Kedu ihe nkọwa acromegaly, akara, mgbochi ọrịa

Anyị na-enye gị ka ị gụọ akụkọ banyere isiokwu: "ihe bụ nkọwa acromegaly, mgbaàmà, mgbochi ọrịa" na nkwupụta ndị ọkachamara. Ọ bụrụ na ịchọrọ ịjụ ajụjụ ma ọ bụ dee okwu, ị nwere ike ịme nke a n'okpuru, mgbe isiokwu ahụ gasịrị. Ọkachamara ọkachamara nke endoprinologist ga-aza gị n'ezie.

Acromegaly - mmụba banyere ọrịa akụkụ ụfọdụ nke ahụ metụtara ịba ụba homonụ nke uto (uto uto) nke akụkụ ahụ na-akpata ahụ mgbu ka ọ na-akpata. Ọ na - eme na ndị okenye ma na - egosipụta ya site na mmụba nke ọdịdị ihu (imi, ntị, egbugbere ọnụ, agbagba ala), mmụba nke ụkwụ na aka, isi ọwụwa na mgbu mgbu oge niile, arụ ọrụ mmekọahụ na ịmụ nwa na ụmụ nwoke na ụmụ nwanyị. Otito eto eto homonụ n’ime ọbara na - ebute ọnwụ n’oge ọrịa kansa, akwara, ọrịa obi.

Vidiyo (pịa igwu egwu).

Acromegaly bidoro itolite ma etolite na uto ahu. Nke nta nke nta, ogologo oge, ihe mgbaàmà na-abawanye, na mgbanwe na-apụta. Ná nkezi, a na-achọpụta acromegaly mgbe afọ asaa gachara site na mmalite ọrịa ahụ. Ọrịa ahụ dịkwa n'etiti ụmụ nwanyị na ụmụ nwoke, ọkachasị mgbe ọ dị afọ 40-60. Acromegaly bụ ọrịa endocrine dị ụkọ, a na-ahụkwa ya na mmadụ iri anọ n'otu nde mmadụ.

Nzuzo nke homonụ nke uto (uto uto, STH) bu nke pituitary gland na-eme. N'oge nwata, homonụ na-eto eto na-achịkwa ịkpụkpụkpụkpụ akpụ akụrụngwa na uto ahịrị, ebe ọ bụ okenye, ọ na - achịkwa usoro carbohydrate, abụba, nnu-mmiri. A na-achịkwa nzuzo nke homonụ na-eto eto site na hypothalamus, nke na-emepụta neurosecrets pụrụ iche: somatoliberin (na-akpali mmepụta GH) na somatostatin (na-egbochi mmepụta nke GH).

Dị ka ọ na-adịkarị, ọdịnaya somatotropin dị n'ọbara na-agbanwe ụbọchị, na-eru ogo ya n'ụtụtụ ụtụtụ. N'ime ndị ọrịa nwere acromegaly, ọ bụghị naanị mmụba na mkpokọta nke STH n'ime ọbara, kamakwa ọ bụ imebi ụda nkịtị nke nzuzo ya. Site na ọtụtụ ebumnuche, mkpụrụ ndụ nke gland pituitary gland na-anaghị erube isi na nchịkwa hypothalamus ma bido mụbawanye. Mmụba nke mkpụrụ ndụ akwara na - eduga n'ilepụta akpụ akpụ akpụ - pituitary adenoma, nke na - emepụta somatotropin kpụ ọkụ n'ọnụ. Ogo nke adenoma nwere ike iru ọtụtụ centimita ma gafere nha nke gland n’onwe ya, na-apị ma na-ebibi mkpụrụ ndụ nkịtị.

Na 45% nke ndị ọrịa nwere acromegaly, ntụpọ pituitary na-emepụta naanị somatotropin, 30% ọzọ na-ewepụta prolactin, na 25% fọdụrụnụ, na mgbakwunye, luteinizing, follicle-akpali, homonụ na-akpali akpali, homonụ na-zoro ezo. Na 99%, ọ bụ pituitary nke adenoma na-akpata acromegaly. Ihe ndị na-akpata mmepe nke pituitary adenoma bụ mmerụ ahụ ụbụrụ, ọnya hypothalamic, mbufụt sinus na-adịghị ala ala (sinusitis). E kenyere ụfọdụ ọrụ na mmepe nke acromegaly n'ihe nketa, ebe ọ bụ na ndị ọrịa na-achọpụtakarị ọrịa na ndị ikwu.

N'oge nwata na etolite etolite, na-emegide uto nke uto, hyperecretion STH na-adịghị ala ala na-akpata gigantism, nke e ji amata oke, mana mmụba nke ọkpụkpụ, akụkụ na anụ ahụ dị nro. Site na mmezu nke uto nke akwara ohuru na mkpochapu nke akwara, nsogbu nke ụdị acromegaly na - etolite - na - eme ka ọkpụkpụ na - eto oke, mmụba nke anụ ahụ na akwara. Site na acromegaly, ọbara mgbali nke parenchyma na stroma nke akụkụ ahụ dị n'ime: obi, akpa ume, akwara, imeju, akwara, eriri afọ. Uto nke anụ ahụ na - eme ka mmadụ nwee mgbanwe mgbanwe n’akwara n’akwara ndị a, ihe ize ndụ nke ịmalite ịrịa ọrịa akpụ na ọrịa ọjọọ, gụnyere ndị nke endocrine.

Ejiri Acromegaly mara ogologo oge. Dabere ogo mgbaama na mmepe nke acromegaly, enwere ọtụtụ nkebi:

Ọkpụkpọ nke preacromegaly - akara mbụ, dị nro nke ọrịa ahụ na-apụta. N'oge a, acromegaly adịkarịghị achọpụta ọrịa, naanị site na ndị na-egosi ọkwa ogo hormone na-eto eto n'ọbara na site na CT nke ụbụrụ.
A na-achọpụta ọkwa hypertrophic - mgbaàmà akpọrọ nke acromegaly.
Azụmaatụ - akara nke mkpakọ nke mpaghara ụbụrụ dị n'akụkụ (ịba ụba intracranial mgbali, nsogbu akwara na anya) na-abịa n'ihu.
Ihe dị na oghere cachexia - ike ọgwụgwụ dị ka nsonaazụ acromegaly.

Ihe ngosi acromegaly nwere ike ịbụ n’ihi oke uto hormone ma ọ bụ ihe nke pituitary adenoma na akwara optic na akụkụ ụbụrụ dị nso.

Okirikiri uto uto na-eme ka mgbanwe dị mma n'ọdịdị nke ndị ọrịa nwere acromegaly: mmụba na mgbada ala, ọkpụkpụ zygomatic, arerciliary arches, hypertrophy nke egbugbere ọnụ, imi, ntị, na-eduga na mkpokọta nke ọdịdị ihu. Site na mmụba nke nkịta ala, enwere nghọtahie na oghere ndị a na - eme na mgbanwe na ntanetị. Enwere mmụba nke ire (macroglossia), nke etinye akara akara ezé. N'ihi hypertrophy nke ire, larynx na ụdọ olu, olu na - agbanwe - ọ na - adị ala ma na - agbagharị. Mgbanwe na ọdịdị acromegaly na-ewere ọnọdụ nwayọ, na-enweghị ike maka onye ọrịa. Enwere mkpịsị aka na-emeghe, mmụba nke okpokoro isi, ụkwụ na aka ka a manyere onye ọrịa ịzụta okpu, akpụkpọ ụkwụ na uwe aka ọtụtụ nha buru ibu karịa na mbụ.

Site na acromegaly, nrụrụ nke ọkpụkpụ na-apụta: spain na-ehulata, obi dị na ogo anteroposterior na-abawanye, na-enweta ụdị nke agba gbọmgbọm, oghere intercostal na-agbasa. Hyzụlite hypertrophy nke akwara na akwara na-eme ka nrụrụ na mgbochi nke agagharị, arthralgia.

Site na acromegaly, a na-ahụ oke ọsụsọ na sebum secretion, n'ihi mmụba nke ọnụ ọgụgụ na ụba ọrụ nke ọsụsọ na gland sebaceous. Akpụkpọ ahụ na ndị ọrịa nwere acromegaly thickens, thickens, ma na-achịkọta n'oghere miri emi, karịsịa na ahịa ala isi.

Site na acromegaly, mmụba nke uru ahụ na akwara dị n'ime (obi, umeji, akụrụ) na-eji mmụba nwayọ nke dystrophy nke eriri akwara. Ndị ọrịa na-amalite ichegbu onwe ha banyere adịghị ike, ike ọgwụgwụ, ọdịda na-aga n'ihu na arụmọrụ. Ọbara ọbara nke myocardial na-etolite, nke a na-ejizi myocardial dystrophy dochie ya na ịba ụba obi. Otu ụzọ n'ụzọ atọ nke ndị ọrịa nwere acromegaly nwere ọbara mgbali elu, ihe fọrọ nke nta ka ọ bụrụ 90% tolitere ọrịa carotid apnea jikọtara ya na hypertrophy nke anụ ahụ dị nro nke akụkụ okuku ume na arụ ọrụ nke akụkụ okuku ume.

Site na acromegaly, ọrụ mmekọahụ na-ata ahụhụ. Imirikiti ụmụ nwanyị nwere oke prolactin na ụkọ nke gonadotropins na-amalite ịkpa arụ na amụghị nwa, galactorrhea na-apụta - mpụta mmiri ara site na ara, ọ bụghị ya na-atụrụ ime na ịmụ nwa. 30% nke ụmụ nwoke nwere mbelata na inwe mmekọahụ. Egosiputa hypocretion nke antidiuretic hormone na acromegaly gosiputara site na mmepe nke insipidus oria shuga.

Ka ọria ahụ na-eto eto, ọ na-enwe mmụba nke intracranial, fotophobia, ọhụụ okpukpu abụọ, ihe mgbu na cheekbones na n'egedege ihu, ọgbụgbọ, ọgbụgbọ, belata ịnụ ntị na isi, ọnụọgụ nke aka. N'ime ndị ọrịa na-arịa acromegaly, ihe egwu nke etolite etuto nke thyroid gland, akụkụ nke eriri afọ, na akwara.

Ihe banyere acromegaly bu ihe omuma ya na nmeko ya site na ihe ndia nile. Ihe kachasị dị na ndị ọrịa nwere acromegaly bụ ọbara mgbali obi, myocardial dystrophy, ọbara mgbali akwara, obi daa. Ihe karịrị otu ụzọ n'ụzọ atọ nke ndị ọrịa na-ebute ọrịa shuga, a na-ahụ ihe dystrophy imeju na pulmonary emphysema.

Hyperproduction nke uto na acromegaly na-eduga na mmepe nke etuto ahụ dị iche iche, ma ọria ma na-emebi emebi. Acromegaly na - ejikarị mgbasa ozi ma ọ bụ nodular goiter, fibrocystic mastopathy, adenomatous adrenal hyperplasia, ovaries polycystic, fibroids uterine, polyposis nke afọ. Ffzụlite ezughi oke pituitary insulence (panhypopituitarism) bụ n'ihi mkpakọ na mbibi akwara nke pituitary gland tumor.

N'ime usoro ndị ọzọ (afọ 5-6 mgbe mmalite nke ọrịa ahụ), enwere ike ịtụ anya acromegaly na-adabere na mmụba nke akụkụ ahụ yana ihe ịrịba ama ndị ọzọ dị na mpụga nke ahụrụ n'oge nyocha. N'ọnọdụ ndị dị otú ahụ, a na-ebugharị onye ọrịa ahụ maka nyocha site na endocrinologist na ule maka nyocha ụlọ nyocha.

