Ciwon sukari insipidus

Insipidus na ciwon sukari (lamba bisa ga ICD-10 - E23.2) cuta ce mai mahimmanci na neuroendocrine, wacce ke tattare da rashin nasarar kodan ta sha ruwa baya da maida hankali. Dalilin cin zarafi ne na samarwa, jigilar kaya ko aikin vasopressin (hormone maganin antidiuretic). Cutar tana bayyana ne ta ƙishirwa cututtukan fata da kuma saki adadin fitsari. Aboutarin bayani game da abin da insipidus ciwon sukari yake, menene nau'in rashin lafiya kuma yadda za a magance shi an tattauna a cikin labarin.

Siffofin ilimin halittar jiki da kuma kimiyyar lissafi

Kodan shine sashin jiki wanda aka hadu, wanda yake a bayan bangon bayan gida a matakin kashin baya da na kashin baya. Sashin jikin yana da kumburi mai zazzagewa, kitsen mai da kitse fascia. Akwai kashin yanayin da koda ya kasu kashi biyu:

• parenchyma sashin jiki - ayyukanta suna cikin aiwatar da tace jini da samuwar fitsari;
• ƙashin ƙugu - tara da cire fitsari daga jiki.

Kowane koda yana da adadin ɗakunan kuɗaɗe na abubuwa nephrons, waɗanda ke ba da damar aikinta. Nephron yana da tsari mai zuwa:

• Glomerulus - wanda ke wakiltar wani yanki mai dauke da karfin jini wanda ke gudana wanda jini ke gudana. An nutsar da glomerulus a cikin kwanson Shumlyansky-Bowman.
• Kabarin yana da bango biyu, kuma akwai sarari kyauta tsakanin su. Capsule ya wuce cikin kogin tubules.
• A tubules suna located a cikin hanyar madaukai a cikin kauri daga cikin na koda parenchyma.

Nephron shine ƙarancin tsarin halittar ƙodan.

Ayyuka

Kodan suna cire ruwa mai yalwa a cikin jikin mutum, metabolites na tafiyar matakai na jikinta, abubuwan guba da guba, da magunguna. Bugu da kari, jiki na da hannu wajen daidaita daidaituwar ruwan-gishiri, yanayin shan jini, da matsa lamba.

Mahimmanci! Ana samar da irin wannan tsari saboda samuwar fitsari.

An kafa hanji kamar haka. Ana tace jini na jijiya a cikin ƙwayar tsohuwar ƙwayoyin nephrons. A nan, zubar jini ya zama mai rauni saboda hauhawar jini a cikin jijiyoyin koda da kuma bambanci a cikin girman tasoshin. Filin plasma da aka tace yana shiga cikin kwalliya tare da gubobi, abubuwan sharar gida, glucose, amino acid. Abubuwan da ke jikin koda ba su wuce sunadarai da sauran manyan kwayoyin halitta ba.

Ari, a cikin urinary tubules na nephrons akwai juzu'in sha na ruwa da abubuwa masu mahimmanci ga jiki. Abubuwan da ba dole ba ne su tara kuma su shiga tsarin fitsari (tattara bututu, ƙashin ƙugu, sannan kuma a cikin ureters da mafitsara).

Menene sakamakon vasopressin?

Ana kiran Vasopressin hormone na hypothalamic-pituitary system, wanda ke cikin aikin urination. Adadin da aka samar ana sarrafa shi ta sodium microelement. Increasearancin adadi a jiki yana ƙaruwa lokacin da yake motsa jiki, wanda yake ragewa yana rage shi.

A karkashin aikin vasopressin, akwai jan ruwa da abubuwan abinci daga fitsari na farko.

Hormone aiki:

• yana samar da raguwar tasoshin nephrons;
• yana kula da matakin matsin lamba;
• haɓaka coagulation na jini;
• yana sarrafa samar da wasu kwayoyin halittu;
• yana kula da maida hankali kan ƙwayoyin ƙwayoyin cuta;
• bege berayen.

