Whakautu tika
Ka ine te whakamātautau cortisol i te homoni cortisol i roto i te toto, te mimi, te huware rānei hei aromatawai i te mahi a ngā repe adrenal me te hypothalamic-pituitary-adrenal (HPA) axis. Ka tautoko te whakamātautau cortisol i te aromatawai i te whakapae o te mate Cushing, te ngoikore rānei o te adrenal. Kāore e taea e te uara cortisol kotahi te whakaū, te whakakore rānei i tētahi o ngā āhuatanga e rua i a ia anō.
Take take
- Ko te tikanga o te wā e akiaki ana: He auau o ia rā te nui o te cortisol, nō reira ka noho noa pea te tau kotahi i te 8 i te ata, ā, ka noho rerekē i te waenganui pō.
- Kāore i te maha ngā wā ka ea te pātai i tētahi uara: Ko ngā whakamātautau hihiri pēnei i te whakamātautau poto Synacthen (whakaohooho ACTH) me te whakamātautau pehi dexamethasone mō te pō e hiahiatia ana.
- Ehara te hua noa i te mea hei whakakorenga: e whakaahua ana i taua tauira, i taua wā tonu, i raro i aua āhuatanga.
- Ka whakapōturi ngā hua i ngā rongoā me ngā āhuatanga noa i ngā huarahi e taea te matapae, i ngā pire kei roto te estrogen, i ngā steroids o tētahi āhua, i te haputanga, i te mate kino, i te mahi whakawhiti.
- Ehara te "ngoikore o te adrenal" i te mate hauora e whakaaetia ana; Kāore te whakamātautau cortisol e tautuhi i tōna āhua.
I te titiro
| Āhuahira | taipitopito |
|---|---|
| He aha te mea e inehia ana | Ko te Cortisol, he homoni steroid mai i te cortex adrenal |
| Ngā momo tauira | Toto (he toto toto), mimi 24-hāora (cortisol kore mimi), cortisol huware i te pō |
| Te wā noa | He toto te nuinga i te ata; he huware te nuinga i te pō; he mimi mō ngā haora 24 katoa |
| Te wa i tangohia | Te tango toto: he meneti torutoru. Te tauira huware: 2-5 meneti ki te kāinga. Te mimi: he kohinga katoa mō ngā haora 24. Te whakamātautau poto mō te Synacthen: tata ki te 30-60 meneti i te wāhi tiaki tamariki. |
| Te nohopuku | Kāore e hiahiatia whānuitia; kei te taiwhanga me ētahi atu whakamātautau kua whakaritea |
| He maha ngā wā ka whaia e | ACTH, whakamātautau pehi dexamethasone, whakamātautau poto Synacthen, whakaahua pituitary, adrenal rānei |
| Ko wai te kaiwhakamāori | Te tākuta i tono i te whakamātautau, me ngā tohu, ngā rongoā me te whakamātautau |
E mohiotia ano ko
- Cortisol toto, cortisol plasma
- Cortisol i te ata, cortisol i te 8 i te ata
- Cortisol huware o te pō (LNSC)
- Cortisol kore mimi (UFC) 24-hāora
- E whakamahia whānuitia ana i Inia hei "whakamātautau homoni cortisol", "whakamātautau homoni ahotea" "whakamātautau adrenal" rānei
- He rite engari he rerekē: Whakamātautau ACTH, whakamātautau Synacthen, whakamātautau pehi dexamethasone
He aha te whakamātautau cortisol
Ka hangaia te cortisol e ngā repe adrenal i raro i te mana o te ACTH mai i te repe pituitary. Ka āwhina te cortisol ki te whakahaere i te huka toto, te toto toto, te urupare ārai mate me te whakahaere a te tinana i te ahotea tinana. He tere te whakaputanga o te cortisol, ā, e whai ana i te manawataki circadian, teitei rawa i te atatu, iti rawa i te waenganui pō i roto i te tangata he tauira moe noa.
Nā taua auau, ka whakamāramahia te whakamātautau cortisol me te wā tika i tangohia ai te tauira. Ka whakautua e ngā momo tauira e toru ngā pātai rerekē:
- Cortisol toto: he whakaahua poto. He tino whai hua i te ata pō ina whakapaehia he ngoikore o te adrenal, i roto rānei i tētahi whakamātautau hihiri.
- Te cortisol huware o te pō: Ka whakamātautauhia mēnā kei te mau tonu te hekenga noa o te cortisol i te pō. Ka whakamahia ina whakapaetia he mate a Cushing.
- Cortisol kore mimi mō ngā haora 24: he inenga whakauru mō te putanga cortisol i roto i te rā. Ka whakamahia hoki mō te whakapae he mate Cushing.
He aha i mahia ai te whakamātautau cortisol
- Te whakapae he ngoikore o te adrenal (tae atu ki te mate a Addison): te ngenge kore e kitea te take me te hekenga o te taumaha, te toto toto iti, te whanoke rānei o te tū, te iti o te konutai, te hiahia ki te tote, te pōuri o ngā kōpura kiri, te iti o te huka toto kore e kitea te take.
- Te whakapae mō te mate Cushing: te ngawari o te marō, ngā tohu totoro papura, te ngoikore o ngā uaua tata, te mate huka hou, te mate huka uaua rānei ki te whakahaere me te toto toto tiketike, te tohatoha anō o te ngako, te kiri angiangi.