Ihe nchoputa ulo ogwu banyere acromegaly bu mkpebi nke obara:

homonụ nke uto n'ụtụtụ na mgbe a gbasịrị glucose,
IRF I - insulin-di nnuku uto.

A na-ekpebi mmụba nke ọkwa homonụ na ihe fọrọ nke nta ka ọ bụrụ ndị ọrịa niile nwere acromegaly. Nnyocha ọnụ nwere ibu glucose n'oge acromegaly gụnyere ikpebi uru mbụ nke STH, na mgbe ị gachara glucose - mgbe ọkara elekere, otu elekere, 1.5 na awa 2. Dị ka ọ na-adịkarị, mgbe ị nwusịrị glukos, ọkwa nke uto uto na-ebelata, yana iji usoro acromegaly na-arụ ọrụ, na ntụle, a na-achọpụta mmụba ya. Ule nnabata glucose na-ezi ozi ọma n'ihe gbasara mmụba dị elu na ọkwa nke STH, ma ọ bụ ụkpụrụ ya. A na-ejikwa nnwale nke glucose na-atụle iji ọgwụgwọ acromegaly dị mma.

Otito homonụ na - arụ ọrụ n'ahụ ahụ site na ihe ndị metụtara insulin. Ngwakọta plasma IRF I na-egosipụta mkpopụta GH kwa ụbọchị. Mmụba na IRF I ọbara ọbara nke okenye na-egosi mmepe nke acromegaly.

Nnyocha ophthalmological na ndị ọrịa nwere acromegaly nwere warara nke ebe a na-ahụ anya, ebe ọ bụ na ụzọ ụzọ dị iche iche si ele ihe anya na-adị na ụbụrụ dị nso na gland pituitary. Mgbe ihe onyonyo nke okpokoro isi gosipụtara mmụba nke saddle Turkey, ebe akụrụngwa pituitary dị. Iji mee ka atụgharị uche na-eto ogwu, a na-eme nchọpụta kọmputa na MRI nke ụbụrụ. Na mgbakwunye, a na-enyocha ndị ọrịa nwere acromegaly maka nsogbu dị iche iche: polyposis intestinal, mellitus diabetes, multinodular goiter, wdg.

Na acromegaly, ebumnuche ebumnuche nke ọgwụgwọ bụ iji nweta mgbaghara nke ọrịa site na iwepu hyatecretion somatotropin na ịhazi ịdị n'otu nke IRF I. Maka ọgwụgwọ acromegaly, endocrinology nke oge a na-eji ọgwụ, ịwa ahụ, radieshon na ụzọ jikọtara ọnụ.

Iji mezie ọkwa nke somatotropin n'ọbara, a na-ahazi nchịkwa nke somatostatin analogues - a neurosecret nke hypothalamus, nke na-egbochi nzuzo nke homonụ na-eto (octreotide, lanreotide). Site na acromegaly, a na-egosi nhọpụta nke homonụ mmekọahụ, dopamine agonists (bromocriptine, cabergoline). Na-esote, a na-eme gamma ma ọ bụ ọgwụgwọ radieshon otu oge na gland pituitary.

Site na acromegaly, ihe kachasị dị irè bụ mwepu ịwa ahụ na ntọala nke okpokoro isi site na ọkpụkpụ sphenoid. Site na obere adenomas mgbe a wasịrị ya ahụ, pasent 85 nke ndị ọrịa nwere ọkwa hormone tozuru oke na ịgbanarị ọrịa ahụ. Site na nnukwu tum tum, pasent nke ọgwụgwọ dịka arụmọrụ nke mbụ ruru 30%. Ọnụ ọgụgụ ndị na-anwụ maka ọgwụgwọ ịwa ahụ acromegaly sitere na 0.2 ruo 5%.

Enweghị ọgwụgwọ maka acromegaly na-eduga nkwarụ nke ndị ọrịa na-arụ ọrụ na afọ ọrụ, na-eme ka ohere nke ịwụchu ọnwụ. Site na acromegaly, a na-ebelata ndụ afọ: 90% nke ndị ọrịa anaghị adị ndụ ruo afọ 60. Ọnwụ na-abụkarị n'ihi ọrịa obi. Nsonaazụ nke ịwa ahụ acromegaly ka mma site na obere adenomas. Ebe enwere nnukwu ọgbụgba nke ọnya ọgbụgba, ugboro ugboro nlọghachi azụ ha na-abawanye.

Iji gbochie acromegaly, o kwesịrị izere mmerụ isi, yana mmebi ọrịa nasopharyngeal kwesịrị ịdị ọcha. Detechọpụta mmalite nke acromegaly na ịhazi ọkwa nke hormone nke uto ga - enyere aka zere nsogbu ma kpatara mgbaghara ọ bụla.

Ihe na - akpata acromegaly

Ahụhụ pituitary gland na-emepụta homonụ somatotropic (STH), nke bụ maka ịkpụkpụ ọkpụkpụ musculoskeletal n'oge nwata, na ndị okenye na-enyocha metabolism mmiri-nnu.

N'ime ndị ọrịa nwere acromegaly, enwere mmebi nke mmepụta nke homonụ a na mmụba na ntinye uche ya na ọbara. Pititaya nke adenoma nwere acromegaly na-etolite na uto nke mkpụrụ ndụ pituitary.

Dị ka ndị ọkachamara si kwuo, ihe na-akpata acromegaly bụ nnuku adenoma, nke nwere ike ịmalite na ọnya ọnya hypothalamic, isi ọnya, na sinusitis na-adịghị ala ala. Ọrụ dị mkpa na mmepe acromegaly bụ ihe ketara eketa.

Ejiri Acromegaly mara ogologo oge, ngosipụta ya dabere na ọkwa nke mmepe:

Ejiri preacromegaly mara maka mmụba dị elu nke GH, n'ihi nke enweghị ntakịrị ihe ngosipụta nke ngosipụta ọrịa,

Hypertrophic ogbo - a na-ahụkarị akara ngosi nke ọrịa ahụ,

Ihe eji mara tumor bụ n ’mmụba nke nrụgide intracranial na nsogbu n’arụ ọrụ nke sistemu na ahụ,

Cachexia - enwere nlebara anya ọrịa.

N'ihi mmepe ogologo na ogbo nke acromegaly, a naghị ahụ ihe ịrịba ama dị na mpụga.

Nlebara anya nke ulo ogwu

Ọrịa acromegaly na ụmụaka na ndị okenye gụnyere:

Mmetụta akụkụ ahụ dị na ogwe aka na nkwonkwo n'ihi mbibi ha na mmepe nke ogbu na nkwonkwo,

Oke ntutu nwoke nwere oke na ụmụ nwanyị,

Mmụba nke oghere dị n’etiti ezé, mmụba n’akụkụ dị iche iche nke ihu, na -akpọ anụ ahụ.

Ọdịdị nke ure na-eto,

Ibawanye thyroid,

Ibelata ikike ọrụ, ike ọgwụgwụ,

Mmepe nke ọrịa obi na akwara nke pụrụ ibute ọnwụ,

Mmepe nke ọrịa shuga

Mmebi nke pigmentation nke anụ ahụ,

Ọkpụkpụ nke sistem.

Na pituitary acromegaly, mkpakọ nke sel dị mma na-apụta, nke na-akpasu iwe:

Mbibi ikike na libido n'ime mmadụ,

Infe nwa, oge nwanyị.

Mighachi ugboro ugboro nke enweghị ọgwụ.

Ọrịa

Ọrịa acromegaly na gigantism ga - ekwe omume dabere na data: MRI ụbụrụ, mgbaàmà, foto nke ụkwụ, parampat biochemical.

N'ime ọmụmụ nyocha ụlọ nyocha, mkpebi siri ike nke ịta STH na ihe nwere insulin dị ka uto-1 ka ahuru iche. Dị ka ọ na-adịkarị, ọkwa nke STH abụghị ihe karịrị 0.4 μg / l, IRF-1 kwekọrọ na njirisi ọkọlọtọ dabere na okike na afọ nke isiokwu ahụ. Site na ndi nwere ezi uche, a gaghi achupu oria nke oria.

A na-ese ihe nlere nke ụkwụ iji chọpụta ogo ya dị nro. Ferencekpụrụ ntụnyere n'ime ụmụ nwoke ruo 21 mm, n'ime ụmụ nwanyị - ruo 20 mm.

Ọ bụrụ na achọpụtala nchọpụta nke ọrịa ahụ, ọmụmụ ihe banyere pathogenesis nke acromegaly na mkpebi siri ike nke ọghọm na pituitary na hypothalamus.

A na-eme atụmatụ ntụgharị uche nke akụkụ pelvic, obi, retroperitoneum, na akụkụ ahụ dị na etiti bụ ihe a na-eme na enweghị ọrịa pituitary na ọnụnọ nke biochemical na ngosipụta nke ọrịa acromegaly.

Usoro ọgwụgwọ acromegaly

Ebumnuche bụ isi nke usoro ọgwụgwọ maka ọrịa dị otú a bụ ime ka mmepụta ọgwụ hormone tolitere, ka ọ bụrụ ihe ewepụtara.

Maka nke a, a na-eji usoro ndị a:

A na-eji usoro ịwa ahụ eme ihe n'ụdị abụọ: transcranial na transgenic. Nke a na-ahọpụta bụ onye neurosurgeon. A rụrụ ịwa ahụ iji wepu microadenomas ma ọ bụ akụkụ ele nke macroadenomas.

A na-egosipụta mkpughe ọkụ na - enweghị mmetụta mgbe ọwachara ahụ, n'ihi na mma gamma a, proton beam, enwere ike iji eriri osooso.

N'ime ọgwụgwọ ọgwụ, a na-eji otu ọgwụ ọgwụ: somatotropic hormone antagonists, somatostatin analogues, ọgwụ dopaminergic.

A na-eji usoro ọgwụgwọ ejikọtara ọnụ na ndụmọdụ dọkịta.

Ekwesịrị ime nhọrọ nke ọgwụgwọ ọgwụgwọ na njikọta ya na onye ọkachamara mụrụ banyere pathogenesis nke acromegaly, mgbaàmà ya na nsonaazụ ọmụmụ ọmụmụ nke ọrịa ahụ.

Dabere na ọnụ ọgụgụ, a na-ahụta ịwa ahụ kacha arụmọrụ, ihe dịka 30% ndị rụrụ ọrụ na-agbake kpamkpam, ma ndị ọzọ nwere oge mgbaghara oge niile.

Maka ebumnuche mgbochi, a na-atụ aro ya:

Oge na-agwọ ọrịa nke na-emetụta nasopharynx,

Zere mmerụ ahụ isi.

Ọ bụrụ na ihe ịrịba ama ọ bụla na-enwe obi abụọ, gaa na nyocha endocrinologist maka ndụmọdụ. Ọ baghị uru ịchọwa n'adabereghị nke onwe ya na ịgwọ ọrịa.

Ihe ngosi acromegaly nke acromegaly sitere na uto nke uto uto, uto uto putara nke emejuputara site n’iguru pituitary, ma obu oria ndi n’eme ka etolite etolite n’azu (pituitary adenomas, etuto ụbụrụ, metastases site n’akwara akụkụ).

Ihe ndị na-ebute mmepe nke ọrịa ahụ na oke mmiri ọgwụ somatotropic, nke bụ isi n'ọdịdị, ma ọ bụ nwee hypothalamic sitere.

