Kab lus no yuav saib qhov ua rau qis progesterone nyob rau theem luteal.
Txo qib ntawm cov tshuaj no yog suav tias yog cov tsos mob ntawm kev ua haujlwm tsis raug ntawm zes qe menyuam. Cov kab mob no raug xa mus rau kev kho mob hu ua luteal phase defect (LPD). Ib theem tsis txaus ntawm progesterone nyob rau lub sijhawm no ua rau muaj kev tsim cov kev mob tsis zoo nyob rau saum npoo ntawm lub tsev menyuam rau kev cog qoob loo ntawm lub qe fetal rau hauv nws. Raws li qhov no, txawm tias thaum yug me nyuam, tus poj niam txoj kev coj khaub ncaws yuav tshwm sim.
Qhov no yog qhov txaus ntshai ntawm qis progesterone nyob rau theem luteal.
Basic concepts
theem no pib nyob rau hauv thib ob ntawm kev coj khaub ncaws thiab kav li ntawm 14 hnub tom qab ovulation tshwm sim, tam sim ntawd tom qab uas cov ntaub ntawv corpus luteum. Nws yog lub luag haujlwm rau kev tsim cov progesterone, uas yog qhov tsim nyog ua ntej cov placenta pib tsim. Yog hais tias fertilization tsis tshwm sim, tus poj niam pibkev coj khaub ncaws. Qee qhov xwm txheej, lub voj voog hloov pauv, vim qhov tsis tshua muaj siab ntawm cov tshuaj hormones. Cov laj thawj tseem ceeb rau qhov tshwm sim no yuav tsum tau qhia meej los ntawm tus kws tshaj lij.
Tus nqi ntawm progesterone nyob rau theem luteal yog dab tsi?
Nrog rau qhov qub, qib ntawm cov tshuaj hormones txawv ntawm 7.0 txog 56.5 nmol / l. Yog tias qhov concentration ntawm cov tshuaj hormones qis dua qhov ntsuas no, peb tab tom tham txog nws qhov tsis txaus.
Cia saib cov laj thawj tseem ceeb ntawm progesterone qis hauv theem luteal.
Vim txoj kev loj hlob
Kev tsim cov progesterone los ntawm corpus luteum yog qhov tsim nyog rau cov txheej txheem ntawm kev cog thiab tsim embryo. Tab sis qee zaum kev tsim cov tshuaj hormones no txo qis, uas yog vim muaj ntau yam ua tau.
Yog tias tsis muaj progesterone tau pom nyob rau hauv theem luteal ntawm kev coj khaub ncaws, nws yuav tsum tau ua qhov kev kuaj mob tsim nyog, uas yuav qhia qhov txawv txav hauv keeb kwm hormonal. Nws muaj peev xwm hais tias tus neeg mob tsim cov tshuaj no nyob rau hauv ib tug npaum li cas, txawm li cas los, lub mucous daim nyias nyias ntawm lub tsev menyuam reacts rau nws incorrectly. Nyob rau hauv lwm yam lus, DLF yog ib tug pathological tshwm sim nyob rau hauv uas lub uterine endometrium tsis tsim kom raug. Vim li no, cov qib progesterone txo qis rau theem luteal, uas ua rau muaj kev cuam tshuam rau lub qe menyuam hauv plab, tiv thaiv nws los ntawm kev cog qoob loo zoo.
Ntau yam tau paub tias tuaj yeem ua rau cov txheej txheem ntau lawm progesterone thiab ua rau muaj kev loj hlob ntawm luteal theem dysfunctions. Lawv tuaj yeem muab faib ua peb pawg tseem ceeb: organic, ua haujlwm thiab iatrogenic.
Yog li ntawd, cia peb saib ua ntejKev ua haujlwm ua rau qis progesterone nyob rau theem luteal.
functional reason
Daim ntawv teev npe ua haujlwm uas tuaj yeem txo qis kev tsim cov progesterone suav nrog cov xwm txheej tshwm sim los ntawm kev ua haujlwm tsis zoo ntawm lub cev xeeb tub. Cov yam tseem ceeb hauv qhov no yog:
- Savage Syndrome. Qhov mob no yog tshwm sim los ntawm kev ua tsis tiav ntawm kev coj khaub ncaws thiab qhov tshwm sim ntawm kev xeeb tub hauv cov poj niam hnub nyoog qis dua 35 xyoos. Lub zes qe menyuam tib lub sij hawm poob rhiab heev rau kev sib deev cov tshuaj hormones uas txhawb kev tsim cov qe. Ib tug kab mob zoo sib xws manifests nws tus kheej raws li kev ua txhaum ntawm kev coj khaub ncaws ntev. Kev kho tshuaj hormone yog xav tau los pab rov qab ua poj niam cev xeeb tub thiab progesterone ntau lawm rau kev xeeb tub.
