Chilichonse Chimene Muyenera Kudziwa Zokhudza Cushing's Syndrome

Zamkati

• Chidule
• Zizindikiro za matenda a Cushing
• Mwa ana
• Mwa akazi
• Mwa amuna
• Cushing's syndrome imayambitsa
• Corticosteroids
• Zotupa
• Matenda a Cushing
• Chithandizo cha matenda a Cushing
• Matenda a Cushing's syndrome
• Kuzindikira zomwe zimayambitsa matenda a Cushing
• Zakudya za Cushing's syndrome
• Zomwe zimayambitsa matenda a Cushing
• Kusamalira matenda a Cushing
• Maganizo a Cushing's syndrome

Chidule

Cushing's syndrome kapena hypercortisolism, imachitika chifukwa cha kuchuluka kwambiri kwa mahomoni a cortisol. Izi zitha kuchitika pazifukwa zosiyanasiyana.

Nthawi zambiri, kupeza chithandizo kumatha kukuthandizani kuyang'anira milingo yanu ya cortisol.

Zizindikiro za matenda a Cushing

Zizindikiro zofala kwambiri za matendawa ndi izi:

• kunenepa
• mafuta amaika, makamaka pakatikati, nkhope (yoyambitsa nkhope yozungulira, yooneka ngati mwezi), komanso pakati pamapewa ndi kumtunda (kuchititsa njati)
• utoto wofiirira pamabele, mikono, pamimba, ndi ntchafu
• khungu lochepetsa lomwe limalalira mosavuta
• kuvulala pakhungu komwe kumachedwa kuchira
• ziphuphu
• kutopa
• kufooka kwa minofu

Kuphatikiza pa zisonyezo zomwe zili pamwambapa, palinso zisonyezo zina zomwe nthawi zina zimawonedwa mwa anthu omwe ali ndi matenda a Cushing's.

Izi zingaphatikizepo:

• shuga wambiri wamagazi
• ludzu lowonjezeka
• kuchuluka kukodza
• kufooka kwa mafupa
• kuthamanga kwa magazi (matenda oopsa)
• mutu
• kusinthasintha
• nkhawa
• kupsa mtima
• kukhumudwa
• kuchuluka kwa matenda

Mwa ana

Ana amathanso kukhala ndi matenda a Cushing's, ngakhale amakula nawo pafupipafupi kuposa achikulire. Malinga ndi kafukufuku wa 2019, pafupifupi milandu yatsopano ya Cushing's syndrome chaka chilichonse imachitika mwa ana.

Kuphatikiza pa zomwe zili pamwambapa, ana omwe ali ndi matenda a Cushing's atha kukhala ndi:

• kunenepa kwambiri
• kukula pang'onopang'ono
• kuthamanga kwa magazi (matenda oopsa)

Mwa akazi

Matenda a Cushing amapezeka kwambiri mwa amayi kuposa amuna. Malinga ndi National Institutes of Health (NIH), azimayi ochulukirapo katatu amakhala ndi Cushing's syndrome poyerekeza ndi amuna.

Amayi omwe ali ndi matenda a Cushing amatha kukhala ndi tsitsi komanso nkhope.

Izi zimachitika nthawi zambiri pa:

• nkhope ndi khosi
• chifuwa
• pamimba
• ntchafu

Kuphatikiza apo, azimayi omwe ali ndi matenda a Cushing amathanso kusamba mosakhazikika. Nthawi zina, msambo sapezeka konse. Matenda a Cushing osachiritsidwa mwa amayi atha kubweretsa zovuta kukhala ndi pakati.

Mwa amuna

Monga momwe zimakhalira ndi amayi ndi ana, amuna omwe ali ndi matenda a Cushing amathanso kukumana ndi zina zowonjezera.

Amuna omwe ali ndi matenda a Cushing's atha kukhala ndi:

• Kulephera kwa erectile
• kutaya chidwi chogonana
• kuchepa kubereka

Cushing's syndrome imayambitsa

Cushing's syndrome imayambitsidwa ndi kuchuluka kwa mahomoni cortisol. Zilonda zanu za adrenal zimatulutsa cortisol.

