Raws li txoj cai, hypogonadotropic hypogonadism yog txuam nrog kev txhim kho ntawm qhov chaw mos thiab cov yam ntxwv ntawm kev sib deev theem nrab. Cov rog thiab cov protein metabolism hauv cov kab mob kuj cuam tshuam, uas ua rau rog rog, cachexia, teeb meem hauv lub cev pob txha thiab ua haujlwm tsis zoo ntawm lub plawv.
Kuv yuav tsum hu rau kws kho mob twg?
Nws yuav tsum tau muab sau tseg tias txiv neej thiab poj niam hypogonadotropic hypogonadism txawv.
Kev kuaj mob thiab kho tus kab mob yog ua ke los ntawm endocrinologists, gynecologists thiab gynecologists-endocrinologist, yog tias tus neeg mob yog poj niam, thiab andrologists, yog tias tus neeg mob yog txiv neej.
Lub hauv paus ntawm kev kho mob yog kev kho tshuaj hormone. Yog tias tsim nyog, phais, phais yas yog qhia.
kab mob cais li cas?
Hypogonadism tuaj yeem yog thawj lossis theem nrab. Thawj daim ntawv yog provoked los ntawm kev ua txhaum ntawm lub functionality ntawm lub testicular ntaub so ntswg vim muaj ib tug tsis xws luag nyob rau hauv lub testicle. Kev ua txhaum ntawm qib chromosomal tuaj yeem ua rau aplasia lossis hypoplasia ntawm cov qog nqaij hlav, tshwm sim thaum tsis muaj androgen secretion lossis tsis txaus ntawm lawv cov khoom rau tag nrho cov tsim. Kev sib deev hauv nruab nrog cev thiab cov yam ntxwv sib deev thib ob.
Hypogonadotropic hypogonadism nyob rau hauv cov tub yog qhia nyob rau hauv lub hlwb infantilism.
Daim ntawv thib ob yog tshwm sim los ntawm kev ua txhaum ntawm cov qauv ntawm lub caj pas pituitary, txo qis hauv nws txoj haujlwm gonadotropic lossis kev puas tsuaj rau cov chaw ntawm hypothalamus, uas cuam tshuam rau lub caj pas pituitary thiab tswj nws cov haujlwm. Tus kab mob no qhia txog kev puas hlwb.
Ob daim ntawv thawj thiab thib ob tuaj yeem ua tau los yog tau txais. Pathology tuaj yeem ua rau muaj menyuam tsis muaj menyuam hauv cov txiv neej hauv 40-60% ntawm cov neeg mob.
Ua rau tus kab mob hauv txiv neej
Tsawg androgens tuaj yeem tshwm sim los ntawm qhov txo qis ntawm cov tshuaj hormones tsim lossis los ntawm cov kab mob pathological ntawm cov noob qes lawv tus kheej, ua haujlwm tsis zoo ntawm hypothalamus thiab pituitary caj pas.
Rau qhov etiology ntawm thawj qhov tshwm sim ntawm tus kab mob tuaj yeem raug ntaus nqi:
- congenital underdevelopment ntawm gonads, uas tshwm sim nrog caj ces tsis xws luag,
- testicular aplasia.
Predisposing factors suav nrog:
- kev ua txhaum ntawm lub cev xeeb tub;
- raug tshuaj lom;
- tswj tshuaj khomob;
- raug rau cov kuab tshuaj organic, nitrofurans, tshuaj tua kab, cawv, tetracycline, tshuaj hormones ntau ntxiv, thiab lwm yam.;
- kab mob ntawm ib qho kab mob sib kis (mob, qhua pias, orchitis, vesiculitis);
- kev mob hluav taws xob;
- kis kab mob qog nqaij hlav;
- twistSpermatic qaum;
- kab mob plab;
- txheej txheem atrophic tom qab phais;
- hernia excision;
- scrotal phais.
Nyob rau hauv thawj hypogonadism, muaj qhov poob ntawm qib ntawm androgens hauv cov ntshav. Kev them nyiaj rov qab ntawm cov qog adrenal tsim, kev tsim cov gonadotropins nce.
Kev mob ntawm lub hypothalamus thiab pituitary caj pas ua rau daim ntawv thib ob (cov txheej txheem inflammatory, neoplasms, cuam tshuam ntawm cov hlab ntsha, pathology ntawm intrauterine kev loj hlob ntawm tus me nyuam hauv plab).
Pab txhawb rau kev loj hlob ntawm theem nrab hypogonadism tuaj yeem:
- loj hlob hormone pituitary adenoma;
- adrenocorticotropic hormone (Cushing's disease);
- Yprolactinoma;
- ua haujlwm ntawm pituitary lossis hypothalamus tom qab phais;
- txheej txheem kev laus, uas ua rau txo qis hauv testosterone hauv cov ntshav.