- Te whakapae he ngoikore tuarua o te adrenal i muri i te mate pituitary, te pokanga pituitary, te whara o te upoko, i muri rānei i te whakaiti, i te whakamutu rānei i te whakamahinga roa o te glucocorticoid.
- Te mate urutā adrenal: He maha ngā wā ka hiahiatia he aromatawai homoni mō te kitea o te puranga repe adrenal i roto i te matawai mō tētahi atu take.
- aroturuki te maimoatanga mō te mate adrenal, pituitary rānei e mōhiotia ana, e ai ki ngā tohutohu a te tākuta endocrinologist.
- Te mate ohorere: I ētahi wā ka tirohia he cortisol matapōkere i roto i tētahi tūroro e hinga ana, e ohorere ana rānei nā te whakapae he raruraru adrenal; i konei ka tīmata te maimoatanga i mua i te putanga mai o ngā hua.
Ko wai me whiwhi i tēnei whakamātautau
He whakamātautau arotahi te whakamātautau cortisol, ehara i te tirotiro whānui, i te whakamātautau "oranga" rānei. He mea tika ina:
- Kua kitea e te tākuta tētahi tauira haumanu e hāngai ana ki te nui rawa, ki te kore rānei o te cortisol.
- Kua mahia he pokanga ki tō pituitary, ki tō adrenal rānei, he radiotherapy rānei, he pukupuku rānei e mōhiotia ana.
- Kua roa koe e tango ana i ngā steroids ā-waha, ā-werohanga, ā-manawa, ā-kiri rānei, ā, kei te aromatawaihia e tō tākuta te ora o te repe adrenal.
- Kua kitea ā-tūponotia he puranga repeure.
- Kei te pāngia koe e te raruraru electrolyte kāore he whakamārama, te hypoglycemia pūmau, te toto toto tiketike ātete me te hypokalemia rānei.
Ko wai te hunga kāore e hiahia ana ki tēnei: ko te hunga e ngenge ana, e ahotea ana, e ngenge rawa ana rānei, kāore he āhuatanga o runga ake nei. I roto i taua rōpū, he onge te whakarerekētanga o te whakahaere i te whakamātautau cortisol, ā, ko ngā hua āhua rerekē he maha ake te whakaata i te wā, i ngā rongoā, i te mate rānei i te mate adrenal. Kōrero ki te tākuta mō te mea e tino akiaki ana i ngā tohu, ko te mate tairoi, te toto toto iti, ngā mate moe, te pouri me te mate huka he whakamārama noa ake.
Ngā mea kāore e taea e te whakamātautau cortisol te kite, te whakakore rānei
- Kāore e taea te tautuhi, te whakakore rānei i te "ngoikore o te adrenal" te "pau kino" rānei. Kāore ēnei i te mōhiotia he mate endocrine, ā, kāore he tauira cortisol e tautuhi ana i a rātou.
- Ahakoa kotahi te cortisol noa, kāore e taea te whakakore i te mate a Cushing. Ka taea e te nui rawa o te cortisol te puta i ngā wā katoa (he Cushing's cyclical), ā, ka puta pea ngā hua tirotiro noa i ngā wā ngawari. Me whai whakamātautau anō, me whai whakamātautau rerekē rānei.
- Kāore te kotahi noa o te cortisol e ārai i te ngoikore o te adrenal, inā koa te ngoikore wāhanga, te ngoikore tuarua rānei. I te nuinga o te wā, me whai whakamātautau whakaohooho.
- Kāore e tautuhi i te raruraru i te rohe. Kāore te cortisol nui e whakaatu mēnā ko te pituitary te pūtake, he pukupuku adrenal, he pukupuku whakaputa ACTH i hea atu, he steroids rānei mai i waho. Me ine te ACTH, me whakamātautau pehi me te whakaahua mō tēnā.
- Kāore e ine i "te nui o tō ahotea" i tētahi huarahi whai hua haumanu, ā, kāore e taea te ine i te ahotea hinengaro.
- Kāore e ine i te pānga o te steroid kiko. Tērā pea he iti te taumata cortisol i roto i te tangata e tango ana i te rongoā steroid i te wā e nui ana te pānga ki te steroid, nā te mea kāore te nuinga o ngā whakamātautau e kite i ngā steroid hangai pērā i te prednisolone, te dexamethasone rānei.
- Kāore e aromatawai i ngā homoni adrenal kē atu. He whakamātautau motuhake te aldosterone, te renin, te DHEAS me ngā catecholamines.
- Kāore te hua kino, hua noa rānei e rite ki te kore e whakaaetia tētahi mate. Ki te mau tonu ngā tohu ahakoa he noa te hua o te cortisol i roto i te whakamātautau toto, me hoki atu ki tō tākuta, kaua e whakaaro kua kati te pātai.