Zimathandizira pantchito zingapo za thupi lanu, kuphatikiza:

• kuwongolera kuthamanga kwa magazi ndi dongosolo la mtima
• kuchepetsa chitetezo cha chitetezo cha mthupi
• kusandutsa chakudya, mafuta, ndi mapuloteni kukhala mphamvu
• kugwirizanitsa zotsatira za insulini
• kuyankha kupsyinjika

Thupi lanu limatha kutulutsa milingo yambiri ya cortisol pazifukwa zosiyanasiyana, kuphatikiza:

• kupsinjika kwakukulu, kuphatikizapo kupsinjika kokhudzana ndi matenda akulu, opareshoni, kuvulala, kapena kutenga pakati, makamaka mu trimester yomaliza
• maphunziro othamanga
• kusowa kwa zakudya m'thupi
• uchidakwa
• kukhumudwa, kusokonezeka, kapena kukhumudwa kwambiri

Corticosteroids

Zomwe zimayambitsa matenda a Cushing ndizogwiritsa ntchito mankhwala a corticosteroid, monga prednisone, pamlingo waukulu kwa nthawi yayitali. Opereka chithandizo chamankhwala amatha kukupatsirani mankhwala ochizira matenda otupa, monga lupus, kapena kupewa kukana chiwalo choikidwa.

Kuchuluka kwa mankhwala ophera jakisoni pochiza kupweteka kwa msana kungayambitsenso matenda a Cushing's. Komabe, mankhwala otsika a steroids monga mawonekedwe a inhalants, monga omwe amagwiritsidwa ntchito pa mphumu, kapena mafuta, monga omwe amafunsidwa ndi chikanga, nthawi zambiri samakhala okwanira kuyambitsa vutoli.

Zotupa

Mitundu ingapo yamatenda imathandizanso kuti cortisol ipangidwe kwambiri.

Zina mwa izi ndi izi:

• Ziphuphu za pituitary. Matenda a pituitary amatulutsa mahomoni ambiri a adrenocorticotropic (ACTH), omwe amalimbikitsa kupanga kwa cortisol m'matope a adrenal. Izi zimatchedwa matenda a Cushing.
• Zotupa za ectopic. Awa ndi zotupa kunja kwa chifuwa chomwe chimatulutsa ACTH. Nthawi zambiri zimachitika m'mapapu, kapamba, chithokomiro, kapena thymus gland.
• Adrenal gland yachilendo kapena chotupa. Kukhazikika kwa adrenal kapena chotupa kumatha kubweretsa kusintha kosasintha kwa kapangidwe ka cortisol, komwe kumatha kuyambitsa matenda a Cushing's.
• Matenda Odziwika a Cushing. Ngakhale kuti matenda a Cushing sanabwerere, ndizotheka kukhala ndi chizolowezi chobadwa nacho chokhala ndi zotupa m'matumbo a endocrine.

Matenda a Cushing

Ngati matenda a Cushing amayamba chifukwa cha chiberekero cha pituitary chomwe chimachulukitsa ACTH chomwe chimasanduka cortisol, chimatchedwa Cushing's disease.

Mofanana ndi Cushing's syndrome, matenda a Cushing amakhudza azimayi ambiri kuposa amuna.

Chithandizo cha matenda a Cushing

Cholinga chachikulu cha chithandizo cha matenda a Cushing ndikutsitsa kuchuluka kwa cortisol mthupi lanu. Izi zitha kuchitika m'njira zingapo. Chithandizo chomwe mumalandira chimadalira zomwe zimayambitsa matenda anu.

Wothandizira zaumoyo wanu akhoza kukupatsani mankhwala kuti athandizire kuthana ndi milingo ya cortisol. Mankhwala ena amachepetsa kupangika kwa cortisol m'matenda a adrenal kapena amachepetsa kupanga kwa ACTH pamatenda a pituitary. Mankhwala ena amalepheretsa cortisol pamatenda anu.

Zitsanzo ndi izi:

• ketoconazole (Nizoral)
• mitotane (Lysodren)
• metyrapone (Metopirone)
• pasireotide (Chizindikiro)
• mifepristone (Korlym, Mifeprex) mwa anthu omwe ali ndi mtundu wa 2 shuga kapena tsankho la glucose

Ngati mugwiritsa ntchito corticosteroids, kusintha kwa mankhwala kapena kuchuluka kungakhale kofunikira. Musayese kusintha mlingo nokha. Muyenera kuchita izi moyang'aniridwa ndi achipatala.

