Boemo ba letlalo, boima ba 'mele, mosebetsi oa tsamaiso ea pelo le lisebelisoa tse ling tsa' mele li laoloa ke li-hormone. Li hlahisoa ke litšoelesa tse ikhethang - litšoelesa tsa adrenal le mokokotlo oa pituitary. Haeba ts'ebetsong ea litho tsa eona e senyeha, ho se leka-lekane ha endocrine ho etsahala.
Matšoao a Isenko-Cushing - ke eng?
Tlhaloso e hlalositsoeng (hypercorticosis) ke sehlopha sa maloetse ao adrenal cortex e hlahisang e ngata ea cortisol kapa hormone ea adrenocorticotropic. Ho bohlokoa ho khetholla pakeng tsa bothata bo hlahlojoang le lefu la Cushing. Ke lehlakoreng la bobeli la tsamaiso ea endocrine, e hlahang khahlanong le mokokotlo oa maloetse a hypothalamus le mohala oa pituitary.
Cushing's Syndrome - E baka
Ho na le mabaka a 'maloa ao ho ka' nang ha e-ba le 'ona a qholotsang lefu lena. Lintho tsohle tse bakang phekolo ea phekolo ea mali li tloaeletsoe ka mefuta e meraro:
- e sa tloaelehang;
- ho mamella;
- e sebetsang.
Ho tšoana haholo le hypercorticosis
Ts'oaetsano ena ea Itenko-Cushing e qala ho susumetsoa ke lintho tse ka ntle. Lebaka le ka sehloohong la ho hlahella ha lona ke tšebeliso e tsoelang pele ea li-hormone tsa glucocorticosteroid. Lefu lena le bakoa ke phekolo, kahoo e boetse e bitsoa iatrogenic hypercorticism. Hangata e hlokomeloa ka mor'a hore ho fetisetsoe li-hormone ho itokiselitsoe ho thibela tšoaetso ea mmele le ho thibela ho lahla setopo. Phekolo ea bongaka ea bongaka e boetse e qala ka ho phekoloa ha ho ruruha ho sa foleng:
- ramatiki ea ramatiki;
- lefu la ho fokola ha pelo;
- systemic lupus erythematosus.
Endogenous hypercorticosis
Mofuta ona oa lefu lena o hlaha ka lebaka la mathata a ka hare 'meleng. Lisosa tse ka sehloohong tsa nts'etsopele ke maemo a lebisang ho se sebetse ha adrenal cortex:
- hyperplasia ;
- kankere;
- neoplasm e ntle;
- ho senya.
Ho halefisa kholo ea lisele tse nang le li-adrenal e ka ba bophelo bo botle, ka hona, e 'ngoe ea lisosa tsa ho hlahisa phekolo ea mali ke mokhoa oa tlhaho oa lefutso. Lefu la Itenko-Cushing le boetse le bakoa ke li-neoplasms, empa lithong tse ling:
- mokokotlo oa pituitary;
- mae a bomme;
- leseli;
- thymus;
- masela;
- lefu la pherekano kapa qoqotho ea thyroid;
- bronchi.
Cushing's pseudo-syndrome
Ho na le maemo ao ho hlahisoang ke cortisol ho feteletseng, empa ha ho na likokoana-hloko tse thibelang hormone 'meleng. Ena ke lefu le sebetsang la hypercorticism, hangata le tsamaea le mafu a kelello le a kelello. Bakeng sa tlhekefetso e khetholloang ke setšoantšo sa bophelo, ho tšoana hantle le lefu la 'nete. Ka linako tse ling boloetse ba pseudo Itenko-Cushing bo baka:
- botenya;
- ho ima;
- tahi (tahi e sa foleng);
- khatello ea kelello ;
- ho tlōla ha methapo ea methapo ea moriana.
Boloetse ba Itenko-Cushing - matšoao
Karolo e ka sehloohong ea hypercorticism ke ho kenya mafura libakeng tse 'maloa:
- molala;
- hlooho;
- mpa;
- sefuba.
Ka lebaka la botenya, ho bonolo ho bonahatsa lefu la Itenko-Cushing, le matšoao a lona ke a latelang:
- pota-pota;
- litho tse seng kae tse tšesaane ha li bapisoa le 'mele;
- pherese-leputsoa e otlolla likoti, maqheka, mpa, mahetleng;
- ho tepella maikutlo le kelello ea mafu ka lebaka la boima bo feteletseng le ponahalo e sa khotsofatsang.
Ha ho se na phekolo, semelo sa hormone se senyeha ka potlako. Ho hlaolela Cushing's syndrome, e leng matšoao a eona ke:
- ho hōla ha moriri ho feta basali (hirsutism ka mofuta oa banna);
- khatello ea mali e phahameng;
- mathata a potoloho ea khoeli;
- ho hloka matla;
- myopathy;
- ho fokola ha masapo le ho kopanela le eona hangata ho robeha ha masapo;
- hlooho ea hlooho;
- ho hlobaela;
- mathata a kelello;
- bofokoli;
- mesifa ea mesifa;
- hernia ea mpeng;
- ho fufuleloa;
- mafura ;
- ho tšoaetsanoa haholo ha libaka tse ling tsa letlalo;
- ho phunyeha ha mokokotlo;
- mesifa e sa tloaelehang ea mpa;
- ho fokotsa ts'ebetso ea sesole sa 'mele;
- ho hlaka ho khanyang.
