Ọrịa mamịrị insipidus: mgbaàmà, ọgwụgwọ, ihe kpatara ya, ihe ịrịba ama

Ọrịa mamịrị insipidus bụ ọrịa nke polyuria na-arịa siri ike n'ihi enweghị akụrụ na-etinye uche mmamịrị n'ihi ụkọ ma ọ bụ na-arụ ọrụ nke ADH.

Mbelata na nzuzo ma ọ bụ mee ihe nke ADH na-esonyere nnukwu mmụba nke mmiri (ND), nke bụ ihe kpatara isi ngosipụta nke ọrịa ahụ.

Ọrịa shuga insipidus (ND) bụ ọnọdụ nke ọgbụgba ndụ ya na-efufu nnukwu mmamịrị na hypotonic mmamịrị.

Ihe na-akpata ọrịa shuga insipidus

Ọnọdụ mbu n'ime ndị okenye bụ mmerụ ahụ nke craniocerebral na ntanetị neurosurgical, ebe ọ bụ n'oge etuto CNS bu akara aka (craniopharyngioma, germinoma, glioma, pituitary adenoma). Ihe ndi ozo nwere ike ibu bu metastases nke neoplasms ojoo, obi akwara obi (obi ọgụ, hemorrhages, aneurysms), ọnya infiltrative (histiocytosis, ụkwara nta, sarcoidosis), ọrịa na-efe efe (toxoplasmosis, cytomegalovirus ọrịa, meningitis, encephalitis). Ọrịa ọnya afọ nke neurohypophysis n'ụdị lymphocytic infundibulohypophysitis dị ụkọ.

Ihe dị ka 5% nke ndị ọrịa nwere usoro ezinụlọ nke ọrịa neurogenic insipidus nwere ihe nketa autosomal. Ọ kpatara ọrịa a site na mmụba nke vasopressin precursor gene, prepropressophysin, nke dị na chromosome nke iri abụọ.

A na-elebu Central insipidus ọrịa shuga anya dị ka ihe dị mkpa nke ọrịa DIDMOAD, ma ọ bụ ọrịa Tungsten. Dabere na data nke oge a, ọrịa mkpụrụ ndụ ihe nketa a dị oke egwu na-apụta n'ihi mmụba nke mkpụrụ ndụ WFS1 na kromstome anọ nke na - etinye protein tungstamine protein, nke na - etinye aka na mbufe ion kalịnda na netwọk endoplasmic nke neurons na β-sel nke agwaetiti pancreatic. Ihe mgbaàmà ndị bụ isi bụ shuga na-arịa ọrịa shuga na mbelata ọhụụ. Mbibi nke usoro ụjọ ahụ, gụnyere ọrịa insipidus nke ọrịa shuga, na-ebilite na mgbe e mesịrị (afọ 20-30) na ọ bụghị na ndị ọrịa niile.

Mmeri nke mpaghara hypothalamic-pituitary na mmepe nke ọrịa shuga insipidus nwere ike ịlele mgbe ụfọdụ ọrịa ọrịa mkpụrụ ndụ dịka Lawrence-Moon-Barde-Beadle syndrome (mkpụmkpụ mkpụmkpụ, oke ibu, nsogbu ụbụrụ, nkwụghachi azụ nke pinal, polydactyly, hypogonadism na urogenital anomalies) Ihe ntụgharị nke Hesxl.

Gestagenic ọrịa shuga na-egosipụta onwe ya n’oge atụrụ ime. N'okwu a, placenta na-abawanye mmebi nke ADH, na-emepụta enzyme cysteine ​​aminopeptidase, nke ezubere ibibi oxytocin, mana ọ na-ebibi vasopressin.

