Hypopituitarism: cov tsos mob, txoj kev mob thiab kev kho mob

Hypopituitarism, cov tsos mob ntawm uas nyob rau hauv lub qhaj ntawv ntawm txaus mob yuav tsis meej pem nrog cov tsos mob ntawm lwm yam loj pathologies, yog ib tug tsis tshua meej ntawm lub pituitary caj pas. Nyob rau hauv no kab mob, lub pituitary caj pas yog ua tsis txaus cov tshuaj hormones, los yog tsis tsim ib tug los yog ntau tshaj ntawm cov tshuaj hormones tsim nyog rau ib txwm hauj lwm ntawm tib neeg lub cev.

Pituitary caj pas - ib tug me me, taum-zoo li tus caj pas nyob rau hauv lub hauv paus ntawm lub hlwb, qab lub qhov ntswg thiab ntawm lub pob ntseg. Dua li ntawm qhov me me luaj li cas, qhov no caj pas ua ib tug tseem ceeb heev muaj nuj nqi: nws tswj lub lag luam ntawm daim card ntawm yuav luag tag nrho cov hauv nruab nrog cev thiab lub cev qhov chaw. Ntxawg kev pab raws qib ua cov tshuaj hormones - cov tsis muaj ntawm lawv tej zaum yuav qhia hypopituitarism. Cov tsos mob rau cov me nyuam muaj feem ntau manifested nyob rau hauv daim ntawv ntawm stunted kev loj hlob thiab lub cev kev loj hlob, nyob rau hauv neeg laus - nyob rau hauv yuam cai ntawm cov ntshav siab thiab kev ua me nyuam muaj nuj nqi.

Tej zaum yuav muaj ib tug lub neej nyob rau hauv lub formulation ntawm xws li ib tug mob koj haus tshuaj, tab sis tej yam tshwm sim ntawm tus kab mob muaj peev xwm yuav khaws cia nyob rau hauv kev tswj.

cov tsos mob

Analyzed pathology nyob rau hauv feem ntau yog hnyav nyob rau hauv cov xwm. Nws tsis yog ib txwm tus kws kho mob yuav tam sim ntawd kev tshawb nrhiav "hypopituitarism": cov tsos mob nyob rau hauv cov me nyuam thiab cov neeg laus yuav ob leeg tshwm sim mam li nco dheev los yog tsim maj tshaj ob peb lub xyoos. Feem ntau tej yam tshwm sim ntawm coj thiab ua li ntawd me ntsis cim uas tus neeg mob rau ib tug ntev lub sij hawm tsuas tsis them nyiaj rau lawv txaus mloog.

Cov tsos mob ntawm tus kab mob sib txawv nyob ntawm seb lub lawm, uas lacks lub cev vim pituitary kawg. Nyob rau hauv tas li ntawd, nws tseem ceeb yuav ua li cas ntse yog tus tsis muaj ib tug kev tshuaj. Tus neeg mob tej zaum yuav muaj kev:

• zoo nkaus li mob nkees;
• tsis libido;
• nce rhiab heev rau tsawg kub, txias;
• qab los noj mov tsis tau.

Nyob rau hauv tas li ntawd mus rau cov ncus rau cov cim ntawm pathology yog:

• qhia poob;
• puffiness ntawm lub ntsej muag;
• anemia;
• ntxiv lawm tshob;
• poj niam - kub flashes, lus ua poj niam, los yog tsis muaj thereof, pubic cov plaub hau tsis, tsis muaj peev xwm yuav tsim ob lub mis mis nyuj rau pub mis me nyuam mos mos ab;
• txiv neej - tsis ntawm cov plaub hau loj hlob nyob rau hauv lub ntsej muag los yog lub cev;
• cov me nyuam - tsis muaj txoj kev loj hlob.

Thaum mus ntsib ib tug kws kho mob

Yog hais tias koj xav nyob rau hauv hypopituitarism, cov tsos mob uas muaj npe saum toj no, teem lub sij hawm ib tug kev sib tham nrog ib tug kev tsim nyog.

