Mayeso a Cortisol: Zimene Zimayesa, Nthawi Yothandiza, ndi Zimene Sizingakuuzeni

Njira zazikulu

• Kutanthauzira kwa nthawi: Cortisol imatsatira kayendedwe ka tsiku ndi tsiku, kotero chiwerengero chomwecho chikhoza kukhala chachibadwa nthawi ya 8 koloko m'mawa ndi chosazolowereka pakati pausiku.
• Mtengo umodzi nthawi zambiri umayankha funso ili: Mayeso osinthika monga mayeso afupiafupi a Synacthen (ACTH stimulation) kapena mayeso oletsa dexamethasone usiku wonse nthawi zambiri amafunika.
• Zotsatira zabwinobwino sizikutanthauza kuti palibe chifukwa chochotsera: imafotokoza chitsanzo chimenecho, panthawiyo, pansi pa mikhalidwe imeneyo.
• Mankhwala ndi matenda wamba amasokoneza zotsatira zake m'njira zodziwikiratu, mapiritsi okhala ndi estrogen, ma steroid amtundu uliwonse, mimba, matenda oopsa, ntchito yosinthana.
• "Kutopa kwa adrenal" si matenda odziwika bwino azachipatala; Kuyezetsa kwa cortisol sikukuzindikira vutoli.

Pang'onopang'ono

Amadziwikanso monga

• Cortisol ya m'magazi, cortisol ya m'magazi
• Cortisol ya m'mawa, cortisol ya 8 koloko m'mawa
• Cortisol ya m'malovu usiku kwambiri (LNSC)
• Cortisol yopanda urinary (UFC) ya maola 24
• Ku India nthawi zambiri amafunsidwa ngati "mayeso a mahomoni a cortisol", "mayeso a mahomoni opsinjika" kapena "mayeso a adrenal"
• Zofanana koma zosiyana: Mayeso a ACTH, mayeso a Synacthen, mayeso oletsa dexamethasone

Kodi mayeso a cortisol ndi chiyani

Cortisol imapangidwa ndi ma adrenal glands motsogozedwa ndi ACTH kuchokera ku pituitary gland. Cortisol imathandiza kulamulira shuga m'magazi, kuthamanga kwa magazi, chitetezo cha mthupi komanso momwe thupi limayankhira kupsinjika kwa thupi. Kutulutsa kwa Cortisol kumagunda ndipo kumatsatira kayendedwe ka circadian, komwe kumakhala kwakukulu m'mawa kwambiri, kotsika kwambiri pakati pausiku mwa munthu amene ali ndi tulo tachizolowezi.

Chifukwa cha kayendedwe kameneka, mayeso a cortisol amatanthauziridwa pamodzi ndi nthawi yeniyeni yomwe chitsanzocho chinatengedwa. Mitundu itatu ya zitsanzo imayankha mafunso osiyanasiyana:

• Cortisol m'magazi: chithunzithunzi. Chothandiza kwambiri m'mawa kwambiri mukaganizira kuti adrenal insufficiency ndi yotsika, kapena ngati gawo la mayeso amphamvu.
• Cortisol ya malovu usiku kwambiri: Imayesa ngati nthawi yogona usiku mu cortisol imasungidwa. Imagwiritsidwa ntchito ngati pali kukayikiridwa kuti matenda a Cushing ndi otani.
• Cortisol yopanda mkodzo kwa maola 24: Muyezo wophatikizana wa kuchuluka kwa cortisol yomwe imachokera patsiku. Amagwiritsidwanso ntchito pa matenda a Cushing omwe akuganiziridwa kuti ndi owopsa.