Ọ na-adịkarị anakwere na usoro ahụike nke na-etolite na nwata, uru dị na nwata, ka ana-akpọ gigantism. Otu njirimara nke gigantism na ụmụaka bụ uto na ngwa ngwa nke akụkụ ahụ, anụ ahụ, ọkpụkpụ ọkpụkpụ, mgbanwe nke homonụ. Usoro dị otua na amalite ito mgbe etolite nke ahụ, n'ime okenye karị, ana - akpọ acromegaly. A na-ahụta njiri mara nke acromegaly dị ka mmụba nke akụkụ ahụ, akwara na ọkpụkpụ nke ahụ, yana mmepe nke ọrịa concomitant.

Ihe ịrịba ama nke gigantism na ụmụaka

Enwere ike ịchọpụta ihe ịrịba ama nke acromegaly (gigantism) na ụmụaka nwa oge ka mmalite mmalite nke mmepe ya. N'ihu, ha na-egosiputa na nkwalite nke ukwu, nke na-abawanye ụba ma bụrụ nke na-esighi ike. N'otu oge, ị nwere ike ịchọpụta na ọkpụkpụ zygomatic, nku anya na-abawanye, enwere hypertrophy nke imi, ọkpọiso, ire na egbugbere ọnụ, n'ihi nke ọdịdị ihu na-agbanwe, na-akawanye njọ.

A na - amata ọgba aghara n'ime edem n'ụdị olu akpịrị na sinuses, nke na - akpata mgbanwe na oge olu, na - eme ka ọ dị ala. Patientsfọdụ ndị ọrịa na-eme mkpesa banyere snoring. Na foto ahụ, a na-egosipụta acromegaly na ụmụaka na ndị nọ eto eto site na uto dị elu, akụkụ ahụ na-agbasawanye n'ụzọ na-ekwekọghị n'okike, mgbatị ogologo n'ihi mmụba nke ọkpụkpụ. Mmepe nke ọrịa a na-esokwa mgbanwe hormonal, ihe mgbaàmà nke ndị a bụ:

hyperecretion nke sebaceous glands,

mụbara shuga

calcium mmamịrị nke ukwuu

enwere ike ibute ọrịa gallstone.

ọrịa thyroid na arụ ọrụ.

Mgbe mgbe n’oge ọ dị obere, a na-ahụta njiri mara akwara ndị nwere njikọ, nke na-ebute ọdịdị nke akpụ na mgbanwe na akụkụ ahụ dị n’ime: obi, umeji, akpa ume, eriri afọ. Ọtụtụ mgbe ị nwere ike ịhụ foto nke ụmụaka amụrụ ọhụrụ nke nwere acromegaly olu, njirimara njirimara nke bụ ịgbatị akwara sternocleidomastoid.

Ọrịa Acromegaly na Ndi okenye

Hyperproduction nke homonụ na-ebute ọgbụgba na ahụ mmadụ, nke na-eduga na mgbanwe ya n'ọdịdị ya, nke enwere ike ịhụ ya na foto ya ma ọ bụ na mmadụ. Dịka iwu, a na-egosipụta nke a n'ọtụtụ akụkụ nke anụ ahụ na-ezighi ezi, gụnyere aka na aka ekpe, aka, ụkwụ na okpokoro isi. Dika umuaka, n’ime ndi oria okenye, n’egedege ihu, imi, udi egbugbere ọnụ, nku anya, ọkpụkpụ zygomatic, mgbanaka dị n’okpuru ala, n’ihi nke oghere oghere na-abawanye. Ọtụtụ ndị ọrịa nwere ọrịa macroglossia, ịmụba asụsụ na-efe efe.

Ọrịa acromegaly, bụ nke a na-ebute n'ọtụtụ ọnọdụ site na pituitary adenoma na ndị okenye, gụnyere nrụrụ akwara, ọkachasị, akụkụ nke akụkụ ogwe aka, ịbawanye obi, na-esote mgbasawanye nke oghere intercostal, na mgbanwe nkwonkwo pathologies. Hypertrophy nke cartilage na anụ ahụ na-ejikọta ọnụ na-eduga n'ịkwụsị ikike ịmegharị nkwonkwo, na-ebute ọrịa arthralgia.

Ọtụtụ mgbe ndị ọrịa na-eme mkpesa banyere isi ọwụwa ugboro ugboro, ike ọgwụgwụ, adịghị ike akwara, na-ebelata arụmọrụ. Nke a bụ n'ihi mmụba nke uru ahụ yana uru nke akwara anụ ahụ na-esote. N'otu oge ahụ, ọdịdị nke myocardial hypertrophy, na-agafe na myocardial dystrophy, na-akpata mmepe nke nkụda obi, ga-ekwe omume.

Ndị ọrịa nwere mgbaàmà acromegaly na-egosipụtakarị mgbanwe omume na ọdịdị ha na-eme ka ha yie. Agbanyeghị, akụkụ ahụ dị n’ime na sistemụ na-enwekwa mgbanwe. Yabụ na ụmụ nwanyị, a na-emebi usoro nsọ, amụtaghị amụba, galactorrhea - mwepụta nke mmiri ara ehi site na ara n’onweghị ime. Ọtụtụ ndị ọrịa, n'agbanyeghị agbụrụ na afọ ole ha dị, ka a chọpụtara na ha nwere nsogbu ihi ura nke na-ehi ụra ngwa ngwa.

Ọ bụrụ na agwọghị ya, dịka iwu, prognosis ahụ ga-abụ ihe na-akụda mmụọ. Ọganiihu nke ọrịa na - eduga na nkwarụ zuru oke, ma na - emekwa ka mmadụ nwee ike ibute ọnwụ mberede nke na - ebute ọrịa obi. Oge ndu ndi oria na acromegaly oria belatara nke oma ma ghara iru iri isii.

Diagnostics

Agnochọpụta acromegaly dị mfe, ọkachasị n'ọgba na-esote, ebe ọ bụ na ihe ngosipụta ya dị na ya kapịrị ọnụ. Agbanyeghị, enwere ọrịa ụfọdụ, ihe mgbaàmà ya bụ nke yiri nke acromegaly. Iji duzie nchọpụta ihe dị iche ma gosipụta (ma ọ bụ wezuga) ọnụnọ nke acromegaly, a na-enye ndụmọdụ nke endocrinologist, yana usoro nlele, ụlọ nyocha na ụzọ maka ịchọpụta acromegaly.

Nyocha nyocha nke onye ọrịa

Tupu ịkọwa usoro ọgwụgwọ dị mkpa na ọgwụgwọ kwesịrị ekwesị, dọkịta ahụ na-achịkọta ihe anamnesis, na-ekpebi ọdịnihu ketara eketa na ọrịa a, ma na-enyocha ebumnuche - palpation, peruseion, auscultation. Dabere na nsonaazụ nyocha mbụ, usoro usoro nchọpụta dị mkpa ka edepụtara.

Usoro nyocha ụlọ nyocha

Maka nyocha nke acromegaly, a na-eji nyocha ụlọ ọdịnala: nyocha ọbara na mmamịrị. Agbanyeghị, ihe ndị na-akọkarị ihe ma na-ejikarị ha eme ihe bụ ihe a kọwara dị ka nkọwa nke homonụ ọbara n'ọbara nke nwere acromegaly: STH - homonụ uto nke somatotropic, yana uto insulin - IGF-1.

Eterchọpụta ọkwa nke STH

Nkwenye nke mmepe nke gigantism ma ọ bụ acromegaly bụ ọdịnaya nke somatotropin dị n'ọbara - homonụ na-eto eto, bụ nke ihe mgbu azụ na-ewepụta. Otu ihe puru iche nke imeputa STH bu ihe gbara okpukpo, ya mere, iji duzie ule iji mara ogo ya, a na-eme otutu onyonyo:

N'okwu nke mbụ, a ga-enyocha nlele ugboro atọ site na nkeji nke nkeji 20., emesịa agwakọta ọbara a yana ekpebie nkezi nke STH,

N'okwu nke abụọ, a na -ele nnwale ọbara ugboro ise site na nkeji elekere abụọ na 2.5, mana a na-ekpebi ọkwa ahụ mgbe ọ bụla natachara ọbara. A na - enweta akara ngosi ikpeazụ site na ịchekwa ụkpụrụ niile.

Nkwenye nyocha nke acromegaly ga - ekwe omume ma ọ bụrụ na ọkwa hormone gafere 10 ng / ml. Enwere ike wepu ọrịa ahụ ma ọ bụrụ na nkezi uru anaghị agafe 2.5 ng / ml.

Mkpebi ọkwa nke IGF-1

Nnwale nyocha ọzọ na-enye ihe ọmụma bụ mkpebi siri ike nke hormone IGF-1. Ọ nwere nnukwu uche na nkọwapụta, n'ihi na ọ dabereghị na mgbanwe dị iche iche, dị ka homonụ nke uto. Ọ bụrụ na ọkwa nke IGF-1 dị n'ọbara karịa ka ọ kwụsịrị, dọkịta nwere ike ịchọpụta acromegaly. Agbanyeghị, ekwesịrị ime ule a na njikọ ndị ọzọ, ebe uru IGF-1 dị nwere ike ịdị iche n'okpuru ihe ụfọdụ:

belata n'ihe banyere ọrụ imeju na-arụ ọrụ, hypothyroidism, oke estrogen, agụụ,

mụbaa n'ọbara ọgwụgwọ ọgwụ homonụ, yana mmụba nke ọkwa insulin n'ọbara.

Ule nnabata glucose

N'ọnọdụ ndị nsonaazụ na-enyo enyo, a na-eme nnwale maka ikpebi STH site na iji glucose mee ka o doo anya nchọpụta ahụ. Maka omume ya, a na-amata ọkwa basal nke uto, emesịa a na-agwa onye ọrịa ka ọ mee usoro glucose. Na enweghị acromegaly, nnwale glucose na-egosi mbelata nke nzuzo nke STH, na mmepe nke ọrịa ahụ, n'ụzọ megidere, mmụba ya.

CT ma ọ bụ MRI

Diagnozọ nchọpụta ọrịa bụ isi ma bụrụkwa ihe si mee bụ CT ma ọ bụ MRI, nke na-enye gị ohere ịchọpụta pitenitary adenoma, yana ogo ya gbasaa na akụkụ ahụ na anụ ahụ. A na-eme usoro ahụ site na iji ihe dị iche na-agbakọ na akwara ndị a gbanwere, nke na-eme ka usoro ọmụmụ ahụ dị mfe ma kwe ka ị chọpụta mgbanwe njirimara na pituitary ma ọ bụ hypothalamus.

N'ime usoro ị na-eme usoro nchọpụta, ọtụtụ ndị ọrịa nwere mmasị ugboro ole kwesịrị ka ejiri mee acromegaly. A na-eme usoro a n'oge mgbali hypertrophy nke akụkụ dị iche iche nke ahụ, mepụtara ọhụụ nke ụlọ ọgwụ, ma emesịa, n'ọrịa tumor, mgbe onye ọrịa ahụ na-eme mkpesa banyere ike ọgwụgwụ, isi ọwụwa, akwara na nkwonkwo mgbu, yana ihe ngosi ndị ọzọ metụtara.

X-ray nke okpokoro isi

Emere usoro a iji mata njiri mara radiological acromegaly, yana ihe ịrịba ama nke mmepe nke pituitary adenoma:

mmụba na toki nke Turkey,

ụba pneumatization nke sinuses,

Na usoro onyoonyo na mmalite ọrịa ahụ, ihe ịrịba ama ndị a nwere ike ọ gaghị anọ, yabụ, ndị ọzọ, ọtụtụ mgbe inyeaka, usoro nchọpụta.

ihe nlere nke ukwu nke ukwu, nke n’eme ka ichoputa oke okpukpu dicha n’azu a.

nyocha site n’aka onye na - ahụ maka ọrịa anya iji mata edema, stasis na optic atrophy, nke na - edugakarị ìsì.