Nrog koj tus kws kho mob tam sim ntawd yog tias muaj tej yam tshwm sim ntawm tus kab mob nyob mam li nco dheev los yog nrog mob taub hau, qhov muag plooj tsis pom kev, tsis meej pem nyob rau hauv lub sij hawm thiab qhov chaw, los yog ib tug ntse poob nyob rau hauv cov ntshav siab. Qhov no yog tsis hypopituitarism - cov tsos mob ntawm no xwm tej zaum yuav qhia hais tias tus pituitary caj pas qhia txhob los ntshav (apoplexy), uas yuav tsum tau ceev kho mob kev pab.

yog vim li cas

Qhov no tsis meej yuav tshwm sim los ntawm kev yug me nyuam tsis xws luag, tab sis nws yog feem ntau muas. Nyob rau hauv feem ntau tus neeg mob, hypopituitarism tshwm sim los ntawm ib tug pituitary qog. Raws li lub qog ua loj, nws squeezes thiab hu plig lub cev nqaij, muaj ib tug tsis zoo ntxim rau cov lawm ntau lawm. Nyob rau hauv tas li ntawd, lub mob yuav hlob lub optic qab haus huv, li no yuav ua tau rau ib tug ntau yam ntawm mob thiab hallucinations.

Lwm yam kab mob, raws li tau zoo raws li tej yam muaj tshwm sim kuj yuav ua kev puas lub pituitary caj pas thiab txhais hypopituitarism (cov tsos mob, cov duab no peb tuaj nyob rau hauv no tsab xov xwm). Cov tsos mob ntawm tus kab mob sib txawv nyob ntawm seb yam tseem ceeb uas txhais txoj kev loj hlob ntawm pathology. Tej yam zoo xws li:

• lub taub hau raug mob;
• Hlwb los yog pituitary mob;
• phais haujlwm rau lub paj hlwb;
• radiotherapy kev kho mob txoj kev;
• autoimmune o (hypophysis);
• stroke;
• kab lub hlwb cov kab mob (e.g. meningitis);
• tuberculosis;
• infiltrative cov kab mob (sarcoidosis - o nyob rau hauv ob peb lub hauv nruab nrog cev, Langerhans cell histiocytosis - ib tug teeb meem nyob rau hauv uas txawv txav hlwb ua cirrhosis nyob rau hauv ntau yam nruab nrog cev thiab lub cev qhov chaw, mas nyob rau hauv lub ntsws, thiab cov pob txha; hemochromatosis - ntev txuam nrog cov hlau nyob hauv lub siab thiab lwm yam ntaub so ntswg);
• loj ntshav poob thaum lub sij hawm tus me nyuam, uas yuav ua kev puas lub anterior pituitary (Simmonds kab mob-Glinski los yog tom qab pituitary necrosis);
• tshuaj ntsuam genetic change uas coj mus rau kev ua txhaum ntawm zus tau tej cov tshuaj hormones nyob rau hauv lub pituitary caj pas;
• hypothalamic kab mob - lub hlwb fragment, uas yog nyob rau saum lub pituitary caj pas - kuj tseem ua hypopituitarism.

Cov tsos mob (yees duab qhia tus kab mob no cov txheej txheem) tshwm sim vim hais tias cov hypothalamus ua nws tus kheej cov tshuaj hormones uas tswj cov hauj lwm ntawm "nyob sib ze" taum-zoo li tus caj pas.

Nyob rau hauv tej rooj plaub, lub genesis ntawm tus kab mob tseem tsis paub hais tias.

Ua ntej lub mus ntsib mus rau tus kws kho mob

Thawj kauj ruam yog mus sau npe kawm nyob rau hauv ib tug kev kho mob sib tham nrog ib tug kws kho mob. Yog hais tias tsim nyog, nws yuav redirect koj los ib tug kws nyob rau hauv hormonal ntshawv siab - lub endocrinologist.