Nyob rau hauv daim ntawv thib ob, muaj qhov txo qis hauv gonadotropins, ua rau txo qis hauv kev tsim cov androgens los ntawm cov noob qes.
Ib hom kab mob uas cuam tshuam rau txiv neej yog qhov txo qis hauv cov phev tsim nrog qib testosterone ib txwm. Nws yog qhov tsawg heev uas pom qhov txo qis hauv testosterone qib nrog cov phev ib txwm muaj.
Cov tsos mob ntawm tus kab mob hauv txiv neej
Hypogonadotropic hypogonadism hauv cov txiv neej muaj nws tus kheej kev kho mob tshwm sim. Lawv yog vim lub hnub nyoog ntawm tus neeg mob, nrog rau theem ntawm androgen deficiency.
Yog ib tug me nyuam tub cov noob qes raug cuam tshuamua ntej puberty, ces ib tug raug eunuchoidism yog tsim. Lub cev pob txha yuav loj heev. Qhov no yog vim qhov qeeb hauv ossification hauv thaj chaw loj hlob. Lub xub pwg nyom thiab hauv siab kuj poob qis hauv kev loj hlob, cov ceg ceg ntev ntev, cov leeg pob txha loj hlob tsis zoo.
Poj niam hom rog, gynecomastia, hypogenitalism yuav raug sau tseg, uas tshwm sim nws tus kheej hauv qhov me me noov, tsis muaj quav hauv lub scrotum, testicular hypoplasia, underdevelopment ntawm lub caj pas prostate, tsis muaj cov plaub hau pubic, underdevelopment ntawm lub scrotum. suab raj kho siab heev.
Nrog rau qhov tshwm sim thib ob ntawm tus kab mob, tus neeg mob hnyav hnyav, nce kev ua haujlwm ntawm adrenal cortex, thiab cuam tshuam ntawm cov thyroid caj pas feem ntau tau sau tseg.
Yog tias cov qog ntshav qis qis tom qab yug me nyuam, tom qab ntawd cov tsos mob ntawm cov kab mob xws li hypogonadotropic hypogonadism tsawg dua.
Cov xwm txheej hauv qab no tau sau tseg:
- qe qe txo;
- cov plaub hau me me ntawm lub ntsej muag thiab lub cev;
- poob ntawm daim tawv nqaij elasticity thiab thinning;
- txo qis kev ua haujlwm ntawm kev sib deev;
- kev tsis sib haum xeeb.
Txo qhov loj ntawm cov noob qes ib txwm cuam tshuam nrog kev txo cov phev. Qhov no ua rau infertility, regression ntawm lwm yam kev sib deev yam ntxwv tshwm sim, cov leeg tsis muaj zog, asthenia yog sau tseg.
Kev kuaj mob hypogonadism hauv txiv neej
Kev kuaj mob yog ua los ntawm anthropometry, kuaj thiab palpation ntawm qhov chaw mos, kev soj ntsuam cov tsos mob ntawm qib ntawm kev puberty.
kev kuaj X-ray yuav pab kwv yees lub hnub nyoog ntawm pob txha. Densitometry yog siv los txiav txim siab qhov saturation ntawm cov pob txha nrog cov zaub mov. Ib qho x-ray ntawm lub eeb Turkish txiav txim siab nws qhov loj me thiab muaj cov neoplasms.
Kev kwv yees hnub nyoog pob txha tso cai rau koj los txiav txim siab los ntawm lub sijhawm ntawm ossification ntawm kev sib koom tes ntawm tes thiab dab teg thaum puberty pib. Qhov no yuav tsum coj mus rau hauv tus account qhov muaj peev xwm ua ntej (rau cov neeg mob yug nyob rau sab qab teb) thiab tom qab ntawd (rau cov neeg mob yug nyob rau sab qaum teb) ossification, nrog rau qhov tseeb tias lwm yam tseem tuaj yeem ua rau muaj kev cuam tshuam osteogenesis.
Kev tshawb fawb hauv chav kuaj phev qhia txog cov xwm txheej xws li azo- lossis oligospermia.
Cov ntsiab lus ntawm cov tshuaj hormones no yog qhia:
- sex gonadotropins;
- tag nrho thiab dawb testosterone;
- luteinizing hormone;
- gonadoliberin;
- Yanti-Mullerian hormone;
- Yprolactin;
- estradiol.
Nyob rau hauv thawj daim ntawv ntawm tus kab mob, theem ntawm gonadotropins hauv cov ntshav tau nce, thiab hauv daim ntawv thib ob nws txo qis. Qee lub sij hawm lawv qib yog nyob rau hauv kev faib tawm ntawm tus qauv.
