Kelyaha - waa maxay? Calaamadaha iyo daaweynta cudurka

Endocrinologists in waxqabadkooda waxaa inta badan soo food leh aan caadi ahayn ee kelyaha. kelyaha - waa maxay? Kelyaha - wajihi doonta xubin, qanjidhada adrenal ku yaalaan oo kaliya sarreeya foomka u jilacsan. Waxaa loo sameeyay lagama maarmaan u ah hormoonada jirka aadanaha (adrenaline, noradrenaliin, glucocorticoids, iyo jinsiga). Hyperplasia jebiya hormoonnada midig, iyo tan waxaa la socda astaamo kala duwan.

kelyaha - waa maxay?

Marka nudaha unugyada kelyaha qanjidhada aaday si isa soo taraysa u fidiya, jidhka waxa si wayn u kordhay size, inkasta oo waligiiba qaab u gaar ah. walax medullary adrenal ka kooban yahay iyo jilif.

Sida caadiga ah saamayn ku kelyaha ah kiliyaha adrenal, waxaa uu yeesho habka bahal ah. buro kala duwan badanaa la baaraa in medulla ah.

Waxaa teedu cudurka da 'kasta ee dumarka, ragga iyo carruurta.

kelyaha Congenital waxaa laga helaa daawada inta badan. Sida caadiga ah waxaa xanbaarsan dhaxlo ah, laakiin sidoo kale ku dhici kara tiro ka mid ah qaar ka mid ah arrimaha gudaha ama dibadda loo kasin. Sida cudurada la xiriira la ogaado in bukaanka qaba Cushing ee syndrome (40% ee kiisaska) syndrome. syndrome Tan waxaa badanaa la ogaadaa in da'da dhexe iyo jirka.

cudurada Tani dhab ah aan la dayacay karo. Marka kelyaha dushooda waxaa carqaladeeyey saarka hoormoonada loo baahdo. In haweenka, waxa inta badan sababa dhalmo la'aan. Waxaa jira dhawr nooc oo cudurka: kelyaha nodular qanjirka adrenal, nodular, waajihi, lagu dhasho iyo micronodular, iyo kelyaha lugaha dillaac fudud. Inta badan cudurkaan ku dhacaa dumarka.

Sababaha cudurka

Sababaha calaamado ka muuqan marka kelyaha ee carruurta, rag ama dumarba waxay noqon doontaa kala duwan. Wax walba waxay ku xirnaan doontaa nooca cudurka. Hyperplasia waxaa loola jeedaa mid ka mid ah noocyada ugu, waxaa laga yaabaa in idiopathic, solteryayuschey, virility.

Marka ay jirto nooca wax soo saarka firfircoon hypertensive of androgens iyo mineralocorticoids, geedi socodka sida saamaynta xun on weelashii kelyaha iyo fundus, inta badan keenta in hypertension syndrome.

Marka kelyaha nooca solteryayuschem kordhay wax soo saarka antiandrogen, sidaas waxaa jira la'aanta hormoonada kale soo saaray kiliyaha adrenal. Yimaado hyperkalemia ama hypoglycemia. Khatartu waxay tahay in jidhku waa fuuq, lumiyaan miisaan badan.

Marka virilnoe kelyaha nooca superaktiven antiandrogen qarsoon. xubnaha taranka si weyn u kordhay size, waxaa jira finan, timaha jirka kordhay, muruqyada aad u horumarsan ee u tiro badan.

First of cudurada oo dhan uu bilaabo inuu horumar u sabab ah dheecaan sii kordhaya ee hormoonnada steroid. Foomka waxaa helay cudurka ayaa tiro ka mid ah sababaha muhiimka ah sababta ay kacday,

• disorder dheefshiidka,
• walaacyada xoog leh,
• cudurka Cushing ee;

kelyaha Congenital ay sabab u tahay xaqiiqada ah in xitaa inta ay uurka leedahay, inta lagu guda jiro uurka, isbedel functional horumariyo. Su'aal kale - gudbinta cudurka heerka hidaha. Arrimaha xanaajin, muujinta calaamadaha cudurka: cillad ah hypothalamus oo pituitary ee aan caadi ahayn ee heer hidde, ah kiliyaha madaxbannaani dhalin aaday qanjidhada, dhaxlaa awowayaashood.

kelyaha nodular

Dhakhaatiirta horumarka ah ee kelyaha qaybi kooxo dhowr ah sida uu sawir caafimaad, iyo sidoo kale nooca socodka.