Ọ bụrụ na ọ dị mkpa, a na-enye onye ọrịa nyocha nyocha iji chọpụta nsogbu: ọrịa shuga, polyposis eriri afọ, nodular goiter, adrenal hyperplasia, wdg.

Acromegaly na-ezo aka na ọrịa ndị enweghị ike ibuga ọgwụgwọ ya ruo mgbe oge ụfọdụ gasịrị. Mmepụta homonụ na-aba ụba nwere ike ibute nkwarụ n’oge ma belata ohere nke ndụ ogologo. Ọ bụrụ na ịnwere mgbaama ndị mbụ, ị ga-agakwuru dọkịta. Naanị dọkịta mgbe ịmechara nyocha niile nwere ike ịchọpụta ọrịa ahụ ma nye gị ọgwụgwọ ziri ezi.

Ebumnuche na usoro

Ebumnuche ebumnuche nke ọgwụgwọ acromegaly bụ:

mbelata nke mmiri ọgwụ hormone (uto uto),

mbelata nke mmepụta insulin-dị ka etolite etolite IGF-1,

mbelata nke pituitary adenoma,

Emere ọgwụgwọ a n'ụzọ ndị a:

Mgbe nyochachara ụlọ ọgwụ, dọkịta na-ahọrọ usoro kachasị mma, na-eburu n'uche usoro ọrịa ahụ na njirimara onye ọrịa ahụ. Ọtụtụ mgbe, a na-eme acromegaly, ọgwụgwọ nke chọrọ nlezianya nke ọma, na-ejikọta usoro dị iche iche.

Ozi izugbe

Gerywa ahụ

A na-ahụta ọgwụgwọ kachasị dị mma maka acromegaly dị ka ọrụ iji wepụ pituitary adenoma. Ndị dọkịta na-atụ aro ịwa ahụ ma microadenoma na macroadenoma. Ọ bụrụ na achọpụtara na etolite tumo, ịwa ahụ bụ naanị ohere iji gbakee.

A na-arụ ọrụ ịwa ahụ n'otu ụzọ abụọ:

Usoro mwakpo nke obere oge. A na-ewepụ akpụ ahụ n’egbughị oge na enweghị isi na craniotomy. A na-arụ ọrụ ịwa ahụ niile site na oghere oghere ma ọ bụ site na iji endoscopic.

Usoro transcranial. A na-eji usoro ịwa ahụ a ma ọ bụrụ na akpụ ahụ erutela nnukwu ma wepu adenoma site na imi agaghị ekwe omume. Ma arụmọrụ yana oge nwughari bụ ihe siri ike, n'ihi na a na-arụ craniotomy.

Mgbe ụfọdụ acromegaly na-alaghachi mgbe a wachara ya ahụ. Ntetọ ahụ pere mpe, ọ nwere ike karị na oge mgbaghara ga-adị ogologo. Iji belata ihe egwu, ọ dị mkpa iji nyocha ahụike na oge.

Ọgwụ ọgwụ

Ndị dọkịta na-ede ọgwụ maka usoro ọgwụgwọ siri ike nke ọrịa.Na ụdị monotherapy, a na-enye ọgwụ ọgwụ obere oge a, ebe ọ bụ na ha na-enyere aka belata mmepụta hormone, ma ha enweghị ike ịgwọ ọrịa ahụ kpamkpam.

Ọtụtụ mgbe, a na-edenye ọgwụ ike n'ọnọdụ ndị dị otú a:

ọ bụrụ na ịwa ahụ arụpụtaghị nsonaazụ,

ọ bụrụ na onye ọrịa ahụ ajụ ịwa ahụ,

ọ bụrụ na enwere contraindications maka arụ ọrụ.

Medications Tụ ọgwụ na-enyere aka belata akpụ ahụ n’obere, yabụ, mgbe ụfọdụ, a na-enye ọgwụ ọgwụ tupu a waa ya ahụ.

Maka ọgwụgwọ acromegaly, a na-eji ọgwụ ndị otu ndị a eme ihe:

somatostatin analogues (octreodite, lantreoditis),

uto homonụ nke na-anabata uto (pegvisomant).

Medications Tụ ọgwụ bụ naanị otu dọkịta si enyere ya aka. Medication -ụ ọgwụ onwe, yana ọgwụ ndị mmadụ nwere ike ime ka ọrịa ahụ ka njọ.

Ọgwụ radieshọn

A naghị eji usoro ọgwụgwọ ụzarị agwọ ọrịa acromegaly, n'ihi na ọ na-enwekarị nsogbu - mmepe nke hypopituitarism. Udiri nsogbu nwere ike ime afọ ole na ole gachara ọgwụgwọ. Na mgbakwunye, nsonaazụ n'ọtụtụ oge mgbe ị na-eji usoro a anaghị eme ozugbo.

A na - eji usoro ndị a nke usoro ọgwụgwọ radieshon ugbu a:

Iji ọgwụ na-agwọ ọrịa radieshon na ọgwụ na-akpakọrịta.

Okwu a bu “acromegaly” putara na obu oria n’abia n’onodu onye na eme ka ihe uto nke uto buru ibu, ya bu, ngosiputa ihe omumu nke uto uto nke uto uto nke uto. N'ihi ya, itolite ogo nke mkpụrụ ndụ ahụ dum, a na-emebi ihe dị n'ime ahụ na anụ ahụ dị nro (nke a bụ n'ihi njigide nitrogen na ahụ). A na-akpọ Acromegaly nke ọma n'ụkwụ anụ ahụ, ihu na isi niile.

Ọrịa a na-aputa ma ụmụ nwoke ma ụmụ nwoke ma emesịa itusiri eto eto. Ihe bu oria bu isi site na ndi mmadu 45-70 n'ime otu nde mmadu. Ahụ nwatakịrị anaghị enwekarị ọrịa. N'ọnọdụ ndị a na-adịghị ahụkebe, n'oge ụmụaka na-etolite, homonụ uto nke uto a na-eduga n'ọnọdụ a na-akpọ gigantism. Mgbanwe dị otú a bụ njirimara n'ezie n'ihi oke uru na oke nke ọkpụkpụ.

Ebe ọ bụ na acromegaly abụghị ihe a na - ahụkarị, ọrịa ahụ wee jiri nke nta nke nta pụọ, ọ dịghị mfe ịchọpụta ọrịa a na mmalite nke mmalite.

Ihe kpatara ihe a niile abụghị naanị n'ihi mmebi nke homonụ nke uto, kamakwa mgbanwe na ọrụ ahụ ike ndị ọzọ.

Dysfunction nke eriri afọ adrenal.

N'ihi acromegaly, metabolism na-agbagha, nke na-eduga n'ọrịa shuga n'ọrịa ma na-eburu ndụ dị ukwuu n'ihe egwu mmadụ. Mana ewela iwe, enwere ụfọdụ ọgwụ ọgwụgwọ nwere ike belata mgbaàmà ma belata mmepe nke acromegaly.

Ọrịa acromegaly bụ ngosipụta nwayọ ma dị aghụghọ maka mmepe ahụike nke ọrịa ahụ. Ọrịa a na - apụta n'ihi enweghị atụba nke hormonal site na mgbanwe nke ọdịdị ahụ, yana ndagide na ọdịmma. Enwere ndị ọrịa chọpụtara ọrịa a naanị mgbe afọ iri gachara. Nnukwu mkpesa ndị ọrịa bụ mmerụ ahụ, imi, aka nke aka na ụkwụ.

N'ịzụlite ọgụ dị mma megide oria, enwere nnukwu nsonaazụ abụọ: neoplasms ọjọọ na ọrịa nke usoro akwara obi. E nwere ụzọ anọ dị mkpa iji wepu ọrịa a:

Zọ ịwa ahụ. Ndị dọkịta tozuru oke wepụrụ akpụ ahụ. Usoro a na - enye gị ohere ịnweta nsonaazụ ngwa ngwa. Arefọdụ nsogbu dị ka ịwa ahụ gasị.

Usoro ọgwụgwọ ma ọ bụ radieshon. Ọtụtụ mgbe, a na-eji usoro a mee ihe n'ọnọdụ mgbe ịwa ahụ enyereghị aka. Ọzọkwa, irradiation nwere ụfọdụ arụ ọrụ nyocha: akwara optic emetụta ya, etuto ụbụrụ nke abụọ.

Usoro ogwu. A na - agwọ Acromegaly site na ụdị ọgwụ atọ ndị a:

Analogs nke FTA (ogologo oge (Samatulin na Sandostatin LAR) na obere oge - Sandostatin Octroedit).

Dopamine agonists (ergoline na ọgwụ nonergoline).

Ejikọtara ọnụ. N'ihi usoro a, a na-enweta nsonaazụ ọgwụgwọ kachasị mma.

Mana ahụmịhe gosiri na ndị dọkịta ka na-agbaso ọgwụ. Usoro a nwere ike ọfụma n'ahụ ahụ mmadụ.

Ndepụta ọgwụ iji lụsoo nsonaazụ acromegaly ezuola:

Genfastat bụ ọgwụgwọ homeopathic.

Octride bu onye mucolytic.

Sandotatin - Beta - ihe mgbochi Adrenergic.

Samatulin bụ ọgwụ mgbochi.

N'ime ọtụtụ ọgwụ ndị a, ihe na-arụ ọrụ bụ octreodite. Ọ bụ dọkịta na ndị na-abịa ya na-ahụ ọgwụ niile usoro ọgwụgwọ na usoro ọgwụgwọ.

Kedu ihe a ga-echeta mgbe ị na-eji ọgwụ ọgwụgwọ ndị mmadụ na ọgwụgwọ nke acromegaly

Ọ bara uru iji mee ka ahụ sie ike ma mee ka ọ dị ngwa ngwa ịgwọ ọrịa ga-abụ decoctions na teas a kwadebere site na ahịhịa na ahịhịa dị ka:

licorice na ginseng

Acromegaly, ọgwụgwọ ọdịnala maka ọgwụgwọ nke ejiri naanị ya na dọkịta kwenyechara, bụ ihe enyemaka zuru oke. Ekwesịrị icheta na infusions na teas sitere na mkpá akwụkwọ ekwesịghị ịchekwa ya ogologo oge. Ekwesịrị iji ha n'ime awa iri abụọ na anọ mgbe ha gbasasịrị na ọghara.

Nke a bụ n'ihi n'eziokwu na ọ bụrụ na ha guzoro ogologo oge, ha ga-efunahụ ọgwụgwọ niile, njikwa mweghachi na, ọbụlagodi nke ka njọ, ha nwere ike ibute nnukwu mmerụ ahụ. Na usoro ọgwụgwọ acromegaly na usoro nri ndi mmadu, nke a anabataghị, n'ihi na mmetụta ọ bụla na-adịghị mma ga-emetụta ahụ na ọrụ nke gland thyroid, nke enyere ya otu n'ime ọrụ bụ isi na nke a.

Nzọụkwụ mmanye, nke ọ dịkwa mkpa ka ya na ndị ọkachamara na-ahazi, bụ usoro ọgwụgwọ nri. Ọ na-enyere gị aka ime ka ahụ sie ike, mee ka metabolism dịkwuo elu ma bulie ogo nke nguzogide anụ ahụ.