Ngā whakamātautau e pā ana engari he rerekē
| whakamātautau | Ka patai te whakautu | Te rereketanga matua |
|---|---|---|
| Cortisol toto o te ata | He tika rānei te nui o te cortisol i te tīmatanga? | Wā kotahi; he mea noa ngā uara waenga, ā, he maha ngā wā me whai whakamātautau whakaohooho hei whakatau |
| Cortisol huware o te pō | Kua ngaro te hekenga noa o te cortisol i te pō? | Te tirotiro mō te nui o te cortisol, ehara i te ngoikore; kāore e whai hua mō te tautuhi i te iti o te cortisol; me whai tauira moe auau |
| Cortisol kore mimi 24-hāora | He aha te tapeke o te cortisol e tukuna ana i te rā? | E whakawhirinaki katoa ana ki te kohinga katoa; kāore e pono mō te mate nui o te whatukuhu |
| Whakamātautau pehi dexamethasone mō te pō / iti te horopeta | Ka memeha noa te cortisol ina hoatu he steroid hangai? | He whakamātautau hihiri me te papa i te wā kua whakaritea; ka pāngia te whakamaoritanga e ngā rongoā e whakarerekē ana i te pākia o te dexamethasone |
| Whakamātautau Poto mō te Synacthen (whakaohooho ACTH) | Ka taea e ngā repe adrenal te urupare ki te whakaohooho? | Ko te whakamātautau whakaū noa mō te korenga o te adrenal; ka taea te kī he tika noa i roto i te ngoikore o te pituitary tata nei |
| ACTH toto | Kei te repe adrenal te raruraru, kei runga ake rānei? | Ka tautuhi i te taumata o te raruraru; me hono tahi me te cortisol i te wā kotahi, ā, me āta whakahaere i roto i te taiwhanga |
| Ka hokona tika ngā "pane ahotea" huware ki ngā kaihoko | Ka hokohokohia hei tātaritanga adrenal, tātaritanga ahotea rānei | Kāore i te rite ki te whakamātautau endocrine tātaritanga, ā, ehara i te pūtake mō ngā whakatau maimoatanga |
Kāore tētahi o ēnei whakamātautau e "pai ake" whānuitia. Ko tēhea te mea tuatahi ka whakawhirinaki ki te pātai haumanu: ko te whakapae he ngoikore te cortisol ka tīmata me te cortisol toto i te atatu; ko te whakapae he nui te cortisol ka tīmata me te cortisol huware i te pō, te cortisol kore mimi 24-hāora, te whakamātautau pehi dexamethasone i te pō rānei, i whiriwhiria e te tākuta e rongoā ana.
Me pehea te whakarite
Ka whakaritea te whakarite e te taiwhanga me te tikanga motuhake kua tohua e tō tākuta. He rerekē ngā tohutohu i waenga i ngā waeine me ngā whakamātautau, ā, ko ngā tohutohu tuhituhi a tō ake waeine te mea nui ake i ngā mea katoa kei runga i tēnei whārangi.
- Kōrero ki tō tākuta mō ia pānga ki te steroid: ngā papa, ngā werohanga ki ngā hononga, ngā rongoā manawa, ngā rehu ihu, ngā pata kanohi, ngā kirimi kiri kaha, me ngā rongoā ayurvedic, homeopathic, otaota, whare takaro tinana/whakatipu tinana kāore i te tapaina. He maha ngā hua pēnei kua kitea kei roto he steroids kāore i te kīia, e pehi ana i te cortisol.
- Whakarārangihia ngā rongoā me ngā tāpiringa katoa, tae atu ki ngā ārai hapū kei roto te estrogen, te rongoā homoni, ngā rongoā ārai mate haurangi, te rifampicin me ngā rongoā harore.
- Kaua e mutu, kaua hoki e whakarerekē i tētahi rongoā kua tohua: tae atu ki ngā steroids, hei whakarite mō tēnei whakamātautau. Pātai atu ki te kaiwhakatakoto tohu; he mea morearea te whakamutu ohorere i ngā steroids.
- Te moe me te mahi whakawhiti: whakahuatia ngā huringa pō, ngā rohe wā rānei kua whiti tata nei, nā te mea ka nekehia e rātou te manawataki o te cortisol.
- nohopuku: kāore e hiahiatia ana mō te cortisol anake i roto i te maha o ngā taiwhanga, engari i ētahi wā ka hiahiatia ina mahia ētahi atu whakamātautau i te wā kotahi. Whakaūtia ki tō pokapū kohikohi.
- Ngā tauira huware: i te nuinga o te wā kāore he kai, he inu, he momi hikareti, he tupeka/paan, he paraihe niho rānei mō tētahi wā i mua i te kohikohinga, ā, kāore hoki he toto o ngā kapia i taua wā. Whaia te matapihi tika i runga i tō kete.
- Mimi 24-hāora: Makahia te tauira tuatahi o te ata, kātahi ka kohia ia pata mō ngā hāora 24 tae atu ki te tauira tuatahi o te ata e whai ake nei, ā, rongoatia kia rite ki ngā tohutohu a te taiwhanga.
Mena kei te hapu koe, kei te whāngai u rānei
Ka piki ake te cortisol me te cortisol-binding globulin i roto i te tinana i te wā e hapu ana, nō reira kāore e tika te whakamahi i ngā wā tohutoro paerewa me ngā whakamātautau tirotiro paerewa. Me whakarite me te whakamārama i ngā whakamātautau i te wā e hapu ana me te whakauru endocrine.