Ọrịa kansa na-arịa ọrịa shuga na Nephirogenic agbasawanye nke hypothalamic-pituitary. Ọrịa shuga na-arịa ọrịa shuga na -akpata ọrịa insipidus bụ ọrịa mkpụrụ ndụ ihe na-adịghị ahụkebe kpatara site na enweghị nchebe na ADH. Thedị ejikọtara X, nke a na-ebute site na mmụba nke ụdị nnabata vasopressin nke 2 dịpụrụ adịpụ, na nkwụghachi akpaaka na njikwa nke aquaporin-2 gene (mmiri mmiri nke apical membrane nke na-anakọta mkpụrụ ndụ abụọ nke mkpụrụ ndụ dị obere).

Insipidus na-arịa ọrịa shuga nabatara na-egosipụta onwe ya ọtụtụ oge karịa ọmụmụ ọgbụgba, mana e ji obere foto doro anya na iweghachite nsogbu. Ihe na-akpata ọtụtụ oge karịa ndị ọzọ bụ nkwadebe lithium, nke nwere ike ịkpaghasị mgbasa ozi intracellular sitere na ndị na-anabata vasopressin. Gentamicin, metacyclin, isophosphamide, colchicine, vinblastine tolazamide, phenytoin, norepinephrine (norepinephrine), loop na osmotic diuretics nwere otu mmetụta na iji ogologo oge na nnukwu ojiji. A pụrụ ịhụ nsogbu nke ọrịa shuga nephrogenic n'ọrịa electrolyte (hypokalemia, hypercalcemia), ọrịa akụrụ (pyelonephritis, tubulo-interstitial nephritis, polycystic, postolosive uropathy), amyloidosis, myeloma, sickle cell anaemia na sarcoidosis.

Pathogenesis nke ọrịa shuga insipidus

A na-achịkwa nzuzo nke vasopressin site na hypothalamus osmoreceptors nke isi, nke na-aza mgbanwe osmolality erughị 1% nke mbụ. Ọnwụ mmiri na - emebi (mmamịrị na ọsụsọ, iku ume) na - eduga n'ịba ụba nke plasma ọbara. Site na mmụba ya na 282-285 mosm / n'arọ, ihe nzuzo nke vasopressin amalite ịba ụba. Nnukwu mmiri mmiri na mbelata na osmolality plasma, n'ụzọ dị iche, na - egbochi ihe nzuzo nke ADH, nke na - eduga n'ịbelata mmiri na njigide mmiri.

Central (neurohypophysial) ọrịa shuga insipidus

Na etiti ND, hypotonic polyuria ka a na-ahụta n'ihi nsonaazụ zuru oke ma ọ bụ nke adịghị ala nke ADH, n'agbanyeghị mkpali zuru oke na nzaghachi ezumike nkịtị na ADH. E kewara Central ND na ụdị subtypes.

Dabere ogo ogo ADH:

• Ejiri Nchịkwa etiti zuru oke na-enwe ike zuru oke na nchịkọta ma ọ bụ izo ya ezo ADH,
• Ejiri usoro NEH zuru ezu na-ezughi ezu ma ọ bụ zoro ezo nke ADH.

Dabere na nketa;

• Central Central ND bụ ọrịa a na - adịghị ahụkebe, nke a ketara site na ụdị autosomal nwere ụdị usoro dị iche iche ma na - etolite na nwata, ọtụtụ ntụpọ mkpụrụ ndụ ihe metụtara ala na - agbanwezi otu ihe ana - eme ka akwara dị n’ime ala nke neurophysin, nke nwere ike imebi njem intracellular nke prohormone,
• nweta Central ND na - ebilite n’ihi ọtụtụ ihe.

Ihe na - ebute oria ogwugwu n’etiti

ND Prim (enwetabeghị)

Secondary ND (enwetara)

Nehrogenic ọrịa shuga insipidus

Ejiri ya nke polyuria hypotonic mgbe niile, n'agbanyeghị ọkwa zuru oke nke ADH, na nchịkwa nke ADH na-apụ apụ anaghị emetụta ma mmịpụta mmamịrị ewepụtara ya ma ọ bụ osoolarity ya. E kere eke nke Nephrogenic n'ime ụdị dị ala.

