Ofaya daga cikin manyan alamun da ake iya shakkar cutar sankara shine yawan ƙishirwa da yawan urination, wanda zai iya kaiwa 5 da 10 a kowace rana.
Ana lura da alamun guda ɗaya tare da insipidus na ciwon sukari, ko insipidus na ciwon sukari. Wannan cututtukan da ba kasafai ake dangantawa da rashin maganin antasouretic hormone vasopressin ba.
Vasopressin na iya kasancewa a cikin da aka rage shi, ko kuma masu karɓa a cikin kodan su daina amsawa. Hakanan, ciwon insipidus na ciwon sukari na iya haɓaka a cikin yara 'yan ƙasa da shekara ɗaya, a cikin na biyu ko na ƙarshen watanni na ciki, lokacin shan magunguna. Siffofin ƙarshe, ya bambanta da na tsakiya da na koda, suna da kyakkyawan tsinkaya da hanya mai sauƙi.
Haɓaka ciwon sukari insipidus: sanadi da inji
Domin ruwan ya dawo cikin jini daga fitsari na farko, ana buƙatar vasopressin. Wannan shine kawai hormone a cikin jikin mutum wanda zai iya yin wannan aikin. Idan ba ta yi aiki ba, to mummunan cuta na rayuwa zai ci gaba - ciwan sukari insipidus.
Ana ƙirƙirar Vasopressin a cikin neurons na hypothalamus - a cikin ƙwayoyin supraoptic. Bayan haka, ta hanyar hanyoyin neurons, yana shiga cikin ginin ciki, wanda yake tarawa kuma yana zama cikin jini. Alamar sakewa shine karuwar osmolarity (maida hankali) na plasma da raguwa a cikin yawan bugun jini.
Osmolarity yana nuna maida hankali ga dukkan narkar da gishiri. A yadda aka saba, yana daga 280 zuwa 300 mOsm / l. A wannan yanayin, jiki yana aiki a cikin yanayin ilimin mutum. Idan ya tashi, to masu karɓa a cikin hypothalamus, hanta da bango 3 na ventricle na kwakwalwa suna aika alamomin game da buƙatar riƙe ruwan, yana ɗaukar sa daga fitsari.
Kwayar ciki shine yake karɓar alamu guda ɗaya daga masu karɓar ƙara a cikin ƙwayar ƙwayar cuta da kuma jijiyoyin jiki a cikin kirji idan ƙarar jini yana kwance a ƙasa da al'ada. Kula da ƙimar al'ada yana ba ku damar samar da kyallen takarda tare da abubuwan gina jiki da oxygen. Tare da raguwa a cikin karfin jini, saukar da saukar karfin jini da microcirculation.
Don kawar da sakamakon raunin ruwa da gishiri mai yawa, an saki vasopressin. Anara yawan matakin antidiuretic hormone yana faruwa ne saboda waɗannan dalilai: girgiza jin zafi yayin rauni, zubar jini, bushewar jiki, psychosis.
Ayyukan vasopressin yana faruwa a cikin wadannan fannoni:
- Zafin jiki ya ragu.
- Ruwa daga fitsari yana shiga jini, yana ƙaruwa da ƙarfi.
- Plasma osmolarity yana raguwa, gami da sodium da chlorine.
- Sautin tsokoki mai santsi yana ƙaruwa, musamman a cikin tsarin narkewa, tasoshin jini.
- Matsin lamba a cikin arteries yana ƙaruwa, sun zama mafi kulawa ga adrenaline da norepinephrine.
- Hawan jini ya tsaya.
Bugu da ƙari, vasopressin yana da tasiri ga halayen ɗan adam, wani ɓangaren yanke hukunci game da halayen zamantakewa, halayen tashin hankali da ƙirƙirar ƙauna ga 'ya'yan uba.
Idan kwayar ta daina shiga cikin jini ko hankali ya lalace, to insipidus na ciwon suga yakan haɓaka.
Siffofin ciwon sukari insipidus
Ciwon sukari na tsakiyar insipidus yana haɓaka tare da raunin da ya faru da ƙwaƙwalwar ƙwaƙwalwa, tare da keta ƙaddamar da jini a cikin hypothalamus ko ƙwayar ƙwayar cuta. Sau da yawa, farkon cutar yana da alaƙa da neuroinfection.
Yin tiyata na pituitary adenoma ko radadi yayin jiyya na iya haifar da alamun cutar insipidus na ciwon suga. Tungsten kwayoyin cutar tare da isasshen samar da vasopressin, wanda ke karfafa faruwar wannan cutar.
Tare da wahalar kafa dalilin, wanda aka lura da shi a cikin wani muhimmin sashi na duk masu haƙuri da tsarin insipidus na ciwon suga, wannan nau'in cutar shine ake kira idiopathic.
A cikin hanyar koda, masu karɓar vasopressin ba su amsa kasancewar sa a cikin jini ba. Wannan na iya zama saboda irin waɗannan dalilai:
- Rashin daidaituwa tsakanin masu karɓa.
- Rashin wahala.
- Take hakkin abun cikin ionic na plasma.
- Shan magungunan lithium.