Zotupa zitha kukhala zoyipa, zomwe zikutanthauza khansa, kapena zabwino, zomwe sizitanthauza khansa.

Ngati matenda anu amayamba chifukwa cha chotupa, wothandizira zaumoyo wanu angafune kuchotsa chotupacho. Ngati chotupacho sichingachotsedwe, wothandizira zaumoyo wanu amathanso kulangiza chithandizo chama radiation kapena chemotherapy.

Matenda a Cushing's syndrome

Matenda a Cushing amatha kukhala ovuta kuwazindikira. Izi ndichifukwa choti zambiri mwazizindikiro, monga kunenepa kapena kutopa, zimatha kukhala ndi zifukwa zina. Kuphatikiza apo, matenda a Cushing omwewo amatha kukhala ndi zifukwa zosiyanasiyana.

Wopereka chithandizo chamankhwala awunikiranso mbiri yanu yazachipatala. Afunsa mafunso okhudzana ndi zizindikilo, matenda aliwonse omwe mungakhale nawo, ndi mankhwala aliwonse omwe mungapatsidwe.

Ayeneranso kuchita mayeso akuthupi komwe adzawone zikwangwani ngati humpi ya njati, ndikutambasula ndi mikwingwirima.

Kenako, atha kuyitanitsa mayeso a labotale, kuphatikiza:

• Kuyezetsa kwa cortisol kwa maola 24: Pachiyeso ichi, mudzafunsidwa kuti mutenge mkodzo wanu kwa maola 24. Magulu a cortisol adzayesedwa.
• Kuyeza kwa cortisol ya malovu: Mwa anthu opanda Cushing's syndrome, milingo ya cortisol imatsika madzulo. Kuyesaku kumayeza mulingo wa cortisol mumate am'madzi omwe asonkhanitsidwa usiku kuti awone ngati milingo ya cortisol ndiyokwera kwambiri.
• Mayeso ochepetsa a dexamethasone: Pachiyeso ichi, mudzapatsidwa mlingo wa dexamethasone nthawi yamadzulo. Magazi anu adzayesedwa milingo ya cortisol m'mawa. Nthawi zambiri, dexamethasone imapangitsa kuti milingo ya cortisol igwere. Ngati muli ndi Cushing's syndrome, izi sizingachitike.

Kuzindikira zomwe zimayambitsa matenda a Cushing

Mukalandira matenda a Cushing's syndrome, wothandizira zaumoyo wanu ayenera kudziwa zomwe zimayambitsa kuchuluka kwa cortisol.

Kuyesa kothandiza kudziwa chomwe chikuyambitsa kungaphatikizepo:

• Mayeso a magazi adrenocorticotropin hormone (ACTH): Mipata ya ACTH m'magazi imayesedwa. Kuchuluka kwa ADTH ndi kuchuluka kwa cortisol kumatha kuwonetsa kupezeka kwa chotupa pamatenda a adrenal.
• Mayeso okondoweza a Corticotropin-release hormone (CRH): Muyeso ili, kuwombera kwa CRH kumaperekedwa. Izi zidzakulitsa milingo ya ACTH ndi cortisol mwa anthu omwe ali ndi zotupa za pituitary.
• Mlingo woyeserera wopondereza wa dexamethasone: Izi ndizofanana ndimayeso ochepa, kupatula kuti ntchito dexamethasone yayikulu imagwiritsidwa ntchito. Ngati ma cortisol amatsika, mutha kukhala ndi chotupa cha pituitary. Ngati satero mutha kukhala ndi chotupa cha ectopic.
• Zitsanzo za sinus Petrosal: Magazi amatengedwa kuchokera mumtsinje pafupi ndi chithandizocho komanso kuchokera ku mtsempha womwe uli kutali ndi kachilomboko. Mfuti ya CRH imaperekedwa. Mlingo waukulu wa ACTH m'magazi pafupi ndi pituitary amatha kuwonetsa chotupa cha pituitary. Magawo ofanana kuchokera kuzitsanzo zonsezi akuwonetsa chotupa cha ectopic.
• Kujambula maphunziro: Izi zitha kuphatikizira zinthu monga CT ndi MRI scan. Amagwiritsidwa ntchito poyerekeza m'matenda a adrenal ndi pituitary kuti ayang'ane zotupa.