Dabere ogo ogo ADH erughi eru.

• Ejiri NJ nephrogenic zuru ezu bụ nke enweghị ike ịzaghachi vasopressin ọbụlagodi na usoro ọgwụ ọgwụ.
• Ejiri mara NEP nephrogenic na-ezighi ezi n'ikike ịza maka ọgwụ ọgwụ nke usoro vasopressin.

Dabere na nketa.

• Ngwakọta nephrogenic na-apụta bụ n'ihi mmụba n'akụkụ abụọ dị iche iche. N'ime 90% nke ikpe, mmụba na-akpata mmebi nke ọrụ vasopressin V₂nnabata nke turule akwara. Usoro nke njikọta X, njikọta, nwanyị na - ebu mmiri, ana - ahụkarị ihe dị na mmamịrị, na - arịa ọrịa mmamịrị na - enweghị ntụpọ. N'ime 10% nke ezinụlọ nwere ọrịa ketara eketa, a na-achọpụta mmụba na mkpụrụ ndụ aquaporin-2 nke dị na chromosome 12, q q mpaghara. Ihe nketa a na mmetuta a nwere ike ịbụ nhachi ma ọ bụ akara.
• Acquired ND na - emekarị n'ihi hyperkalemia ma ọ bụ hypercalcemia. N'okwu abụọ ahụ, a na-egbochi ọrụ nke aquaporin-2 n'ime akụrụ. Lithium nwere mmetụta yiri ya. Okpu akwara gbasara akwara na mgbochi oghere itegharị nwere ike gbagwojuru anya site na mmepe nke NE nephrogenic.

Ihe kpatara achoro achoro ogwu Nkan

Polydipsia nke mbụ

Site na polydipsia nke mbụ, mmiri mmiri na-abawanye na mbụ, nke a nwere ike ịkpọ ya "mmetọ" nke mmiri ahụ, bụ nke polyuria na - esokarị ma belata osmolality ọbara. Ejiri polydipsia nke izizi kee ụdị abụọ.

• Dipsogenic ND, nke uzo osmotic maka mkpali itinye uche na ADH ka edobere ya n’azu, ebe onodi osmotic di ala maka mmekpa ahu na-etolite. Nmebi a na - eduga na polydipsia hypotonic mgbe ọ bụla, ebe ọ bụ na a na-echekwa osmolarity serum n'okpuru mbido mkpali nke ADH.
• Psychogenic polydipsia, ebe enwere paroxysmal ụba mmiri, nke na-akpalite ihe gbasara mmụọ ma ọ bụ ọrịa uche. N'adịghị ka dipsogenic ND, n'ọnọdụ ndị a enweghi mbelata osmotic iji mee ka akpịrị kpọọ gị nkụ.

Ọrịa na ihe ịrịba ama nke ọrịa shuga insipidus

Dịka e kwuru, isi ihe na-egosi ọrịa shuga insipidus bụ akpịrị ịkpọ nkụ, polyuria na polydipsia (n'agbanyeghị oge ụbọchị). Ọrịa na-amasịkarị ndị ọrịa ị waterụ mmiri oyi ma ọ bụ ihe ọ chiụ chiụ gbara agba. Akpịrị na-akpọ n'abalị na polyuria na-akpaghasị ụra, na arụmọrụ nke uche na ọrụ ọgụgụ isi na-ebelata Constant Theụ mmiri mgbe niile, na - eduga na afọ, yana mbelata ọnya afọ.

Afọ nke mmalite nke ọrịa insipidus e nwetara nwere ike ịbụ nke ọ bụla, ebe n'ụdị ọmụmụ ya enwere ụfọdụ ụkpụrụ.