- Cutar amai da gudawa a cikin matakan ci gaba.
Kwayar cutar insipidus a cikin mata masu juna biyu ana rarrabe su a matsayin mai jinkiri (wucewa), yana da alaƙa da gaskiyar cewa enzymes da aka samar daga mahaifa suna lalata vasopressin. Bayan haihuwa, ciwon mara na cikin insipidus ya gushe.
Insipidus na ciwon sukari na ɗan lokaci shima yana shafar yara na farkon rayuwa, wanda ke da alaƙa da samuwar pituitary da hypothalamus.
Zurfin cutar da matakin rikicewar metabolism na ruwa-electrolyte ya danganta da matsayin rashin ruwa na jiki. Akwai nau'ikan nau'ikan insipidus na ciwon sukari:
- Mai tsananin - urination daga lita 14 a rana.
- Matsakaicin diuresis yana daga 8 zuwa 14 a kowace rana.
- m - marasa lafiya excrete har zuwa 8 lita a rana.
- Tare da asarar ƙasa da lita 4 a kowace rana - ɓangare (m) ciwon sukari insipidus.
Ciwon sukari na lokaci-lokaci a cikin yara da mata masu juna biyu galibi yakan gudana cikin tsari mai sauƙi Lokacin shan magunguna (iatrogenic) - matsakaici. Tare da siffofin tsakiya da na koda, mafi kyawun hanya na ciwon insipidus an lura.
Ciwon sukari insipidus an dauki shi wani abu ne da ba kasafai ake samun shi ba. Amma kwanan nan, an sami cikakken kwanciyar hankali na siffofin tsakiya dangane da karuwa da raunin craniocerebral da ayyukan tiyata don cututtukan kwakwalwa.
Mafi yawancin lokuta, ana gano cutar insipidus da cututtukan ta a cikin maza masu shekaru 10 zuwa 30.
Bayyanar ciwon sukari insipidus
Bayyanar cututtukan cututtukan insipidus suna da alaƙa da yawaitar fitsari da kuma ci gaba da bushewa. Kari akan haka, rashin daidaituwa a cikin wutan lantarki a cikin jini kuma yayi raguwar hauhawar jini.
Muni a cikin tsananin da tsananin cutar da dalilin dalilin ya faru. Babban korafi na marasa lafiya, kamar yadda a cikin ciwon sukari na mellitus, yana da ƙishirwa mai ƙuna, ƙoshin bushewa kullun, bushe, fata mai narkewa da membranes na mucous, har ma da yawan urination.
Marasa lafiya na iya shan ruwa fiye da lita 6 na ruwa a kowace rana kuma yawan fitsari ya ƙaru zuwa lita 10 - 20. Inganta dare diuresis da yawa.
Misalin alamun cutar insipidus masu ciwon sukari sune:
- Gajiya, rashin ƙarfi.
- Rashin damuwa ko ƙara yawan nutsuwa.
- Rage salivation.
- M maƙarƙashiya.
- Girgiza ciki a ciki bayan cin abinci, bel.
- Ciwon ciki da amai.
- Zazzaɓi.
A wani bangare na tsarin zuciya da jijiyoyin jini, wani hadadden alamomin tsarin nakasar jijiyoyin jiki ke tashi - faduwa cikin karfin jini, hauhawar zuciya, katsewa a cikin aikin zuciya. Yawan jiki yana raguwa, rashin daidaituwa na urinary yana tasowa cikin yara bayan shekaru 4, marasa lafiya suna damuwa da yawan fatar fata.
Alamar jijiyoyin jiki suna tasowa ne sakamakon asarar ƙwayoyin jijiyoyi a cikin fitsari - ciwon kai, makarkata ko murkushe tsokoki, ƙin yatsun kafa da sauran sassan jiki. Insipidus na maza na maza suna da irin wannan bayyanuwar halitta a matsayin raguwa a cikin jima'i da haɓakar lalata ƙwalƙwalwa.
Don tabbatar da bayyanar cututtuka na insipidus na ciwon sukari, ana gudanar da gwaje gwaje da gwaje-gwaje na musamman don fayyace asalin cutar insipidus. Ana gudanar da bambance-bambancen cututtukan cututtukan koda da na tsakiya na cutar, kuma ba'a cire ciwon sukari ba.
A matakin farko, ana yin nazari da yawaitar fitsari, yawancinta da kuma tsakar jikinta. Ga masu ciwon sukari insipidus, waɗannan dabi'u sune halaye:
- Ga kowane kilogiram na nauyin jiki a rana, fiye da 40 ml na fitsari an cire shi.
- Rage yawan adadin fitsari a ƙasa 1005 g / l
- Kwayar ƙwayar ƙwayar ciki ba ƙasa da 300 mOsm / kg ba
A cikin nau'in renal na insipidus na ciwon sukari, alamu masu zuwa suna bayyana: hypercalcemia, hyperkalemia, haɓaka da ƙwaƙwalwar ƙwayar cuta a cikin jini, alamun rashin nasara na koda ko kamuwa da cuta a cikin urinary fili. A cikin cututtukan cututtukan cututtukan zuciya, mai nuna alama shine ƙaruwar sukari jini.
