Isifo i-Addison sidalwa ukubhujiswa kwecortex yezindlala ezithile ze-adrenal. Lokhu kusho ukuthi indlala ye-adrenal ilahlekelwa amandla ayo okukhiqiza amahomoni e-glucocorticoid, ikakhulukazi i-cortisol, i-aldosterone, nama-sex steroids. Abantu abanalesi sifo baba nezimpawu ngenxa yalokho lokhu kulahlekelwa kwamahomoni e-adrenal.
Mayelana ne- Izimpawu zesifo sika-Addison, kumelwe kushiwo ukuthi lezi zimpawu ngokuvamile zivela kancane kancane. Lokhu kungenxa yokuthi kuthatha izinyanga noma ngisho iminyaka i-adrenal cortex ibhekana nomonakalo omkhulu ngokwanele ukubangela izimpawu kumuntu. Ngokuvamile, izimpawu ezinjengokukhathala, ukuncipha komzimba, ukuquleka, ubuhlungu bamalunga, kanye nokucindezeleka kungabonakala.
Siyini isifo sika-Addison?
Lokhu ukuphazamiseka kwenzeka phakathi 4 kubantu abayizi-100.000 ngonyaka. Kwenzeka kubo bobubili ubulili, kunoma ibuphi ubudala futhi kuvame ukuvela kakhudlwana ezimeni zengcindezi ye-metabolic, lapho kukhona ukuhlukumezeka noma ukutheleleka. Izindlala ze-adrenal zitholakala ngenhla nje kwezinso futhi lapho zithinteka, zakha inani elincane lamahomoni athile, okuhlanganisa i-cortisol ne-aldosterone.
Isifo sika-Addison saziwa nangokuthi i-adrenal insufficiency. Isizathu esivame kakhulu salesi sifo i-autoimmunity, yingakho ngokuvamile sibizwa nge-autoimmune Addison's disease. Imvamisa, amasosha omzimba ahlasela amagciwane namagciwane awahlaselayo, nokho-ke, uma kukhulunywa nge-autoimmunity, amasosha omzimba awahambi kahle. ukuhlasela nokubhubhisa i-adrenal cortex sengathi yisifo. Ukubeka ngenye indlela, ama-adrenals wonakaliswa yisifo se-autoimmune nalapho i-autoimmune system. ihlasela amangqamuzana nezitho zomuntu ngokwakhe.
Uma kukhona isifo esiyingozi yingoba sepsis kwenzeka. Ezinye izimbangela zingase zibe ukuhlinzwa, ukuhlukumezeka, noma ukulahlekelwa sodium ngenxa ukujuluka ngokweqile. Uma isiphetho singafinyelelwanga, kungacatshangwa ukuthi kube khona inkinga ye-adrenal futhi iphathwe ngendlela engafanele noma ukweqisa okungaqondile kokushintshwa kwama-hormone.
Ezinye izifo ezingabangela isifo sika-Addison: Isifo sofubaungomunye wemiphumela evame kakhulu. Noma uma unayo HIV / AIDS lapho i-immunodeficiency ingakwazi ukulwa nezifo eziye zabangelwa isifo sika-Addison.
Izimpawu zesifo i-Addison
Izimpawu zivela kancane bangabonakala kancane kancane futhi ekugcineni baphathwe isifo ebilokhu iqhubekela phambili. Ezimweni eziningi kudalwa isimo sokucindezeleka noma ukulimala okwenza izimpawu zibe zimbi nakakhulu. Izimpawu ezilandelayo zingase zenzeke:
- Kuvela ukukhathala okukhulu. Uphawu oluyinhloko yilapho kukhona ukukhathala okudlulele kanye nokuba buthakathaka kwemisipha, okuholela ekunyakazekeni kwemisipha. Ukuntuleka kokukhiqizwa kwe-cortisol ne-aldosterone yizimbangela zalesi sibonakaliso.
- Umfutho wegazi ophansi, nobuhlungu bekhanda, isiyezi ngisho nokuquleka. Ukunyakaza okunensayo, ukozela kanye nokuntuleka kokugxilisa ingqondo nakho kungenzeka. Uzozwa ukungabekezelelani amakhaza nokushisa.
- Ubuhlungu besisu
- Isicanucanu, isifo sohudo, noma ukuhlanza (imvamisa izinkinga zesisu).
- Ukuncipha kwesisindo nokuncipha kwesifiso sokudla. Ezinye izimpawu kufanele zihlolwe ukuze lesi sibonakaliso singadideki nesibonakaliso sokucindezeleka noma i-anorexia.