Mena he mate huka tōu kei te rongoā whakaheke huka
Ki te tonoa koe kia nohopuku, kia haere rānei ki tētahi whakamātautau hihiri, pātai atu ki te kaiwhakatakoto whakaaro i mua i te wā me pēhea te whakahaere i te insulin, i te sulfonylurea rānei i taua ata, me te kawe i te hukahuka. Kaua e nohopuku mō ngā wā roa me te kore taua tohutohu.
Mena he mate tākihi mau tonu tōu
Ka kore e pono te cortisol kore mimi mō ngā haora 24 i te mea ka heke te mahi a te whatukuhu, ā, tera pea he iti rawa ngā hua. Kōrerohia ngā whakamātautau kē atu me tō tākuta.
Mena he ngoikore tō ngākau, he herenga wai rānei tōu
Kaua e whakanuia te nui o te wai e kainga ana mō te kohi mimi. Kohia te nui o te mimi e puta ana i te nuinga o te wā, ā, me haere tonu ki te whakawhāiti i whakaritea.
tamariki
He rerekē te whakamātautau cortisol tamariki, te inenga mō ngā whakamātautau whakaohooho me te whakamaoritanga i ērā o ngā pakeke, ā, me tirotirohia e te tākuta tamariki, e te tākuta endocrinologist tamariki rānei. He pai ake te kohi huware hei whakaiti i te taumahatanga o te ngira, mā te whakamahi i ngā taputapu e tika ana mō te reanga.
Nga pakeke
Ko te maha o ngā rongoā, te moe koretake, te mate pāwera me te uaua ki te whakaoti i te kohikohinga katoa mō ngā haora 24 ka uaua ake te whakamaoritanga. He maha ngā wā ka whai hua ake te whakamātautau māmā ake, pai ake te wā.
He aha te mea ka tupu i te wa o te whakamātautau cortisol
- Tauira toto: Ka tāpirihia he herenga toto, ka tangohia te toto mai i tētahi uaua i te ringa, ā, ka tuhia te wā e kohia ai. E torutoru meneti te roa o te tango toto.
- Tauira huware o te pō: Ka kohia e koe i te kāinga i te wā kua whakaritea, i te nuinga o te wā i te 11 i te pō ki te waenganui pō, mā te ngaungau i tētahi ūkui, mā te ringihia rānei te wai ki roto i tētahi ngongo, kātahi ka rongoatia, ka whakahokia mai e ai ki ngā tohutohu. He torutoru meneti te roa o ia tauira.
- Mimi 24-hāora: Ka kohia te kohinga i te ao me te pō katoa i roto i tētahi ipu kua tohua.
- Whakamātautau poto mō te Synacthen: he tauira taketake, he werohanga ACTH hangai, kātahi ka kotahi, e rua rānei ngā tauira i ngā wā kua whakaritea. Me noho ki te wāhi tiaki tamariki mō te 30-60 meneti pea, i ētahi wā ka roa ake i runga i te tikanga.
- Whakamātautau pehi dexamethasone i te pō: he papa i te haora kua whakaritea i te pō ki te kāinga, ā, i muri mai ka tangohia he tauira toto i te ata i muri mai.
Ka rerekē ngā hua i runga i ngā āhuatanga haumanu takitahi, ā, ko te wā pūrongo e whakawhirinaki ana ki te whakahaere i te whakamātautau i roto i te whare, ki te tukuna rānei ki tētahi taiwhanga matua. Pātai atu ki tō pokapū kohikohinga āhea ka tae mai te pūrongo.
Te mārama ki tō pūrongo cortisol
Pānuihia te hua o te cortisol me ētahi mea e toru kua tāia ki runga, kua tāpirihia rānei ki te pūrongo: te momo tauira, te wā tika o te kohikohinga, me te wā tohutoro o te taiwhanga. He rerekē ngā whakamātautau cortisol i waenga i ngā tūāpapa, nō reira he motuhake ngā wā tohutoro ki ia taiwhanga, ā, kāore ngā hua mai i ngā taiwhanga e rua e ōrite tika ana. Kaua e whakataurite i tō tau ki tētahi awhe e kitea ana i runga ipurangi, i roto rānei i tētahi pūrongo tawhito mai i tētahi taiwhanga rerekē.
I roto i ngā kupu whānui:
- He hua tino teitei ka whakaara ake i te tūponotanga o te nui rawa o te cortisol, mai i te rongoā steroids, te pituitary adenoma (te mate a Cushing), te pukupuku adrenal, te whakaputanga ACTH ectopic rānei. Ka taea hoki e ia te whakaatu i te mate ohorere, te mamae, te haputanga, te rongoā oestrogen, te ahotea nui rānei i te wā e tangohia ai te tauira.
- He iti rawa te hua, Ina koa i te atatu me ngā tohu e rite ana, ka piki ake te tūponotanga o te korenga o te adrenal, tuatahi (adrenal) tuarua rānei (pituitary/hypothalamic), tae atu ki te pehi i te maimoatanga steroid.
- He hua waenga he mea noa, ā, he maha ngā wā kāore e whai kōrero ana i a ia anō. Koinei te wāhi e tāpirihia ai te whakamātautau hihiri.
Ehara i te mea mā te whakamātautau cortisol anake e whakatau he mate huka koe. Nā te tākuta i tono te whakamaoritanga, i runga anō i te horopaki o ō tohumate, o tō whakamātautau me ō rongoā.