Kev txiav txim siab ntawm estradiol hauv cov ntshav ntshav yog qhov tsim nyog rau kev kho mob feminization thiab qhov tshwm sim theem nrab ntawm tus kab mob, nyob rau hauv lub xub ntiag ntawm cov qog nyob rau hauv cov noob qes uas tsim cov tshuaj estrogen, los yog qog nyob rau hauv cov qog adrenal..
tso zis ketosteroids yuav zoo li qub lossis qis. Yog tias xav tias Klinefelter's Syndrome, qhov kev tshuaj ntsuam chromosome tau qhia.
Testicular biopsy tsis yogmuaj peev xwm muab cov ntaub ntawv rau kev kuaj mob kom raug.
Kev kho mob
Kev kho mob ntawm hypogonadotropic hypogonadism yog txhawm rau tshem tawm cov laj thawj tseem ceeb uas ua rau muaj kab mob. Lub hom phiaj ntawm kev kho mob yog nyob rau hauv kev tiv thaiv kev ntsuas uas pab txhawb rau normalization ntawm kev sib deev kev loj hlob, lub tom ntej restoration ntawm testicular ntaub so ntswg ntawm lub testicles thiab tshem tawm infertility. Kev kho yog ua raws li kev saib xyuas ntawm urologist thiab tus kws kho mob endocrinologist.
Yuav ua li cas yog hypogonadotropic hypogonadism hauv txiv neej tshem tawm? Kev kho mob nyob ntawm ntau yam:
- kho mob daim ntawv ntawm pathology;
- mob hnyav ntawm kev cuam tshuam ntawm hypothalamus, caj pas pituitary thiab kev ua me nyuam;
- muaj qhov sib npaug ntawm cov kab mob uas twb muaj lawm;
- sijhawm pib muaj kab mob;
- hnub nyoog ntawm tus neeg mob.
Kev kho mob ntawm cov neeg laus yog kho cov theem ntawm androgens thiab tshem tawm kev ua txhaum ntawm kev sib deev. Infertility tshwm sim los ntawm congenital hypogonadism tsis tuaj yeem kho.
Nyob rau hauv cov ntaub ntawv ntawm ib tug thawj congenital anomaly los yog ib tug kis tau tus kab mob, nrog rau preservation ntawm endocrinocytes nyob rau hauv lub noob qes, siv tshuaj stimulant. Cov menyuam yaus raug kho nrog cov tshuaj uas tsis yog tshuaj hormonal, thaum cov neeg laus raug kho nrog tshuaj hormonal (androgens thiab gonadotropins hauv koob me me).
Nyob rau hauv qhov tsis muaj kev ua haujlwm ntawm cov qog nqaij hlav, hloov kho nrog androgens thiab testosterone yog qhia. Kev noj tshuaj hormonal yog nqa tawm thoob plaws lub neej.
Nyob rau hauv daim ntawv thib ob ntawm tus kab mob hauv cov menyuam yaus thiabCov neeg laus yuav tsum tau siv cov tshuaj hormones nrog gonadotropins. Yog tias tsim nyog, lawv tau ua ke nrog cov tshuaj hormones deev.
Kev kho mob thiab kev kawm lub cev kuj qhia.
Kev ua haujlwm rau tus kabmob muaj nyob rau hauv kev hloov lub zes qe menyuam nrog cryptorchidism, nrog rau kev txhim kho ntawm noov, kev phais yas yog siv. Rau kev kho kom zoo nkauj, lawv siv rau kev cog qoob loo ntawm cov noob qes ntawm cov khoom siv hluavtaws (thaum tsis muaj cov noob qes nyob hauv lub plab kab noj hniav).
Kev phais yog siv cov txheej txheem microsurgical nrog rau kev tswj hwm lub cev tsis muaj zog, qib tshuaj hormones, thiab cov khoom siv cog qoob loo.
Nyob rau hauv cov txheej txheem ntawm kev kho mob, androgen deficiency txo, kev loj hlob ntawm cov yam ntxwv ntawm kev sib deev theem nrab rov pib dua, potency yog ib feem rov qab, tshwm sim ntawm pob txha pob txha thiab pob txha hnub nyoog poob qis.
Tus kab mob no tshwm sim rau poj niam li cas
Hypogonadotropic hypogonadism hauv cov poj niam yog tus cwj pwm los ntawm kev txhim kho tsis zoo thiab nce kev ua haujlwm ntawm gonads ntawm zes qe menyuam. Thawj daim ntawv yog vim muaj qhov tsis zoo ntawm lub zes qe menyuam lossis kev puas tsuaj thaum lub sijhawm menyuam mos.
Muaj qhov txo qis hauv kev tsim cov tshuaj hormones kev sib deev, uas ua rau muaj kev nce qib ntawm gonadotropins uas txhawb nqa zes qe menyuam.