Chifukwa chiyani mayeso a cortisol amachitidwa

• Kukayikiridwa kuti adrenal insufficiency (kuphatikizapo matenda a Addison): kutopa kosaneneka komwe kumayenderana ndi kuchepa thupi, kuthamanga kwa magazi pang'ono kapena chizungulire, sodium yochepa, chilakolako cha mchere, khungu likuda, shuga wotsika m'magazi mosaneneka.
• Matenda a Cushing omwe akukayikiridwa: kuvulala kosavuta, mabala ofiirira, kufooka kwa minofu pafupi, matenda a shuga atsopano kapena ovuta kuwalamulira komanso kuthamanga kwa magazi pamodzi, kugawa mafuta m'thupi, kuonda khungu.
• Kukayikiridwa kuti adrenal insufficiency yachiwiri Pambuyo pa matenda a pituitary, opaleshoni ya pituitary, kuvulala mutu, kapena pambuyo pa kugwiritsa ntchito glucocorticoid kwa nthawi yayitali, mankhwalawa amachepetsedwa kapena kuyimitsidwa.
• Adrenal incidentaloma: matenda a impso: Chidutswa cha adrenal chomwe chimapezeka pa scan yochitidwa pazifukwa zina nthawi zambiri chimafunika kuyezetsa mahomoni.
• Kuwunika chithandizo cha matenda odziwika bwino a adrenal kapena pituitary, monga momwe dokotala wa endocrinologist adalangizira.
• Matenda oopsa: Nthawi zina cortisol yosadziwika imayesedwa mwa wodwala amene akugwa kapena amene akudabwa ndi vuto la adrenal lomwe likuganiziridwa kuti ali nalo, apa chithandizo chimayamba zotsatira zake zisanabwere.

Ndani ayenera kuchita mayesowa?

Kuyesa kwa cortisol ndi mayeso owunikira, osati mayeso wamba kapena mayeso a "umoyo". Ndikoyenera pamene:

• Dokotala wapeza njira yochizira yomwe ikugwirizana ndi kuchuluka kwa cortisol kapena kusowa kwake.
• Mwachitidwa opaleshoni ya pituitary kapena adrenal, radiotherapy kapena chotupa chodziwika bwino.
• Mwamwa mankhwala a steroid opangidwa pakamwa, obayidwa jakisoni, opumira mpweya kapena amphamvu kwa nthawi yayitali ndipo dokotala wanu akuyang'ana momwe adrenal adrenal imachira.
• Mwangozi, adrenal mass yapezeka.
• Muli ndi vuto losadziwika bwino la electrolyte, hypoglycemia yobwerezabwereza, kapena kuthamanga kwa magazi komwe kulibe vuto ndi hypokalemia.

Ndani nthawi zambiri safuna izi: anthu omwe amamva kutopa, kupsinjika maganizo kapena kutopa popanda chilichonse mwa izi. Mu gulu limenelo, mayeso a cortisol nthawi zambiri samasintha kasamalidwe kake ndipo zotsatira zake sizimawoneka bwino nthawi zambiri zimasonyeza nthawi, mankhwala kapena matenda kuposa matenda a adrenal. Lankhulani ndi dokotala za chomwe chikuyambitsa zizindikiro, matenda a chithokomiro, kuchepa kwa magazi m'thupi, matenda ogona, kuvutika maganizo ndi matenda a shuga ndi zifukwa zofala kwambiri.

Zimene mayeso a cortisol sangathe kuzizindikira kapena kuzichotsa

• Sizingazindikire kapena kuchotsa "kutopa kwa adrenal" kapena "kutopa". Izi sizikudziwika kuti ndi matenda a endocrine ndipo palibe cortisol yomwe imazindikirika.
• Cortisol imodzi yabwinobwino sikutanthauza kuti matenda a Cushing ndi ofala. Kuchuluka kwa Cortisol kumatha kuchitika nthawi ndi nthawi (kuzungulira kwa Cushing), ndipo milandu yocheperako ingapereke zotsatira zabwinobwino. Kubwerezabwereza kapena kuyezetsa kwina kungafunike.
• Cortisol imodzi yabwinobwino simachotsa kusakwanira kwa adrenal, makamaka kusakwanira pang'ono kapena kwachiwiri. Kuyesa kolimbikitsa nthawi zambiri kumafunika.
• Sizikudziwitsa vuto lenileni. Kuchuluka kwa cortisol sikukuuzani ngati gwero lake ndi pituitary, adrenal chotupa, chotupa chomwe chimapanga ACTH kwina, kapena ma steroids akunja. Zimenezi zimafuna kuyeza ACTH, kuyeza kupsinjika ndi kujambula.
• Sizikutanthauza "kupsinjika maganizo kwanu" mwanjira iliyonse yothandiza kuchipatala, ndipo sizingathe kuwerengera kupsinjika maganizo.
• Sizimayesa mphamvu ya steroid m'thupi. Munthu amene akumwa mankhwala a steroid akhoza kukhala ndi cortisol yotsika pamene ali ndi steroid yambiri, chifukwa mayeso ambiri sapeza ma steroid opangidwa monga prednisolone kapena dexamethasone.
• Sichiyesa mahomoni ena a adrenal. Aldosterone, renin, DHEAS ndi catecholamines ndi mayeso osiyana.
• Zotsatira zoyipa kapena zabwinobwino sizifanana ndi vuto lomwe lachotsedwa. Ngati zizindikiro zikupitirirabe ngakhale kuti cortisol yabwera bwino, bwererani kwa dokotala m'malo moganiza kuti funsolo latha.