Ina he te āhua o ngā hua o te cortisol
Ngā hua ka taea te whakaputa teka
- Ngā ārai hapū kei roto te estrogen, te rongoā homoni me te hapūtanga: ka whakapiki ake i te cortisol-binding globulin, nō reira ka piki ake te cortisol katoa i roto i te toto ahakoa he noa te cortisol kore utu, hohe.
- Te mate whakapeka, te sepsis, te pokanga, te whara, te mamae nui, te mate haurangi kāore i te taea te whakahaere: ngā pikinga tūturu i puta mai i te ahotea, engari kāore e tohu i te mate a Cushing.
- Te pouri, te inu waipiro mau tonu, te mate huka kāore i te tino whakahaerehia, te apnea moe aukati: ka taea te whakaputa i te taikaha cortisol ngawari me ngā whakamātautau pehi rerekē me te kore he mate a Cushing.
- Te mahi pō, te haereere roa rānei i ngā wā tata nei: ka taea te tango i tētahi tauira "i te mutunga o te pō" i te ata e aromatawai ana te tinana o te tangata.
- Te poke o te tauira huware: Ka taea e ngā kirīmi steroids, ngā toenga manawa, te tupeka/paan, te kai, te toto rānei mai i ngā kapia i roto i te mangai te whakapohehe i ngā inenga huware.
- Ngā rongoā e tere ake ai te whakakorenga o te dexamethasone (rifampicin, phenytoin, carbamazepine, phenobarbitone) ka āhua rite te whakamātautau pehi kāore i pehia.
Ngā hua ka taea te whakaheke hē
- Te pānga ki te glucocorticoid, tae atu ki ngā steroids manawa, ihu, hononga-ā-tinana, ā-waha, huna rānei i roto i ngā tāpiringa kore tapanga me ētahi rongoā tuku iho.
- Te whakamātautau i te ahiahi, i te ahiahi rānei, Ina iti te cortisol i te taha tinana, kāore he tikanga o te "cortisol iti" i te 6 i te ahiahi.
- Ngā pūmua iti te here: Ka whakaitihia te katoa o te cortisol e te mate nephrotic, te mate ate kino, ngā āhua ngaro pūmua me te mate kino, ā, tera pea he rawaka te cortisol kore utu.
- Ko te kohinga mimi 24-hāora kāore i oti: te take kotahi tino kitea mō te iti o te cortisol kore mimi, he mea whakapohehe.
- Nga mate whatukuhu mau tonu, e whakaiti ana i te whakaputanga cortisol i roto i te mimi.
- Ngā rongoā e aukati ana i te hanganga steroids ka whakararuraru rānei i ngā whakamātautau motuhake, me ngā tāpiringa biotin, ka whakararuraru pea i ētahi whakamātautau ārai mate.
Mena kāore te hua e ōrite ki te pikitia haumanu, he maha ngā wā ka nui ake ngā mōhiohio mā te whakahoki i te whakamātautau i raro i ngā āhuatanga whakahaere i te mahi i runga i te tau tuatahi.
Ngā mōrearea me te haumaru
Te whakamātautau toto
He iti noa ngā mōrearea, ā, he rohe noa iho te nuinga: he mamae poto, he marō, he māuiui, ā, he onge noa iho te puta o te haematoma iti, te mate rānei i te wāhi i werohia ai. Kōrero atu ki te tākuta toto mēnā kei te tango koe i ngā rongoā whakangawari toto, kua hemo rānei koe i te wā o ngā whakamātautau toto i mua.
Te kohi huware me te mimi
Kāore he ngira e whakamahia ana mō ēnei, ā, kāore hoki he mōrearea tinana. Ko te raru nui ko te hapa tauira, kaua ko te kino.
Whakamātautau Poto mō te Synacthen (whakaohooho ACTH)
He pai te manawanui ki te nuinga o te wā. Ka puta pea te whero, te reka konganuku, te whakapairuaki poto rānei. He onge ngā tauhohenga mate pāwera ki te ACTH hangai engari kua pūrongohia, nō reira ka mahia te whakamātautau ki ngā wāhi e wātea ana ngā kaimahi me ngā whare whakaora.
Whakamātautau pehi Dexamethasone
Kotahi te horopeta iti o te steroid kāore e puta he pānga kino. Tērā pea ka puta te hiamoe poto, te huringa o te wairua, te pikinga rānei o te huka toto, he mea nui ake tēnei mēnā he mate huka tōu. Kōrero atu ki te tākuta e tono ana mēnā he mate huka tōu, he mate pāwera kaha, he mate hinengaro rānei i mua i te whakamātautau.
Whakamātautau manawanui insulin
I ētahi wā ka whakamahia i roto i ngā pokapū tohunga hei aromatawai i te tuaka HPA. Ka puta te hypoglycemia i roto i tēnei whakamātautau, he mōrearea tūturu, ā, ka mahia anake me te tirotiro hauora me ngā ārai mārama pēnei i te mate ngakau ischaemic, te haurangi rānei.
Nga haki Whero
Āhua ohorere inaianei
Haere tonu ki te tari whawhati tata, waea atu rānei ki ngā ratonga whawhati tata, mēnā kei a koe, kei te whanake rānei:
- He ngoikore nui me te ruaki, te mamae o te puku, te taha rānei, me te hinga, tera pea he raruraru repe adrenal, he mea morearea ki te ora, ā, me hiahia he steroids me ngā wai i roto i te uaua.
