Thaum tus neeg pom cov lus kho mob nyuaj, nws pib disassemble nws rau hauv nws cov khoom kom nkag siab txog nws tus kab mob. Yog li ntawd, nws thawj lo lus nug rau nws tus kheej yuav yog: "Lub caj pas pituitary yog dab tsi?". Tom qab tshawb nrhiav cov ntaub ntawv zoo, nws yuav pom tias qhov no yog cov qog endocrine uas tswj hwm kev ua haujlwm ntawm tag nrho lwm cov qog hauv lub cev. Kev tshawb fawb ntxiv yuav ua rau tus neeg mob mus rau cov npe ntawm cov tshuaj hormones thiab lub hom phiaj ntawm lub cev tsim los ntawm nws. Thiab tsuas yog tom qab ntawd nws yuav thaum kawg txiav txim siab seb cov kab lus "pituitary prolactinoma" txhais li cas. Qhov no yog cov qog uas tsim cov tshuaj hormones ntau dhau rau lub cev. Tshaj prolactin ntau dhau thiab ua rau cov tsos mob tshwm sim. Tab sis ua ntej ua ntej.
Pituitary caj pas yog dab tsi?
Lub caj pas pituitary yog dab tsi? Lub caj pas pituitary yog ib feem ntawm lub midbrain, nyob rau ntawm nws basal nto, nyob rau hauv ib tug pob txha tsim hu ua Turkish eeb. Cov qog no tsim cov tshuaj hormones uas tswj tib neeg txoj kev loj hlob, metabolic tus nqi thiab kev loj hlob ntawm cov xeeb ntxwv. Lub caj pas pituitary yog tus neeg xyuas pib ntawm endocrinetshuab. Kev cuam tshuam nrog hypothalamus, lawv ua ke tswj lub cev, muab nws cov haujlwm tseem ceeb.
Muaj peb ntu lossis lobes hauv lub caj pas pituitary:
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Lub lobe anterior tsim cov tshuaj hormones tropic. Lawv raug hu vim tias lawv cuam tshuam rau qee yam kabmob thiab muaj tshuaj lom neeg rau lawv cov ntaub so ntswg. Cov no suav nrog:
- thyroid-stimulating hormone (koom nrog cov thyroid caj pas); - adrenocorticotropic hormone (stimulates lub qog adrenal); - follicle-stimulating hormone (tswj kev ua haujlwm ntawm kev sib deev., induces qe maturation);
- luteinizing hormone (stimulates ovulation);
- kev loj hlob hormone yog lub luag hauj lwm rau kev loj hlob;
- luteotropic hormone, los yog prolactin (tswj cov tsos ntawm colostrum thiab mis nyuj nyob rau hauv cov poj niam cev xeeb tub, yog lub luag hauj lwm rau niam instinct). Pituitary prolactinoma tsim nyob rau hauv lub lobe anterior, nws "perverts" ua hauj lwm ntawm luteotropic hormone.
- Vasopressin yog zais rau hauv lub lobe tom qab (lub luag haujlwm tswj cov ntshav siab thiab kua dej hauv cov ntaub so ntswg), nrog rau oxytocin, uas yog qhov tsim nyog thaum cev xeeb tub thiab pub menyuam yaus. Nws ua rau cov leeg du kom cog lus.
- Melanocytes, cov tshuaj hormones uas txhawb cov tawv nqaij, yog synthesized nyob rau hauv nruab nrab lobe.
Kev ua haujlwm, raws li koj xav tau, lub caj pas pituitary muaj ntau yam. Nws tswj kev faib tawm ntawm tes thiab cov protein synthesis los tsim cov ntaub so ntswg tshiab. Tsis tas li ntawd, nws tswj lub maturation ntawm qe thiab phev, nrog rau lub cev teb rau cov teebmeem ntawm kev sib deev cov tshuaj hormones. cuam tshuam nrog lub cev tiv thaiv kab mob los ntawm stimulating los yog inhibiting muaj nuj nqithyroid caj pas. Tswj cov ntshav siab nyob rau hauv cov hlab ntsha, tus nqi ntawm cov rog thiab qhov zoo ntawm kev pw tsaug zog. Lub caj pas pituitary tsis khoom 24 teev hauv ib hnub, 7 hnub hauv ib lub lis piam, tag nrho peb lub neej.