Model na kwayoyin vasopressin - hormone mai maganin antidiuretic, gazawar hakan yana haifar da ci gaba da cutar

Tsarin ilimin Pathology

Cutar Endocrine ba ta haɗu da jinsi ko shekaru. Zai iya faruwa a kowane mutum, amma mafi yawan lokuta yakan inganta ne bayan ya balaga.

Wannan rabuwa mai zuwa:

• Insipidus na cutar sankara ta tsakiya - yana faruwa ne sakamakon cutar sankarau na samar da abubuwan da ke motsa jiki: nau'in gado; nau'in da aka samo.
• Insipidus na ciwon sukari na Nehrogenic - yana haɓakawa da tushen asali na ƙarancin jijiyoyin kodan zuwa aikin hormone antidiuretic: gado; hali
• Polydipsia na farko - yawan shan ruwa mai yalwa ya zama sanadin: nau'in psychogenic - babban ruwa mai ɗorewa a gaban rikicewar kwakwalwa; Nau'in Dipsogenic - saukar da ƙarancin masu karɓar waɗanda ke tsinkaye canje-canje a cikin ƙwayar osmotic na ruwa mai kewaye.

Rashin kamuwa da cututtukan ciwon siga

Wannan ya haɗa da ciwon sukari na gestagen, wanda ke da alaƙa da haɓaka aikin ƙwayoyin enzymes. Bayan haihuwar jariri, yanayin mahaifiyar yana kwantar da hankali.

Gestagenic diabetes insipidus - cuta ce da ke faruwa yayin daukar ciki

Nau'in aiki yana haɓaka a cikin jarirai. Hakan ya faru ne saboda rashin girman tsarin tattara hankali na kodan da kuma ƙara yawan aiki na phosphodiesterase-5, wanda ke haifar da raguwa a cikin hankalin masu karɓar zuwa hormone da tasirinsa na ɗan gajeren lokaci.

Insipidus na ciwon sukari na Iatrogenic wani nau'i ne na ɗan lokaci wanda lalacewa ta haifar dashi.

Dalilai na ci gaba

Akwai da dama abubuwan etiological a ƙarƙashin rinjayar wanda insipidus ciwon sukari ke faruwa. Kara karantawa game da kowane.

Dalilai

Duk Game da Nau'in 1 Ciwon sukari

Insipidus na cututtukan ƙwayar cutar sankara na haɓaka ta jiki sakamakon maye gurbi na kwayoyin vasopressin ko kuma cikin ammoniya a cikin tsarin na agabar na ciki. Bayyanar cututtuka na wannan nau'in cutar ana iya gani a cikin shekaru biyar na farko na rayuwar jariri. Tare da shekaru, pathology ya ci gaba, alamu na raguwar vasopressin raguwa.

Mahimmanci! Abubuwan asibiti na ingantacciyar ci gaba a cikin yanayin rashin lafiyar mata da maza fiye da shekaru 40 sanannu ne.

Rashin hormone na iya zama wani ɓangare na cututtukan hereditary, wanda, ban da insipidus na ciwon sukari, ya haɗa da ciwon suga, ƙin ji, atrophy na jijiyoyin jijiyoyi.

Asalin gado

Yara suna da babban matakin abubuwa na motsa jiki a cikin dare, wanda ke rage yawan fitsari. A jarirai marasa lafiya masu fama da matsalar urinary na cikin dare a lokacin, yawan maganin antidiuretic yana raguwa sosai da daddare, bi da bi, an fitar da babban adadin fitsari mai narkewa.

Raunin kai

Yawancin raunin da ya faru (alal misali, karaya daga gindin kwanyar, wani rauni na sirdi na turki) na iya haifar da ci gaba da kumburi a cikin sel waɗanda ke da alhakin samar da hormone. Rashin iya haɗawa na iya zama na ɗan lokaci ko na dindindin. A cikin wasu marasa lafiya, alamun cutar na faruwa ba a da farko ba bayan watanni 1-1.5 bayan raunin.