Ezi ntụziaka a na-achọkarị

Ọ bụrụ na ị nwere acromegaly, usoro nri ndị mmadụ ga - enyere aka ịkwụsị ụfọdụ ihe mgbaàmà nke ọrịa ahụ. Otu Ezi ntụziaka kachasị ewu ewu bụ ngwakọta nwere mkpụrụ osisi ugu, ahịhịa ata, mgbọrọgwụ nke ginger, mkpụrụ sesame na 1 tsp. mmanụ a .ụ. Ekwesịrị iji ngwakọta a gosipụtara maka 1 tsp. ugboro anọ n'ụbọchị. Ọ bụrụ na mgbe ụbọchị 14-16 gasịrị enweghị mgbanwe dị mma na usoro ọgwụgwọ, ọ dị mkpa, mgbe ị gbasoro endocrinologist, iji dozie ihe mejupụtara ahụ ma ọ bụ jụ iji ọgwụ a.

Iweghachite site na ntuziaka ndi mmadu acromegaly gunyere iji ego osisi. Ngwakọta ọgwụ a gosipụtara gụnyere ihe ndị dị ka:

Mixgwakọta osisi (opekata mpe 10 g.) Brewed na 200 ml. esi mmiri esi. Iji jikwa usọ a gosipụtara achọrọ maka 40-50 ml. tupu iri nri ma ekwesịrị ime nke a ugboro anọ n'ime awa 24.

Ọ kwesiri iburu n'uche na iji ọgwụ ndị eji eme ihe na usoro nri na ọgwụgwọ nke acromegaly bara uru n'ezie. Nke a bụ n'ihi mmetụta dị mma na gland endocrine. Agbanyeghị, ekwesiri imesi ike na ọgwụgwọ acromegaly ọ bụghị naanị na ndenye ọgwụ, kamakwa iji ọgwụ, ụzọ ịgwọ ọrịa nke mgbake. Site na njikọta ziri ezi nke ụzọ ndị enyere, nsonaazụ ga-abụ 100%.

Gịnị bụ acromegaly?

Maka mmepụta homonụ nke uto, akụkụ ụbụrụ - ụmụ irighiri ihe na - ahụ ọfụma. Dị ka ọ na-adịkarị, a na-emepụta hormone a na ụmụaka site na ụbọchị mbụ nke ndụ, ọ na-agbasi ike karịsịa n'oge mgbanwe nwoke, mgbe mmụba nke uto nwere ike iru 10 cm n'ọtụtụ ọnwa. Mgbe emechara ogbo a, somatotropin na-ebelata ọrụ ya na ntụzi: mpaghara zụlite etolite na nkezi afọ iri na asaa maka ụmụ nwanyị na 20-22 maka ụmụ nwoke.

Acromegaly - Nke a bụ ọnọdụ a na - eme ka homonụ na - eto eto na - emepụtakwa ọfụma na ndị okenye. Enwere oge mgbe ọ malitere imegharị ọzọ na ndị ọrịa guzobere n'ụzọ zuru oke bụ ndị bụbu izu oke.

Hoto ahụ uto anaghị akwụsị imepụta ahụ mmadụ ihu.

A na-edozi homonụ a dị mma, na-ahụ maka:

carbohydrate metabolism - na - echebe pancreas, na - enyocha ọbara shuga,
metabolism abụba - yana njikọta homonụ mmekọahụ na-achịkwa nkesa oke abụba,
metabolism nke mmiri - na - emetụta ọrụ akụrụ, diuresis.

Ahụhụ pituitary gland na-arụ ọrụ yana akụkụ ụbụrụ ọzọ - hypothalamus. Nke ikpeazụ a na-ahụ maka zoro ezo nke somatoliberin, nke na-agba ume na mgbakwunye nke mmepụta somatotropic na somatostatin - otu isi, inhibitory oke ma ghara ikwe ka oke mmetụta na akụkụ ahụ mmadụ.

Echiche a nwere ike ịbụ nke mmadụ dabere na agbụrụ, ihe sitere na mkpụrụ ndụ ihe okike, okike, afọ, na njiri nri. Ya mere, na nkezi, ihu nke agbụrụ Europe dị elu karịa ndị nnọchi anya ndị Eshia, ụmụ nwoke nwere aka na ụkwụ ogologo karịa ụmụ nwanyị, wdg. A na-ewere ihe ndị a niile dị iche iche.

Mgbe ị na-ekwu maka acromegaly, ọ pụtara nsogbu ọrịa nke ọrụ hypothalamus na pituitary gland. Enwere ọtụtụ ihe kpatara ya, mana enwere ike ịme nchọpụta ahụ naanị site na nsonaazụ nyocha, nke gụnyere ọkwa na oge nke nzuzo nke homonụ ibu yana IRF I, ụdị uto insulin.

Acromegaly bu oria nke ndi okenye, n’iru ike. Ọ bụrụ na ihe mgbaàmà ahụ na-abawanye site na nwata, mgbe ahụ a na-akpọ ọnọdụ ahụ gigantism.

Ihe omumu abuo a abughi naani na-emetụta odidi mmadu. Ha bụ na-akpata ọtụtụ nsogbuOtu n'ime ike ọgwụgwụ, ọnọdụ nke mmalite nke ọrịa cancer nke otu ụdị, na nsonaazụ ndị ọzọ dị njọ.

Nchọpụta oge na ụzọ ọgwụgwọ na-enyere aka ịchịkwa ọrịa ahụ, na-ezere nsonaazụ ga-adịte aka maka ahụike na ndụ. Ekwesịrị ịme ihe na mbido mbụ nke ọrịa endocrine, n'ọnọdụ ụfọdụ, dabere na ihe kpatara ya, ọ ga-ekwe omume iwepụ ihe mgbaàmà ahụ kpamkpam.

Ihe kpatara Acromegaly

Usoro izugbe maka mmepe nke mgbanwe nke acromegaly bụ zoro ezo nke homonụ na-ezighi ezi, nke na-akpalite mgbasa nke mkpụrụ ndụ.

Otu n'ime ihe ndị na-akpata ya bụ:

Ọrịa tumadi, dịka iwu, pituitary adenomas ghọrọ ihe kpatara acromegaly n'ihe karịrị 90% nke ikpe. Nwa gigantism na-akpakọrịta kwa otu usoro ọmụmụ, n'ihi na ụdị neoplasms ahụ na-etolitekarị na nwata na nwata ma ọ bụ na nwata nọ na mmalite nke oria.
Ọkpụkpụ na ihe ndị ọzọ metụtara hypothalamus, bụ́ ndị na-akpata ma ọ bụrụ na mmadụ enweghị homonụ nke na-egbochi mmiri ọgwụ ọ na-eto, ma ọ bụ, na-eme ka ọ bụrụ na ọ na-eme ka ọria ahụike nwere ike ịmụba ụba ihe ahụ. Nke a bụ ihe nke abụọ na-ebute acromegaly.
Ihe na-ebute ihe kpatara ọrịa ahụ na-emerụkarị ahụ na okpokoro isi, ụbụrụ, gụnyere mgbarịta ụka. Mwepu ma ọ bụ mmebi na-eme, na-ebute cysts ma ọ bụ akpụ. Akuko banyere otutu ndi okenye oria anakpo acromegaly, isi ya agha na adi oke.
Mmeputa emeputara nke IGF, nke nwekwara ike ibute oria, oria nke usoro homonụ, imeju. A na - emepụta hepatocytes protein ahụ, mana ọdịnaya ya n'ime ọbara nwere ike imetụta ọtụtụ ihe - insulin, ọdịnaya nke testosterone na estrogen, na ọrụ nke gland thyroid.
N'ọnọdụ ndị na-adịghị ahụkebe, enwere ihe nzuzo nke ụsọ mmiri nke etuto ahụ site na akụkụ ahụ ndị ọzọ - thyroid, ovaries, testicles. Nke a abụghị ọrịa a na-ahụkarị, kamakwa achọpụtara ya na ndị ọrịa nwere acromegaly na gigantism.

Nwere ike ịmata ọrịa ahụ ugbua na mbido mmalitemgbe obere mgbanwe bidoro. N'oge okenye, ọdịdị ahụ na-agbanwe ngwa ngwa, na-eme ka ọmarịcha ihe osise banyere ọrịa ahụ. N'ihe banyere nwatakịrị nwere gigantism, nnyocha nwa ahụ zuru oke site na endocrinologist, neuropathologist na ndị ọkachamara ndị ọzọ dị mkpa.

Ọgwụ Acromegaly

Dị ka ọrịa endocrine niile, Achọghị acromegaly nke ọma. Ya mere, nchọpụta oge na ịchọpụta ihe dị mkpa, bụ nke na-enye ohere ịchọpụta ọrịa n’oge na - egbochi ihe ibute nsogbu. Ugbu a, ọgwụgwọ zuru oke na onye ọrịa na-alaghachi steeti tupu ọrịa ahụ dị ịtụnanya, mana enwere ike ịme ihe iji gbochie ọrịa ahụ ibute.

Ngwọta nke ọgwụgwọ dị gosipụtara:

Ihe ogwugwo - mwepu nke pituitary adenomas, mbufụt nke hypothalamus na neoplasms ndị ọzọ na ụbụrụ na-emetụta mmepụta hormone. Ọ bụ ihe nwute, usoro a anaghị adị mma mgbe niile, mgbe ụfọdụ oke ibu ya pere mpe, mana ọ na-aga n'ihu na-emetụta mpaghara ụbụrụ na-emetụta.
Ọgwụ radieshọn - bịara dochie arụmọrụ ahụ, ọ bụrụ na enweghị ụzọ wepụ tumor ahụ. N'okpuru mmetụta nke radieshon pụrụ iche, ọ ga-ekwe omume ịnweta mmezu nke neoplasm, mbelata ya. Cons nke ọgwụgwọ: siri ike ịnagide onye ọrịa, ọ bụghị enwe mmetụta ọ bụla mgbe niile.
N'ikuku Ihe mgbochi STH na-egbochi ya, otu n'ime ọgwụ ndị akọwapụtara bụ Sandostatin. Nhọrọ nke ọgwụ a ga-eburu site na endocrinologist, yana usoro onunu ogwu, usoro nke ọgwụ.
Otu akụkụ dị mkpa nke ịkwado ndị ọrịa nwere acromegaly dị elu bụ ndị na-egbu mgbu, chondroprotector na ndị ọzọ na-enyere aka belata ngosipụta nke ọrịa.

Site na nyocha nke oge mbụ na enweghị nsogbu dị egwu, enwere ike ị nweta nsonaazụ dị mma, ruo mgbe onye ọrịa laghachiri na ndụ nkịtị. Ọzọkwa, a na-enye ndị ọrịa ọgwụ shuga mellitus prophylaxis, nri kalori ka akwadoro, nke na - enyere aka inye anụ ahụ ihe dị mkpa iji mee ka ahụ sie nri, mana obere glucose na shuga dị obere, maka na ntachiri ahụ na - egbochi ihe a.

Ihe kpatara oria a

Ihe kacha mkpa maka mmepe acromegaly bụ mmebi nke glanduatis, nke egosiri na oke mmiri somatropin (homonụ nke uto). N'oge ọ bụ nwata, homonụ a na-akpali uto nke ọkpụkpụ nwata, na ndị okenye, ọ na-achịkwa usoro carbohydrate na abụba. Na acromegaly, mkpụrụ ndụ pituitary maka ọtụtụ ebumnuche na-aba ụba na-enweghị azaghachi mgbaàmà anụ ahụ (nke a na-ebute n'ọtụtụ ọnọdụ site na ọrịa aghara)
Isi ihe kpatara mmepe nke ọrịa gụnyere:

Pitenti adenoma, nke na-akpalite ịba ụba nke homonụ somatropin.

