Hypopituitarism, uas nws cov tsos mob tuaj yeem tsis meej pem nrog cov cim qhia ntawm lwm cov kab mob loj heev thaum tsis muaj kev kuaj mob txaus, yog qhov tsis tshua muaj tshwm sim ntawm lub qog pituitary. Hauv tus kab mob no, lub caj pas pituitary yog tsim los ntawm cov tshuaj hormones tsis txaus, lossis tsis tsim tag nrho ib lossis ntau cov tshuaj hormones tsim nyog rau kev ua haujlwm ntawm tib neeg lub cev.
Lub caj pas pituitary yog ib lub qog taum me me nyob ntawm lub hauv paus ntawm lub hlwb, qab lub qhov ntswg thiab nruab nrab ntawm pob ntseg. Txawm hais tias nws qhov me me, lub caj pas no ua haujlwm tseem ceeb: nws cov zais cia tswj kev ua haujlwm ntawm yuav luag txhua yam hauv nruab nrog cev thiab qhov chaw ntawm lub cev. Txoj haujlwm ntawm kev tswj hwm yog ua los ntawm cov tshuaj hormones - lawv qhov tsis txaus yuav qhia tau tias hypopituitarism. Cov tsos mob hauv cov menyuam yaus feem ntau tshwm sim raws li kev loj hlob tsis txaus ntseeg thiab kev loj hlob ntawm lub cev, thiab hauv cov neeg laus ua rau cov ntshav siab tsis zoo thiab kev ua me nyuam ua haujlwm.
Tej zaum thaum ua yeeb yamNrog rau qhov kev kuaj mob zoo li no, koj yuav tau noj tshuaj mus tas koj lub neej, tab sis cov cim qhia ntawm tus kab mob tuaj yeem tswj tau.
Symptoms
Cov tshuaj ntsuam xyuas kab mob hauv feem ntau yog nce zuj zus. Nws tsis yog ib txwm ua tau rau tus kws kho mob kom kuaj pom hypopituitarism tam sim: cov tsos mob ntawm cov menyuam yaus thiab cov neeg laus tuaj yeem tshwm sim tam sim ntawd lossis loj hlob zuj zus ntau xyoo. Feem ntau, cov cim qhia ntawm kev ua txhaum cai yog qhov tsis tseem ceeb uas tus neeg mob tsuas yog tsis saib xyuas lawv ntev.
Cov tsos mob ntawm tus kab mob sib txawv nyob ntawm seb cov tshuaj hormones uas lub cev tsis muaj vim yog kev ua haujlwm ntawm lub qog pituitary. Tsis tas li ntawd, nws tseem ceeb npaum li cas qhov tsis muaj peev xwm ntawm ib qho tshuaj twg. Tus neeg mob yuav ntsib:
- xav mob ntev;
- txoov deev tsav;
- nce rhiab heev rau qhov kub thiab txias, txias;
- poob qab los.
Ntxiv rau qhov kev xav saum toj no, cov cim qhia ntawm pathology suav nrog:
- poob phaus tsis tau piav qhia;
- puffy face;
- ntshav qab zib;
- kev muaj menyuam;
- poj niam - kub flashes, tsis xwm yeem lossis tsis muaj kev coj khaub ncaws, poob ntawm cov plaub hau, tsis muaj peev xwm tsim cov kua mis rau cov menyuam yug tshiab;
- hauv cov txiv neej - poob ntawm cov plaub hau loj hlob ntawm lub ntsej muag lossis lub cev;
- cov menyuam yaus muaj qhov qis qis.
Thaum mus ntsib kws kho mob
Yog koj xav tias koj muajhypopituitarism, cov tsos mob uas tau teev tseg saum toj no, teem caij nrog tus kws tshaj lij.
Mus ntsib koj tus kws kho mob tam sim yog tias muaj cov tsos mob tshwm sim tam sim ntawd lossis nrog mob taub hau hnyav, pom kev cuam tshuam, tsis meej pem hauv lub sijhawm thiab qhov chaw, lossis kev poob siab sai sai. Qhov no tsis yog hypopituitarism lawm - cov tsos mob ntawm qhov xwm txheej no txhais tau tias tam sim ntawd los ntshav (apoplexy) tau qhib rau hauv lub caj pas pituitary, xav tau kev kho mob ceev.
Yog vim li cas
Qhov kev tsis sib haum no yuav tshwm sim los ntawm cov kab mob hauv lub cev, tab sis feem ntau nws tau txais. Feem ntau, hypopituitarism yog tshwm sim los ntawm cov qog pituitary. Raws li cov neoplasm loj hlob tuaj, nws compresses thiab puas cov ntaub so ntswg ntawm lub cev, ua rau tsis zoo rau kev tsim cov tshuaj hormones. Tsis tas li ntawd, cov qog tuaj yeem ua rau cov hlab ntsha ntawm qhov muag, yog li ua rau muaj kev cuam tshuam ntau yam kev pom thiab hnov lus.