- Syndrome of hyperinhibition nyob rau hauv zes qe menyuam - qhov tsis muaj poj niam los ntshav, vim kev kho mob los ntawm inhibition ntawm gonadotropic zog ntawm zes qe menyuam. Dab tsi ntxiv tuaj yeem ua rau qis qis progesterone nyob rau theem luteal?
- Stein-Leventhal syndrome, uas yog nrog los ntawm qhov tsis xwm yeem lossis tsis muaj ovulation, nce cov tshuaj estrogen, uas inhibits zus tau tej cov progesterone.
- Ovarian exhaustion syndrome. Cov kab mob no, vim muaj ntau yam, pib ua haujlwm tsis raug, ua rau muaj qhov pib ua tsis tau tiav ntxov.
- Hypothyroidism, uas yog ib qho mob pathological uas tshwm sim los ntawm qhov tsis txaus ntawm cov tshuaj hormones uas tsim los ntawm cov thyroid caj pas. Hauv lwm hom kab mob no, cov qauv hypothalamic-pituitary puas lawm. Qhov ua rau qis qis progesterone nyob rau theem luteal tuaj yeem txiav txim siab nyuaj.
- Pituitary hypogonadism, uas yog ib qho mob tshwm sim los ntawm kev ua haujlwm tsis txaus ntawm cov gonads nrog kev ua haujlwm tsis zoo ntawm cov tshuaj hormones. Kev kho mob ntawm cov kab mob no yog ua raws li kev siv tshuaj hormone hloov kho.
- Hyperprolactinemia, uas yog tshwm sim los ntawm kev nce qib ntawm cov tshuaj hormones pituitary, tshwj xeeb tshaj yog prolactin. Hauv cov poj niam uas muaj kev kuaj mob zoo sib xws, kev coj khaub ncaws tsis xwm yeem raug sau tseg, kev muaj menyuam tsis taus.
Cov laj thawj saum toj no tuaj yeem ua rau txo qis hauv cov ntsiab lus ntawm progesterone hauv LF. Qhov tshwm sim ntawm qhov no yog kev ua txhaum ntawm ovulatory theem thiab kev ua me nyuam ua haujlwm.
Lwm yam ua rau qis progesterone nyob rau theem luteal paub?
Organic Causes
Cov laj thawj no yog vim muaj cov kab mob ntawm lub cev xeeb tub thiab lwm yam kab ke uas tuaj yeem cuam tshuam rau cov qauv thiab kev ua haujlwm ntawm lub tsev menyuam. Cov no suav nrog:
- uterine fibroids;
- Asherman syndrome;
- Yendometrial hyperplasia;
- uterine cancer;
- cirrhosis ntawm daim siab thiab kab mob siab;
- endometritis.
Nrog synechia hauv tsev menyuam, hypomenstrual syndrome lossis amenorrhea theem nrab tuaj yeem tshwm sim. Intrauterine synechia tsis tso cai rau lub qe fetal txuas mus rau endometrium, yog li conception ua tsis tau.
Lub caij nyoog ntawm cev xeeb tub txo qis nrog kev loj hlob ntawm endometrial hyperplasia. Tus kab mob ua rau muaj kev cuam tshuam ntawm kev coj khaub ncaws, ua rau qis qis ntawm progesterone hauv LF.
Iatrogenic ua rau
Iatrogenic yam muaj xws li cov xwm txheej uas tshwm sim los ntawm kev kho mob. Gynecological tu yog nqa tawm los tsim kom muaj qhov tsis xwm yeem ntawm kev coj khaub ncaws, ntev thiab hnyav los ntshav hauv fibroids, hyperplasia, polyps. Hauv qhov no, tus kws kho mob tshwj xeeb tuaj yeem cuam tshuam cov qauv ntawm endometrium, tom qab ntawd synechia tsim, ua rau muaj qhov tsis txaus ntawm cov tshuaj hormones tom qab hauv LF..
Kev rho menyuam cev xeeb tub kuj muaj teeb meem hormonal zoo sib xws. Txhawm rau kho nws, kev kho tshuaj hormone hloov pauv feem ntau yuav tsum tau ua. Hauv qee tus neeg mob, qib ntawm progesterone txo qis, uas dhau los ua qhov tseem ceeb hauv kev loj hlob ntawm kev xeeb tub. Fertility tom qab xws li manipulations yog rov qab maj mam, nrog kev pab los ntawm kev kho tshuaj kho mob kom zoo.