Isenko-Cushing syndrome - ho hlahlojoa
Ntho e ka sehloohong e lumellang hore motho a belaelle hypercorticism ke matšoao a lefu la patholo. Ka mor'a ho bokella annesis le ho hlahloba ka ho feletseng, setsebi sa thuto ea ho qetela ha sekolo se fana ka lihlopha tsa lipatlisiso ho fumana lisosa tsa liketsahalo tsa bongaka, ho khetholla ha lefu le mathata a mang. Cushing's syndrome - ho hlahlojoa:
- ho hlahloba motsoako oa mali le mali maling a li-hormone tsa corticosteroid;
- radiography ea libaka tsa serethe le lehata la Turkey;
- khomphuta ea khomphuta kapa khoheli ea li-gland tsa pituitary le tsa adrenal;
- dexamethasone;
- biochemistry ea mali;
- X-ray ea mokokotlo le thorax;
- khalala ea litšoelesa tsa adrenal.
Matšoao a Isenko-Cushing - phekolo
Maqheka a phekolo a itšetlehile ka lisosa tse bakang hypercorticism. Ka mabaka a sa tloaelehang, ho tlosoa butle-butle, ho fokotseha ha litekanyo tsa glucocorticoids kapa ho nkeloa sebaka ke lithethefatsi tse ling tsa immunosuppressive ho khothalletsoa. Ka ho tšoanang, ho tšoaroa ke matšoao a lefu la Itenko-Cushing, le reretsoeng ho tsosolosa lits'ebetso tsa metabolic le boima ba 'mele bo boima, bo etsoa.
Tabeng ea tšimoloho e sa feleng ea tlhahiso ea cortisol e feteletseng, sesosa sa eona se tlameha ho felisoa. Khetho e le 'ngoe feela e sebetsang ka pel'a mahlaseli a bakang kankere ea Cushing e tšoaroa ka ho buuoa. Neoplasm e tlosoa, e lateloa ke mahlaseli a kotsi le phekolo ea meriana e telele. Khetha metsoako ea meriana e fokotsang maqhubu a corticosteroid maling le ho thibela tlhahiso ea bona:
- Motanane;
- Aminoglutethimide;
- Mammoth le ba bang.
Ho phaella moo, ho hlokahala ho emisa matšoao a patholose. Ho etsa sena, sebelisa (ka khetho ea setsebi sa thuto ea ho qetela):
- litokisetso tsa potasiamo;
- lithethefatsi tse matlafatsang;
- lijo;
- divithamini le liminerale;
- meriana ea hypoglycemic;
- calcitonins;
- bisphosphonates;
- anabolic steroids;
- litsebi;
- ho imeloa kelellong.
Netefatsi bakeng sa phekolo e nepahetseng
Lijo ha li thuse haholo ho fokotsa tlhahiso ea cortisol, empa e tla etsa bonnete ba hore mokhoa o tloaelehileng oa ts'ebeliso ea metsoako e le 'meleng. Ke habohlokoa hore ho be thata ho thibela hypercorticism - kalafo e hlileng e akarelletsang ho lokisoa ha lijo le thibelo kapa ho tlosoa lihlahisoa tse latelang:
- margarine;
- lihlahisoa tsa liphoofolo;
- mayonnaise;
- botoro;
- lisebelisoa tsa tsuba;
- letsoai;
- nama e mafura le tlhapi;
- ho baka;
- marinades;
- pickling;
- tee e matla le kofi;
- joala;
- li-sweets.
Ho tsamaisa lefu la Itzenko-Cushing ke habohlokoa ho sebelisa:
- mahe;
- lihlahisoa tse entsoeng ka lebese;
- chisi e thata;
- li-sopho e tlaase tse mafura kapa limela tsa meroho;
- phala;
- nama ea pheho e phehiloeng;
- litholoana le meroho;
- meroho;
- li-tea tsa litlama;
- li-compute tse seng tsa acid le litholoana tsa litholoana.
Mathata a Itenko-Cushing lefu lena
Tlhahlobo eo re e nahanang e tloaelehile ho tsoela pele, ha ho se na phekolo e lekaneng ho ka lebisa liphellong tse tebileng. Lefu le lefu la Itenko-Cushing li amahanngoa le mathata ana:
- stroke;
- ho ikhopotsoa ha mosebetsi oa pelo;
- sepsis;
- ho hloleha ha renal ho sa foleng;
- pyelonephritis e matla;
- phlegone;
- ho robeha ha masapo a mangata;
- tšenyo e ke keng ea qojoa mokokotlong;
- furunculosis;
- ho thehoa majoe a liphio;
- Likokoana-hloko le likokoana-hloko tsa letlalo le ho fokotsa lijo;
- ho senyeheloa ke mpa;
- tlhaloso e thata.
Ka linako tse ling lefu la lefu kapa lefu la Itenko-Cushing le baka boemo bo kotsi haholo bo ka felisang mathata a kotsi-adrenal (adrenal). Lipontšo tsa eona:
- hypoglycemia;
- bohloko bo bohloko ka mpeng;
- ho hlatsa ho hlokehang;
- hyperkalemia;
- tahlehelo ea tsebo;
- ho oela ho matla khatellong ea mali;
- hyponatremia;
- metsolic acidosis.