kuchita opaleshoni m'dera la pituitary gland kapena hypothalamus
• Zotupa mkati kapena pafupi ndi vuto lamatenda

Nephrogenic DI imakhudza vuto la impso. Zotsatira zake, impso sizimayankha ku ADH. Monga pakati pa DI, nephrogenic DI ndiyosowa kwambiri. Nephrogenic DI itha kuyambitsidwa ndi:

• Mankhwala ena, monga lithiamu
• Mavuto amtundu
• Mulingo wambiri wa calcium m'thupi (hypercalcemia)
• Matenda a impso, monga matenda a impso a polycystic

Zizindikiro za DI ndi izi:

• Ludzu lokwanira lomwe lingakhale lalikulu kapena losalamulirika, nthawi zambiri limafunikira kumwa madzi ambiri kapena kulakalaka madzi oundana
• Kuchuluka kwamkodzo
• Kukodza kwambiri, nthawi zambiri kumafunikira kukodza ola lililonse usana ndi usiku
• Kuchepetsa kwambiri, mkodzo wotumbululuka

Wothandizira zaumoyo adzafunsa za mbiri yanu yazachipatala komanso zizindikilo zake.

Mayeso omwe atha kulamulidwa ndi awa:

• Magazi a sodium ndi osmolality
• Vuto la Desmopressin (DDAVP)
• MRI ya mutu
• Kupenda kwamadzi
• Mkodzo ndende ndi osmolality
• Kutulutsa mkodzo

Omwe amakupatsani mwayi atha kukuwonetsani dokotala yemwe amagwiritsa ntchito matenda am'magazi kuti akuthandizeni kupeza matenda a DI.

Zomwe zimayambitsa vutoli zidzathandizidwa ngati zingatheke.

Central DI imatha kuwongoleredwa ndi vasopressin (desmopressin, DDAVP). Mumatenga vasopressin ngati jakisoni, utsi wa m'mphuno, kapena mapiritsi.

Ngati nephrogenic DI imayambitsidwa ndi mankhwala, kuimitsa mankhwalawo kumatha kuthandizanso ntchito ya impso. Koma atagwiritsa ntchito mankhwala ena kwa zaka zambiri, monga lithiamu, nephrogenic DI imatha kukhala yokhazikika.

Hereditary nephrogenic DI ndi lithiamu-induced nephrogenic DI amathandizidwa ndikumwa madzi okwanira kuti agwirizane ndi mkodzo. Mankhwala omwe amatsitsa mkodzo amafunikanso kumwa.

Nephrogenic DI imathandizidwa ndi mankhwala odana ndi zotupa komanso okodzetsa (mapiritsi amadzi).

Zotsatira zimadalira matendawa. Akalandira mankhwala, DI siyimayambitsa mavuto akulu kapena kufa msanga.

Ngati ludzu la thupi lanu ndilabwino ndipo mumatha kumwa madzi okwanira, palibe zovuta pamadzimadzi amthupi kapena mchere.

Kusamwa madzi okwanira kumatha kubweretsa kuchepa kwa madzi m'thupi komanso kusalinganika kwa ma elektroni, zomwe zingakhale zowopsa.

Ngati DI imathandizidwa ndi vasopressin ndipo ludzu lanu la thupi siili labwinobwino, kumwa madzi ambiri kuposa momwe thupi lanu likufuniranso kumatha kuyambitsa kusamvana kowopsa kwa ma elekitirodi.

Itanani omwe akukuthandizani mukakhala ndi matenda a DI.

Ngati muli ndi DI, funsani omwe akukuthandizani ngati mukukodza pafupipafupi kapena mukamva ludzu kwambiri.

• Matenda a Endocrine
• Mayeso a Osmolality

Hannon MJ, Thompson CJ. Vasopressin, matenda a shuga insipidus, ndi matenda a antidiuresis osayenera. Mu: Jameson JL, De Groot LJ, de Kretser DM, et al, olemba. Endocrinology: Akuluakulu ndi Ana. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2016: mutu 18.

Zamatsenga JG. Kusokonezeka kwamadzi. Mu: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, olemba. Brenner ndi Rector a Impso. 10th ed. Philadelphia, PA: Elsevier; 2016: chap 16.