Yellow body
Txawm hais tias cov kws kho mob tseem tsis tau kawm tag nrho cov tsos mob ntawm cov qib progesterone qis thaum lub sijhawm LF, lawv hais nrog kev ntseeg siab tias qhov tseem ceeb ntawm cov kab mob no yog qhov txawv txav ntawm lub cev luteum lossis endometrial qauv.
Lub corpus luteum, uas nws lub luag haujlwm tsis zoo, vim qee qhov tsis tuaj yeem ua haujlwm tau zoo, uas ua rau cov khoom tsis txaus ntawm progesterone. Ntau yam tseem ceeb tau paub tias yog lub luag haujlwm rau kev ua haujlwm tsis txaus ntawm corpus luteum lossis nws qhov tsis tuaj. Cov no suav nrog:
- tsis tu ncua kev loj hlob ntawm follicles. Txij li thaum lub corpus luteum yog tsim los ntawm tib lub hlwb uas ua rau cov follicle tseem ceeb, nws txoj haujlwm yuav raug cuam tshuam. Kev tsim cov follicle tuaj yeem cuam tshuam los ntawm ntau yam, suav nrog cov khoom noj tsis txaus, cov dawb radicals ntau dhau, thiab kev hloov pauv hauv cov metabolism.
- qib ntawm cov tshuaj hormones. Rau cov txheej txheem tsim nyog ntawm kev loj hlob ntawm lub follicle, qhov sib npaug tshwj xeeb hauv cov tshuaj hormones yog tsim nyog. Kev tsis sib haum xeeb hauv keeb kwm hormonal tuaj yeem cuam tshuam kev tsim cov hauv paus, lub cev luteum thiab cov txheej txheem ntawm ovulation.
- Kev sib tw. Cov txheej txheem ntawm kev ua haujlwm zoo ntawm corpus luteum yog cuam tshuam los ntawm qhov xwm txheej ntawm cov ntshav ntws. Anomalies nyob rau hauv tsim cov hlab ntsha thiab circulatory disorders yog ze ze rau kev tsim ntawm lub corpus luteum thaum lub sij hawm luteal theem, thiab vim li no tau raug pov thawj los ntawm ntau yam kev tshawb fawb.
- Cov lus teb uterine txawv txav rau progesterone. Txawm hais tias ib txwm tsim cov tshuaj progesterone, endometrial defects tsis cia nws teb rau cov tshuaj no. Qhov no ua rau muaj kev cuam tshuam ntawm kev tsim ntawm lub tsev menyuam hauv ob sab phlu, uas ua rau muaj kev cuam tshuam rau kev cog qoob loo ntawm embryo.
Cov tsos mob ntawm pathology
Tsawg concentration ntawm progesterone nyob rau theem luteal yog qhov nyuaj heev rau kev kuaj pom, tshwj xeeb tshaj yog thaum tus poj niam tsis npaj yuav xeeb tub, tsis mus kuaj kuaj, tab sis sim xeeb tub yam tsis muaj kev kho mob. Ntau tus tseem tsis tau paub txog qhov kev kuaj mob no, vim lawv tsis paubyam ntxwv ntawm kev coj khaub ncaws. Cov tsos mob ntawm qis progesterone nyob rau theem luteal yog:
- teeb meem xeeb;
- kev nchuav menyuam thaum ntxov;
- luv luv kev coj khaub ncaws (tsawg dua 24 hnub);
- ntu ntu ntawm PMS;
- ovulation uas tshwm sim ntxov.
Nyob rau theem ob, tus poj niam yuav tsum tsis txhob mob, los ntshav lossis raws plab. Yog tias cov cim no cuam tshuam, pom muaj teeb meem nrog kev xeeb tub, ces nws raug nquahu kom mus kuaj.
Yuav ua li cas thiaj kuaj tau qis luteal theem progesterone?
Diagnosis
Vim kev nkag siab tsis txaus ntawm pathophysiology thiab tsis muaj kev sib koom ua ke rau kev kuaj mob qhov tshwm sim no, nws txoj kev kho mob feem ntau nyuaj. Thaum lub sijhawm kuaj mob, tus kws kho mob tshwj xeeb pib sau cov anamnesis, uas yuav tsum muaj cov ntaub ntawv hauv qab no:
- case keeb kwm;
- neeg tsis txaus siab;
- peculiarities ntawm kev coj khaub ncaws ua haujlwm;
- OB/GYN history.
- yam ntxwv ntawm kev nyob;
- kev sib deev tsis tu ncua.