kelyaha nodular. Foomkan waxaa iska dhaxlo. Inta badan laga helay ee dadka waayeelka ah, waxaa sii xumeeyey waqti. Marka qabashada cudurka shaaca ka qaaday feature sifo - on jilif qanjira adrenal sameeyay. Waxay noqon karaan badan (dhismeedka lobed) iyo hal ah, ilaa 4-5 cm. Kordhisaa Cushing ee syndrome. cudurradana waxaa sabab u ah kicinta xoog badan oo ah hormoonka adrenocorticotropic, uu ku dhexsameeysmo qanjirka pituitary ee. Muuqaaladan ugu weyn ee kelyaha dushooda nodular la Cushing ee syndrome ka mid ah:

• madax-xanuun,
• "U Duulay" indhahaaga hortooda;
• gariir,
• wareer;
• qidmeyntiibulshada ee guud;
• miisaanka oo kordha (horrayn caloosha, qoorta, wajiga);
• kor u kacay rabitaanka cuntada,
• fidin marks on maqaarka,
• finan;
• hirsutism (haweenka);
• cusboonaysiinta masaakiinta;
• hyperpigmentation;
• cadaadiska dhiigga ee sareeya,
• jab soo noqnoqda,
• niyad-jabka.

kelyaha waajihi

In foomkan of kelyaha prostate ma badasho qaabka, korodhka waa si tartiib ah. Laakiin waqti isku mid ah ay u sameeyaan qanjira. Aqoonso nooca cudurka waa ay adag tahay. In habka caadiga ah ee lagu ogaado ultrasound ah natiijada lahayn. Isbedelada ee jirka waxaa laga helaa oo kaliya on MRI ama CT. Inta badan waxay yeeshaan qaabab hybrid, kaas oo ka dhici marka calaamadaha soo socda: kelyaha in haweenka inta badan keenta in la kordhiyo in timaha jirka, muujiyey weerarada argagaxa leh, hypertension, cayilka. Meelaha qaarkood waxaa jira dhaawac glomerular iyo horumarinta ee kelyaha laba geesood ah.

cudurada ee aldosteronism idiopathic ku salaysan yahay korodhka dheecaan aldosterone. Marka kelyaha zone glomerular muujinayaa calaamadaha soo socda: hypertension, gariir, tabar-dari muruq, xaddidaadda dhaqdhaqaaqa, qallafsanaan ilaa curyaannimo, harraad, wax soo saarka kaadida kordhay, kaadida habeenkii. Xadgudubka sababa la kordhiyo potassium dhiig, aysiidh sumaysan. La kordhiyo cadaadiska dhiigga ayaa lagu arkay joogto ah.

Nodular oo lagu dhasho foomamka

foomka nodular badanaa soconayo in carruurta iyo dhallinyarada. Waxay ka muuqan karaan sababtoo ah khaladaad ama function adrenal sabab u ah qiyaasta xad dhaafka ah ee glucocorticoids. Tilmaamo muhiim ah oo qaab nodular: baruur kayd aan joogto ahayn, atrophy muruqa, midabka maqaarka, calaamadaha sonkorowga, waxyeellada dareemayaasha iyo wadnaha, osteoporosis. Haddii carruurta calaamadaha cudurka waxaa la ogaado in waqtiga, fuliyaa daaweynta hormoon, saadaasha waa wanaagsan. Hyperplasia qanjirka adrenal bidix - waa maxay? Xaaladdan oo kale, kelyaha oo aan ku xidhan tahay tallaabada hormoonnada. Marka shanta hablood burooyinka hawlgal ka weyn yahay 3 cm ayaa loo baahan yahay. Laparoscopy waxaa loo isticmaalaa ama sida ay Fedorov lyumbotomicheskim habka helitaanka peritoneum dhinaca bidix.

kelyaha lagu dhasho (VDKN) waxaa lagu ogaada ayado inta badan noocyada kale. In dhallaanka laga helay inta jeer ah 1 ilaa 12 kun. In xaaladan, dheefshiidka ilmaha dareemi iyo muuqaalka. Waxaa jira saddex noocyo weyn ee (non-classical, fudud classical, virility iyo solteryayuschaya.

Qaabka ugu badan waa solteryayuschaya. Muujiyey in gabdhaha waxaa germofroditizm sida beenta ah, wiilasha maqaarka madow ee ku wareegsan xiniinyaha ah, guska kordhay size. Bukaanka lagu gartaa koritaanka yar yahay iyo calaamadaha sida hurdo, lalabo, feejignaan xumo, cadaadiska dhiigga oo hooseeya, fuuq-bax, cunto xumo. Cudurku waa in lagu daaweeyo maalmood ee ugu horreeya jiritaanka, ama dhimasho ay suurtagal tahay.

In foomka classical kama sarreeyo calaamado, laakiin waxaa jira koror in ereygu wuxuu ahaa ee hormoonnada jinsiga lab. Haddii cudurka aan la daawayn, dhibaatooyin dheeraad ah ka dhaca haweenka ee caafimaadka galmada iyo maskaxda.