Nchọpụta ọrịa shuga insipidus

Dchọpụta ihe kpatara polyuria anaghị ebute nsogbu ọ bụla, mana mgbe ụfọdụ ọ bụ ọrụ siri ike. Ya mere, nchọpụta ọrịa shuga na onye ọrịa nwere polyuria na-egosi nke ọma ihe kpatara ya. Ọnụnọ nke ọrịa uche na onye ọrịa na mgbakwunye hypotonic polyuria na-egosi polydipsia isi (psychogenic). N'aka nke ọzọ, hypotonic polyuria megide mmalite nke osmolarity plasma na ụba sodium dị elu ewezuga nchọpụta nke polydipsia bụ isi. Mgbe polyuria pụtara mgbe aachara ahụ ma ọ bụ trauma na mpaghara hypothalamic-pituitary, nchọpụta nke Central ND na-apụta ìhè. N'okwu ndị na-apụtaghị ìhè, ule pụrụ iche dị mma.

Mgbe a wasịrị ya ahụ na mpaghara hypothalamic-pituitary ma ọ bụ mmerụ ahụ, mmebi nke nguzo mmiri na-abụkarị n'ụzọ atọ.

• A na - esonye akụkụ nke mbụ nke oge ebilite na ujo na akwara na enweghị ike nke mkpụrụ ndụ akwara iji wee nwee ike imepụta ihe. Ọ na-egosipụta onwe ya n'ime awa iri abụọ na anọ mbụ mgbe mmerụ ahụ wee mezie n'ime ụbọchị ole na ole.
• E gosipụtara usoro nke abụọ site na ADH hypersecretion syndrome, na - apụta ụbọchị 5-7 mgbe mmerụ ahụ wee jikọta ya na mwepụta nke ADH site na mkpụrụ ndụ akwara na - agbagha ADH nke na - emebi n'ihi trauma (ọgba aghara trophic, ọbara ọgbụgba).
• Akụkụ nke atọ bụ mmepe nke etiti ND, mgbe ihe karịrị 90% nke mkpụrụ ndụ na-emepụta ADH bibiri trauma.

N'ụzọ doro anya, anaghị ahụ usoro mgbanwe ahụ akọwapụtara akọwapụtara na ndị ọrịa niile - na ụfọdụ ndị ọrịa naanị mpaghara nke mbụ nwere ike ịmalite, na ndị ọzọ - nke mbụ na nke abụọ, na ụfọdụ ndị ọrịa, mmerụ ụbụrụ na-ejedebe na etiti Central.

A na - agbanwe ụkpụrụ nke nchoputa nke etiti ọgwụ na mwepu nke ihe ndị ọzọ nwere ike ịkpalite ND. Karịsịa, mbelata olu nke mmamịrị nke a na - eme na vasopressin anaghị akwado nchoputa nke Central ND, ebe ọ bụ na mmeghachi omume dị otú ahụ na - eme na polydipsia bụ isi, na ndị ọrịa mgbe a gbasịrị ụbụrụ, yana ndị ọrịa nwere nguzozi nke mmiri, na nke ikpeazụ, njigide mmiri nwere ike ọbụna ị intoụ mmiri. Nchikota ihe omimi choputara na etiti Central bu ngwakọta nke hypotonic polyuria megide obara ala nke elu aru ma obu uda elu ADR n’ime obara. N'adịghị ka polydipsia nke bụ isi, nke ọbara ọgbụgba na-abawanye, ma mgbe ụfọdụ ọ na-ebelata.

Nnwale mmiri mgbochi

N'oge nnwale ahụ na mmachi mmiri, a theụghị mmiri naanị, kamakwa mmiri ọ bụla ka ewepụrụ iji mee ka akpukpọ ahụ wee si otú a na-eme ka mkpali zuru oke maka ADH kacha elu. Ogologo oge iji gbochie mmiri ị fluidụ mmiri na-adabere na ọnụọgụ nke ahụ na - efufu, ọ na - abụkarị ule ahụ ruo awa anọ ruo awa 18. Ọ ga - adaba ka ị duzie nnwale ahụ n'ime ụlọ ebe enweghị mmiri. Tupu ịmalite nnwale ahụ, onye ọrịa ahụ kwesịrị ka ọ jin, mgbe nke ahụ gasịrị, a ga-atụgharị ya. Site na oge a, a na-enyocha ahụ onye ọrịa ahụ n'oge awa ọ bụla, a na-edekọ ụda mmamịrị na-eme, na-ekpebi osmolarity mmamịrị kwa oge. A kwụsịrị ule a n'okwu ndị a:

• ibu felatara ruru 3%,
• onye ọrịa gosipụtara ihe ịrịba ama nke enweghị ike na sistemụ akụrụngwa obi,
• mmamịrị osmolarity mmamịrị (mgbanwe osmolarity na akụkụ atọ nke mmamịrị agafeghị 30 mOsm / kg),
• hypernatremia mepụtara (karịa 145 mmol / l).

Ozugbo osmolarity ahụ kwụsịrị ma ọ bụ onye ọrịa ahụ furu efu karịa ihe karịrị 2% nke ịdị ahụ, a na-eme nyocha ọbara ndị a:

• ọdịnaya sodium
• osmolarity
• ịta vasopressin.

Mgbe nke ahụ gasịrị, a na-ewere onye ọrịa ahụ na arginine-vasopressiner (5 nkeji) ma ọ bụ desmopressin (1 mg) subcutaneously, yana ntụgharị osmolarity na olu ya na-atụle 30, 60 na minit 120 mgbe ọ gbasịrị. Ejiri uru osmolarity kachasị elu (peak) iji nyochaa nzaghachi na nchịkwa nke arginine-vasopressinar. Maka izuzu nke nyocha ahụ, ọ dị mkpa iji mụọ osmolarity plasma na mbido ule ahụ, mgbe ahụ - tupu iwebata arginine-vasopressin ma ọ bụ desmopressin na mgbe nchịkwa ọgwụ.

N'ime ndị ọrịa nwere polyuria siri ike (ihe karịrị 10 l / ụbọchị), ọ bụ ihe amamihe dị na ya ịmalite ule ahụ na afọ efu n'ụtụtụ, a na-arụkwa ya nlezianya banyere ọnọdụ onye ọrịa site n'aka ndị ọrụ ahụ ike. Ọ bụrụ na polyuria na-agafeghị oke, mgbe ahụ enwere ike ịmalite ule ahụ site na awa 22, n'ihi na mmachi mmiri maka awa 12-18 nwere ike ịdị mkpa.

Tupu nnwale ahụ, ọ bụrụ na ọ ga-ekwe omume, ọgwụ ndị na-emetụta njikọ na nzuzo nke ADH kwesịrị ịkwụsị. A na-akagbu ihe ọụ Cụ kọfị, yana mmanya na sịga, opekata mpe awa 24 tupu nyocha ahụ. N'oge nnwale ahụ, ọ dị mkpa iji nlezianya nyochaa onye ọrịa, karịsịa ngosipụta nke mgbaàmà nwere ike ịkwalite nzuzo nke vasopressin megide ndabere nke osmolarity nkịtị (dịka ọmụmaatụ, ọgbụgbọ, hypotension art, ma ọ bụ mmeghachi omume vasovagal).

Mma. N'ime ndị ahụ dị mma, mmachi mmiri na-eme ka njide ADH dị elu ma na - akpata mmamịrị kachasị. N'ihi ya, iwebata ADH ndị ọzọ ma ọ bụ ihe analogues agaghị eduga na mmụba osoolarity karịa 10% na mmamịrị nke etinyeburu.

Polydipsia nke mbụ. Mgbe osmolarity mmamịrị erughi ọkwa dị elu karịa osmolarity nke ọbara, ewepụrụ polydipsia nke bụ isi, belụsọ na ọ nwere onye ọrịa ahụ zoro ezo na mmiri. N'okwu ikpeazu, oke osmolarity ọbara ma ọ bụ mmamịrị osmolarity na-abawanye nke ọma n'oge ule mmachi mmiri.Ihe ozo n’egosi na edoghi anya na uzo nnwale bu odi iche di n’iru ike nke aru n’iru ma oburu olu nke obubu n’iru ya karie ma obu karie ya na udiri aru nke onye obia aghaghi karia ma obu karia otu odi n’iru nke aru.