YProlactin - yog dab tsi?
Muaj kev nkag siab me ntsis ntawm lub cev thiab lub cev ntawm lub cev endocrine, koj tuaj yeem mus rau qhov kev soj ntsuam ntxaws ntxiv ntawm nws. Tau kawg, nrog swoop, tsis muaj kev cob qhia tshwj xeeb, nws yuav tsis yooj yim, tab sis koj tuaj yeem sim tsawg kawg. Hauv kev kuaj mob, ntxiv rau lo lus "pituitary caj pas", kuj muaj prolactin. Dab tsi yog?
Prolactin yog ib qho ntawm cov tshuaj hormones secreted los ntawm acidophilic hlwb ntawm lub anterior pituitary caj pas. Raws li nws cov qauv tshuaj, nws belongs rau cov qauv protein. Cov kws tshawb fawb txheeb xyuas tag nrho tsev neeg ntawm cov khoom uas muaj cov yam ntxwv zoo sib xws. Cov no suav nrog:
- prolactin;
- proliferin (tswj kev faib tawm ntawm cov ntaub so ntswg sib txuas);
- somatotropin; - placental lactogen (zais thaum cev xeeb tub).
Cov khoom tam sim no paub ntawm prolactin yog ncaj qha lossis ncaj qha rau kev ua haujlwm ntawm kev sib deev thiab kev tsim tawm. Lub hom phiaj lub cev yog, raws li lub npe implies, cov qog mammary. Cov tshuaj hormones txhawb kev tsim cov colostrum thiab nws hloov mus rau hauv cov mis nyuj. Thaum cev xeeb tub thiab thaum cev xeeb tub, nws yog lub luag haujlwm rau kev loj hlob thiab kev loj hlob ntawm cov qog mammary, tus naj npawb ntawm lobules thiab ducts. Qhov tseeb nthuav: prolactin receptors muaj nyob rau hauv yuav luag tag nrho cov kabmob thiab cov ntaub so ntswg ntawm tib neeg lub cev, tab sis dab tsi cuam tshuam rau lawv tseem tsis tau paub.
YPituitary prolactinomaNws tshwm sim vim kev hloov pauv hauv cov hlwb ntawm adenohypophysis. Nws provokes ntau lawm ntawm prolactin thiab txhim kho nws cov khoom, uas cuam tshuam rau kev noj qab haus huv thiab tsos ntawm cov neeg mob. Hmoov zoo, kev kuaj mob thiab kev kho mob ntawm cov kab mob no twb paub thiab kuaj tau zoo, yog li qhov kev kuaj mob no tsis yog kab lus kiag li.
YProlactinoma
Prolactinoma ntawm lub qog pituitary yog ib qho ntawm cov kab mob benign tshaj plaws ntawm lub caj pas pituitary anterior (raws li kev txheeb cais, txog li 30 feem pua ntawm tag nrho cov qog nqaij hlav). Nws tshwm sim hauv cov poj niam uas muaj hnub nyoog me nyuam. Qhov piv ntawm cov neeg sawv cev ntawm cov neeg muaj zog thiab kev sib deev ncaj ncees yog 1 txog 6.