Lwm cov kab mob, nrog rau qee qhov xwm txheej, tuaj yeem ua rau lub caj pas pituitary thiab pib hypopituitarism (cov tsos mob, cov duab tau muab rau hauv kab lus no). Cov tsos mob ntawm tus kab mob yuav txawv nyob ntawm seb tus yam ntxwv uas ua rau txoj kev loj hlob ntawm pathology. Cov xwm txheej no suav nrog:
- mob taub hau;
- hlwb lossis qog pituitary;
- brain phais;
- kev kho mob hluav taws xob;
- autoimmune o (hypophysitis);
- stroke;
- kis kab mob ntawm lub hlwbhlwb (xws li mob meningitis);
- tuberculosis;
- kab mob infiltrative (sarcoidosis - mob nyob rau hauv ntau yam kabmob sab hauv; Langerhans cell histiocytosis - ib tug kab mob nyob rau hauv uas txawv txav hlwb ua rau caws pliav nyob rau hauv ntau yam kabmob thiab ib feem ntawm lub cev, feem ntau nyob rau hauv lub ntsws thiab cov pob txha; hemochromatosis - ntau tsub zuj zuj ntawm hlau. hauv daim siab thiab lwm yam ntaub);
- ntshav poob loj thaum lub sijhawm yug menyuam uas tuaj yeem ua rau lub caj pas pituitary ua rau lub ntsej muag (Simmonds-Glinsky tus kab mob lossis tom qab yug menyuam pituitary necrosis);
- kev hloov pauv caj ces uas ua rau muaj kev cuam tshuam cov tshuaj hormones hauv lub caj pas pituitary;
- mob ntawm lub hypothalamus - ib daim ntawm lub hlwb nyob ncaj qha saum lub caj pas pituitary - tuaj yeem ua rau hypopituitarism.
Cov tsos mob (daim duab qhia txog cov kab mob) tshwm sim vim tias hypothalamus tsim nws cov tshuaj hormones uas tswj kev ua haujlwm ntawm "cov neeg nyob sib ze" taum caj pas.
Nyob rau hauv qee kis, lub genesis ntawm tus kab mob tseem tsis paub.
Ua ntej mus ntsib kws kho mob
Ua ntej, koj yuav tsum sau npe rau kev sab laj nrog tus kws kho mob. Yog tias tsim nyog, nws yuav xa koj mus rau tus kws kho mob tshwj xeeb hauv cov kab mob hormonal - tus kws kho mob endocrinologist.
- Tshawb nrhiav ua ntej yog tias koj xav tau kom ua tau raws li qhov yuav tsum tau ua kom ntseeg tau qhov tseeb ntawm kev kuaj mob.
- Sau cov npe kom ntxaws ntawm txhua yam cim qhia ntawm pathology uas koj saib hauv koj tus kheej. Yog tias koj xav tias hypopituitarism, cov tsos mob ntawm tus kab mob, ntawmthaum pom thawj zaug tsis muaj feem cuam tshuam rau pituitary dysfunction yuav tsum tau muab tso rau hauv daim ntawv no.
- Sau cov ntsiab lus tseem ceeb ntawm tus kheej, suav nrog kev hloov pauv hauv lub neej lossis kev hloov pauv ntawm koj lub peev xwm los daws kev ntxhov siab.
- Sau cov ntaub ntawv kho mob yooj yim, suav nrog kev phais tsis ntev los no, tshuaj noj tsis tu ncua, thiab mob ntev. Koj tus kws kho mob tseem yuav xav paub seb koj puas tau raug mob taub hau tsis ntev los no.
- Coj ib tug txheeb ze los yog phooj ywg nrog koj uas yuav tsis tsuas yog npaj los txhawb kev ncaj ncees, tab sis kuj pab nco ntsoov tag nrho cov lus pom zoo ntawm tus kws tshaj lij.
- Ua ib daim ntawv teev cov lus nug uas koj xav nug koj tus kws kho mob.
Cov lus nug rau tus kws kho mob endocrinologist
Nws raug nquahu kom ua cov npe ntawm cov lus nug uas txaus siab ua ntej kom lub sijhawm sib tham koj tsis pom cov ntsiab lus tseem ceeb. Yog tias koj txhawj xeeb txog hypopituitarism (koj txaus siab rau cov tsos mob thiab kev kho mob), suav nrog cov lus nug hauv qab no ntawm koj daim ntawv teev npe:
- Yuav ua li cas thiaj ua rau kuv cov tsos mob thiab tus mob tam sim no?
- Puas muaj peev xwm pom tias cov tsos mob ntawm tus kab mob tshwm sim los ntawm lwm tus kab mob?