ND zuru ezu. Na etiti ma na nephrogenic ND, n'ihe banyere ND zuru ezu, osmolarity mmamịrị adịghị agafe osmolarity plasma na njedebe nke nnwale ahụ na mmachi mmiri. Dabere na mmeghachi omume na nchịkwa nke arginine-vasopressin ma ọ bụ desmopressin, ụdị abụọ nke ND a nwere ike iche. Site na nephrogenic ND, ntakịrị mmụba nke osmolarity ga-ekwe omume mgbe nchịkwa nke arginine-vasopressin ma ọ bụ desmopressin, mana ọ bụghị ihe karịrị 10% enweta na njedebe nke mmiri akpịrị. N'etiti etiti etiti, nchịkwa nke arginine-vasopressin na-akpata mmụba na osmolarity mmamịrị karịa 50%.

NDI ezughi oke. N'ime ndị ọrịa nwere ND na-ezughi ezu, ma n'ihe banyere etiti na nephrogenic ND, mmamịrị mmamịrị nwere ike ịgafe osmolarity ọbara na njedebe nke ule ahụ site na mmachi mmiri. N'otu oge ahụ, yana etiti etiti etiti, ọkwa ADH nke plasma dị ala karịa ka a ga-atụ anya ya na ọkwa osmolarity a na-ahụ anya, ebe ya na nephrogenic ND ha zuru oke.

Hypertonic Sodium Chloride Influ

Thiszọ a na-enye ohere ịkewapụta ND na-ezughi ezu na polydipsia bụ isi.

Andzọ na ntụgharị

N'oge ule a na-akpali akpali, a na-agbanye 3% sodium chloride ngwọta intravenously na ọnụego 0.1 ml / n'arọ kwa nkeji maka awa 1-2. Mgbe ahụ, a na-ekpebi ọdịnaya ADH mgbe ọkwa osmolarity na plasma sodium erughị> 295 mOsm / l na 145 mEq / l, karị.

N'ime ndị ọrịa nwere nephrogenic ND ma ọ bụ polydipsia bụ isi, mmụba nke serum ADH na nzaghachi na mmụba nke osmolarity ga-abụ ihe nkịtị, na ndị ọrịa na Central Central, mmụba dị ala na ihe nzuzo ADH ka edekọtara ma ọ bụ na-anọghị ya kpamkpam.

Ọgwụgwọ nnwale

Methodzọ a na-enye ohere ịkewapụta etiti etiti ezughi ezu na NEP nephrogenic na-ezughị ezu.

Andzọ na ntụgharị

Nwee ọgwụgwọ nnwale na desmopressin maka ụbọchị 2-3. Ọgwụ a kpochapụrụ ma ọ bụ belata ngosipụta nke Central ND na anaghị emetụta usoro NEF nephrogenic. Na polydipsia bụ isi, nhọpụta nke ọgwụgwọ a naghị emetụta mmiri ị waterụ mmiri, ọ bụ ezie na mgbe ụfọdụ ya na Central ND, onye ọrịa nwere ike ịga n'ihu na-eri oke mmiri.
Nke mbu, ị ga - agba mbọ hụ na onye ọrịa ahụ nwere polyuria.

Onye ọrịa na - ezere ị intụ mmiri ruo mgbe oke ahụ belatara ihe kariri 5% nke mbido ma ọ bụ akpịrị ịkpọ nkụ ga - abụ nke a na - agaghị edili. Maka nke a, n'ọtụtụ oge, awa 8-12 ezuola. Na ndị mmadụ nwere ahụike, n'ọnọdụ ndị a, mbelata nke ọnụọgụ na mmụba na mmụba mmamịrị na-eme, ebe ndị ọrịa nwere ọrịa insipidus, olu mmamịrị ewepụtabeghị nke ukwuu, na osmolality ya adịghị karịa 300 ala ala / l Mmụba na osmolality mmamịrị ruo 750 mosm / l na-egosi ọrịa insipidus neurogenic.