- hyperpigmentation, lapho isikhumba siba mnyama. Lapho i-ACTH (ihomoni ekhiqizwa indlala ye-pituitary) ikhula futhi i-cortisol incipha, kulapho isikhumba se-hyperpigmentation senzeka. Ibonakala noma yikuphi emzimbeni, inamabala anjengamabala noma imibimbi. Kwezinye izimo kwenzeka i-vitiligo, kuwuphawu oluphambene ne-hyperpigmentation yesikhumba, lapho isikhumba sesikhumba senzeke khona.
- Ngifuna ngempela ukudla usawoti. Lokhu kungenxa yokuntuleka komlingani emzimbeni kanye nevolumu ye-plasma. Ukuntuleka kwe-aldosterone nakho kubangela ukulangazelela ukudla okunosawoti.
- Umfutho wegazi uphansi nethuba lokuzwa isiyezi esikhulu lapho umile.
- I-Hipoglucemia: ushukela wegazi ophansi.
- Isifo sikashukela i-insipidus.
- kuvele kuvele ukungabekezelelani kokudla nezidakamizwa.
- Udinga ukuchama kaningi.
- Izilonda ngaphakathi emlonyeni. Izinkinga ezivame kakhulu zizoba phakathi kwezilonda nezilonda.
- Ubuhlungu bemisipha namalunga.
- ukulahlekelwa izinwele zomzimba kanye nokungasebenzi kahle kwezocansi kwabesifazane.
- ukucindezeleka nokucasuka. Kunezinguquko ezibalulekile ezithinta imizwa, odokotela noma ochwepheshe bavame ukukudida ngoba bedlula isikhashana sokucindezeleka noma ukuphazamiseka okuthile kwengqondo. Kulezi zimo, ama-antidepressants anqunyelwe futhi abe nemiphumela emibi kakhulu ngoba adala ukungasebenzi kahle kwe-adrenal.
Lapho uhlushwa ukungasebenzi kahle kwezindlala ze-adrenal, izimpawu zingavela ngokuzumayo nangokuzumayo. Ngaphambi kokuvela kwalezi zibonakaliso, kuyadingeka ukuya kudokotela ophuthumayo ukuze ukushaqeka okusongela ukuphila kungabangelwa. Phakathi kwalezi zimpawu:
- Ukudideka.
- Ubuthakathaka obujwayelekile kanye nomfutho wegazi ophansi.
- Ubuhlungu emhlane ongezansi nasemilenzeni.
- Ubuhlungu obukhulu besisu, nohudo nokuhlanza.
Indlela Isifo sika-Addison sitholakala ngayo
Ukuxilongwa kuzokwenziwa ngokusebenzisa izivivinyo zomtholampilo. Kudingeka ukuqoqa eziningi zezimpawu ukuze kuhlolwe futhi kwenziwe nezinye izinhlobo zokuhlola.
- Kuzokwenziwa ukuhlolwa kwegazi ukuhlola amazinga egazi e-sodium, i-hydrocortisone, i-potassium, ne-adrenocorticotropic hormone eshukumisa i-adrenal cortex ukukhiqiza amahomoni. nayo izokwaziswa ukukala amasosha omzimba.
- Ukuhlolwa kwe-adrenocorticotropin hormone stimulation. Kufanele ulinganise amazinga ayo ngoba iyimbangela yokuyala izindlala ze-adrenal ukuthi zikhiqize i-hydrocortisone.
- Ukuhlolwa kwe-hypoglycemia i-insulin ekhiqizwayo. Kubandakanya ukuhlola ushukela wegazi (iglucose) namazinga e-hydrocortisone ngemuva kokunikeza umjovo we-insulin. Kubantu abanempilo, amazinga eglucose ehla ngaphandle kwenkinga futhi amazinga e-hydrocortisone ayanda.
- Ukuxilongwa kwe-imaging lapho kwenziwa khona i-CT scan yendawo yesisu ukuze kubhekwe ubukhulu bendlala ye-adrenal futhi kutholakale ukuthi kukhona yini okungavamile. Esinye isibhamu esingase si-odwe i-MRI ye-pituitary gland.
Ukwelashwa okungamiselwa
Ukwelashwa kuzokwenziwa ngemithi. Kufanele ulungise amazinga amahomoni e-steroid umzimba ongawakhiqizi. Lapho uthatha le mithi, i-hydrocortisone, i-prednisone noma i-methylprednisolone izokwakhiwa ukuze ithathe indawo ye-cortisol. I-Fludrocortisone acetate nayo izobekwa esikhundleni se-aldosterone.