Cov tawv nqaij mob, lub cev qhov hnyav, kev ua haujlwm hauv plawv thiab lwm yam tsis muaj mob tsis muaj kev tswj hwm los ntawm hormones. Lawv yog cov qog tshwj xeeb - cov qog ntawm cov qog thiab cov qog pituitary. Yog hais tias qhov hauj lwm ntawm lub plab hnyuv siab raum yog cuam tshuam, endocrine tsis txaus tshwm sim.
Isenko-Cushing syndrome - nws yog dab tsi?
Qhov kev piav qhia (hypercorticosis) yog ib pawg ntawm cov kabmob uas cov adrenal cortex ua rau ntau npaum li cas ntawm cortisol lossis adrenocorticotropic hormone. Nws yog ib qho tseem ceeb kom paub qhov txawv ntawm qhov teeb meem raws li kev xav thiab Cushing tus kab mob. Nws yog ib qhov mob qis dua ntawm qhov kev tiv thaiv kab mob endocrine, tsim tawm tsam cov keeb kwm ntawm cov kab mob hypothalamus thiab pituitary caj pas.
Cushing's Syndrome - Ua rau
Muaj ntau ntau yam uas tsimnyog ua rau tus kabmob no tsis zoo. Tag nrho cov ua rau ntawm cov tshuaj hypercorticism yog cais raws li 3 hom:
- exogenous;
- endogenous;
- haumxeeb.
Exogenous hypercorticosis
Qhov Syndrome no ntawm Itenko-Cushing tsim tawm hauv tus cwj pwm ntawm lwm yam. Lub ntsiab ua rau nws tshwm sim yog kev siv cov tshuaj hormone glucocorticosteroid. Qhov kev mob ntawm tus mob no yog los ntawm kev kho, yog li ntawd nws tseem hu ua iatrogenic hypercorticism. Nws yog feem ntau pom tom qab kev sib hloov - hormonal preparations yog kws kho rau suppress tiv thaiv thiab tiv thaiv tsis kam ntawm transplanted hloov. Kev kho mob hypercorticism kuj pib nrog kev kho mob ntawm cov mob ntev:
- rheumatoid kev mob caj dab;
- bronchial hawb pob;
- kev mob lupus erythematosus.
Endogenous hypercorticosis
Qhov no variant ntawm tus kab mob no tshwm sim vim muaj mob hauv lub cev. Lub ntsiab ua rau kev loj hlob yog cov kev ua rau txoj kev ua haujlwm ntawm lub qog nqaij hlav:
- hyperplasia ;
- mob cancer;
- benign neoplasm;
- dystrophy.
Yuav ua rau kom muaj kev loj hlob ntawm cov hlav adrenal tuaj yeem ua qhov caj npab, yog li ntawm ib qho ntawm cov kev tshwm sim ntawm qhov kev tshwm sim ntawm hypercorticism yog ib qho kev tshuaj ntsuam genetic predisposition. Itenko-Cushing tus kab mob kuj yog tshwm sim los ntawm neoplasms, tab sis lwm yam kabmob:
- pituitary caj pas;
- zes qe menyuam;
- lub teeb;
- thymus;
- noob qes;
- txiav lossis thyroid caj pas;
- bronchi.
Cushing's pseudo-syndrome
Muaj cov mob uas ua dhau cortisol ntau lawm, tiam sis tsis muaj hormone-secreting hlav hauv lub cev. Qhov no yog ib qho kev mob plab hnyuv su ntawm hypercorticism, feem ntau nws nrog cov kev mob hlwb thiab hlwb. Rau kev ua txhaum los ntawm ib daim duab raug mob, tag nrho zoo li tus kab mob tseeb. Qee zaum pseudo-Syndrome Itenko-Cushing provoke:
- rog;
- cev xeeb tub;
- kev quav dej quav cawv (mob qog nqaij ntev);
- kub siab ;
- kev ua txhaum ntawm carbohydrate metabolism.
Mob ntawm Itenko-Cushing - cov tsos mob
Lub ntsiab ntawm lub ntsiab lus ntawm hypercorticism yog kev tso roj ntawm ntau thaj chaw:
- caj dab;
- taub hau;
- plab;
- hauv siab.
Vim yog rog, nws txawm pom kev yooj yim kom pom cov Itenko-Cushing syndrome, cov tsos mob ntawm cov uas muaj raws li nram no:
- puag ncig lub ntsej muag;
- disproportionately thin nquag piv nrog lub cev;
- kua xiav-xiav ntawm lub pob tw, lub plab, lub plab, lub xub pwg;
- kev nyuaj siab thiab kev puas siab puas ntsws vim muaj qhov hnyav tshaj thiab pom tsis zoo.
Thaum tsis tuaj yeem kho, tus keeb kwm hormonal deteriorates sai. Ua kom tus Cushing's syndrome hnyav, cov tsos mob uas yog:
- tshaj cov plaub hau kev loj hlob ntawm cov poj niam (hirsutism nyob rau hauv hom txiv neej);
- ntshav siab;
- kab mob qaum kev mob;
- impotence;
- myopathy;
- osteoporosis thiab txuam nrog nws feem ntau pob txha;
- mob taub hau;
- insomnia;
- kev puas siab puas ntsws mob hlwb;
- tsis muaj zog;
- nqaij atrophy;
- plab huam tuaj;
- tawm hws;
- pob txuv ;
- hyperpigmentation ntawm tej thaj chaw tawv nqaij;
- curvature ntawm qaum;
- tsis meej mob plab;
- tsis ua haujlwm ntawm lub cev;
- ci ntsa iab.
