ʻO nā mea āpau āu e ʻike ai e pili ana iā Cushing's Syndrome

Anter

• Hōʻike Overview
• Nā ʻōuli o Cushing's syndrome
• I nā keiki
• I nā wahine
• I nā kāne
• ʻO Cushing's syndrome ke kumu
• Corticosteroids
• Nā Tumors
• Maʻi ʻo Cushing
• ʻO ka mālama ʻana iā Cushing's Syndrome
• ʻIkeʻike maʻi maʻi Cushing
• Ke hōʻike nei i ke kumu o ka maʻi o Cushing
• ʻO ka papaʻai Syndrome o Cushing
• ʻO nā kumu pilikia ʻo Cushing's syndrome
• ʻO ka mālama ʻana iā Cushing's syndrome
• ʻO ka nānā ʻana o Cushing's Syndrome

Hōʻike Overview

Loaʻa ʻo Cushing's syndrome a i ʻole hypercortisolism, ma muli o nā kiʻekiʻe kiʻekiʻe ʻole o ka hormone cortisol. Hiki i kēia ke hana no nā kumu like ʻole.

I ka hapanui o nā hihia, hiki i ka loaʻa ʻana o ka lāʻau ke kōkua iā ʻoe e hoʻokele i kāu pae cortisol.

Nā ʻōuli o Cushing's syndrome

ʻO nā ʻōuli maʻamau o kēia ʻano:

• loaʻa kaupaona
• nā waihona momona, ʻo ia hoʻi i ka midsection, ka maka (ke kumu o ka helehelena a puni ke ʻano o ka mahina), a ma waena o nā poʻohiwi a me ke kua o luna (ke kumu o ka puʻupuʻu buffalo)
• nā kikoo poni ma nā poli, nā lima, ʻōpū, a me nā ʻūhā
• ʻili lahilahi e palapū me ka maʻalahi
• ʻeha nā ʻili i lohi e hoʻōla
• huehue
• luhi
• nāwaliwali o nā mākala

Ma waho aʻe o nā hōʻailona maʻamau ma luna, aia kekahi mau hōʻailona ʻē aʻe i ʻike ʻia i kekahi manawa i ka poʻe me Cushing's syndrome.

Hiki i kēia mau mea ke:

• kō kō kiʻekiʻe
• hoʻonui ka make wai
• hoʻonui urination
• ʻosteoporosis
• ke koko kiʻekiʻe (hypertension)
• he ʻeha poʻo
• huli ke ʻano
• hopohopo
• ukiuki
• kaumaha
• ka hoʻonui ʻia o nā maʻi

I nā keiki

Hiki i nā keiki ke loaʻa iā Cushing's Syndrome, ʻoiai hoʻomohala lākou iā ia ma mua o ka poʻe mākua. Wahi a kahi noiʻi 2019, e pili ana i nā hihia hou o Cushing's syndrome i kēlā me kēia makahiki i nā keiki.

Ma waho aʻe o nā hōʻailona ma luna aʻe, loaʻa pū nā keiki me Cushing's syndrome:

• momona
• lohi o ka ulu ʻana
• ke koko kiʻekiʻe (hypertension)

I nā wahine

ʻOi aku ka maʻi o Cushing's syndrome ma mua o nā kāne. Wahi a ka National Institutes of Health (NIH), ʻekolu manawa ka nui o nā wahine e hoʻomohala iā Cushing's syndrome ke hoʻohālikelike ʻia me nā kāne.

Hiki i nā wahine me Cushing's syndrome ke hoʻomohala i ka lauoho maka a me ke kino.

Kū pinepine kēia ma ka:

• alo a me ka ʻāʻī
• umauma
• ʻōpū
• ʻūhā

Hoʻohui ʻia, ʻike paha nā wahine me Cushing's syndrome i ka menstruation maʻamau. I kekahi mau hihia, ʻaʻole pau ka menstruation. Hiki i ka untreated Cushing's syndrome ke alakaʻi i nā pilikia i ka hāpai ʻana.