• Nrhiav tawm nyob rau hauv ua ntej seb koj yuav tsum ua raws li nrog rau tej uas yuav tsum tau kom peb ua tau diagnostic tests.
• Ua ib tug ncauj lus kom ntxaws daim ntawv teev cov tag nrho cov kab mob cov tsos mob uas koj pom nyob rau hauv tsev. Yog hais tias koj xav hypopituitarism, cov tsos mob ntawm tus kab mob, thaum xub thawj siab ib muag tsis txheeb ze rau pituitary kawg, yuav tsum tau muaj nyob rau hauv daim ntawv no.
• nyob rau hauv kev sau ntawv txhim kho ib tug tseem ceeb tus kheej cov ntaub ntawv, nrog rau cov loj-scale hloov nyob rau hauv lub neej los yog teeb meem loj hloov koj lub peev xwm los mus daws kev nyuaj siab.
• Sau yooj yim ntaub ntawv kho mob, xws li tsis ntev los no kev phais, lub npe tsis tu ncua yuav siv sij hawm tshuaj thiab kab mob. Tus kws kho mob yuav kuj xav paub yog hais tias koj pauv mus rau ib tug tsis ntev los no lub taub hau raug mob.
• Coj ib tug neeg hauv tsev neeg los yog phooj ywg uas yuav tsis tsuas yog yuav kam muab kev ncaj ncees them nyiaj yug, tab sis kuj pab koj nco ntsoov tag nrho cov tswv yim pom zoo ntawm cov kws muaj txuj.
• Ua ib daim ntawv teev cov lus nug uas koj xav nug koj tus kws kho mob.

cov lus nug endocrinologist

Nws yog ib advisable mus ua ib daim ntawv teev cov feem ntau txaus siab rau koj cov lus nug nyob rau hauv ua ntej mus rau thaum lub sij hawm sib tham yog tsis txhob poob pom ntawm qhov tseem ceeb kom paub meej. Yog hais tias koj muaj kev txhawj xeeb hypopituitarism (cov tsos mob thiab kev kho mob rau cov kab mob uas koj xav nyob rau hauv), xws li nyob rau hauv koj daim ntawv teev cov lus nug no:

• Dab tsi ua rau tus mob cov tsos mob thiab kuv tam sim no lub xeev?
• Yog nws tau hais tias tej yam tshwm sim ntawm tus kab mob tshwm sim los ntawm lwm?
• Yuav ua li cas koj yuav tsum tau xeem kom dhau qhov kev xeem?
• Yog kuv tus mob ib ntus los yog mob?
• Yuav ua li cas kho mob ua koj pom zoo kom?
• Ntev npaum li cas koj yuav tsum coj lub pom zoo tshuaj?
• Yuav ua li cas yuav koj saib xyuas cov hauj lwm zoo ntawm txoj kev kho?
• Kuv muaj ib tug mob mob. Yuav ua li cas los xyuas kom meej qhov simultaneous kev kho mob ntawm tag nrho cov kev ntshawv siab?
• Kuv puas yuav tau ua raws li tej kev txwv?
• Puas muaj analogues tshuaj koj cov tshuaj?
• Kuv xav tau cov lus qhia ntxiv hais txog dab tsi yog hypopituitarism. Cov tsos mob thiab tus mob muaj tseeb; dab tsi ntaub ntawv hais txog ntau yam kev kho mob yuav koj qhia?

Tsis txhob yig nug lwm cov lus nug, Yog hais tias thaum lub sij hawm sib tham koj xav paub ib yam dab tsi txog tshwj xeeb.

Yuav ua li cas tus kws kho mob hais tias

Endocrinologist, nyob rau hauv lem, yuav hais kom koj ib tug xov tooj ntawm nws tus kheej cov lus nug. Ntawm lawv, feem ntau yuav, yuav tsum tau li nram qab no:

• Vim li cas koj xav hais tias koj muaj hypopituitarism?
• Cov tsos mob thiab ua rau ntawm tus kab mob uas koj pom koj tus kheej, pom zoo nrog qhov kev piav qhia ntawm tus kab mob nyob rau hauv cov kev kho mob cov ntaub ntawv?
• Puas muaj tej yam cim qhia ntawm pathology hloov lub sij hawm?
• Koj puas pom tej yam qhov muag pom kev tsis taus?
• Koj puas raug kev txom nyem los ntawm sab kev mob taub hau?
• Koj puas tau hloov koj cov tsos? Tej zaum koj poob ceeb thawj los yog tau pom ib tug txo nyob rau hauv lub ntim ntawm cov plaub hau rau lub cev?
• Koj puas tau poob kev txaus siab nyob rau hauv pw ua niam txiv? Yog koj cev ntas hloov?
• Seb koj yuav mus thaum lub caij kho mob? Los yog, tej zaum, dhau txoj kev kho nyob rau hauv tsis ntev los no yav dhau los? Yuav ua li cas cov kab mob tau raug tshuaj lawm?
• Muaj koj nyuam qhuav yug tau ib tug me nyuam?
• Koj puas tau txais lately ib lub taub hau raug mob? Koj neurosurgical kev kho mob twb raug?
• Kev tshawb nrhiav seb koj nyob ze cov txheeb ze pituitary mob los yog hormonal ntshawv siab?
• Yuav ua li cas koj xav hais tias, nws yuav pab tau alleviate cov tsos mob?
• Yuav ua li cas, nyob rau hauv koj lub tswv yim, muaj txhawb rau worsening ntawm cov tsos mob?

diagnostics

Seb tus kws kho mob yuav tam sim ntawd xav tias hypopituitarism? Cov tsos mob thiab ua rau koj tsis zoo lub xeev thawb tej tus kws khomob tshwjxeeb muab nws, qhov no pib mob, kom paub tseeb tias koj xav tau kom dhau ob peb qhov kev ntsuam xyuas los mus txiav txim rau theem ntawm ntau yam tshuaj hormones rau hauv lub cev. Yog vim li cas rau qhov chaw kawm xws li ib tug mob yuav pab raws li ib tug tsis ntev los no lub taub hau raug mob los yog ib tug ua kom tiav chav kawm ntawm radiotherapy - cov muaj tej yam kuj muaj cuab kav mus ua rau txoj kev loj hlob ntawm tus kab mob.

Cov nab npawb ntawm cov txheej txheem diagnostic kev ntsuam xyuas muaj xws li:

• Kuaj ntshav. Kuj yooj yim kev ntsuam xyuas muaj peev xwm ntes tsis muaj peev xwm ntawm tej yam cov tshuaj hormones, uas sawv raws li ib tug tshwm sim ntawm pituitary kawg. Piv txwv li, kuaj ntshav yuav pom nyob rau theem sab ntawm cov tshuaj hormones ua los ntawm cov thyroid caj pas, adrenal cortex, los yog genitals, - tus tsis muaj cov tshuaj no feem ntau yog txuam nrog impaired hauj lwm ntawm lub pituitary caj pas.
• Stimulation los yog dynamic kev ntsuam xyuas. Txawm ib tug kws muaj txuj nws yog ib qhov nyuaj kom paub txog hypopituitarism; tsos mob ntawm tus me nyuam rau tag nrho cov tej zaum yuav zoo ib yam li cov tsos mob ntawm ib tug ntau yam ntawm kev tshuaj ntsuam genetic ntshawv siab. Yog xav tau qhov tseeb diagnostic tau, tus kws kho mob yuav tej zaum yuav xa koj mus rau ib tug kws lub tsev kho mob endocrinological kev tshawb fawb, qhov uas koj coj tus thawj kev zoo tshuaj mus tsim kho lub zus tau tej cov tshuaj hormones, thiab ces xyuas seb yuav ua li cas nce volume ntawm pa.
• lub hlwb imaging txoj kev tshawb no. Sib Nqus resonance imaging (MRI) ntawm lub paj hlwb yuav ntes ib tug mob ntawm lub pituitary thiab lwm yam ntxwv txawv txav.
• Qhov muag piab. Tshwj xeeb ntsuam xyuas txiav txim seb tus pituitary lub pob loj hlob ntxim rau cov muaj peev xwm mus saib los yog saib.