- Kuv yuav tsum tau xeem dab tsi?
- Kuv tus mob puas yog ib ntus lossis mob ntev?
- Yuav ua li cas kho koj li cas?
- Kuv yuav tsum noj tshuaj ntev npaum li cas koj pom zoo?
- Koj yuav saib xyuas qhov kev kho mob li cas?
- Kuv muaj mob ntev. Yuav ua li cas kom paub meej tias txhua yam kev mob raug kho ib txhij?
- Kuv puas yuav tsum ua raws li kev txwv?
- Puas muaj cov tshuaj analogues uas koj tau sau tseg?
- Kuv xav paub ntau ntxiv txog qhov hypopituitarism yog dab tsi. Cov tsos mob thiab kev kuaj mob twb paub meej lawm; Dab tsi yog cov peev txheej uas koj xav pom ntawm ntau yam kev kho mob?
Xav nug lwm yam lus nug yog tias koj xav nug tus kws tshaj lij thaum lub sijhawm sib tham.
Tus kws kho mob yuav hais li cas
Tus kws kho mob endocrinologist, dhau los, yuav nug koj cov lus nug ntawm nws tus kheej. Ntawm lawv, feem ntau yuav yog cov hauv qab no:
- Vim li cas koj xav tias hypopituitarism?
- Puas cov tsos mob thiab ua rau cov kab mob uas koj tau pom hauv koj tus kheej pom zoo nrog cov lus piav qhia ntawm tus kab mob hauv cov ntaub ntawv kho mob?
- Puas cov cim qhia ntawm pathology hloov lub sijhawm?
- Koj puas pom muaj qhov muag tsis pom kev?
- Koj puas mob taub hau?
- Koj puas tau hloov pauv? Koj puas tau poob phaus lossis pom qhov txo qis hauv cov plaub hau?
- Koj puas tau poob siab rau kev sib deev? Puas yog koj lub caij coj khaub ncaws hloov pauv?
- Koj puas tau kho? Los yog tej zaum koj tau txais kev kho mob yav dhau los? Cov kab mob dab tsi tau kuaj pom?
- Koj nyuam qhuav muaj me nyuam?
- Koj puas tau raug mob taub hau tsis ntev los no? Koj puas tau txais kev kho mob neurosurgical?
- Puas muaj cov txheeb ze tau kuaj pom muaj kab mob pituitary lossis hormonal?
- Koj xav li cas pab txo cov tsos mob?
- Koj xav li cas ua rau koj cov tsos mob hnyav?
Diagnosis
Tus kws kho mob puas yuav xav tias hypopituitarism tam sim? Cov tsos mob thiab ua rau koj tus mob tsis noj qab haus huv yuav yeej thawb tus kws kho mob kom ua qhov kev kuaj mob tshwj xeeb no, kom paub tseeb tias koj yuav tsum tau mus rau ntau qhov kev ntsuam xyuas los txiav txim siab txog qib ntawm ntau yam tshuaj hormones hauv lub cev. Yog vim li cas rau kev kuaj mob zoo li no tuaj yeem yog qhov raug mob taub hau tsis ntev los no lossis ua tiav chav kawm ntawm kev kho hluav taws xob - cov kev pheej hmoo no muaj peev xwm ua rau muaj kev loj hlob ntawm pathology.
Cov kev kuaj ntsuas tus qauv suav nrog:
- kuaj ntshav. Cov kev ntsuam xyuas yooj yim tuaj yeem kuaj pom qhov tsis txaus ntawm qee cov tshuaj hormones vim yog pituitary tsis ua haujlwm. Piv txwv li, kev kuaj ntshav tuaj yeem qhia tau tias qis qis ntawm cov tshuaj hormones tsim los ntawm cov thyroid caj pas, adrenal cortex, lossis qhov chaw mos - qhov tsis muaj cov tshuaj no feem ntau cuam tshuam nrog kev ua haujlwm tsis zoo ntawm lub qog pituitary.
- Kev sim siab lossis kev sim siab. Txawm tias tus kws kho mob tshwj xeeb tuaj yeem pom nws nyuaj rau kev paub txog hypopituitarism; Cov tsos mob ntawm tus me nyuam tej zaum yuav zoo ib yam li cov tsos mob ntawm ntau yam kab mob. Txhawm rau kom tau txais kev kuaj pom tseeb, tus kws kho mob feem ntau yuav xa koj mus rau lub chaw kho mob tshwj xeeb. Cov kev tshawb fawb endocrinological, qhov twg koj yuav xub hais kom noj cov tshuaj muaj kev nyab xeeb los txhawb kev tsim cov tshuaj hormones, thiab tom qab ntawd lawv yuav xyuas seb qhov tso tawm ntau npaum li cas.