Nws qhov ntev, raws li txoj cai, tsis pub tshaj ob lossis peb millimeters, tab sis cov txiv neej kuj tuaj yeem muaj cov qauv loj - ntau tshaj li ib centimeter ntawm txoj kab uas hla. Cov qog no ua haujlwm hormonally, vim lawv tsim prolactin. Feem ntau, nws yog synthesized nyob rau hauv ob qho tib si poj niam txiv neej. Prolactin tuaj yeem cuam tshuam rau hauv nruab nrog cev ntawm nws tus kheej thiab ua ke nrog cov tshuaj luteinizing thiab follicle-stimulating hormones. Lawv qhov kev txiav txim tshwj xeeb tshaj yog thaum cev xeeb tub thiab lactation. Tab sis dhau ntawm qhov ntawd, lawv tswj kev coj khaub ncaws thiab qhov pib ntawm ovulation.
Ntau dhau ntawm cov tshuaj hormones ua rau muaj qhov cuam tshuam. Ib tug poj niam yuav tsis muaj menyuam, uas yog, nws xeeb tsis tau thiab yug tau menyuam. Cov txiv neej, ntawm qhov tod tes, uas muaj titers siab ntawm prolactin, muaj teeb meem nrog potency thiab erection, nco ntsoov subjective thiab lub hom phiaj lub mis o.
Yog vim li cas
Cov kws tshawb fawb tseem tsis tau paub meej tias vim li cas ib tug neeg muaj qhov noneoplasm, tab sis pom ib co nta uas yog yam ntxwv ntawm tag nrho cov neeg mob uas muaj ib tug zoo xws li kev kuaj mob.
Ua ntej ntawm tag nrho cov, tau kawg, peb tab tom tham txog kev mob caj ces ntawm cov kab mob endocrine. Raws li txoj cai, cov no yog ntau yam neoplasias (uas yog, muaj cov qog nyob rau hauv yuav luag tag nrho cov qog endocrine). Tsis tsuas yog prolactin, tab sis kuj tseem muaj cov tshuaj hormones ntawm cov thyroid thiab parathyroid qog, pancreas, qog adrenal, pituitary caj pas thiab muaj cov kab mob hauv plab..
Nws paub tias cov neeg txheeb ze muaj feem ntau dua ntawm cov kab mob no dua li qhov nruab nrab rau cov pej xeem. Cov noob caj noob ces niaj hnub tsis tso tseg thiab tab tom nrhiav cov noob lub luag haujlwm hloov cov yam ntxwv ntawm adenohypophysis hlwb, tab sis txog tam sim no tseem tsis tau muaj kev vam meej hauv cheeb tsam no.
Kev faib tawm
Pituitary adenoma (prolactinoma) tuaj yeem sib txawv ntawm qhov chaw nyob hauv Turkish eeb. Muaj ob pawg ntawm cov qog:
- Intrasellar prolactinomas uas tsis pub tshaj ib centimeter ntawm qhov loj thiab tsis ncav cuag lub pob txha ciam teb ntawm pituitary fossa.
- Extrasellar prolactinomas uas loj thiab loj hlob dhau lub eeb Turkish.
Qhov hnyav ntawm cov tsos mob nyob ntawm qhov loj ntawm cov qog. Qhov no siv tsis tau tsuas yog rau qhov tshwj xeeb kev txiav txim ntawm cov tshuaj hormones. Cov qog voluminous compresses lwm lub hlwb cov qauv, ua rau cov tsos mob ntawm lub paj hlwb thiab focal. Qhov no tej zaum yuav yog qhov muag tsis pom kev, tsis hnov tsw, kev puas tsuaj rau lwm cov hlab ntsha (trigeminal, ntsej muag, oculomotor). Cov tsos mob xws li mob taub hau,kev nyuaj siab, ntxhov siab vim, chim siab thiab kev xav lability.
Pituitary prolactinoma: cov tsos mob ntawm cov poj niam
Nyob ntev, tus poj niam yuav tsis pom kev cuam tshuam ntawm nws lub cev, tshwj xeeb tshaj yog tias nws muaj teeb meem nrog kev coj khaub ncaws ua ntej tus kab mob. Hauv cov neeg mob, muaj qhov txo qis ntawm cov hnub ntawm kev coj khaub ncaws, tsis txaus ntawm kev tso tawm lossis lawv qhov tsis tuaj. Cov poj niam uas xav kom muaj menyuam tsis tuaj yeem ua tau vim tsis muaj ovulation.