Turewa

Yin tiyata don cire pituitary adenoma, metastases, craniopharyngiomas shine sananniyar hanyar sanadin ciwon insipidus. Kwararren likita yakamata ya bambanta tsakanin abin da ya faru da ilimin halittar mutum da kuma hanyar da ake bi wajen cire ruwa wanda ya shiga jiki ta hanyar infusions yayin tiyata.

Kunkuru

Babban dalilin shine dysgerminoma. Don haifar da farkon cutar, tumbi ya zama babba ko yana zaune kai tsaye a wurin da lambar mafi yawan ƙwayoyin take da alhakin ɓoye vasopressin ke zaune. Ciwon sukari insipidus na iya haɓaka tare da lalacewar hypothalamus ta hanyar metastases a gaban kansa na koda, huhu, ko nono.

Endocrinologist - mataimaki a cikin yaki da Pathology

Neuroinfection

Abubuwan da suka haifar da haɓaka nau'in cututtukan cututtukan cututtukan ƙwayar cuta sune meningococcal, kamuwa da cuta na cryptococcal, toxoplasmosis, cytomegalovirus, wanda ya shafi tushe da membrane na kwakwalwa a cikin aiwatar.

Alamomin cutar

Alamar halayyar farko ita ce ƙishirwar cututtukan jijiyoyi da yawan urination (duka da rana da dare). Yawan fitsari na iya kaiwa lita 13-18 a rana. Mai haƙuri yana da gunaguni mai zuwa:

• bushe fata da mucous membranes;
• nauyi asara;
• rashin ci;
• yawan maƙarƙashiya;
• Rage matsin lamba, tachycardia;
• jin rauni na kullun;
• yawan tashin zuciya da amai;
• tashin hankali na bacci;
• tashin hankali, juyayi, hawaye.

Don ƙarin bayani game da alamun cutar insipidus na ciwon sukari, duba wannan labarin.

Of alamun cututtukan yara a cikin yara kusan ba su bambanta ba. Jariri ya yi kadan nauyi, ya ƙi shayarwa, yana son madara da ruwa. Yaron yana cikin damuwa, tare da hawaye, hawaye na iya zama a ɓoye ko kaɗan.

Maƙiyi - populationungiyar yawan jama'a wanda halayyar haɓaka ta haifar da nau'in cuta ta tsakiya

Bayyanar cututtukan dake bushewa a jiki sun bayyana: zazzabi jiki yana raguwa, fasallan fuska suna dimauwu, idanuwan su ya dushe, hanci ya kara bayyana, tayin hanci a fili yake bayyane. Amai yawanci yakan faru. Rashin ruwa mai narkewa na haifar da lalacewa da asarar hankali. A wannan yanayin, taimako da cancanta nan da nan ya zama dole, tunda koda sakamako mai mutuwa yana yiwuwa.

Karanta ƙarin game da alamun bayyanar cutar insipidus na yara a cikin wannan labarin.

Binciko

Idan duk bayanan ayyukan anamnesis da alamun bayyanar cututtuka suna nuna ƙishirwar cututtukan jijiyoyi da yawan urination, ya zama dole a yi nazarin waɗannan alamomi masu zuwa:

• matakin abubuwan gano abubuwa zuwa jini (alli, sodium, potassium);
• alamomin sukari na jini da fitsari (ɗaya daga cikin bambance-bambancen dake tsakanin cutar sankara da ciwon sukari);
• alamun urea a cikin ilimin halittu;
• takamaiman nauyi na fitsari;
• osmotic taro na jini da fitsari.

Gwajin rashin ruwa a jiki

Wannan hanyar tana ba da damar kawai tabbatar da kasancewar cutar, har ma don bambance tsakanin tsakiya da insipidus na ciwon sukari. Da safe akan komai a ciki, a auna nauyin jikin mara haƙuri, bayan haka kada ya sha wani ruwa. Tsawon lokacin shine 6-8 - 6,00. Kowane sa'a, ana ɗaukar nauyi, adadi da takamaiman ƙarfin fitsari, alamomin sodium da maida hankali osmotic.