The qaab aan classical u muuqataa in fidisa haweenka iyo dhallinyarada. The cabashooyinka ugu weyn ee dhalmo la'aan, khaladaad caadada, hirsutism iyo finan.

kelyaha, calaamadaha guud

Inta badan, caruurta, rag iyo dumar oo loo kuurgalay foomka cudurka tirtirayaa, marka ma jiraan wax calaamado la cadeeyay, in kiisaska noocaas ah waa adag tahay in la ogaado cudurka. foomka Congenital waxaa lagu qeexaa in caruurta marka hore at sannaddii kowaad iyo labaad ee nolosha.

Guud ahaan, kelyaha (waxa ay tahay, aynu hore u sharaxay) ayaa soo socda calaamadaha ugu muhiimsan:

• cadaadiska dhiigga deganayn (hoose ama sare);
• Xawliga ah ee horumarka ah ee diabetes mellitus,
• korodhka miisaanka;
• daliilka osteoporosis;
• kabuubyo muruqyada, ay atrophy xiga;
• Haweenku waa "wejiga moon-sida";
• dhantaalan xasuusta,
• jaba neerfayaasha,
• midabka,
• fidin marks on maqaarka,
• rabshooyin ee mareenka caloosha iyo mindhicirka,
• hoos ka mid ah difaaca jirka,
• sii daayo nocturnal kaadida;
• harraad xad-dhaaf ah;
• waalli;
• dhalmo la'aan;
• amenorrhea;
• aan da'da ku haboon koritaanka sare;
• ururayaa qoordiidka ee gobolka joogaan,
• hirsutism.

Ragga iyo dumarka kala duwan yihiin calaamadaha caafimaad ee cudurka.

Tilmaamaha daweynta

The salaysan daaweynta sida xaqiiqada ah waa therapy ah hormoon. Seynisyahanno aan weli go'aansaday sida ugu wanaagsan ee ay u dhaqmaan on kelyaha ee adrenal. Daaweynta waxaa badanaa la isku daray. Waayo, dhallinyarada loo qoondeeyay hab kaas oo caadi hadal of sifooyinka sare galmada, gabdhaha muujiyay estrogens iyo wiilasha - androgens.

Isticmaalo in lagu daaweeyo oo ka mid ah isu-gaynta socda ee glucocorticoids:

• copolymer cortisone;
• hydrokortisoni;
• Dexamethasone;
• prednisolone.

Inta lagu jiro maalinta bukaanka helo 2 ama 3 qiyaasood oo ah hormoonada (oo tiro ahaan siman). Diiwaan galinta iyo 5% xal glucose. Girls, wiilasha, dhammaan nolosha leedahay in la sameeyo diyaar garowga loo baahan.

Waayo, bukaan kasta dhakhtarka waa in la helo hab gaar ah si ay u yeelaan istaraatijiyad ay daaweynta (waxa ay ku xiran uu waayo-aragnimo iyo aqoon). therapy Single ee daaweynta cudurkan kajirin.

kelyaha Congenital of kiliyaha adrenal daran loola dhaqmo by dhakhtar qalliin. Waxaa jira xaalado in xubnaha taranka oo aan la kala karaa sida dumar ah ama lab. Waayo, gabdhaha waxaa lagu talinayaa caag ah oo leh qaab aan caadi ahayn ee siilka. Horeba sannaddii kowaad oo nolosha ku tusi hawlgal noocan oo kale ah, mararka qaarkood (xaalad daran) waxaa lagu fuliyaa ka dib. Samee hawlgalka iyo in burooyinka.

Haddii jidhka oo ka maqan cusbo, bukaanka waa in la kordhiyo qiyaasta maalinlaha ah ee 1-3 garaam. Waxa loo magacaabay in kiisaska noocaas ah, iyo mineralocorticoid.

therapy daroogada ee kelyaha waajihi uusan saameyn badan lahayn. Waxaa loo baahan yahay in kiisaska noocaas ah adrenalectomy. daaweyn natiijo la'aan iyo aldosteroma marka la isku daro ee kelyaha waajihi. Saadaasha aanay haboonayn. Mawduuca ku saabsan doorashada waa therapy daroogada iyo kelyaha dushooda ka glomerulosa Zona-geesoodka ah (hyperaldosteronism idiopathic). Operation ay dhacdo in this - waa qiyaas ah xad-dhaaf ah.

halbowlaha ee daaweynta IGA - qaata spironolactone, waa antagonist ah aldosterone. Sidoo kale wax ku ool ah waa eplerenone daroogada. Spironolactone waxaa inta badan lala qaato antagonist calcium ah. Haddii calaamadaha hypertension halbowlaha joogo, daaweynta la celiyeyaasha ACE ku xiran yahay.