Cov poj niam muaj lwm yam tsos mob dab tsi? Pituitary prolactinoma txhawb kev tsim cov colostrum thiab mis nyuj txawm nyob rau hauv cov poj niam uas tsis npaj los ua niam. Cov kua tuaj yeem tso tawm hauv tee thaum lub sij hawm kho tshuab compression ntawm cov areola los yog ntws tawm ntawm nws tus kheej (feem ntau yog vim muaj ntau cov mis nyuj). Cov poj niam uas muaj cov tsos mob no ua ntej txhua tus xav txog kev mob qog noj ntshav lossis lwm yam kev hloov hauv zos, tab sis nrog kev kuaj xyuas kom zoo, koj tuaj yeem pom lub hauv paus ntawm qhov teeb meem.
Cov tsos mob ntawm pituitary prolactinoma nyob rau hauv cov poj niam tsis yog tsuas yog tso tawm ntawm colostrum thiab mis nyuj, nws kuj yog ib qho kev nce hauv cov pob txha fragility mus rau pob txha. Tsis tas li ntawd, qhov tsis txaus ntawm lwm cov tshuaj hormones poj niam txiv neej, xws li estrogen, ua rau cov kua dej hauv lub cev thiab qhov hnyav nce sai. Cov tsos mob tuaj yeem hloov pauv tau - polymorphic pob txuv ntawm daim tawv nqaij, nce plaub hau saum daim di ncauj thiab saum lub auricles. Tag nrho cov no yuav tsum coj tus kws kho mob mus rau lub tswv yim ntawm pituitary qog.
Symptoms in men
Prolactinoma ntawm cov qog pituitary hauv cov txiv neej yog tshwm sim los ntawm kev txo qis hauv testosterone qib thiab ua txhaum ntawm kev tsim cov kab mob. Ntawd yog, nws kuj ua rau tsis muaj menyuam. Tab sis nrog rau aspermia, erection ploj, libido txo, potency txo.
Dhau li ntawm qhov no, cov neeg sawv cev ntawm cov neeg muaj zog ib nrab pom qhov nce thiab kev hloov pauv ntawm cov qog mammary - gynecomastia. Raws li txoj cai, nws tshwm sim hauv cov kws ncaws pob uas tau tsom mus rau cov leeg nqaij, thiab hauv ib tus neeg uas tsis noj cov tshuaj steroids, nws yuav tsum yog qhov txaus ntshai. Qee zaum cov kua mis tuaj yeem tawm ntawm lub mis loj.
Ntawm lwm yam, hauv cov txiv neej, atrophy ntawm gonads tshwm sim dhau sijhawm, cov yam ntxwv ntawm kev sib deev thib ob ploj, cov pob txha tawg ntau dhau thiab cov leeg tsis muaj zog tshwm sim.
Diagnosis
Ib qog pituitary (prolactinoma) feem ntau kuaj pom tom qab kuaj neuroimaging (magnetic resonance imaging). Tsis tas li ntawd, peb xav tau tsis yog ib daim duab saib xwb, tab sis lub hom phiaj tshawb nrhiav pathology ntawm lub caj pas pituitary siv tus neeg sawv cev sib txawv - gadolinium, tropic rau cov ntaub so ntswg neuroendocrine. MRI tso cai rau koj los txiav txim qhov loj thiab qhov chaw ntawm neoplasm.
Thaum cov qog me me, txog li ib centimeter, nws yog ib qho tsim nyog yuav tsum tau siv kev suav tomography, vim nws yog cov ntaub ntawv ntau dua. CT qhia meej txog cov pob txha pob txha thiab lawv cov kev hloov hauv cov txheej txheem ntawm kev loj hlob adenoma.