Mgbanwe akwara nje ke n'ihu ihu hypothalamus.
Mmụba anụ ahụ na-abawanye na homonụ nke uto.
O ketara eketa, ọnụnọ nke ọrịa nke samatotrophinomas.
Formationzụ cysts na ụbụrụ, mmepe nke a nwere ike ibute site na mmerụ ahụ ụbụrụ ma ọ bụ ọrịa na-akpata mkpali.
Ọnụnọ nke etuto ahụ n’arụ.

Oge nke Acromegaly Development

Ọrịa ahụ gafere ogo atọ nke mmepe ọrịa:

Oge mbu bụ preacromegalic. N'oge a, enweghị mgbaàmà nke ọrịa a, yabụ ọ fọrọ nke nta ka ọ bụrụ ihe na - agaghị amata ya, enwere ike ịchọpụta ya na ndagide oge nyocha ahụike niile.
A na-egosipụta ọkwa hypertrophic site na ngosipụta mbụ nke mgbaàmà, mgbanwe mgbanwe na akụkụ ahụ. Na ọkwa a, akpụ ahụ tolitere na ihe ịrịba ama pụtara ìhè: ịba ụba intracranial pressure, mbelata n'ọhụụ, adịghị ike nke ahụ.
Ọkpụkpụ cachectal bụ ọkwa ikpeazụ nke ọrịa ahụ, ebe a na-ahụ mbelata nke ahụ, ụdị nsogbu dị iche iche na-etolite.

Mgbochi Ọrịa

Iji gbochie mmepe nke pituitary acromegaly, ọ dị mkpa ịgbaso usoro mgbochi dị mfe:

Zere craniocerebral ma ọ bụ mmerụ isi ndị ọzọ.
Na-egbochi mmepe nke ọrịa ụbụrụ (dịka ọmụmaatụ, meningitis).
Kwa oge, na-eme nyocha ụlọ nyocha maka homonụ nke uto n'ọbara.
Jiri nlezianya nyochaa ahụike nke usoro iku ume ma na-arụzigharị oge ha.

Acromegaly - foto, ihe kpatara ya, ihe ịrịba ama mbụ, akara na ọgwụgwọ nke ọrịa ahụ

Acromegaly bụ ọrịa na-efe efe nke na-aga n'ihu n'ihi oke mmiri site na ọnụnọ nke pituitary nke somatotropin mgbe ekpochapụchara mkpụrụ nke epiphyseal. Ọtụtụ mgbe, acromegaly nwere mgbagwoju anya na gigantism. Ma, ọ bụrụ na gigantism sitere na nwata, ọ bụ naanị ndị okenye na-arịa ọrịa acromegaly, ihe ngosi a na-ahụ anya pụtara naanị afọ 3-5 ruo mgbe ọ malitesịrị n'ime ahụ.

Acromegaly bu oria nke emeputa homonụ nke uto (homonụ nke uto) na-abawanye, ebe enwere mmebi nke itule nke ọkpụkpụ na akwara ime, na mgbakwunye, enwere nsogbu metabolic.

Somatropin na-eme ka njikọ nke protein protein dịkwuo elu, ma na-arụ ọrụ ndị a:

na-eji nwayọọ na-agbadata protein,
na-eme ngwangwa ntụgharị mkpụrụ ndụ,
na -ebelata itinye ego nke anụ ahụ nke nwere abụba n'ụdị subcutaneous,
na - eme ka mmụba dị n’agbata oke olu na anụ arụ na - adị n’iru.

Ọ dị mma ịmara na ọkwa nke homonụ ahụ na-adabere kpọmkwem na ndị na-egosi afọ, yabụ, a na-ahụta nsonaazụ kachasị elu nke somatropin na afọ mbụ nke ndụ rue ihe dị ka afọ atọ, mmepụta kachasị kacha pụta na oge ntorobịa. N'abalị, somatotropin na-abawanye ụba, yabụ, ọgba aghara ụra na-eduga n'ịbelata ya.

Ọ na - eme ya na ọrịa nke sistem na - emetụta gland, ma ọ bụ n'ihi ihe ndị ọzọ, a na - emepụta ahụ ahụ na homonụ somatotropic karịa. N'ime akara ngosi, a na-abawanye ụba. Ọ bụrụ na nke a mere n'oge itozu, mgbe a na-emechi mpaghara mmepe tozuru oke, nke a na-eyi acromegaly.

N'ime 95% nke ikpe, ihe kpatara acromegaly bụ ngwongwo nke oghere - adenoma, ma ọ bụ somatotropinoma, nke na-eme ka mmụba dị ukwuu nke homonụ na-eto, yana ntinye na-ekwekọghị na ọbara.

Dịka iwu, acromegaly na-etolite mgbe mmerụ ahụ nke sistemụ akwara na-efe efe, ọrịa ya na-efe efe na ọrịa na-adịghị efe efe. E kenyere ụfọdụ ọrụ na mmepe na ketara eketa.

Acromegaly na-etolite nwayọ nwayọ, ya mere ihe mgbaàmà mbụ ya na-apụtakarị. Ọzọkwa, njirimara a siri ike maka nchọpụta mbụ nke ọrịa.

Foto a na-egosi mgbaàmà agwa acromegaly na ihu

Ndị ọkachamara na-egosipụta isi ihe mgbaàmà nke pituitary acromegaly:

isi ọwụwa ugboro ugboro, na-abụkarị n'ihi nrụgide intracranial na-abawanye,
nsogbu ihi ụra, ike ọgwụgwụ,
fotophobia, ụfụ ịnụ,
n'oge ụfọdụ, anya isi,
Ọkpụkpụ aka na elu aka ya
ike ọgwụgwụ, arụmọrụ belatara,
mgbu na azụ, nkwonkwo, nkwụsị nke njikọ nkwonkwo, akwara ụkwụ,
ọsụsọ

Mmụba homonụ na-eto eto na-eduga n'ọdịdị njirimara ndị ọrịa nwere acromegaly:

Ire, ire gluu na akwara na-eduga n'inwe ụda n’olu - o juo nti, uda na-egosi,
ịmụba ọkpụkpụ dị
obere jaw
nku anya
ọbara mgbali nke ntị
imi
egbugbere ọnụ.

Nke a na-eme ka ihu mmadụ dịwanye mma.

Ọkpụkpụ ahụ na-emebi emebi, enwere mmụba na obi, mgbasawanye nke oghere intercostal, spain na-agbada. Uto nke uturu anu na aru anakpo ahu na ebute eduga na nmeghari nke nkwonkwo ha, ndu ha, ihe mgbu na ebute.

N'ihi mmụba nke akwara dị n'ime nha na olu, akwara dystrophy nke onye ọrịa na-abawanye, nke na-eduga n'ọdịdị nke adịghị ike, ike ọgwụgwụ, yana mbelata nke ike n'ọrụ. Hypertrophy nke akwara obi na nkụda obi na-aga ngwa ngwa.

Ejiri Acromegaly mara ogologo oge. Dabere ogo mgbaama na mmepe nke acromegaly, enwere ọtụtụ nkebi:

Preacromegaly - a na-eji akara izizi ya, achọpụtara ya adịkarịkebeghi, ebe ọ bụ na anaghị egosi ihe mgbaàmà ya. Mana na, n'oge a, enwere ike ịchọpụta acromegaly site na enyemaka nke agbakọtara na ụbụrụ tomography, yana ọkwa hormone na-eto n'ime ọbara.
A na-achọpụta ọkwa hypertrophic - mgbaàmà akpọrọ nke acromegaly.
Ihe na-egosipụta: a na-eji ya na akara ngosi nke mmebi yana arụ ọrụ nke ihe owuwu ndị dị nso. Nke a nwere ike bụrụ imebi ọrụ nke akụkụ ahụ nke ọhụụ ma ọ bụ mgbali intracranial hiri nne.
Oge ikpeazu bụ ogbo nke cachexia, o bu oke ume oku na eso ya.

Were ọgwụ mgbochi ọgwụ niile dị mkpa iji nyere aka chọpụta ọrịa ahụ n'oge mmalite.

Ihe egwu nke acromegaly na nsogbu ya, nke a na-ahụ site n'ihe fọrọ nke nta ka ọ bụrụ akụkụ niile dị n'ime. Nsogbu ndị a na-ahụkarị:

nsogbu ụjọ
pathology nke usoro endocrine,
mastopathy
Eriri akpa nwa na
polycystic ovary syndrome,
polyps eriri afọ
ọrịa akwara ọbara
obi obara
ọbara mgbali ike.

Ma anụahụ, usoro ndị ahụ na - ebilite:

Isi akpụkpọ anụ,
waatị
seborrhea,
igba oke onu
hydradenitis.

Ọ bụrụ na ihe mgbaàmà mbụ pụtara na-egosi acromegaly, ị kwesịrị ịkpọtụrụ dọkịta ozugbo maka nyocha na nchọpụta ziri ezi. A na-achọpụta Acromegaly na data nyocha ọbara maka ọkwa nke IRF-1 (somatomedin C). Na ụkpụrụ dị mma, a na-atụ aro nnwale na-akpali agụụ nwere ibu glucose. Maka nke a, a na-enyocha onye ọrịa nwere obere acromegaly kwa nkeji iri atọ ọ bụla ugboro anọ kwa ụbọchị.

Iji kwado nchoputa ya ma choo ihe kpatara ya:

Nchịkọta izugbe ọbara na mmamịrị.
Nnyocha ọbara biochemical.
Ultrasound nke thyroid gland, ovaries, akpanwa.
X-ray nke okpokoro isi na mpaghara nke Turkish saddle (ọkpụkpụ dị na okpokoro isi ebe enwere pituitary gland) - a na-achọpụta mmụba na nha nke Turkish saddle ma ọ bụ uzo ya kwuru.
Nyocha CT nke ọnụnọ pituitary na ụbụrụ ya na ntụgharị nke iwu ma ọ bụ MRI na-enweghị ọdịiche
Nnyocha nyocha nke anya (nyocha nke anya) - na ndị ọrịa a ga-ebelata ntaramahụhụ anya, mmachi nke ubi anya.
Ọmụmụ ihe atụ na - egosi foto nke onye ọrịa n’ime afọ 3-5 gara aga.

Mgbe ụfọdụ, a na-amanye ndị dọkịta ịmalite usoro ịwa ahụ maka ọgwụgwọ acromegaly. Ọ na - abụkarị nke a, ọ bụrụ na akpụ akpụ akpụpụtara buru nnukwu ibu ma jikota ụbụrụ ụbụrụ gbara ya gburugburu.

Ọgwụ nchekwa maka pituitary acromegaly mejupụtara n'iji ọgwụ na egbochi mgbochi homonụ nke uto. Ugbu a, a na-eji otu ọgwụ ọgwụ abụọ maka nke a.

Otu otu - analogues nke somatostin (Sandotastatin, Somatulin).
Otu abuo bu dopamine agonists (Parloder, Abergin).

Ọ bụrụ na adenoma ruru ogo dị ukwuu, ma ọ bụ ọ bụrụ na ọrịa ahụ na-aga n’ihu ngwa ngwa, ọgwụgwọ ọgwụ naanị agaghị ezuru - na nke a, a na-egosi onye ọrịa ọgwụgwọ ọgwụgwọ. Site na nnukwu etuto ahụ, a na-arụ ọrụ nkebi abụọ. N'otu oge ahụ, a na-ebupụ akụkụ ahụ etuto ahụ dị na cranium, mgbe ọnwa ole na ole gasịrị, a na-ewepụ mkpochapụ nke pituitary adenoma site na imi.