I nā kāne

E like me ka hihia me nā wahine a me nā keiki, hiki i nā kāne me Cushing's syndrome ke ʻike i kekahi mau hōʻailona hou aʻe.

Loaʻa i nā kāne me Cushing's syndrome:

• ka hana erectile
• he nalowale o ka hoihoi wahine
• hoʻemi i ka momona

ʻO Cushing's syndrome ke kumu

Hoʻokumu ʻia ʻo Cushing's Syndrome e ka nui o ka hormone cortisol. Hoʻokumu kāu mau adrenal adrenal i ka cortisol.

Kōkua ia i nā hana a kou kino, me:

• ke hoʻoponopono nei i ke kahe o ke koko a me ka ʻōnaehana cardiovascular
• e hoʻemi ana i ka pane hoʻoweliweli o ka pale pale
• ke hoʻohuli nei i nā haʻuki, nā momona, a me nā protein i ka ikehu
• ke kaulike ʻana i nā hopena o ka insulin
• ke pane nei i ke koʻikoʻi

Hiki i kou kino ke hana i nā kiʻekiʻe kiʻekiʻe o ka cortisol no nā ʻano kumu like ʻole, e like me:

• nā pae kiʻekiʻe, me ke koʻikoʻi e pili ana i kahi maʻi maʻi, ʻoki kino, ʻeha, a hāpai keiki paha, keu hoʻi i ka trimester hope loa
• hoʻomaʻamaʻa haʻuki
• hana maikaʻi ʻole
• ʻalekohola
• kaumaha, pilikia panic, a i ʻole nā ​​pae kiʻekiʻe o ke kaumaha i ka naʻau

Corticosteroids

ʻO ke kumu maʻamau o ka maʻi ʻo Cushing ka hoʻohana ʻana i nā lāʻau corticosteroid, e like me prednisone, i nā kiʻina kiʻekiʻe no kahi wā lōʻihi. Hiki i nā mea lawelawe olakino ke kuhikuhi i kēia mau mea e mālama ai i nā maʻi ʻino, e like me ka lupus, a i ʻole e pale aku i ka hōʻole ʻia ʻana o kahi mea kanu i kanu ʻia.

ʻO nā lāʻau kiʻekiʻe o nā steroid i hoʻopili ʻia no ka mālama ʻana i ka ʻeha o ke kua hiki ke kumu pū kekahi i ka maʻi o Cushing. Eia nō naʻe, ʻo nā lāʻau steroid haʻahaʻa i ke ʻano o nā inhalant, e like me nā mea i hoʻohana ʻia no ka hānō, a i ʻole nā ​​kalima, e like me nā mea i kuhikuhi ʻia no ka eczema, ʻaʻole lawa ka hānai ʻana i ke ʻano.

Nā Tumors

Hiki i kekahi mau ʻano tumors ke alakaʻi aku i kahi kiʻekiʻe o ka hana o ka cortisol.

ʻO kekahi o kēia mau mea:

• Nā hikukū pituitary gland. Hoʻokuʻu ka pituitary gland i ka nui o ka hormone adrenocorticotropic (ACTH), kahi e hoʻoulu ai i ka hana cortisol i nā adrenal glands. Kapa ʻia kēia maʻi ʻo Cushing.
• Nā kūpuna ectopic. ʻO kēia nā tumors ma waho o ka pituitary e hana ana iā ACTH. Kū pinepine lākou i ka lung, pancreas, thyroid, a i ʻole gland.
• ʻO ke kino a adrenal gland a i ʻole ka tumo. ʻO kahi maʻamau adrenal a i ʻole ka tumo hiki ke alakaʻi i nā kumu kūlike ʻole o ka hana cortisol, kahi e hiki ai ke loaʻa iā Cushing's syndrome.
• Familial Cushing's syndrome. ʻOiai ʻaʻole hoʻoilina maʻamau ʻo Cushing's syndrome, hiki i ka hoʻoilina hoʻoilina ke hoʻomōhala i nā tumors o nā gland endocrine.

Maʻi ʻo Cushing

Inā ʻo Cushing's syndrome ke kumu o ka pituitary gland overproducing ACTH a lilo i cortisol, kapa ʻia ʻo Cushing's disease.