Gwajin Desmopressin

An gudanar da shi akan asalin gwajin rashin ruwa ko kuma daban shi. An tsara mai haƙuri Desmopressin a cikin kwamfutar hannu ko fom allura. An gwada marasa lafiya bisa ga Zimnitsky, an ƙaddara yawan ƙwaƙwalwar osmotic, alamu na sodium a cikin fitsari yayin shan maganin kuma kafin a tsara shi.

Kayan aikin gwaji

Ana amfani da hanyoyi masu zuwa:

• MRI na kwakwalwa - yana ba ku damar ƙayyade ba wai kawai kasancewar ilimin ƙwayar cuta ba, har ma don kafa dalilin cutar.
• Duban dan tayi na kodan.
• X-rayukan huhun huhu.
• CT scan na rami na ciki.
• Mamografi

Siffofin jiyya

Makasudin aikin likita shine kawar da ƙishirwa cututtukan jijiyoyi da yawan urination, kuma a kula da ingancin rayuwa ga mara haƙuri. Da farko dai, sun kawar da dalilin da ya haifar da ci gaban cutar. Bayan haka, ana wajabta magunguna dangane da nau'in insipidus na ciwon suga.

Ingantaccen tsarin shaye shaye shine ɗayan matakan kulawa da cutar

Tsarin tsakiya

Hanyar sarrafa haƙuri na mai haƙuri ya dogara da yawan ruwa mai ɓacewa. Idan adadin yawan fitsari ya kasa da lita 4 a rana, ba a amfani da magunguna. Masanin kwararrun ya ba da izinin tsarin abinci da isasshen tsarin sha.

Idan adadin yawan fitsari ya wuce lita 4, ana amfani da maganin sauyawa ko kuma wadancan magungunan da ke karfafa aikin hodar. Na dogon lokaci, an rubuta magani wanda aka allura a cikin hanyoyin hanci (Desmopressin). Yanzu, don canzawa, ana amfani da analog na Minirin.

Magunguna waɗanda ke taɓar da ƙwayar maganin rigakafi: Chlorpropamide, Carbamazepine, Miskleron.

Learnara koyo game da jagororin kulawa da ciwon sukari a cikin wannan labarin.

Kulawar koda

Da farko dai, ana sarrafa tsari don sake sarrafa ruwan. Na gaba, an tsara maganin maganin:

• Thiazide diuretics ba baƙon abu bane, amma tare da insipidus na ciwon sukari suna ba da gudummawa ga maimaitawar ruwa yayin fitsari na biyu. Wakilan ƙungiyar - Hydrochlorothiazide, Indapamide.
• NSAIDs - godiya ga takamaiman matakai, wakilai na wannan rukunin suna haɓaka osmolarity na fitsari da rage adadinsa (Indomethacin, Ibuprofen).

Magungunan ƙwayar cuta shine ɗayan babban ingantaccen magani

An ba da izinin jiyya tare da magunguna na jama'a, duk da haka, kawai bayan tattaunawa tare da kula da endocrinologist.

Abincin far

Abincin don insipidus na ciwon sukari ya dogara da waɗannan ka'idodi:

• iyakance yawan cin gishiri zuwa 4 g a rana;
• dafa abinci ba tare da gishiri ba, ƙara gishiri a cikin abin da aka gama;
• amfani da 'ya'yan itatuwa bushe;
• ƙi yarda da Sweets;
• wariyar giya;
• cin kayan marmari daga 'ya'yan itace, ruwan' ya'yan itace da abubuwan sha, kayan kifi, qwai;
• ƙuntatawa na furotin, da kitsen da carbohydrates dole ne su kasance cikin wadataccen adadi;
• ƙarancin abinci mai gina jiki a cikin ƙananan rabo.

Yana da mahimmanci a tuna cewa cutar kanta tana da sakamako mai kyau. Tare da ziyartar lokaci na kwararru, bin shawarwarin da kawar da sanadin, zaku iya samun saurin warkewa.