- Kev tshawb fawb ntawm lub hlwb. Sib nqus resonance imaging (MRI) ntawm lub hlwb tuaj yeem kuaj pom cov qog pituitary thiab lwm yam kev txawv txav.
- Kev pom kev pom. Cov kev ntsuam xyuas tshwj xeeb txiav txim siab seb qhov kev loj hlob ntawm cov qog pituitary puas cuam tshuam rau lub peev xwm pom lossis qhov pom kev.
Kev kho mob
Hypopituitarism, cov tsos mob thiab cov lus piav qhia uas tau hais los saum toj no, yuav luag txhua qhov tshwm sim, thiab tsis yog kab mob ywj pheej. Kev kho mob ntawm nws cov hauv paus hauv paus hauv feem ntau tso cai rau koj mus tas li tshem tawm cov tsos mob ntawm cov tshuaj hormonal cuam tshuam nrog pituitary tsis ua haujlwm. Yog tias qhov kev kho mob ntawm tus kab mob thawj zaug rau ib qho laj thawj ua tsis tau lossis tsis muaj txiaj ntsig, hypopituitarism yog kho nrog tshuaj hormonal. Qhov tseeb, xws li kev cuam tshuam rau lub cev tsis yog ntau txoj kev kho mob raws li kev hloov pauv rau cov khoom uas ploj lawm. Cov koob tshuaj yuav tsum tau muab los ntawm tus kws kho mob endocrinologist uas tsim nyog nkaus xwb, txij li lawv tau suav rau ntawm tus kheej thiab them nyiaj nruj me ntsis rau cov tshuaj hormones thiab cov nyiaj uas lawv muaj nyob hauv lub cev noj qab haus huv. Kev hloov kho tuaj yeem nyob mus ib txhis.
Yog tias tus qog tau ua rau hypopituitarism, cov tsos mob, kev kho mob, thiab kev kho mob tom ntej yuav nyob ntawm seb tus qauv ntawm neoplasm. Feem ntau yog tshuajKev phais mob kom tshem tawm cov kab mob pathological. Qee zaum, kev kho hluav taws xob tau ua.
Tshuaj
Cov tshuaj hloov pauv tuaj yeem sawv cev los ntawm cov tshuaj hauv qab no:
- Corticosteroids. Cov tshuaj no (piv txwv li hydrocortisone thiab prednisolone) hloov cov tshuaj hormones ib txwm ua los ntawm adrenal cortex. Lawv tsis txaus vim adrenocorticotropic insufficiency. Corticosteroids tau noj los ntawm qhov ncauj.
- "Levothyroxine" ("Levoxil" thiab lwm yam). Cov tshuaj no hloov cov thyroid hormones rau cov thyroid disorders.
- Sex Hormones. Raws li txoj cai, rau cov txiv neej nws yog testosterone, rau cov poj niam nws yog estrogen los yog ib tug ua ke ntawm estrogen thiab progesterone. Yog tias koj xav tias koj muaj hypopituitarism, cov tsos mob thiab kev tiv thaiv ntawm tus kab mob pituitary yuav zoo ib yam li cov tsos mob thiab kev kho mob rau kev sib deev hormone tsis meej. Yog tias tus kws kho mob kuaj pom cov kab mob pathology, cov tshuaj tau siv rau hauv cov ntawv tshwj xeeb los hloov cov tshuaj hormones uas ploj lawm: testosterone gel lossis txhaj tshuaj rau txiv neej thiab ntsiav tshuaj, gels lossis thaj ua rau poj niam.
- YGrowth Hormone. Nrog endocrine ntshawv siab, cov khoom no, hu ua somatropin hauv kev kho mob science, nkag mus rau hauv lub cev los ntawm kev txhaj tshuaj subcutaneous. Somatropin tso cai rau lub cev loj hlob, ua kom muaj kev loj hlob zoo hauv cov menyuam yaus. Cov neeg laus kuj tau muab cov tshuaj hloov pauv, uas txhim kho tus neeg mob lub cev, tab sis kev loj hlob ib txwm tsis tuaj yeem rov qab los.
Saib xyuas
Tus kws kho mob endocrinologist yuav saib xyuas koj cov ntshav cov tshuaj hormones kom paub meej txaus tab sis tsis muaj cov khoom noj uas tseem ceeb heev.
Tej zaum koj yuav tau hloov koj cov tshuaj corticosteroid yog tias koj mob hnyav lossis muaj kev ntxhov siab rau lub cev hnyav. Nyob rau lub sijhawm ntawd, lub cev tsim cov tshuaj hormone cortisol ntxiv. Tej zaum koj yuav tau hloov koj cov tshuaj yog tias koj mob khaub thuas, mob raws plab lossis ntuav, lossis raug phais lossis kho hniav. Ntau tus neeg mob tau muab tshuaj CT lossis MRI.
