Ciwon sukari mellitus (insipidus na sukari) cuta ce mai saurin kamuwa da cuta wanda ke faruwa sakamakon nakasar ƙwaƙwalwar ƙwayar cuta, aikin hypothalamus, ko aikin koda. Cutar tana nunawa ta hanyar polydipsia (jin daɗin kullun ƙishirwa) da polyuria (haɓaka haɓakar fitsari - daga lita 6 zuwa 50 a kowace rana).
Wannan cuta cuta ce, tana iya ci gaba a cikin mata da maza a kowane zamani, amma galibi cutar sankara ce insipidus tana faruwa a cikin mutane masu shekaru 18 zuwa 28.
Cutar gitsiya da kuma hypothalamus sune gabobin endocrine wadanda suke da juna. Suna wakiltar wani kwamiti mai kulawa wanda ke kula da glandar endocrine na jiki.
Kula! Neurons na hypothalamus suna haifar da kwayoyin halittar ciki - oxytocin da vasopressin.
Antidiuretic hormone - vasopressin an tattara a cikin gorin baya na ciki. Ana saki hormone lokacin da ya cancanta kuma yana kulawa da juyar da maye ruwa a cikin ƙwayoyin koda.
Game da karancin taro na antidiuretic hormone a cikin jini a cikin kodan a cikin hanyoyin dawo da ruwa - yana samun rauni, wanda shine dalilin da yasa aka kirkiri polyuria.
Bayyanar cututtuka da kuma abubuwan da ke haifar da cutar insipidus
Cutar sankarar mellitus na bayyana idan canje-canje na cututtukan cuta sun bayyana a cikin jikin mutum, sanadin abubuwanda ke faruwa a cikin:
- haɓaka fashewar vasopressin;
- abin da ya faru na halittar a cikin ƙwayar gwal da hypothalamus;
- a cikin ƙwayoyin da aka yi niyya a cikin koda, raunin hankali ga hormone antidiuretic yana faruwa;
- rashin daidaituwa na hypothalamus ko ƙwayar ƙwayar cuta na ciki;
- gado na gado (yanayin tsinkaye ga nau'in mulkin mallaka);
- lalacewa ta kai ko tiyata marasa nasara, wanda ke haifar da lalacewar jijiyoyin vasopressin;
- metastases oncological wanda ke da mummunan tasirin ayyukan gland;
- autoimmune da cututtukan cututtukan da ke lalata neurons na maganin antidiuretic.
Babban alamun cutar mellitus na ciwon sukari sune polydipsia da polyuria, tare da matakan digiri daban-daban.
Kwayar cutar dake bayyana tare da tsawan lokaci na cutar
Tsawon lokaci na cutar, alamu kamar karuwa a cikin mafitsara, prolapse da nisantar ciki suna halayyar su. Bayyanar cututtukan cututtukan cututtukan insipidus sun hada da anorexia (asarar nauyi mai yawa), amai, da tashin zuciya.
Alamomin halayen masu zuwa su ne ƙananan haɓakar jini, ƙarancin hutu, da asthenia. Hakanan ciwon sukari mellitus yana tare da alamu kamar su migraine da kwantar da hankali na filin gani.
Symptomsarin alamun bayyanar cututtukan ƙwayar insipidus suna kwance cikin bushewar jiki:
- bushe da fata atonic;
- yiwu cramps;
- kunci cheekbones.
Hakanan, wani lokacin tare da canji mai mahimmanci a cikin yanayin jikin mutum, mai haƙuri yana haɓaka bayyanar cututtuka irin su lalata orthostatic.
Binciko
Lokacin ƙayyade ganewar asali, yana da mahimmanci don tabbatar da daidai nau'in cutar don magani ya zama mafi kyau duka. Don gano cutar, ananannesis da alamomin dake nuna polydipsia da polyuria (fiye da lita biyu a rana) suna da mahimmanci.
Idan tarihin asibiti da tarihin likita sun nuna alamun ciwon sukari insipidus, to, likita ya tsara wasu gwaje-gwaje. A wannan yanayin, mutum yana buƙatar yin watsi da ruwa na ɗan lokaci.
Mai haƙuri kuma yana bayar da gwajin fitsari da jini domin sanin:
- yawan fitsari;
- osmolarity;
- taro na nitrogen, potassium, glucose, sodium, alli a cikin jini;
- glucosuria.