- Te pōhēhē, te hiamoe, te ngoikore rānei me te toto toto tino iti
- Te nui o te huka toto, te haurangi, te kore rānei e aro
- Mō te ngoikore o te adrenal me te kirika, te ruaki, te mate korere, te whara rānei, ina kore e taea e koe te tango, te pupuri rānei i tō horopeta steroid, whakamahia tō mahere hydrocortisone ohorere mēnā kei a koe tētahi, ka rapu awhina hauora.
Ra kotahi
- Te ruaki tonu, te korere rānei mēnā ka tangohia e koe he rongoā whakakapinga steroid mō te wā roa
- Te tere haere o te ngoikore, te whanoke i te tū, te pōuri hou rānei o ngā kiri i te hekenga o te taumaha
- Te toto toto tiketike hou me te ngoikore o te uaua, te iti rawa rānei o te pāhare pāporo i runga i te pūrongo
- Te ānini nui ohorere me te panoni tirohanga i roto i te tangata he pukupuku pituitary e mōhiotia ana
Te wā whakarite noa
- Te ngenge tonu, te hurihanga o te taumaha, te hurihanga o te wairua, te paheketanga koretake, te hurihanga o te makawe rānei, me te kore e kitea ngā āhuatanga o runga ake nei
- He hua cortisol rerekē, kāore he tohu, hei arotake kua whakaritea
- Ngā pātai mō te whakaiti i te maimoatanga steroid mō te wā roa, me te kaiwhakatakoto tohu, kāore i te takitahi
Nga ahuatanga motuhake
Te wa hapu
Ka piki ake te cortisol, te cortisol-binding globulin me te cortisol kore mimi i te haere tonu o te haputanga. Kāore i te pai te mahi a te whakamātautau pehi dexamethasone i te wā e hapu ana. Ka whakawhirinaki te tātaritanga i te wā e hapu ana ki te whakamaoritanga a te tohunga, ā, ka whakarerekētia hoki ngā kōwhiringa whakaahua.
tamariki
He tohu nui te korenga o te tipu, te roa o te pakeketanga, te whakarerekētanga rānei o te taumaha kāore i te whakamāramatia mō ngā tamariki. He tohu motuhake ki te reanga ngā wā tohutoro, ngā horopeta whakamātautau whakaohooho me ngā rahinga tauira.
Nga pakeke
He nui ngā tohu o te nui rawa, te kore rānei o te cortisol e hono tahi ana me ētahi atu āhuatanga e pā ana ki te koroheketanga me te maha o ngā rongoā. Ko te arotake tupato i ngā rongoā he wāhanga o te whakamaoritanga.
Ngā tāngata e rongoā ana mō te wā roa ki te steroids
Ka pehia e ngā steroids roa mō te mate huango, te mate rumatiki, te mate kiri, te mate nephrotic syndrome, te whakawhitinga rānei te tuaka HPA. Ko te iti o te cortisol i tēnei āhuatanga e whakaatu ana i te rongoā, ehara i te mate adrenal hou. Me whakarite te whakaiti steroids e te kaiwhakatakoto tohu, ā, me whai mahere horopeta rā mate pea koe.
Mate kino
He whakatau a te tohunga te whakamārama i te cortisol i roto i te tiaki nui; kāore e whai mana ngā paepae noa me ngā whakaaro here-pūmua.
Te whakamātautau cortisol i roto i te horopaki Inia
- He mea tino whakapoauau te pānga o te steroids ngaro, ā, he mea e maha ana te whakararuraru. Ka taea e ngā kirimi steroid kore-tohu mō ngā mate kiri, ngā werohanga hononga kei roto he steroid, ngā tāpiringa whare takaro kāore i te whakahaeretia, me ētahi AYUSH kāore i te tapangahia, arā, ngā rongoā "whakamamae mamae" rānei, te pehi i te cortisol, te whakaputa rānei i te mate Cushing iatrogenic. Kawea mai ngā hua katoa e whakamahia ana e koe, tae atu ki te takai, ki te kōrero.
- Ngā kereme hokohoko: Ko te ture Inia (te Drugs and Magic Remedies (Probjectionable Advertises) Act, 1954) e aukati ana i ngā pānuitanga e oati ana i ngā rongoā mō ēnei āhuatanga. Kia ruarua koe ki ngā kete "reihana adrenal" me te "cortisol detox" e hokona tika ana ki ngā kaihoko.
- Ko te mate kohi tonu te take o te ngoikore o te adrenal tuatahi i Inia, he mea nui i roto i ngā tau kua pahure ake nei, ā, ka kitea pea te whakapūngā o te adrenal i roto i te whakaahua. He mea nui anō hoki te rongoā ārai-kohi mō te whakamātautau: ka tere ake te pākia o te steroid e te rifampicin, ā, ka taea e ia te whakararuraru i te whakamātautau dexamethasone me te whakanui ake i ngā whakaritenga whakakapinga steroid.