E like me ka maʻi o Cushing, pili ka maʻi ʻo Cushing i ka nui o nā wahine ma mua o nā kāne.

ʻO ka mālama ʻana iā Cushing's Syndrome

ʻO ka pahuhopu nui o ka mālama ʻana ʻo Cushing's syndrome e hoʻohaʻahaʻa i nā kiʻekiʻe o ka cortisol i kou kino. Hiki ke hoʻokō i kēia ma nā ʻano like ʻole. ʻO ka lāʻau i loaʻa iā ʻoe e kaukaʻi ʻia i ka mea e hopena nei i kou ʻano.

Kākau paha kāu mea mālama ola i kahi lāʻau e kōkua i ka mālama ʻana i nā pae cortisol. Hoʻoemi kekahi mau lāʻau i ka hana cortisol i loko o nā gland adrenal a i ʻole hoʻemi i ka hana ACTH i ka pituitary gland. Paʻa nā lāʻau ʻē aʻe i ka hopena o ka cortisol i kāu mauʻaʻaʻa.

ʻO nā laʻana me:

• ketoconazole (Nizoral)
• mitotane (Lysodren)
• metyrapone (Metopirone)
• pasireotide (mea hōʻailona)
• mifepristone (Korlym, Mifeprex) i kēlā me kēia kanaka me ka maʻi diabetes type 2 a i ʻole ka hoʻomanawanui ʻole o ka glucose

Inā ʻoe e hoʻohana i nā corticosteroids, pono paha kahi loli i ka lāʻau a i ʻole nā ​​mea hana. Mai hoʻāʻo e hoʻololi i ke ana iā ʻoe iho. E hana ʻoe i kēia ma lalo o ka nānā ʻana o ka lāʻau.

Hiki ke hōʻino nā tumors, ʻo ia hoʻi ka maʻi ʻaʻai, a i ʻole ke ʻano maikaʻi, ʻo ia hoʻi noncancerous.

Inā hopena ʻia kou ʻano e ka tumo, makemake paha kāu mea mālama ola e hemo i ka tumer ma ke kaʻe. Inā ʻaʻole hiki ke hemo ka tumo, hiki i kāu kauka olakino ke koi aku i ka radiation therapy a i ʻole chemotherapy.

ʻIkeʻike maʻi maʻi Cushing

Hiki i ka Cushing's syndrome ke paʻakikī loa e kuhikuhi. ʻO kēia no ka nui o nā ʻōuli, e like me ka loaʻa ʻana o ke kaumaha a luhi paha, hiki ke loaʻa i nā kumu ʻē aʻe. Hoʻohui ʻia, hiki i kā Cushing's syndrome ponoʻī ke loaʻa i nā kumu like ʻole he nui.

E nānā kāu kauka olakino i kāu mōʻaukala olakino. E nīnau lākou i nā nīnau e pili ana i nā hōʻailona, ​​nā kūlana olakino āu e loaʻa ai, a me nā lāʻau āu e kuhikuhi ʻia ai.

E hana pū lākou i kahi hoʻokolohua kino kahi e nānā ai lākou i nā hōʻailona e like me ka puʻupuʻu buffalo, a me nā kaha kauō a me nā palapū.

A laila, kauoha paha lākou i nā hoʻokolohua hoʻokolohua, e like me:

• Hōʻike cortisol manuahi urinary 24-hola: No kēia hoʻāʻo, e noi ʻia ʻoe e ʻohiʻohi i kou mimi ma kahi o 24 mau hola. E hoʻāʻo ʻia nā pae o cortisol.
• Ana salivary cortisol: I ka poʻe me ka ʻole o Cushing's syndrome, hāʻule nā ​​pae cortisol i ke ahiahi. Ana kēia hōʻike i ke kiʻekiʻe o ka cortisol i kahi hāpana lawela i hōʻiliʻili ʻia i ka pō e ʻike inā kiʻekiʻe loa ka pae o ka cortisol.
• Hōʻike hoʻohaʻahaʻa dexamethasone haʻahaʻa haʻahaʻa: No kēia hoʻāʻo, e hāʻawi ʻia ʻoe i ka mahele lāʻau dexamethasone i ke ahiahi. E hoʻāʻo ʻia kou koko no nā pae cortisol i ke kakahiaka. ʻO ka maʻamau, dexamethasone ke kumu e hāʻule ai nā pae cortisol. Inā loaʻa iā ʻoe ka maʻi Cushing, ʻaʻole hiki mai kēia.