Ana yin wani bincike don bushewar abinci, a cikin abin da mara haƙuri ba ya shan ruwa daga 8 zuwa 24 hours. A cikin gwajin gwaji, ana yin rikodin nauyi, yawa da kuma yawan fitsari a kowace sa'a kuma ana auna abubuwan da ke cikin sodium.
Idan nauyin mai haƙuri ya ragu da 5%, kuma adadin yawan sodium ya fi 3 mmol / l, to an kammala nazarin. Don haka, yana yiwuwa a ɓoye ko tabbatar da kasancewar insipidus na ciwon sukari, a cikin babu sinadarin antidiuretic, wanda ke sa ya yiwu a aiwatar da ƙwaƙwalwar ƙwayar cuta tare da ƙwayar jijiya da ta kwakwalwa.
Bambancin ganewar asali na nephrogenic da hypothalamic diabetes insipidus syndrome ya kunshi bincike ta amfani da Minirin: ana yin gwaji ne bisa ga Zimnitsky kafin shan Minirin da bayan amfani da wannan magani. Idan, bayan shan magungunan, yawan fitsari yana raguwa kuma yawanta yana ƙaruwa, wannan yana tabbatar da bayyanar cututtuka na hypothalamic diabetes insipidus.
Don bambancin ganewar asali na nau'in nephrogenic da hypothalamic, abun ciki na vasopressin a cikin jini yana da matukar muhimmanci: tare da ciwon sukari nephrogenic, adadin wannan hormone yana ƙaruwa, kuma a cikin na biyu ba a tunanin shi.
Don bincika nau'in mellitus na ciwon sukari na tsakiya, an yi MRI, wanda ke ƙaddara kasancewar abubuwan da ke tattare da cututtukan ƙwayoyin cuta, wurare masu haske da kuma samuwar a cikin ƙwayar pituitary.
Jiyya
Cutar sankara ta tsakiya
Jiyya don wannan nau'in insipidus na ciwon sukari ya ƙunshi amfani da ci gaba da sauyawa magani. Babban magani wanda ake aiwatar da magani mai nasara shine Desmopressin da nau'ikansa:
- Minirin (Allunan) - analogue na mutum na hormone antidiuretic;
- Adiuretin (ampoules) - don amfani da intranasal.
Minirin (vasopressin na wucin gadi)
Bayan gudanarwa, ana iya gano maganin a cikin jini bayan mintuna 15-30, kuma an kai ga maida hankali ne bayan minti 120.
Likita ya zabi sashi daban, yana lura da sakamakon maganin yayin da magani yake a matakin farko. An saita kashi, gwargwadon yawan ruwan sha da yawan urination. A matsayinka na mai mulkin, shine allunan 1-2 a kowace rana.
Ana shan miyagun ƙwayoyi rabin sa'a kafin abinci ko bayan 2 hours bayan cin abinci. Tsawon Minirin daga 8 zuwa 12 ne, don haka yakamata a karɓi sau uku a rana.
Idan akwai yawan abin sama da ya kamata, yana iya bayyana:
- kumburi;
- ciwon kai
- rage fitar fitsari.
Abubuwan da ke haifar da yawan ƙwayar cuta yawanci suna da alaƙa da sashin da ba daidai ba, canjin yanayi, zazzabi da canjin rayuwa.
Jiyya na ciwon sukari insipidus nau'in nephrogenic
Kulawa da wannan nau'in cutar ta ƙunshi yin amfani da maganin warkewa, yana kunshe da nau'ikan nau'ikan nau'ikan cututtukan cututtukan ƙwaƙwalwa tare da ƙarancin gishiri. Wannan ya zama dole don haɓakar tasirin thiazide diuretics.
A matsayin magani na haɗin kai, ana amfani da inhibitors na prostaglandin: ibuprofen, asfirin, indomethacin.
Kula! Tare da nau'in nephrogenic na ciwon sukari insipidus, Desmopressin ba shi da tasiri.
Yin magani na nau'in dipsogenic na cutar ba ya buƙatar magani. Babban burinta shine a rage yawan ruwan da ake sha.
Tare da ciwon sukari insipidus syndrome, mai haƙuri yakamata ya iyakance adadin gishiri, barasa da abinci mai gina jiki. Babban bangaren abincinsa yakamata ya kasance kayan kiwo, 'ya'yan itatuwa da kayan marmari.
Kuma don rage ƙishirwa, ya kamata ku sha ruwan sha mai sanyi tare da apple da lemun tsami.