- Mate pākia i te BMI iti iho: Ka pāngia ngā tāngata o Āhia ki te Tonga e te mate huka me te toto toto tiketike i te iti o te taupū taumaha tinana, nō reira he mea noa te whakakotahitanga o te mate huka wawe, te toto toto tiketike me te tohatoha ngako pokapū, ā, ehara i te mate Cushing. E tika ana te whakamātautau cortisol ina kitea ngā āhuatanga wehewehe motuhake, pērā i te ngawari o te maru, te ngoikore o te uaua tata, te whānui o ngā striae papura.
- Te rerekētanga o te whakamātautau: He rerekē ngā taputapu tātari me ngā tikanga e whakamahia ana e ngā taiwhanga puta noa i Īnia. Mā te whakamātautau whai muri i te taiwhanga kotahi ka nui ake te whai tikanga o te whakataurite.
- Tiaki Raraunga: Ko ngā mōhiohio hauora whaiaro e kohia ana mō te whakamātautau kei raro i te Ture Tiaki Raraunga Whaiaro Mamati o Īnia, 2023. Pātai atu me pēhea te penapena me te tohatoha i ō pūrongo me ō raraunga tuakiri.
Te utu me te inihua i Inia
He rerekē rawa ngā utu i waenga i ngā whare kāwanatanga, i ngā taiwhanga motuhake me ngā wāhanga endocrine o te hōhipera, me waenga i ngā tāone. Kaua e whakahua i tētahi tatauranga, tonoa he whakatau tata tuhituhi i mua i te tuhi pukapuka. Ko ngā āhuatanga e neke ake ai te utu ko:
- Momo tauira: Ko te cortisol toto kotahi te kōwhiringa iti rawa te utu; ko te cortisol mimi huware me te cortisol mimi 24-hāora te tikanga he nui ake te utu nā ngā kete, te whakahaere me ngā whakamātautau motuhake.
- Te maha o ngā tauira: me maha ngā whakamātautau hihiri, nō reira ka nui haere te utu.
- Te utu rongoā o te kaihoko whakaoho, pehi rānei (ACTH hangai, dexamethasone) me ngā utu tiaki tamariki, utu tirotiro tamariki rānei.
- Tikanga whakamātautau: He nui ake te utu o te whakamātautau cortisol e hangai ana ki te ine papatipu i te whakamātautau ārai mate noa, ā, ka tukuna pea ki tētahi taiwhanga tohutoro.
- Ngā whakamātautau tāpiri: He nui te tāpiritanga o te ACTH, ngā electrolytes, te DHEAS, te plasma renin/aldosterone, ngā whakamātautau tairoi me te whakaahua.
- Te kōrero me te whai ake: Ko te arotake i te endocrinology, te whakamātautau anō me te whakaahua he wāhanga pinepine o te huarahi.
He rerekē anō hoki ngā whanonga inihua: he maha ngā wā kāore e hipokina ngā whakamātautau tātaritanga o waho mēnā kāore i te hono atu ki tētahi whakaurunga hōhipera, ki tētahi kaupapa here rānei me te painga OPD kua tautuhia. Pātai atu ki tō kaiinihua, ki te tēpu inihua rānei o te hōhipera i mua i te whakamātautau, ā, puritia te whakahaunga e kī ana i te tohu haumanu.
Ngā pūrākau me ngā meka
| Talatupu'a | Fact |
|---|---|
| Mā te whakamātautau cortisol koe e mōhio ai ki te nui o tō ahotea | Ka aro te cortisol ki ngā whakaurunga ā-tinana maha. Ehara i te kaute ahotea, ā, kāore e taea te ine i te ahotea hinengaro. |
| Ka taea te whakaū i te "ngoikore o te adrenal" mā te whakamahi i tētahi paparanga cortisol huware. | Ehara te ngenge adrenal i te mate e mōhiotia whānuitia ana. Kāore ngā panera cortisol tika-ki-te-kaiwhakamahi e whakaū i tēnei, ā, ko ngā uara āhua rerekē e whakaatu ana i te wā tika, i ngā rongoā rānei. |
| Ko te tikanga o te cortisol he pai ngā repe adrenal | He uara noa te whakaahua i taua tauira. Ka taea e ngā mate wā poto, wā poto rānei te whakaputa hua tirotiro noa, ā, me whai whakamātautau anō pea. |
| Ko te cortisol teitei te tikanga o te mate Cushing | Ka taea e te mate, te mamae, te hapūtanga, te rongoā estrogen, te whakamahi waipiro, te apnea moe me te pouri te whakapiki i te cortisol, engari kāore e pāngia e te mate a Cushing. |
| He rite tonu ngā awhe tohutoro cortisol i ngā wāhi katoa | He motuhake ngā awhe ki te whakamātautau me te taiwhanga, ā, kāore e taea te whakawhiti i waenga i ngā taiwhanga. |
| Me mutu tō rongoā steroid i mua i te whakamātautau | Kaua rawa e mutu te tango i ngā steroids. Mā te tango ohorere ka pā mai he raruraru adrenal. Ko te kaiwhakatakoto whakaaro anake hei whakatika i te horopeta. |
| He pai te whakamātautau toto cortisol i ngā wā katoa o te rā | Ko te wā te mea nui ki te whakamārama. He maha ngā wā kāore e taea te whakamārama i tētahi tauira kāore anō kia wā. |
Pātai auau
He aha te mea e tirohia ana e te whakamātautau cortisol?