Zakudya za Cushing's syndrome

Ngakhale kusintha kwa kadyedwe sikungathetse vuto lanu, kumatha kuthandizira kuti milingo yanu ya cortisol isakwere kwambiri kapena kuthandizira kupewa zovuta zina.

Malangizo ena a omwe ali ndi Cushing's syndrome ndi awa:

• Onetsetsani kalori yanu. Kusunga kalori yanu ndikofunikira chifukwa kunenepa ndi chimodzi mwazizindikiro zazikulu za Cushing's syndrome.
• Yesetsani kupewa kumwa mowa. Kumwa mowa kumalumikizidwa ndi kuchuluka kwa milingo ya cortisol, makamaka, malinga ndi kafukufuku wa 2007.
• Onetsetsani shuga lanu lamagazi. Cushing's syndrome imatha kukhala ndi shuga wambiri m'magazi, chifukwa chake yesetsani kuti musadye zakudya zomwe zingayambitse shuga. Zitsanzo za zakudya zofunika kudya ndi monga masamba, zipatso, mbewu zonse, ndi nsomba.
• Dulani ndi sodium. Cushing's syndrome imalumikizananso ndi kuthamanga kwa magazi (kuthamanga kwa magazi). Chifukwa cha izi, yesetsani kuchepetsa kuchuluka kwa sodium. Njira zina zosavuta kuchita izi ndikuphatikiza kusawonjezera mchere pachakudya komanso kuwerenga mosamala zolemba kuti muwone zomwe zili ndi sodium.
• Onetsetsani kuti mwapeza calcium yokwanira ndi vitamini D. Matenda a Cushing amatha kufooketsa mafupa anu, kukupangitsani kuti muzithyoka. Ma calcium ndi vitamini D onse amatha kuthandiza kulimbitsa mafupa anu.

Zomwe zimayambitsa matenda a Cushing

Choyipa chachikulu pakukula kwa Cushing's syndrome ndikumamwa kotikisi wa corticosteroids kwa nthawi yayitali. Ngati wothandizira zaumoyo wanu wakupatsani corticosteroids kuti muthane nayo, afunseni za mlingo wake ndi nthawi yayitali bwanji.

Zina mwaziwopsezo zingaphatikizepo:

• mtundu wa 2 matenda ashuga omwe samayendetsedwa bwino
• kuthamanga kwa magazi (matenda oopsa)
• kunenepa kwambiri

Matenda ena a Cushing's amachitika chifukwa chotupa chotupa. Ngakhale pakhoza kukhala chizolowezi cha majini kuti apange zotupa za endocrine (banja la Cushing's syndrome), palibe njira yoletsera zotupa kuti zisapangidwe.

Kusamalira matenda a Cushing

Ngati muli ndi Cushing's syndrome, ndikofunikira kuti iziyendetsedwa bwino. Ngati simupeza chithandizo chake, matenda a Cushing atha kubweretsa zovuta zosiyanasiyana zomwe zingakhale zovuta.

Izi zingaphatikizepo:

• kufooka kwa mafupa, komwe kumawonjezera chiopsezo cha mafupa
• kutayika kwa minofu (atrophy) ndi kufooka
• kuthamanga kwa magazi (matenda oopsa)
• mtundu wa 2 shuga
• matenda pafupipafupi
• matenda a mtima kapena sitiroko
• kukhumudwa kapena kuda nkhawa
• zovuta zazidziwitso monga zovuta kuzilingalira kapena zovuta zokumbukira
• kukulitsa kwa chotupa chomwe chilipo kale

Maganizo a Cushing's syndrome

Mukangoyamba kumene kulandira chithandizo, zotsatira zake zimakhala zabwino. Ndikofunika kuzindikira kuti malingaliro anu payekha amadalira chifukwa komanso chithandizo chomwe mumalandira.

Zitha kutenga nthawi kuti zizindikilo zanu ziziyenda bwino. Onetsetsani kuti mwafunsa wothandizira zaumoyo wanu kuti akupatseni malangizo azakudya zabwino, pitilizani nthawi yotsatira, ndikuwonjezera gawo lanu pochita pang'onopang'ono.

Magulu othandizira angakuthandizeni kuthana ndi matenda a Cushing. Chipatala chakwanuko kapena wothandizira zaumoyo atha kukupatsirani zambiri zamagulu omwe amakumana mdera lanu.