Kev saib xyuas kuj tau them rau qhov piv ntawm qhov hnyav thiab qhov siab, kev faib cov ntaub so ntswg adipose, cov plaub hau hauv lub cev. Tsis pub dhau ib hlis, tus neeg mob raug pom zoo los ntsuas qhov kub thiab txias kom tus kws kho mob tuaj yeem ntsuas qhov pib ntawm luteal theem thiab ovulation.
Kuj tau kuaj gynecological, ultrasoundkawm. Ib qho yuav tsum tau ua ua ntej rau kev kuaj mob kom txaus yog ua cov kev kuaj sim los txiav txim siab tsim cov tshuaj luteinizing thiab follicle-stimulating hormones, progesterone, estrogen, inhibin, 17-OH progesterone, TSH, testosterone.
Tsis tas li ntawd, koj yuav tsum pub ntshav rau coagulogram, txhawm rau ua cov tshuaj biochemical.
Yog li, tus poj niam tus progesterone qis dua li qub nyob rau theem luteal. Kev kho mob yuav tsum tam sim.
Kev cuam tshuam kho mob
Lub hom phiaj tseem ceeb ntawm kev kho rau cov kab mob no yog txhawm rau txhim kho qhov zoo ntawm lub cev luteum thiab follicle, txo cov qib ntawm oxidation thiab nce qib ntawm progesterone. Txhawm rau ua qhov no, tag nrho cov kev ntsuas tsim nyog tau ua tiav, uas suav nrog qee qhov kev cuam tshuam gynecological (yog tias tsim nyog), piv txwv li, hysteroscopy, kev kho tshuaj nyob rau hauv cov ntaub ntawv ntawm cov txheej txheem inflammatory uas twb muaj lawm hauv kev ua me nyuam, kev kho tshuaj hormone los kho cov qib hormonal. Kev hloov kho ncaj qha nyob ntawm seb qhov txiaj ntsig ntawm progesterone, qhov hnyav ntawm nws qhov txo qis, qhov concentration ntawm lwm cov tshuaj hormones poj niam txiv neej raug coj mus rau hauv tus account.
Qhia rau cov neeg mob
Nws yog ib qho tseem ceeb heev tsis yog kom tau txais kev kho kom raug rau qis progesterone nyob rau theem luteal, tab sis kuj ua raws li cov lus pom zoo hauv qab no:
- noj qab nyob zoo. Cov zaub mov yuav tsum muaj tag nrho cov khoom noj, kom muaj protein ntau zoo, rog, thiab ntau cov txiv hmab txiv ntoo thiab zaub. Cov poj niam raug qhia kom haus dej kom ntau thiab tsis txhob haus cawv,caffeine thiab qab zib.
- Tsis txhob ntxhov siab. Hauv theem luteal, qhov txo qis hauv progesterone tuaj yeem cuam tshuam nrog kev ntxhov siab ntev lossis mob ntev. Lub cev xav tau ntau dua progesterone los tsim cortisol. Qhov no ua rau muaj qhov tseeb tias thaum lub sijhawm LF, progesterone tsis txaus los ua nws txoj haujlwm ncaj qha.
- Siv cov tshuaj uas pab ua haujlwm ntawm cov qog adrenal thiab cov qog uas tsim cov cortisol, uas tuaj yeem pab tau kom nce qib progesterone thiab stabilizing lub luteal theem.
- Cov kws tshaj lij pom zoo kom siv cov tshuaj tshwj xeeb los tswj cov tshuaj progesterone: Wild Yam, Vitex, Melatonin thiab vitamin B6.
- Kev tshem tawm ntawm qhov chaw mos thiab cov txheej txheem inflammatory hauv lub appendages thiab uterus. Qhov no yog ua los ntawm kev noj tshuaj tua kab mob.
- Ua raws li kev nyiam huv thiab kev cai ntawm lub neej sib raug zoo. Tus poj niam raug pom zoo kom muaj lub neej kev sib deev nrog tus khub sib deev tsis tu ncua, uas yuav pab kom tsis txhob muaj ntau yam tshwm sim hauv kev sib deev thiab ua txhaum ntawm qhov chaw mos microflora.
Kev kho tus qauv rau progesterone qis dua ib txwm nyob rau theem luteal yog raws li kev siv tshuaj. Vitamin complexes, kev siv cov tshuaj antiestrogens, kev siv ntawm kev npaj ntawm chorionic gonadotropin, follitropins - tag nrho cov no yog pom zoo kom ua nyob rau hauv tib lub sij hawm. Kev kho mob nyuaj tso cai rau koj kom nce progesterone thiab tiv thaiv qhov tshwm sim loj ntawm tus mob no xws li kev xeeb tub, nchuav menyuam,placental insufficiency, oncological kab mob ntawm endometrium thiab lub mis, tsim ntawm polyps thiab fibroids.