kev kho mob

Hypopituitarism, cov tsos mob hais thiab piav saum toj no, yog yuav luag ib txwm ib tug tsim nyog tau ntau dua li ib cov kab mob. Kev kho mob ntawm cov hauv paus hniav ua, nyob rau hauv Feem ntau, eliminates tag nrho cov tsos mob ntawm tus hormonal ntshawv siab txuam nrog kawg ntawm lub pituitary caj pas. Yog hais tias cov thawj zaug mob txoj kev kho rau ib co yog vim li cas muab tau tsis yooj yim sua los yog tsis zoo, yog kho nrog hormonal txoj kev kho rau hypopituitarism. Thaum zoo xws li cov teebmeem ntawm lub cev tsis yog li ntawd ntau npaum li cas kev kho mob raws li kev hloov ntawm tau ploj lawm yam. Noj tshuaj npaum cas yuav tsum muab xwb mas txawj endocrinologist, txij li thaum lawv xam rau ib tug neeg hauv paus thiab nyiaj rov qab nruj me ntsis cov tshuaj hormones thiab nyob rau hauv lub ntau nyob rau hauv uas lawv uas hais nyob rau hauv ib tug noj qab nyob zoo lub cev. Hloov kho yuav kav ib sim neej.

Yog hais tias lub qog tau tshwm sim los hypopituitarism, cov tsos mob, kev kho mob thiab tom ntej kev ncaj ncees txoj kev kho yuav yog nyob ntawm seb yam ntxwv xwm ntawm lub qog. Feem ntau tus kws kho phais kom tshem tawm cov kev txawv txav ntawm tes. Nyob rau hauv tej rooj plaub, tawg txoj kev kho.

npaj

Medicaments substituents tej zaum yuav sawv cev los ntawm cov hauv qab no tshuaj:

• Corticosteroids. Cov tshuaj (piv txwv tej zaum yuav pab tau raws li hydrocortisone thiab prednisolone) pawg cov tshuaj hormones nyob rau hauv lub qub xeev los ntawm cov adrenal cortex. Lawv tsis txaus vim adrenocorticotropic tsis muaj peev xwm. Corticosteroids coj hais lus.
• "Levothyroxine" ( "LeVox" thiab al.). Cov tshuaj ntau xyoo cov thyroid hormone nyob rau hauv cov kev ntshawv siab.
• Pw ua ke cov tshuaj hormones. Raws li ib tug txoj cai, rau cov txiv neej yog testosterone rau cov poj niam - cov tshuaj no los yog thaum lawv tseem tshuaj nrog progesterone. Yog hais tias koj xav tias koj muaj hypopituitarism, cov tsos mob, thiab kev tiv thaiv kev mob ntawm lub caj pas pituitary tej zaum yuav zoo ib yam li cov tsos mob thiab cov hau kev ntawm kev tiv thaiv kev mob uas muaj feem rau kev sib deev cov tshuaj hormones. Yog hais tias lub abnormality thiaj paub tias yog tus kws kho mob, los hloov cov uas ploj lawm yam tshuaj cov tshuaj siv nyob rau hauv ib cov ntaub ntawv: gel los yog testosterone tshuaj rau cov txiv neej thiab cov ntsiav tshuaj, tshuaj kua los yog thaj ua rau thaj - rau cov poj niam.
• Kev loj hlob lawm. Cov tshuaj yeeb dej caw yog hu ua nyob rau hauv kev kho mob science somatropin nrog endocrine ntshawv siab, nkag mus rau hauv lub cev los ntawm cov subcutaneous kev txhaj tshuaj. Kev loj hlob hormone tso cai rau lub cev loj hlob tuaj, kom ntseeg tau qub kev loj hlob nyob rau hauv cov me nyuam. Cov neeg laus taw sawv txhaj tshuaj, pab txoj kev mob ntawm tus neeg mob, tab sis ib txwm loj hlob nyob yuav tsis tsum rov qab los.

xyuas

Lub endocrinologist yuav saib xyuas koj ntau ntau cov tshuaj hormones nyob rau hauv cov ntshav, los xyuas kom meej txaus, tab sis tsis ntev npaum li cas tseem ceeb heev tshuaj.

Tej zaum koj yuav tsum tau kho cov koob tshuaj corticosteroids, yog hais tias koj mob heev los yog yuav raug kev txom nyem loj heev lub cev kev nyuaj siab. Thaum muaj tej lub sij hawm, lub cev ua ib tug ntxiv lawm cortisol. Hloov cov tshuaj yuav tsum nyob rau hauv cov neeg mob, thaum koj catch ib txias, koj yuav raug kev txom nyem los ntawm raws plab los yog ntuav, los yog yuav raug kev txom nyem los yog phais tus kho hniav. Muaj ntau cov neeg mob tus kws kho periodic CT los yog MRI.