Qhov kev tshuaj ntsuam qhia pom cov qib siab ntawm cov tshuaj hormones uas txhawb cov follicles thiab lutein, nrog rau qib qis ntawm cov tshuaj estrogen. Kev txo qis cov tshuaj estrogen ua rau atrophy lossis underdevelopment ntawm cov poj niam ntawm qhov chaw mos, cov qog mammary, tsis muajmenses.
Yog tias qhov kev ua haujlwm ntawm zes qe menyuam tau ua tsis taus ua ntej kev laus, ces muaj qhov tsis muaj kev sib deev thib ob.
Hypogonadotropic hypogonadism hauv cov poj niam hauv nws daim ntawv tseem ceeb tau sau tseg raws li cov xwm txheej hauv qab no:
- kev tsis sib haum xeeb ntawm qib caj ces;
- congenital zes qe menyuam hypoplasia;
- cov txheej txheem kis kab mob (syphilis, tuberculosis, mumps, radiation, phais tshem tawm ntawm zes qe menyuam);
- kev tawm tsam ntawm qhov xwm txheej autoimmune;
- testicular feminization syndrome;
- polycystic zes qe menyuam.
Secondary hypogonadotropic hypogonadism nyob rau hauv cov poj niam tshwm sim nrog pathology ntawm pituitary caj pas thiab hypothalamus. Nws yog qhov txawv los ntawm cov ntsiab lus qis lossis kev ua tiav ntawm kev tsim cov gonadotropins uas tswj hwm zes qe menyuam ua haujlwm. Cov txheej txheem no yog tshwm sim los ntawm o ntawm lub paj hlwb. Cov kab mob zoo li no muaj kev puas tsuaj thiab nrog los ntawm kev txo qis ntawm gonadotropins ntawm zes qe menyuam.
Cov kab mob xws li hypogonadotropic hypogonadism hauv poj niam thiab cev xeeb tub cuam tshuam li cas? Kev loj hlob ntawm tus menyuam hauv plab tsis zoo tuaj yeem cuam tshuam qhov tshwm sim ntawm pathology.
Cov tsos mob ntawm tus kab mob hauv poj niam
Cov tsos mob hnyav ntawm tus kab mob hauv lub sijhawm yug menyuam yog kev ua txhaum ntawm kev coj khaub ncaws lossis tsis tuaj.
Cov poj niam cov tshuaj hormones qis ua rau muaj qhov tsis zoo ntawm qhov chaw mos, cov qog mammary, ua tsis tausdeposition ntawm fatty cov ntaub so ntswg thiab cov plaub hau kev loj hlob tsis zoo.
Yog tias tus kab mob no tshwm sim, ces cov yam ntxwv ntawm kev sib deev tsis tshwm sim. Cov poj niam muaj lub pelvis nqaim thiab pob tw.
Yog tus kab mob tshwm sim ua ntej puberty, ces cov yam ntxwv ntawm kev sib deev uas tshwm sim tseem khaws cia, tab sis kev coj khaub ncaws nres, qhov chaw mos cov ntaub so ntswg atrophy.
Diagnostics
Hauv hypogonadism, muaj qhov txo qis hauv cov tshuaj estrogen thiab nce qib ntawm gonadotropins. Los ntawm txoj kev ultrasound, kuaj pom qhov txo qis hauv tsev menyuam, mob pob txha thiab ncua lub cev pob txha raug kuaj.
Kev kho mob ntawm cov poj niam pathology
Hypogonadotropic hypogonadism hauv cov poj niam kho li cas? Kev kho mob muaj kev hloov kho. Cov poj niam tau muab tshuaj, nrog rau cov tshuaj hormones kev sib deev (ethinyl estradiol).
Thaum muaj kev coj khaub ncaws, tshuaj tiv thaiv qhov ncauj uas muaj estrogens thiab progestogens, nrog rau cov tshuaj "Trisiston", "Trikvilar" raug sau.
txhais tau tias "Klimen", "Trisequens", "Klimonorm" raug muab rau cov neeg mob tom qab 40 xyoo.
Kev kho mob nrog cov tshuaj hormonal yog contraindicated nyob rau hauv cov xwm txheej hauv qab no:
- cov qog nqaij hlav hauv thaj tsam ntawm cov qog mammary thiab cov plab hnyuv siab raum;
- kab mob plawv thiab hlab ntsha;
- pathology ntawm lub raum thiab siab;
- Ythrombophlebitis.
Kev Tiv Thaiv
Ib kab mob xws li hypogonadotropichypogonadism, muaj kev pom zoo. Kev tiv thaiv muaj kev kawm txog kev noj qab haus huv rau pej xeem thiab saib xyuas cov poj niam cev xeeb tub, nrog rau kev txhawb nqa kev noj qab haus huv.