Mgbe ịchọpụta insipidus nephrogenic na-achọ nyocha zuru oke banyere ọnọdụ nke akụrụ, mwepu nke nsogbu ọgba aghara.

Nchịkọta nke akụkọ gbasara ezi na ụlọ, nyocha nke ndị ikwu onye ọrịa na-enye anyị ohere ịchọpụta na iche ọdịiche dị iche iche maka ọrịa shuga insipidus.

Ọgwụ nke ọrịa shuga insipidus

Izu oke mmiri

Ndị ọrịa nwere ngosipụta dị nro nke ND (ihe ọkụkụ kwa ụbọchị anaghị agafe 4 l) yana usoro echekwara nke akpịrị ịkpọ nkụ na-eche na ọ dịghị mkpa ịkọ ọgwụ ọgwụ, o zuru ezu ka ọ ghara amachi oriri ị fluidụ mmiri.

NDU Central. Denye analog nke vasopressin - desmopressin.

Ọrụ kachasị na V₂-emechi anya na akụrụ na obere ihe na-anabata ndị na - anabata V₁ vasopressin n’ime arịa. N'ihi nke a, ọgwụ nwere belata belata uto utịp na antidiuretic na-enwekwukwa. Na mgbakwunye, ọ na-abawanye ọkara ndụ.

Enwere ike ịkọ ọgwụ a ugboro 2 n'ụbọchị n'otu usoro onunu ogwu ya, na usoro dị irè na ndị ọrịa dị iche dịgasị iche iche.

• onunu ogwu nke 100-1000 mcg / day,
• intranasal dose nke 10-40 mcg / ụbọchị,
• subcutaneous / intramuscular / dị n’ime nke 0.1 ruo 2 mcg / ụbọchị.

NDhrogenic ND

• A na - ewepụ ihe kpatara ọrịa ahụ (metabolic ma ọ bụ ọgwụ).
• Nnukwu ọgwụ desmopressin dị elu na-arụ ọrụ mgbe ụfọdụ (dịka ọmụmaatụ, ruo 5 mcg intramuscularly).
• Iri mmiri zuru oke.
• Thiazide diuretics na ndị na-egbochi prostaglandin, dị ka indomethacin, nwere ike ịdị irè.

Ọ na-esiri ike ịgwọ ọrịa uche dị n'ụgwọ ọrịa psychigenic polydipsia.

Ọ bụrụ na Central insipidus na - etolite megide ndabere nke mgbanwe mgbanwe enwere ike na mpaghara hypothalamic-pituitary, ekwesịrị ime mgbalị etiotropic (ọgwụgwọ ịwa ahụ ma ọ bụ radieshon na chemotherapy nke etuto ahụ, ọgwụgwọ mgbochi mkpali maka sarcoidosis, meningitis, wdg).

Etinyebeghị ọgwụgwọ dị mma maka ọrịa shuga na nephrogenic. Ọ bụrụ na ọ ga - ekwe omume, ekwesịrị iwepụ ihe kpatara ọrịa ahụ enwetara (dịka ọmụmaatụ, belata dose nke nkwadebe lithium). A na-egosi ndị ọrịa ọrịa ụgwọ zuru oke, mmachi nke nnu.

Prognosis maka ọrịa shuga insipidus

Ọrịa shuga insipidus mgbe arụchara akwara ozi na mmerụ ahụ ụbụrụ na - abụkarị nwa oge, a na - akọwapụta usoro mgbanwe ụdị ọrịa ahụ.

Amụma nke ndị ọrịa nwere ọrịa insipidus nke neurogenic, dị ka a na-achị, bụ nke a na-ekpebisi ike na ọrịa na-eduga na mmebi nke hypothalamus ma ọ bụ neurohypophysis, yana enweghị nkwekọrịta adenohypophysis.