Isenko-Cushing syndrome - kev kuaj mob
Qhov tseem ceeb tshaj plaws uas tso cai rau kev txhaum hypercorticism yog cov tsos mob ntawm tus kab mob pathology. Tom qab khaws cov tshuaj anamnesis thiab kev soj ntsuam tag nrho, cov kws kho mob endocrinologist muab ntau cov kev tshawb fawb los txiav txim seb qhov xwm txheej tshwm sim, qhov sib txawv ntawm cov kab mob piav thiab lwm yam mob. Cushing's syndrome - mob:
- kev ntsuam xyuas zis thiab ntshav ntawm cov ntsiab lus ntawm corticosteroid hormones;
- radiography ntawm thaj av ntawm lub tsho ntawm Turkish thiab pob txha taub hau;
- khoos phis tawj los sis nqaj hlau resonance ntawm cov qog pituitary thiab adrenal;
- dexamethasone kuaj;
- biochemistry ntawm cov ntshav;
- Xoo hluav taws xob ntawm qaum thiab tob;
- scintigraphy ntawm qog adrenal.
Isenko-Cushing syndrome - kev kho mob
Txoj kev kho tactics yog nyob ntawm seb ua rau lub siab ua kom pom kev hypercorticism. Nrog cov qee yam tawm kev noj qab haus huv, kev tshem tawm kev sib tw, txo qis ntawm glucocorticoids lossis lawv cov hloov los ntawm lwm cov tshuaj tiv thaiv kabmob. Nyob rau hauv parallel, symptomatic kev kho mob ntawm Itenko-Cushing tus kab mob, aimed ntawm restoring metabolic kev ua thiab normalizing lub cev hnyav, yog nqa tawm.
Nyob rau hauv cov ntaub ntawv ntawm lub keeb kwm ntawm cov cortisol ntau heev, nws ua rau yuav tsum tau muab tshem tawm. Qhov kev xaiv tsuas yog qhov muaj cov hlav uas ua rau Cushing's syndrome muaj kev phais. Neoplasm raug tshem tawm, raws li hluav taws xob thiab kev siv tshuaj kho mob ntev heev. Xaiv cov chaw tshuaj pharmacological uas txo cov concentration ntawm corticosteroid hormones nyob rau hauv cov ntshav thiab suppress lawv cov:
- Mitotane;
- Aminoglutethimide;
- Mammoth thiab lwm tus.
Tsis tas li ntawd, nws yog ib qho tsim nyog yuav tsum tau tso tseg cov tsos mob ntawm tus kab mob pathology. Ua li no, siv (thaum xaiv tus endocrinologist):
- kev npaj cov potassium;
- tshuaj antihypertensive;
- noj zaub mov;
- vitamins thiab minerals;
- tshuaj hypoglycemic;
- calcitonins;
- bisphosphonates;
- anabolic steroids;
- sedatives;
- antidepressants.
Khoom noj khoom haus rau kev kho mob
Kev noj haus tsis pab txo qhov qoob loo ntau ntau, tab sis yuav ua kom lub cev tuaj ntawm cov txheej txheem metabolic hauv lub cev. Nws yog ib qho tseem ceeb rau kev xav suppress hypercorticism - kev kho mob yuav tsum muaj kev kho ntawm kev noj haus nrog kev txwv lossis cais ntawm cov khoom nram qab no:
- margarine;
- tsiaj nqaij;
- mayonnaise;
- butter;
- cov khoom haus luam yeeb;
- ntsev;
- fatty nqaij thiab ntses;
- ci;
- marinades;
- pickling;
- muaj zog tshuaj yej thiab kas fes;
- cawv;
- khoom qab zib.
Yuav pab txhawb nws lub Itzenko-Cushing syndrome nws yog ib qho tseem ceeb uas yuav tau siv:
- qe;
- fermented mis nyuj khoom;
- nyuab cheese;
- tsawg-rog lossis nqaij noj zaub;
- porridge;
- boiled noj zaub mov;
- txiv hmab txiv ntoo thiab zaub;
- zaub ntsuab;
- tshuaj ntsuab teas;
- non-acid compotes thiab txiv hmab txiv ntoo haus.
Teeb meem ntawm Itenko-Cushing tus kab mob
Tus kab mob pathology no yog qhov nws tshwm sim rau kev mob, thaum tsis muaj kev kho tus mob nws tuaj yeem ua rau muaj kev rau txim loj. Tus kab mob thiab tus Itenko-Cushing Syndrome no yog txuam nrog cov teeb meem xws li:
- mob stroke;
- decompensation ntawm kev ua si lub plawv;
- sepsis;
- mob hawb pob tsis ntev;
- mob hnyav pyelonephritis;
- phlegmon;
- ntau pob txha ntawm pob txha;
- irreversible kev puas tsuaj rau txha caj qaum;
- furunculosis;
- tsim ntawm pob raum pob zeb;
- Fungal thiab kab mob ntawm daim tawv nqaij mob nrog lub cev;
- nchuav menyuam;
- nyuab nyuab.
Qee lub sij hawm muaj tus mob Syndrome los yog kab mob ntawm Itenko-Cushing ua rau muaj kev phom sij heev uas yuav xaus tau ua kom tuag - lub plawv (adrenal). Cov cim qhia:
- hypoglycemia;
- mob mob hauv plab;
- ntuav ntuav;
- hyperkalemia;
- tsis nco qab;
- ib tug ntse poob hauv cov ntshav siab;
- hyponatremia;
- metabolic acidosis.