Ka ine te whakamātautau cortisol i te nui o te homoni cortisol i roto i te toto, te huware, te mimi rānei. Ka whakamahia e ngā tākuta te whakamātautau cortisol hei aromatawai mēnā kei te nui rawa, kei te iti rawa rānei te cortisol e whakaputaina ana e ngā repe adrenal, me te mea kei te mahi te pūnaha whakahaere pituitary-adrenal e ai ki te mea e tika ana.
Me nohopuku ahau mō te whakamātautau cortisol?
Kāore e hiahiatia ana te nohopuku mō te ine i te cortisol i roto i te maha o ngā taiwhanga, engari he rerekē ngā whakaritenga i runga i te waeine me te wā e whakaritea ai ētahi atu whakamātautau. Whakaūtia ki tō pokapū kohikohinga. Mena kei te tango koe i te insulin, i te sulfonylureas rānei, ā, ka tonoa kia nohopuku, pātai atu ki te kaiwhakatakoto tohu i te tuatahi.
He aha te take me tango toto i te ata?
Ka whai te Cortisol i te auau o ia rā, ka eke ki tōna taumata teitei i te ata pō. Ko te tauira o te ata te matapihi tino whai kōrero ina whakapaehia he ngoikore o te adrenal, nā te mea he mea nui te iti o te uara o te ata, engari ko te iti o te uara o te ahiahi he mea ā-tinana, kāore hoki he kōrero.
Kia pehea te roa o te mahinga katoa?
E torutoru meneti te roa o te tango toto. E rua ki te rima meneti te roa o te tauira huware i te kāinga. Ka kohia he mimi 24-hāora mō te rā katoa. Ko te tikanga o te whakamātautau poto Synacthen he 30 ki te 60 meneti i te wāhi tiaki tamariki, i ētahi wā ka roa ake i runga i te tikanga ā-rohe.
He aha te rerekētanga o te whakamātautau cortisol i te whakamātautau toto?
Ka pātai te cortisol huware o te pō mēnā kua ngaro te hekenga noa o te cortisol i te pō, nō reira ka tirotirohia mēnā he nui rawa te cortisol. Ka pātai te cortisol toto o te ata mēnā he rawaka te whakaputanga taketake. Kāore e taea te whakamahi i te whakamātautau huware hei tautuhi i te iti o te cortisol.
Ka taea e ngā rongoā te whakarerekē i te hua o taku whakamātautau cortisol?
Āe, ā, i ngā taha e rua. Ka piki ake te cortisol katoa i roto i ngā pire kei roto te estrogen me te haputanga; ka heke iho te cortisol i roto i ngā momo steroids katoa, tae atu ki ngā kirīmi, ngā inhaler me ngā steroids huna i roto i ētahi tāpiringa. Ka whakapōrearea te Rifampicin me ētahi rongoā antiepileptic i te whakamātautau dexamethasone. Whakarārangihia ngā mea katoa e tangohia ana e koe.
He āhua rerekē te taumata o taku cortisol engari kei te pai ahau. He aha te mahi i muri mai?
He mea noa ngā uara cortisol kāore i te tino rerekē, ā, he maha ngā wā e whakaata ana i te wā, ngā rongoā, te tauira moe, ngā mate pāwera rānei. Ko te mahi noa ko te arotake a te tākuta e tono ana, i ētahi wā me te whakamātautau tuarua, te whakamātautau hihiri rānei i raro i ngā āhuatanga whakahaere, kaua ki te maimoatanga tonu.
Ka whakamahia te whakamātautau cortisol hei tātaritanga i ngā raruraru tairoi, i te PCOS rānei?
Kāo. Ka aromatawaihia te mate tairoi mā te whakamahi i ngā whakamātautau mahi tairoi, me te mate ovary polycystic me ngā paearu haumanu, ngā taumata androgen me te ultrasound. I ētahi wā ka tāpirihia te whakamātautau cortisol ina whakaatu ana ngā āhuatanga i te mate Cushing, ka taea te whai i te PCOS.
Ka taea te whakamātautau cortisol mō ngā tamariki?
Āe. Ka whakamahia te whakamātautau cortisol tamariki mō te whakapae he ngoikore te adrenal, he aroturukitanga mō te hyperplasia adrenal whānau, me te pehitanga e pā ana ki te steroid. Ko ngā horopeta mō ngā whakamātautau whakaohooho, ngā rahinga tauira me ngā wā tohutoro he mea motuhake ki te reanga, ā, me tirotirohia e te tākuta tamariki, e te endocrinologist tamariki rānei.
Rauemi
- He aratohu mahi haumanu a te Endocrine Society mō te tautuhi i te mate Cushing
- He aratohu mahi haumanu nā te Endocrine Society mō te tātaritanga me te maimoatanga o te ngoikore o te adrenal tuatahi.
- He aratohu nā te European Society of Endocrinology me te ENSAT mō te whakahaere i ngā mate adrenal incidentalomas
- Ngā mōhiohio mō ngā tūroro o te National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) mō te mate Cushing me te koretake o te adrenal
- Ture mō ngā Rongoā Tarukino me te Makutu (Pānuitanga Whakahē), 1954, Kāwanatanga o Īnia
- Ture Tiaki Raraunga Whaiaro Mamati, 2023, Kāwanatanga o Īnia