In the case of dhaweynta ah virilization daroogada dayactirka si joogto ah. Haddii nooca kelyaha loola jeedaa virilizing ah, waa in ay ahaataa magacaabista cortisol. Waxaa loo adeegsan karaa sidii irbad muruqyada dhexdooda. Qiyaasta gaaray dhakhtarkaaga. Waayo, carruurta waaweyn waxay isticmaali karaan prednisolone.

Haddii aanu jirin dawayn habboon, kelyaha dushooda waxay keeni kartaa in horumarka cudurka Kona ama cudur Cushing ee. daaweynta cudurka sax ah ka dib markii si degdeg ah waa in ay bilaabaan.

ogaanshaha cudurka

kelyaha - waa maxay? Sida loo ogaado cudurka? kelyaha nodular iyo waajihi ogaado in koorsada cilmi iyo shaybaarka. Baadhista xanuunada waxaa ka mid ah: sahan bukaanka, baaritaan jireed, baaritaan caafimaad, baaritaan shucaac ama magnetic resonance imaging, iskaanka radionuclide. Sida laga soo xigtay natiijooyinkii qiimaha la qiimeeyey, iyo qaab labada qanjidhada adrenal. Radioimmunoassay sameeyaa cilmi baaris shaybaar. Go'aamisay in cortisol kaadida iyo dhiigga. Si ay u qiimeeyaan xaaladda oo hormoon ah, qaban-lala dayo immunosorbent. Mararka qaarkood waxaa lagama maarmaan ah si ay u qabtaan dalool rajo gelin.

Sida ay natiijada baaritaanka takhtarka ku qaaday cudurka wareejiyaa habka ugu haboon ee daaweynta.

dadka waaweyn Hyperplasia: waxa la sameeyo?

Sida caadiga ah fawdada ah ee kiliyaha adrenal ayaa lagu ogaadaa in yaraantaadii, laakiin calaamadaha cudurka muuqan in dadka waaweyn. kelyaha ee dumarka waxa lagu gartaa koritaanka sare oo timaha shuunka, cod qoto dheer, finan, xanuun xagga dambe ee madaxa, qalal nocturnal, quudinta masaakiinta, kordhay cadaadiska dhiigga, adrenal syndrome.

Haddii aad isku aragto in calaamadahan, ha isku dayin in aad iskaaga u ogaado. Xaaladahan ma caawin, iyo dawayn lahaa dad. Si degdeg ah wax looga qabto in dhakhaatiirta. Waa lagama maarmaan in daaweyn hormoon. Sida caadiga ah, dumarka qaba cudurka noocan oo kale ah laguma talinayo in la qorsheeyo uurka. Marar badan, xataa mamnuuc ah in la siiyo dhalashada. Mararka qaar ayaa xalka ugu fiican ee dhibaatada - tirtiridda dhamaystiran oo kelyaha buka oo dhan, iyo appendages ay.

ka hortagga

waa kelyaha maxay - si gaar ah u baahan tahay in la ogaado kuwa lamaane kuwaas oo la qorsheeyay dhalashada ilmaha iyo qoyska ay (hiddo) xaalado kelyaha lagu dhasho. Fadlan tixraac geneticists - xirfad leh, xirfadlayaal aqoon u leh. Waayo, ka hortagga cudurka u baahan doontaa inaad cudurka of dhalida (muddada marka ilmuhu uu weli soo koraya iyo waa uurka hooyada). In saddexda bilood ee ugu horeeya uurka waxaa lagu fuliyaa villus sampling chorionic. In qeybtii labaad ee falanqaynta baahan yahay dheecaanka amniotic, kaas oo go'aamin doona heerka hoormoonka.

Xulashada - IVF. Xaaladdan oo kale, waxaad samayn kartaa falanqayn hordhac hidaha ee unugyada jeermiga hor inta aan la bacrimiyey.

Inta lagu guda jiro uurka haweenka ee cudurka kelyaha waa in ka yar kormeer joogta ah dhakhtar si joogta ah u gudbin dhan imtixaanada loo baahanyahay. laga saaro waa in laga nolosha oo dhan walxaha sunta ah ee suurtogalka ah iyo saameynta shucaaca.

Wixii ka hortaga kelyaha ciyaaraa ah imtixaanada doorka iyo baaritaan oo muhiim ah in la sameeyaa ilmaha dhashay. Waayo, falanqaynta waxaa lagama maarmaan ah ka gaddoonka ah (meel doortay dalool kid ciribta) si ay dhiig u qaadan.