Tab sis ntxiv rau cov txheej txheem ntsuas uas tsim nyog rau kev lees paub zaum kawgKev kuaj mob thiab kev npaj rau kev phais, kuj tseem muaj cov txheej txheem kuaj mob. Ua ntej tshaj plaws, qhov no yog kev txiav txim siab ntawm qib ntawm prolactin hauv cov ntshav. Kev tsom xam yuav tsum tau nqa tawm peb zaug, nyob rau hnub sib txawv ntawm kev coj khaub ncaws, txhawm rau tshem tawm cov txiaj ntsig tsis zoo lossis tsis tseeb tshwm sim los ntawm kev ntxhov siab lossis kev hloov pauv ntawm lub cev. Qhov tshwm sim uas qhia ntau tshaj 200 nanograms ib milliliter yog yuav luag 100% pov thawj ntawm cov qog.
Yog tias koj cov qib prolactin hloov pauv ntawm 40 thiab 100 nanograms, ces muaj lub sijhawm zoo uas cov kev nyeem no yog tshwm sim los ntawm cov thyroid ua haujlwm qis, mob lub mis, lossis lub raum tsis ua haujlwm. Tau kawg, cov kev kuaj mob no kuj tsis txhawb kev cia siab.
Kev kuaj nrog thyroliberin yog qhov qhia tau tshaj plaws. Tom qab nws cov tshuaj txhaj tshuaj, tom qab ib nrab ib teev, kev nce hauv kev tsim cov prolactin tau pom. Qhov concentration ntawm cov tshuaj hormones yuav tsum yog tsawg kawg yog ob zaug ntawm lub hauv paus. Nrog prolactinoma hauv cov neeg mob, tus nqi ntawm prolactin hauv cov ntshav tsis hloov lossis nce me ntsis. Yog hais tias ib qho pathological nce qib ntawm cov tshuaj hormones tsis yog tshwm sim los ntawm cov qog, tab sis los ntawm lwm yam, ces cov tshuaj tiv thaiv rau thyroliberin yuav nyob ze rau qhov qub.
Tsis txhob hnov qab txog kev sab laj ntawm cov kws kho mob tshwj xeeb thiab kev soj ntsuam tus neeg mob kom meej. Txhawm rau xav tias tus kab mob pathology, qee zaum nws txaus los nug cov lus nug zoo.
Kev kho mob
Kev kho rau pituitary prolactinoma feem ntau yog kho mob. Kev kho mob yog tsom rau txo qis qib ntawm cov tshuaj hormones thiab qib nws. Cov teebmeem tsis zoo. Kev xaiv cov tshuaj thiab cov tswv yim rau lawv cov kev tswj hwm tsuas yog ua los ntawm tus kws kho mob endocrinologist raws li kev tswj hwm ntawm chav kuaj mob. Tus kws kho mob lub arsenal suav nrog tshuaj xws li Bromkriptin, Levodopa, Cyproheptadine, Cabergoline thiab lwm yam. Feem ntau cov neeg mob tau pab los ntawm kev teem caij ntawm "Bromocriptine". Cov nyhuv yuav pom tau tom qab ob peb lub lis piam. Tab sis nws muaj ntau yam kev phiv, yog li qhov kev xaiv zoo tshaj plaws yog Cabergoline. Tsis tas li ntawd, nws yooj yim siv (ob zaug hauv ib lub lis piam txaus).
Nyob rau hauv cov txheej txheem ntawm kev kho, qhov loj ntawm cov qog txo qis, qhov tso tawm ntawm prolactin txo qis, tsis pom kev rov qab los, thiab colostrum tsis ntws. Hauv cov poj niam uas muaj hnub nyoog yug me nyuam, kev coj khaub ncaws rov tshwm sim, kev ua haujlwm me nyuam rov qab los. Txiv neej tsis muaj menyuam, kev sib deev rov los.