Ihe ngosi putara ihe maka ogwugwo bu ihe ohuru n’ile anya. A na-ewepụ tum tum site na sphenoid ọkpụkpụ. N'ime pasent 85 nke ndị ọrịa, ka ewepụchara oria ahụ, mmụba dị ukwuu na ọkwa uto uto ya ka edobere nke ịdị na-egosipụta ma wezuga ọrịa ahụ.

A na-egosi ọgwụgwọ radieshion nke acromegaly naanị mgbe ọgwụgwọ ịwa ahụ agaghị ekwe omume yana ọgwụgwọ ọgwụ anaghị arụ ọrụ, n'ihi na mgbe emesịrị ya n'ihi ihe egbu oge, mgbaghara na-apụta naanị mgbe afọ ole na ole gasịrị, ihe ize ndụ nke ịmalite mmerụ radieshon dị oke elu.

Nnọọ nke ọrịa a dabere na oge ọgwụgwọ na izi ezi nke ọgwụgwọ. Enweghị usoro iji kpochapụ acromegaly nwere ike ibute nkwarụ nke ndị ọrịa nke ịrụ ọrụ na afọ ike, na-emekwa ka ohere nke ịnwụ.

Site na acromegaly, a na-ebelata ndụ afọ: 90% nke ndị ọrịa anaghị adị ndụ ruo afọ 60. Ọnwụ na-abụkarị n'ihi ọrịa obi. Nsonaazụ nke ịwa ahụ acromegaly ka mma site na obere adenomas. Ebe enwere nnukwu ọgbụgba nke ọnya ọgbụgba, ugboro ugboro nlọghachi azụ ha na-abawanye.

Ebumnuche nke acromegaly bu ụzọ chọpụta oge mbụ nke nsogbu ndị na - egbochi hormonụ. Ọ bụrụ na oge iji mee ka ụba mmiri ọgwụ ahụ too nke uto, ị nwere ike izere mgbanwe mgbanwe akwara na akwara nke ime ahụ, na-emegwara mgbaghara.

Mgbochi gụnyere nnabata na usoro ndị a:

zere mmerụ ahụ isi,
gakwuru dibia bekee ka ogba aghara aghara.
jiri nlezianya na-agwọ ọrịa ndị na-emetụta akụkụ ahụ nke akụkụ iku ume,
Nri nke umuaka na ndi okenye kwesiri itozu oke ma nwee ihe ndi ozo bara uru.

Acromegaly bụ ọrịa nke gland na-arịa ya na ịbawanye ụba nke uto uto - somatotropin, nke a na-ahụ na uto nke akwara na akụkụ ahụ, mmụba nke ọdịdị ihu na akụkụ ndị ọzọ nke ahụ, ọrịa metabolic. Ọrịa a na-arụpụta ọrụ nke mbụ ahụ, uto nke anụ ahụ arụchaala. N'oge mmalite, mgbanwe nke ọrịa nke ọ kpatara enweghị atụ ma ọ bụ na-anaghị ahụcha ma ọlị. Acromegaly na-aga n'ihu ogologo oge - ihe mgbaàmà ya na-abawanye, mgbanwe na ọdịdị na-apụta ìhè. Ná nkezi, afọ 5-7 na-amalite site na mmalite nke ihe mgbaàmà mbụ nke ọrịa ahụ na nchọpụta ọrịa.

Ndị tozuru oke na-arịa ọrịa acromegaly: dịka iwu, n'oge afọ 40-60, ma ụmụ nwoke ma ụmụ nwanyị.

Mmetụta somatotropin n'ahụ akụkụ ahụ na akwara mmadụ

Ihe nzuzo nke homonụ nke uto - uto uto - a ka nke pituitary gland na-ebu. Ejiri hypothalamus na-achịkwa, nke, ọ bụrụ na ọ dị mkpa, na-emepụta neurosecretions somatostatin (na-egbochi mmepụta hormone) na somatoliberin (na-eme ka ọ rụọ ọrụ).

N'ime ahụ mmadụ, homonụ na-eto eto na-ebute okirikiri nke ọkpụkpụ nwata ahụ (ya bụ, uto ya n'ogologo) yana ọ bụ maka usoro kwesịrị ekwesị nke usoro akwara ahụ.

N'ime ndị okenye, somatotropin na-ekere òkè na metabolism - ọ nwere mmetụta anabolic akpọpụtara, na-akpali usoro njikọ protein, na-enyere aka belata oke abụba n'okpuru anụ ahụ ma na - eme ka mkpokọta ya dịkwuo elu, na - eme ka uru ahụ dịkwuo elu ma nwee abụba. Na mgbakwunye, homonụ a na-edozi metabolism metabolism, ịbụ otu n’ime homonụ mgbochi-homonụ, i.e., na-abawanye ọkwa glucose n’ime ọbara.

Enwere ihe akaebe na mmetụta uto hormone na-immunostimulating na ịba ụba nke calcium site na anụ ahụ.

Ihe na-akpata na usoro nke acromegaly

Na 95% nke ikpe, ihe kpatara acromegaly bụ akpụ puru - ihe adenoma, ma ọ bụ somatotropinoma, nke na-eme ka ụba eto hormone tolite. Na mgbakwunye, ọrịa a nwere ike ime na:

pathology nke hypothalamus, na-akpalite ịba ụba nke somatoliberin,
Mmụba na-akpata insulin dị ka uto,
hypersensitivity nke anụ ahụ na uto homonụ,
pathologies zoro ezo nke uto hormone ke esịtidem akụkụ (ovaries, akpa ume, akwara, akụkụ nke eriri afọ) - ectopic secretion.

Dịka iwu, acromegaly na-etolite mgbe mmerụ ahụ nke sistemụ akwara na-efe efe, ọrịa ya na-efe efe na ọrịa na-adịghị efe efe.

E gosiputara na ndi nwere oria a na enwe oria acromegaly karia.

A na - ahụta mgbanwe mgbanwe akwara na acromegaly site na hypertrophy (mmụba na olu na oke) nke akwara nke akụkụ ahụ dị n'ime, uto nke anụ ahụ na - ejikọta ha - mgbanwe ndị a na - eme ka ohere nke ịmalite ịrịa ọrịa na adịghị mma na ahụ onye ọrịa.

Ihe iriba ama nke oria a bu:

ịmụba aka, ụkwụ,
mmụba na nha ihu nke mmadụ - nnukwu nku anya, imi, ire (enwere nbipụta ezé), agbatị agbatị agbatị ala, mgbawa na-apụta n’etiti ezé, anụ ahụ n’oghere n’egedege ihu, ogwe nasolabial bịara dị omimi, ụta ahụ na-agbanwe ,
mkpọtụ olu
isi ọwụwa
paresthesia (mmetụta ị na-eme nke ịbụ arụ, ịsụ ngagharị, ihe na-akpụ akpụ n'akụkụ dị iche iche nke ahụ),
mgbu na azụ, nkwonkwo, mmachi nkwaghari,
ọsụsọ
Ọkpụkpụ aka na elu aka ya
ike ọgwụgwụ, arụmọrụ belatara,
dizzness, vomiting (bụ ihe ịrịba ama nke ịba ụba intracranial nrụgide na a nnukwu pituitary tumo),
ọnya aka
nsogbu nwoke
belatara mmekọahụ na mbanye na ikike,
nkwarụ anya (ọhụhụ abụọ, ụjọ nke enwu gbaa),
ịnụ ụfụ na isi ọnwụ,
mmiri ara ehi mpụtara site na mammary glands - galactorrhea,
oge mgbu n'ime obi.

Nnyocha nyocha nke onye na-arịa acromegaly, dọkịta ga-achọpụta mgbanwe ndị a:

Ọzọ, dọkịta ga-elebara nbawanye anya nke ọdịdị ihu na nha aka,
nrụrụ nke ọkpụkpụ ọkpụkpụ (curvature nke spain, nke nwere sọrel - mụbara na ogo nke anteroposterior - obi, oghere intercostal gbatịrị),
ihu ya na aka ya,
ọsụsọ
hirsutism (ụmụ nwoke tozuru oke na ụmụ nwanyị),
mmụba na nha thyroid gland, obi, imeju na akụkụ ndị ọzọ.
proximal myopathy (i.e., mgbanwe na akwara dị na nso idi nso etiti akpati),
ọbara mgbali elu
ihe onyonyo na electrocardiogram (akara nke akpọrọ obi acromegaloid),
ọkwa prolactin dị elu n'ime ọbara,
nsogbu nke metabolic (na nkeji iri na ise nke ndị ọrịa, e nwere ihe ịrịba ama nke ọrịa shuga mellitus, na-eguzogide ọgwụ (kwụsie ike, na-enweghị nsogbu) na usoro ọgwụgwọ hypoglycemic, gụnyere nchịkwa nke insulin.

N'ime mmadụ 9 n’ime mmadụ 10 ọ bụla nwere ọrịa acromegaly n’oge ọ malitere, achọpụtara ihe mgbaàmà nke ọrịa apnea ihi ụra. Ihe dị na ọnọdụ a bụ na n'ihi ọbara mgbali elu nke anụ ahụ dị nro nke akụkụ okuku ume na oke arụ nke ebe iku ume na ụmụ mmadụ, njide iku ume dị mkpirikpi na-eme n'oge ụra.Onye ọrịa ahụ n'onwe ya, dịka iwu, anaghị enyo ha enyo, mana ndị ikwu na ndị enyi nke onye ọrịa ahụ toara ntị na mgbaàmà a. Ha na-achọpụta na ịmịchasị abalị, nke na-akwụsị site na ịkwụsịtụ, mgbe oge mmegharị iku ume nke obi onye ọrịa anaghị anọ. Oge ndị a na-akwụsị oge ole na ole, mgbe nke a gasịrị onye ọrịa kpọtere na mberede. E nwere ọtụtụ ihe na-eteta n'oge abalị nke na onye ọrịa anaghị ehi ụra nke ọma, ọ na-enwe mmetụta nke ukwuu, ọnọdụ ya na-akawanye njọ, ọ na-ewe iwe. Na mgbakwunye, enwere ohere ịnwụ onye ọrịa ma ọ bụrụ na otu n'ime njide iku ume na-egbu oge.

N'oge mmalite nke mmepe, acromegaly anaghị ewetara onye ọrịa ahụ erughị ala - ọ bụghị ndị ọrịa nwere nlebara anya anaghị achọpụta ozugbo mmụba na otu akụkụ ahụ ọzọ. Ka ọrịa ahụ na-akawanye njọ, ihe mgbaàmà ya na-apụtawanye nke ọma, n'ikpeazụ enwere mgbaàmà nke obi, imeju na nkụda mmụọ. N'ime ndị ọrịa dị otú ahụ, ihe egwu nke ibute ọrịa atherosclerosis, ọbara mgbali elu bụ usoro dị elu karịa nke ndị mmadụ anaghị arịa acromegaly.

Ọ bụrụ na pituitary adenoma toro na nwatakịrị mgbe akụkụ mpaghara nke ọkpọ ya ka ghe oghe, ha bido ngwa ngwa - ọrịa ahụ gosipụtara onwe ya dịka gigantism.

Nkọwa nke obere pathology

Acromegaly na - etolite, dịka iwu, ya na akwara neoplasms dị na mpaghara ahụ, ọ bụ onye na-ahụ maka mmepụta homonụ nke uto. N'ime ndị ọrịa na-arịa ọrịa a, ọdịdị ihu na-agbanwe (buruwanye ibu), aka na ukwu na-abawanye. Na mgbakwunye, usoro ahụ na - eso nkwonkwo na isi ọwụwa na - esonyere ya, enwere mmebi na usoro ọmụmụ.