Ke hōʻike nei i ke kumu o ka maʻi o Cushing

Ma hope o kou loaʻa ʻana i ke kuhi o ka maʻi ʻo Cushing, pono e hoʻoholo pono kāu kauka no ke kumu o ka nui o ka hana cortisol.

ʻO nā hoʻāʻo e kōkua ai e hoʻoholo i ke kumu e komo pū paha:

• Hōʻike adrenocorticotropin hormone (ACTH) hōʻike: Ana ʻia nā pae o ka ACTH i ke koko. Hiki i nā pae haʻahaʻa o ADTH a me nā pae kiʻekiʻe o cortisol ke hōʻike i ke kū ʻana o kahi tumo ma nā adrenal glands.
• Hōʻike hoʻonāukiuki e hoʻokuʻu nei iā Corticotropin (CRH): I kēia hōʻike, hāʻawi ʻia kahi kī o CRH. E hāpai kēia i nā pae o ka ACTH a me ka cortisol i ka poʻe me nā tumā pituitary.
• ʻO ka hoʻāʻo suppression dexamethasone kiʻekiʻe loa: Ua like kēia me ka hoʻowalewale hoʻowalewale hoʻowalewale, koe wale no ka hoʻohana ʻia ʻana o kahi lāʻau kiʻekiʻe o dexamethasone. Inā hāʻule nā ​​pae o cortisol, loaʻa paha iā ʻoe kahi maʻi pituitary. Inā ʻaʻole lākou hiki iā ʻoe ke loaʻa kahi tumo ectopic.
• ʻO ka laʻana sinus petrosal: Kuhi ʻia ke koko mai kahi aʻa kokoke i ka pituitary a mai kahi aa koko mamao loa mai ka pituitary. Hāʻawi ʻia kahi pana o CRH. Hiki i nā pae kiʻekiʻe o ACTH i ke koko kokoke i ka pituitary ke hōʻike i kahi tumo pituitary. Hōʻike nā pae like mai nā ʻelua i kahi tumo ectopic.
• Nā noiʻi kiʻi: Hiki i kēia ke hoʻopili i nā mea e like me ka scan CT a me MRI. Hoʻohana ʻia lākou e nānā i nā adrenal a me nā pituitary glands e nānā ai no nā tumors.

ʻO ka papaʻai Syndrome o Cushing

ʻOiai ʻaʻole e hoʻōla nā loli dietary i kou kūlana, hiki iā lākou ke kōkua e mālama i kāu pae cortisol mai ka piʻi ʻana a nui a i ʻole ke kōkua e pale i kekahi mau pilikia.

ʻO kekahi mau ʻōlelo aʻoaʻo no ka poʻe me ka Cushing's syndrome e komo pū ana:

• Nānā i kāu ʻai calorie. He mea nui ka mālama ʻana i kāu lawe ʻana i ka calorie mai ka loaʻa ʻana o ke kaupaona kekahi o nā ʻōuli nui o ka maʻi ʻo Cushing.
• E hoʻāʻo e hōʻalo i ka inu lama ʻana. Ua hoʻopili ʻia ka inu waiʻona me ka piʻi ʻana o ka pae cortisol, keu hoʻi, e like me ka noiʻi 2007.
• E nānā i kāu kō kō. Hiki i ka Cushing's syndrome ke alakaʻi i ka glucose koko kiʻekiʻe, no laila e hoʻāʻo ʻaʻole e ʻai i nā meaʻai e hiki ai ke piʻi aʻe i ke kō kō. ʻO nā laʻana o nā meaʻai e nānā i ka ʻai ʻana me nā mea kanu, nā huaʻai, nā kī piha, a me nā iʻa.
• E ʻokiʻoki i ka sodium. Pili pū ʻia ʻo Cushing's syndrome me ke koko kiʻekiʻe (hypertension). Ma muli o kēia, e hoʻāʻo e kaupalena i kāu lawe ʻana i ka sodium. ʻO kekahi mau ala maʻalahi e hana ai i kēia me ka hoʻohui ʻole i ka paʻakai i ka meaʻai a me ka heluhelu pono ʻana i nā lepili meaʻai e nānā ai i ka ʻike sodium.
• E hōʻoia e loaʻa ka nui o ka calcium a me ka huaʻai D. Hiki i ka Cushing's syndrome ke hoʻonāwaliwali i kou mau iwi, e hoʻolaki iā ʻoe i nā haki. Hiki i ka calcium a me ka huaola D ke kōkua i ka hoʻoikaika ʻana i kou mau iwi.

ʻO nā kumu pilikia ʻo Cushing's syndrome

ʻO ka mea nui makaʻu no ka hoʻomohala ʻana i ka maʻi o Cushing e lawe nei i nā lāʻau kiʻekiʻe ma luna o kahi manawa lōʻihi. Inā ua kau aku kāu mea mālama ola i nā corticosteroids e mālama i kahi kūlana olakino, e nīnau iā lākou e pili ana i ke ana a me ka lōʻihi o kāu lawe ʻana iā lākou.

Hiki i nā kumu pilikia ʻē aʻe ke komo pū me:

• ʻano-2 diabetes ʻaʻole mālama pono ʻia
• ke koko kiʻekiʻe (hypertension)
• momona

ʻO kekahi mau hihia o Cushing's syndrome ma muli o ka hoʻokumu ʻia o ka tumo. ʻOiai aia kahi predisposition genetical e hoʻomohala i nā tumors endocrine (familial Cushing's syndrome), ʻaʻohe ala e pale ai i nā tumors mai ka hana ʻana.

ʻO ka mālama ʻana iā Cushing's syndrome

Inā loaʻa iā ʻoe ka maʻi Cushing, he mea nui ia e mālama pono ʻia. Inā ʻaʻole ʻoe e mālama i ka lāʻau no ia, hiki i ka Cushing maʻi ke alakaʻi i nā ʻano maʻi olakino koʻikoʻi koʻikoʻi paha.

Hiki i kēia mau mea ke:

• osteoporosis, hiki ke hoʻonui i kou makaʻi i nā haʻi iwi
• nalo nāʻiʻo (atrophy) a me ka nāwaliwali
• ke koko kiʻekiʻe (hypertension)
• ʻano 2 diabetes
• nā maʻi pinepine
• hōʻeha puʻuwai a i ʻole hahau
• kaumaha a hopohopo paha
• nā pilikia noʻonoʻo e like me ka pilikia e noʻonoʻo a i ʻole nā ​​pilikia me ka hoʻomanaʻo
• hoʻonui ʻana o kahi tumo e kū nei

ʻO ka nānā ʻana o Cushing's Syndrome

Ke hoʻomaka koke ʻoe i ka lāʻau, ʻo ka maikaʻi ka hopena i manaʻo ʻia. He mea nui e hoʻomaopopo i kāu nānā ʻana i kēlā me kēia mea pili i ke kumu kikoʻī a me ka mālama ʻana i loaʻa iā ʻoe.

Lōʻihi paha ka manawa no ka hoʻomaikaʻi ʻana o kāu mau ʻōuli. E nīnau pono i kāu kauka no nā alakaʻi olakino olakino, mālama i nā wā i ukali ʻia, a hoʻonui mālie i kāu pae hana.

Hiki i nā hui kākoʻo ke kōkua iā ʻoe e kū me ka maʻi ʻo Cushing. Hiki i kāu haukapila kūloko a i ʻole mea lawelawe olakino ke hāʻawi iā ʻoe i ka ʻike e pili ana i nā hui e hui i kou wahi.