Mayeso olimbikitsa a ACTH

Mayeso okondoweza a ACTH amayesa momwe adrenal gland amayankhira ndi adrenocorticotropic hormone (ACTH). ACTH ndi timadzi tomwe timapangidwa m'matumbo a pituitary omwe amachititsa kuti adrenal glands atulutse hormone yotchedwa cortisol.

Kuyesaku kwachitika motere:

• Magazi anu akokedwa.
• Kenako mumalandira mfuti (ACTH), nthawi zambiri mumisempha paphewa panu. ACTH ikhoza kukhala yopangidwa ndi anthu (kupanga).
• Pakatha mphindi 30 kapena 60, kapena onse awiri, kutengera kuchuluka kwa ACTH yomwe mumalandira, magazi anu amakopedwanso.
• Labu imayang'ana mulingo wa cortisol m'magazi onse.

Muthanso kuyesa magazi ena, kuphatikiza ACTH, ngati gawo loyesa magazi koyamba. Pamodzi ndi kuyezetsa magazi, mutha kuyesedwanso mkodzo wa cortisol kapena mkodzo wa 17-ketosteroids, womwe umaphatikizapo kusonkhanitsa mkodzo kwa nthawi yamaola 24.

Muyenera kuchepetsa zochitika ndikudya zakudya zomwe zili ndi chakudya chama 12 mpaka 24 maola mayeso asanayesedwe. Mutha kupemphedwa kusala kudya kwa maola 6 mayeso asanayesedwe. Nthawi zina, palibe kukonzekera kwapadera komwe kumafunikira. Mutha kupemphedwa kuti musiye kumwa mankhwala kwakanthawi, monga hydrocortisone, yomwe imatha kusokoneza kuyesa kwa magazi a cortisol.

Pamene singano imayikidwa kuti ikoke magazi, anthu ena amamva kupweteka pang'ono. Ena amangomva kubaya kapena kuluma. Pambuyo pake, pakhoza kukhala kupunduka kapena kuvulala pang'ono. Izi posachedwa zichoka.

Jekeseni lapa phewa limatha kupweteka kapena kuluma pang'ono.

Anthu ena amamva kufutukuka, kuchita mantha, kapena kunyozedwa pambuyo pobayidwa ndi ACTH.

Kuyesaku kungakuthandizeni kudziwa ngati matumbo anu a adrenal ndi pituitary ali abwinobwino. Amagwiritsidwa ntchito nthawi zambiri pamene wothandizira zaumoyo akuganiza kuti muli ndi vuto la adrenal gland, monga matenda a Addison kapena kusakwanira kwamatenda. Amagwiritsidwanso ntchito kuwona ngati matenda anu am'mapapo komanso adrenal apeza chifukwa chogwiritsa ntchito mankhwala a glucocorticoid kwa nthawi yayitali, monga prednisone.

Kuwonjezeka kwa cortisol pambuyo polimbikitsidwa ndi ACTH kuyembekezeredwa. Mulingo wa Cortisol pambuyo pa kukondoweza kwa ACTH uyenera kukhala wapamwamba kuposa 18 mpaka 20 mcg / dL kapena 497 mpaka 552 nmol / L, kutengera kuchuluka kwa ACTH yogwiritsidwa ntchito.

Mitengo yamtengo wapatali imatha kusiyanasiyana pakati pa ma labotore osiyanasiyana. Ma lab ena amagwiritsa ntchito miyeso yosiyana kapena amatha kuyesa mitundu yosiyanasiyana. Lankhulani ndi omwe akukuthandizani za tanthauzo la zotsatira zanu zoyeserera.

Mayesowa ndi othandiza podziwa ngati muli:

• Mavuto ovuta a adrenal (zoopsa zomwe zimachitika pakakhala cortisol yokwanira)
• Matenda a Addison (adrenal gland samatulutsa cortisol yokwanira)
• Hypopituitarism (pituitary gland sakupanga mahomoni okwanira monga ACTH)

Pali chiopsezo chochepa chotenga magazi anu. Mitsempha ndi mitsempha imasiyana mosiyanasiyana kuchokera pa munthu wina kupita kwina, komanso kuchokera mbali imodzi ya thupi kupita mbali inayo. Kutenga magazi kuchokera kwa anthu ena kumatha kukhala kovuta kuposa ena.

Zowopsa zina zomwe zimakoka magazi ndi zochepa, koma mwina ndi izi:

• Kutaya magazi kwambiri
• Kukomoka kapena kumva mopepuka
• Ma punctures angapo kuti mupeze mitsempha
• Hematoma (magazi akuchuluka pansi pa khungu)
• Kutenga (chiopsezo chochepa nthawi iliyonse khungu likasweka)

Kuyesedwa kwa malo osungira adrenal; Kuyesa kosangalatsa kwa Cosyntropin; Chiyeso cholimbikitsa cha Cortrosyn; Chiyeso cholimbikitsira cha Synacthen; Kuyesa kwakukopa kwa Tetracosactide

Barthel A, Willenberg HS, Gruber M, Bornstein SR. Kulephera kwa adrenal. Mu: Jameson JL, De Groot LJ, de Kretser DM, et al, olemba. Endocrinology: Akuluakulu ndi Ana. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2016: chap 102.

Chernecky CC, Berger BJ. Mayeso olimbikitsa a ACTH - kuzindikira. Mu: Chernecky CC, Berger BJ, olemba., Eds. Kuyesa Kwantchito ndi Njira Zakuzindikira. Lachisanu ndi chimodzi. St Louis, MO: Elsevier Saunders; 2013: 98.

Stewart PM, Newell-Price JDC. Kachilombo kotchedwa adrenal cortex. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 15.