Ọ dị mkpa! Ọrịa a, dị ka acromegaly, na-emetụta naanị ndị ọrịa okenye. Nkà mmụta banyere ọrịa nwanyị na-amalite itozu mgbe uto ya na uto ya!

Dabere na ọnụ ọgụgụ, ndị ọrịa nọ n'afọ 40 ruo 60 afọ na-emetụta acromegaly kachasị emetụta. Ejiri usoro a na - ahụkarị site na nwayọ nwayọ, nwayọ. N'ọnọdụ ka ukwuu, a na-achọpụta ọrịa ahụ mgbe afọ 6-7 site na mmalite nke mmepe ya, nke na-agbagha usoro ọgwụgwọ sochirinụ.

Ndị dọkịta na-achọpụta ọdịiche ndị a na mmepe nke usoro pathological:

Na ogbo nke mbụ, ọrịa a bidoro n'ụdị latent, latent, enwere ike ịchọpụta mgbanwe naanị site na mkpokọta ụbụrụ nke ụbụrụ.
Na ọkwa a, njirimara Sympedomatology nke pathology gosipụtara onwe ya nke ọma.
N'ime ọkwa nke atọ, enwere mmụba nke akpụ neoplasm dị na gland pituitary nke isi. N'otu oge ahụ, a na-emejupụtara akụkụ ụbụrụ agbata obi, nke na-eme ka ekpughere nke akara ụfọdụ akọwapụtara, dịka nkwarụ anya, nsogbu ụjọ, yana mmụba nke nrụgide intracranial.
Akara Acromegaly nke anọ ikpeazụ ka mmepe nke cachexia na mbelata nke ahụ onye ọrịa.

Mmụba nke hormone na-eto eto na-akwalite mmepe nke ọrịa obi, akwara na oncological ọrịa, nke na-ebute ọnwụ nke ndị ọrịa na-arịa acromegaly.

Amụma na mgbochi acromegaly

Enweghị ọgwụgwọ, prognosis ahụ adịghị mma, ndị ọrịa na-adị ndụ afọ atọ ruo afọ ise, ya na nnukwu ịmụ nwa, ndị mmadụ adịkarịghị ka afọ iri abụọ tupu ịpụta ọgwụ ọgwụ. Modernzọ ọhụụ nwere ike igbochi mmepụta nke uto hormone ma ọ bụ belata uche nke ahụ ya. Mgbe ụfọdụ wepu ito ahu kpamkpamnke ahụ abụrụla ihe kpatara ya. Ya mere, site na usoro ọgwụgwọ ziri ezi, prognosis nwere ike iru afọ 30 nke ndụ, mana achọrọ ọgwụgwọ mmezi mgbe niile. Ọtụtụ ndị ọrịa nwere oke nkwarụ.

Mgbochi ọrịa ndị dị obere na ndị dị mgbagwoju anya bụ ihe gbara ọkpụrụkpụ, ebe ọ bụ na ọ nweghị otu ihe kpatara ọrịa acromegaly. Nkwado n'aka ndị dọkịta nwere ike ịbụ ndụmọdụ zere mmerụ ahụ isi, na maka ndị nwechara mkparịta ụka, gaa na dọkịta na-agwọ ọrịa akwara na endocrinologist ruo ọtụtụ afọ mgbe ihe ọghọm gasịrị, nke ga-enye gị ohere ịchọpụta mgbanwe mgbanwe ọrịa ahụ na ọrịa pituitary gland na mmalite.

Usoro nke mmepe na ihe na-akpata acromegaly

N'oge nwata na etolite etolite, na-emegide uto nke uto, hyperecretion STH na-adịghị ala ala na-akpata gigantism, nke e ji amata oke, mana mmụba nke ọkpụkpụ, akụkụ na anụ ahụ dị nro. Site na mmezu nke uto physiologic na akwara nke ọkpụkpụ, nsogbu nke ụdị acromegaly na - etolite - ịkpa oke nke ọkpụkpụ, mmụba nke akwara dị n’ime ya na njiri mara metabolic. Site na acromegaly, ọbara mgbali nke parenchyma na stroma nke akụkụ ahụ dị n'ime: obi, akpa ume, akwara, imeju, akwara, eriri afọ. Uto nke anụ ahụ na - eme ka mmadụ nwee mgbanwe mgbanwe n’akwara n’akwara ndị a, ihe ize ndụ nke ịmalite ịrịa ọrịa akpụ na ọrịa ọjọọ, gụnyere ndị nke endocrine.

Nsogbu nke Acromegaly

Kedu ihe ogwu a dị ize ndụ?

Na mgbakwunye na eziokwu ahụ bụ na acromegaly na-emebi ọdịdị nke onye ọrịa ma belata ogo ndụ ya, na enweghị ọgwụgwọ kwesịrị ekwesị, ọrịa a na-akpalitekwa mmepe nke nsogbu ndị dị oke egwu.

N'ihe ka ọtụtụ, usoro acromegaly ruo ogologo oge na-eduga n'ọdịdị nke ọrịa ndị a na-ejikọta:

nsogbu nke eriri afọ,
nsogbu ụjọ
pathology nke usoro endocrine,
hyperplasia adrenal
fibroids
polyps eriri afọ
amụghị nwa
ọrịa ogbu na nkwonkwo na ọrịa ogbu na nkwonkwo,
ọrịa akwara ọbara
obi obara
ọbara mgbali ike.

Biko rụba ama:Ihe dị ka ọkara nke ndị ọrịa nwere acromegaly nwere nsogbu dịka ọrịa shuga mellitus.

Imebi ihe nlere na nlezi anya nke akwarache a nwere ike ime ka onye nti chiri na kpuo ìsì zuru oke. Ọzọkwa, mgbanwe ndị a agaghị agbanwe agbanwe!

Acromegaly na - abawanye oke ihe ọghọm dị n’ịdịpụta akwara ọrịa malia, yana ọrịa dị iche iche nke akwara dị n’ime. Ọrịa acromegaly na-egbu ndụ ọzọ bụ ọrịa njide nke iku ume, nke na - abụkarị ọnọdụ nke ụra.

Ọ bụ ya mere onye ọrịa nke chọrọ ịzọpụta ndụ ya, mgbe ihe ịrịba ama mbụ nke na-egosi acromegaly pụtara, ọ ga-achọ enyemaka ọkachamara site n'aka ọkachamara ruru eru - onye na - arịa ọrịa endocrinologist!

Esi mata ọrịa?

N'ọtụtụ oge, ọkachamara nwere ike iche na ọnụnọ nke acromegaly adịlarị n'ọdịdị onye ọrịa, njirimara njirimara yana n'oge nyocha nke akụkọ nchịkọta. Agbanyeghị, iji mee nyocha ziri ezi, chọpụta usoro nke usoro ọrịa na ogo mbibi ahụ dị n'ime, a na-edepụtara ndị ọrịa nyocha nyocha ndị a:

Ọ dị mkpa! Diagnozọ nchọpụta isi bụ nyocha nke uto uto site na iji glucose. Ọ bụrụ na pituitary gland na-arụ ọrụ dịkarịsịrị mma, glucose na-eme ka mbelata ogo hormone na-eto, ma ọ bụghị ọkwa homonụ, na Kama nke ahụ, na-abawanye.

Iji chọpụta nsogbu mgbagwoju anya nke mmepe acromegaly, a na-eme usoro nyocha ndị ọzọ dị otú a:

Mgbe emechara nyocha zuru oke, ọkachamara ahụ nwere ike ọ bụghị naanị ime nchọpụta ziri ezi, kamakwa ịchọpụta ọnụnọ nke ọrịa concomitant, nke na-enye ohere ka ekenye onye ọrịa ahụ usoro ọgwụgwọ zuru oke na nke kwesịrị ekwesị maka otu okwu!

Treatmentzọ Ọgwụ Acromegaly

Isi ọrụ nke ndị dọkịta n’ịchọpụta acromegaly bụ imejupụta onwe ya, yana ịhazi usoro mmepụta homonụ nke uto.

Enwere ike iji usoro ndị a maka ebumnuche ndị a:

na-a medicationsụ ọgwụ
radieshon ọgwụgwọ
ọgwụgwọ ịwa ahụ.

Ọ dị mkpa! N'ọtụtụ oge, ọgụ dị irè megide ọrịa a chọrọ ọgwụgwọ nkwonkwo dị mgbagwoju anya.

Ervzọ ichekwa

Iji belata oke uto hormone, a na-enye ndị ọrịa usoro ọgwụgwọ homonụ site na iji anaatogues nke somatostatin. A na-edenyekarị ndị ọrịa ọgwụ dịka Bromocriptine, nke e mepụtara dopamine, nke na-egbochi njikọta homonụ somatotropin.

Na ọnụnọ nke nsogbu na njiri mara njiri mara, a na-eme ọgwụgwọ kwesịrị ekwesị, usoro a na-ewepụta maka onye ọrịa ọ bụla n'otu n'otu.

Ojiji a na-eji ogwu n’osimiri egosila ezigbo ihe.. Usoro a bụ nsonaazụ mpaghara mpaghara mebiri emebi nke pituitary gland site na ụzarị gamma doro anya. Dabere na ọnụ ọgụgụ na ule ụlọ ọgwụ, arụmọrụ nke usoro a dị ihe dịka 80%!

Otu n'ime ụzọ kachasị ugbu a iji na - achịkwa acromegaly bụ radiotherapy. Dabere na ndị ọkachamara, mmetụta nke ụzarị x-ray na-enye aka na nkwụsị ọrụ nke uto tumor neoplasms na mmepụta nke uto uto. Oge nkuzi x-ray zuru oke na-enye gị ohere ị nweta ọnọdụ nke onye ọrịa ma wepu njiri mara njiri mara acromegaly, ọbụlagodi ọdịdị ihu onye ọrịa na-adịtụ mma!

Romwa Ahụ Acromegaly

A na-egosi ntinye ịwa ahụ maka acromegaly maka nnukwu tumor neoplasms, ọganihu nke usoro a na - efe efe, yana enweghị enweghị ụzọ ọgwụgwọ ọgwụgwọ.

Ọ dị mkpa! Wa ahụ bụ otu n'ime ụzọ kachasị dị irè nke ịchịkwa acromegaly. Dabere na ọnụ ọgụgụ, 30% nke ndị ọrịa na-arụ ọrụ ka a gwọrọ kpam kpam ọrịa, na na 70% nke ndị ọrịa enwere mgbaghara, na-adịgide adịgide!

Wa ahụ acromegaly bụ ihe ana - eme iji wepu akwara ogwu neoplasm. N'okwu ndị siri ike, enwere ike ịchọ ọrụ nke abụọ ma ọ bụ usoro ọgwụgwọ ọzọ.

Kedu otu esi egbochi pathology?

Iji gbochie mmepe nke acromegaly, ndị dọkịta na-enye ndụmọdụ ịgbaso ndụmọdụ ndị a.

zere mmerụ ahụ isi,
na-agwọ ọrịa na-efe efe n'oge
gakwuru dibia bekee ka ogba aghara aghara.
jiri nlezianya na-agwọ ọrịa ndị na-emetụta akụkụ ahụ nke akụkụ iku ume,
kwa mgbe maka ule maka uto hormone na - egosiputa nzube.

Acromegaly bụ ọrịa na-adịghị ahụkebe ma dịkwa egwu, nke nwere ọtụtụ nsogbu. Agbanyeghị, nyocha oge na ezigbo tozuru oke, ọgwụgwọ zuru oke nwere ike ịnwe mgbaghara zuru ezu ma weghachi onye ọrịa ahụ ka ọ bie ndụ maara nke ọma!

Sovinskaya Elena, onye na-ahụ maka ahụike

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