Yog tias tom qab kev kho mob ntev ntev, qhov xwm txheej tsis tau hloov pauv mus rau qhov zoo dua lossis muaj qhov tsis zoo, ces tus kws kho mob neurosurgeon, nrog rau endocrinologist, txiav txim siab txog qhov teeb meem ntawm kev phais. Rau cov neeg mob uas muaj contraindications rau kev phais, muaj lwm txoj kev - kev kho hluav taws xob. Tab sis nws muaj qhov tsis zoo: pituitary tsis ua haujlwm, thiab yuav tsum tau hloov kho lub neej.
Kev noj zaub mov rau pituitary prolactinoma yog txhawm rau txo qhov hnyav, uas tshwm sim ntawm keeb kwm ntawm hormonal tsis ua haujlwm. Tus kws kho mob endocrinologist lossis kws kho mob noj zaub mov yuav pab tsim cov phiaj xwm khoom noj khoom haus uas yuav muaj tag nrho cov macro thiab micronutrients tsim nyog, nrog rau muaj.nce cov ntsiab lus ntawm calcium thiab phosphorus, tsim nyog rau kev tiv thaiv osteoporosis. Kev noj zaub mov kom zoo tuaj yeem ua raws txawm tias tom qab tus kab mob no yeej.
Kev kho mob ntawm pituitary prolactinoma nrog cov tshuaj pej xeem yog kev poob siab heev los ntawm cov kws tshaj lij, vim tias infusions thiab decoctions tsis coj cov nyhuv xav tau, tab sis tib lub sijhawm lawv inhibit kev ua haujlwm ntawm cov thyroid caj pas thiab cov qog adrenal. Qhov no tuaj yeem cuam tshuam tsis zoo rau tus neeg mob txoj kev noj qab haus huv, nrog rau kev kwv yees kom rov zoo. Yog tias koj xav tsim txom koj tus kheej nrog pog cov zaub mov, nco ntsoov nrog koj tus kws kho mob.
Huab cua thiab tiv thaiv
Pituitary prolactinoma puas kho tau? Qhov tshwm sim ntawm qhov cuam tshuam ntawm ntau lawm ntawm cov tshuaj hormones nyob rau hauv lub cev yog xws li tias, txawm tias cov qog nws tus kheej ploj mus, ib tug neeg yuav rov qab ua haujlwm ploj mus ntev. Tsis tas li ntawd, cov kws kho mob tsis ua qhov kev kwv yees txog kev ceev ntawm kev rov qab los thiab kev ua tiav ntawm kev kho mob.
Rov qab tshwm sim li ntawm ib nrab ntawm cov neeg mob, thiab tom qab kev phais, cov txheeb cais tseem qis dua - tsuas yog peb caug feem pua ntawm kev kho.
Puas yog kev kuaj mob ntawm pituitary prolactinoma yog kev tuag? Nws yog ib qho nyuaj rau kev kwv yees. Kev kho mob tuaj yeem siv sijhawm ntau xyoo thiab tsis muaj txiaj ntsig. Ib zaug txhua ob peb xyoos, cov kws kho mob qhia kom so ntawm cov kev kawm ntawm cov tshuaj kom tshem tawm lub raum thiab daim siab. Tab sis tib lub sijhawm, kev tshem tawm cov tshuaj tuaj yeem ua rau mob qog noj ntshav thiab qog nqaij hlav.
Kev soj ntsuam lub tsev kho mob raug tsim los rau cov neeg mob. Txhua xyoolawv yuav tsum tau ua kev suav lossis sib nqus resonance imaging ntawm lub hlwb, sab laj nrog kws kho mob ophthalmologist, gynecologist thiab endocrinologist, thiab kuj kuaj cov qib prolactin. Xws li kev kuaj xyuas kom zoo, sib piv cov ntsuas hauv qhov muaj zog thiab hloov kho raws sijhawm ua rau nws muaj peev xwm ua tau qee qhov kev xav txog kev rov zoo ntawm cov neeg mob.