Lokacin aiwatar da gwaji tare da cin bushewa, alamomin rashin ruwa a jiki da asarar nauyi yana ƙaruwa cikin sauri ga marasa lafiya. Tsarin tsakiya na insipidus na ciwon sukari ana cire shi da sauri ta hanyar gwajin desmopressin.
Tabbatar, idan ba a tabbatar da ganewar cutar ba, gudanar da wani hoton da ya shafi kwakwalwa, da kuma nazarin kwayoyin.
Jiyya don ciwon sukari insipidus
Zabi na dabara don magance cututtukan insipidus na sukari ya dogara da nau'in cutar. Don lura da tsari na tsakiya saboda lalacewar hypothalamus ko glandar ciki, ana amfani da analog na vasopressin da aka samu.
Magungunan da aka dogara da desmopressin suna samuwa a cikin nau'ikan Allunan ko kuma fesa hanci. Sunayen ciniki: Vasomirin, Minirin, Presinex da Nativa. Yana inganta juyarwar juyar da ruwa a cikin kodan. Sabili da haka, lokacin amfani da shi, kuna buƙatar sha kawai tare da jin ƙishirwa, don kada ku haifar da maye ga ruwa.
Idan akwai wani yawan zubar ruwan desmopressin ko yin amfani da ruwa mai yawa yayin amfani dashi, masu zuwa na iya faruwa:
- Hawan jini.
- Haɓaka nama edema.
- Rage yawan maida hankali akan sodium a cikin jini.
- Rashin hankali.
An zabi kashi daban-daban daga 10 zuwa 40 mcg kowace rana. Ana iya ɗaukar shi sau ɗaya ko zuwa kashi biyu. Yawanci, ana ba da haƙuri ga miyagun ƙwayoyi, amma sakamako masu illa suna iya yiwuwa a cikin nau'in ciwon kai da rashi, jin zafi a cikin hanji, tashin zuciya, da hauhawar jini a matsakaici.
Lokacin amfani da fesawa na desmopressin ko saukad, kuna buƙatar tuna cewa tare da hanci mai saurin gudu saboda kumburi da mucous membrane, ɗaukar ƙwayar yana ragewa, don haka a irin waɗannan lokuta ana iya narkewa a ƙarƙashin harshen.
A cikin tsakiyar insipidus na ciwon sukari, shirye-shiryen tushen carbamazepine (Finlepsin, Zeptol) da chloropropamide ana amfani dasu don haɓaka samar da vasopressin.
Insipidus na ciwon sukari na mahaifa yana haɗuwa da rashin iyawar kodan don amsa vasopressin, wanda zai iya isa cikin jini. Koyaya, lokacin gudanar da gwaji tare da desmopressin, amsawar ba ta faruwa.
Don lura da wannan nau'in, ana amfani da thiazide diuretics da magungunan anti-mai kumburi steroidal - Indomethacin, Nimesulide, Voltaren. A cikin abincin, adadin gishiri yana da iyaka.
Ana kula da insipidus na ciwon suga na ciki tare da shirye-shiryen desmopressin, ana yin magani ne kawai a lokacin daukar ciki, bayan haihuwa babu buƙatar irin wannan ilimin.
A cikin insipidus masu ciwon sukari mai sauƙi ko a cikin wani sashi na sashi, ana iya amfani da maganin rashin magani a cikin tsari mai kyau na shan shan ruwa don hana bushewa.
An tsara abinci don insipidus na ciwon sukari don rage nauyi a kan kodan. Manufofinsa:
- Haramcin kariya, musamman nama.
- Isasshen yawan kitse da carbohydrates.
- Yawancin abinci mai juzu'i.
- Hada sabo da kayan marmari da 'ya'yan itatuwa.
- Don ƙishir da ƙishirwa, amfani da ruwan 'ya'yan itace, ruwan' ya'yan itace ko abubuwan sha.
Ana tantance tasirin magani ne ta hanyar kyautatawar marasa lafiya da raguwar adadin fitsari.
Tare da cikakken diyya, alamun cututtukan insipidus na sukari sun shuɗe. Insipidus na ciwon sukari mai cike da ƙwayar cuta yana tare da ƙishirwar matsakaici da urination mai yawa. Tare da hanya mai lalacewa, alamomin ba su canzawa ƙarƙashin tasirin ilmin likita.
Mafi kyawun jiyya shine cututtukan koda na yara a yara, tare da shi yakan haifar da gazawar ƙwayar cutar koda, yana buƙatar hemodialysis da haɓakar koda. Halin idiopathic na insipidus na ciwon sankara bashi da haɗari ga rayuwa, amma maganganun cikakkiyar magani basu da wuya.
Tare da tsarin tsakiya na insipidus na ciwon sukari, ingantaccen aikin kwantar da hankali yana ba marasa lafiya damar kula da ƙarfin aiki da ayyukan zamantakewa. Cutar sankarar mahaifa, da alaƙa da magunguna da cututtuka a cikin yara a farkon shekarar rayuwarsu, galibi suna ƙarewa cikin murmurewa. Bidiyo a cikin wannan labarin yana ɗaga taken ciwon insipidus.