Mayeso ofanana koma osiyana

Palibe mayeso aliwonse awa omwe ali "abwino" padziko lonse lapansi. Chomwe chimabwera poyamba chimadalira funso lachipatala: kusowa kwa cortisol komwe kumaganiziridwa nthawi zambiri kumayamba ndi cortisol m'mawa kwambiri; kuchuluka kwa cortisol komwe kumaganiziridwa nthawi zambiri kumayamba ndi cortisol ya m'malovu usiku kwambiri, cortisol yopanda mkodzo kwa maola 24 kapena mayeso oletsa dexamethasone usiku wonse, osankhidwa ndi dokotala wothandiza.

Momwe mungakonzekerere

Kukonzekera kumakhazikitsidwa ndi labotale komanso ndi njira yeniyeni yomwe dokotala wanu walamula. Malangizo amasiyana pakati pa mayunitsi ndi mayeso, ndipo malangizo olembedwa a yunitsi yanu ndi omwe amaperekedwa patsogolo kuposa chilichonse chomwe chili patsamba lino.

• Uzani dokotala wanu za momwe mumagwiritsira ntchito mankhwala a steroid: mapiritsi, jakisoni m'malo olumikizirana mafupa, mankhwala opumira, mankhwala opopera m'mphuno, madontho a m'maso, mafuta amphamvu a pakhungu, ndi mankhwala opangidwa ndi ayurvedic, homeopathic, zitsamba kapena masewera olimbitsa thupi/zomanga thupi. Mankhwala angapo otere apezeka kuti ali ndi ma steroids osatchulidwa, omwe amaletsa cortisol.
• Lembani mankhwala onse ndi zowonjezera, kuphatikizapo njira zolerera zomwe zili ndi estrogen, mankhwala a mahomoni, mankhwala oletsa khunyu, rifampicin ndi mankhwala opha mabakiteriya.
• Musasiye kapena kusintha mankhwala aliwonse omwe mwapatsidwa: kuphatikizapo ma steroids, kuti mukonzekere mayesowa. Funsani dokotala; kusiya ma steroids mwadzidzidzi kungakhale koopsa.
• Kugwira ntchito yogona ndi yogwira ntchito: tchulani kusinthana kwa usiku kapena madera omwe angodutsa kumene nthawi, chifukwa amasintha kamvekedwe ka cortisol.
• Kusala kudya: Sizofunikira nthawi zonse pa cortisol yokha m'ma laboratories ambiri, koma nthawi zina zimafunika pamene mayeso ena atengedwa nthawi imodzi. Tsimikizirani ndi malo anu osonkhanitsira.
• Zitsanzo za malovu: nthawi zambiri simuyenera kudya, kumwa, kusuta fodya, kutsuka mano, kapena kutsuka mano kwa nthawi yayitali musanatenge, komanso simuyenera kutulutsa magazi m'kamwa panthawiyo. Tsatirani zomwe zili pa bokosi lanu.
• Mkodzo wa maola 24: Tayani chitsanzo choyamba cha m'mawa, kenako tengani dontho lililonse kwa maola 24 kuphatikiza chitsanzo choyamba cha m'mawa wotsatira, ndikusunga monga momwe labotale imalangizira.

Ngati muli ndi pakati kapena mukuyamwitsa

Cortisol ndi cortisol-binding globulin zimawonjezeka m'thupi la mayi ali ndi pakati, kotero nthawi zowerengera nthawi ndi mayeso owunikira nthawi zonse sizigwira ntchito molunjika. Kuyesa panthawi ya mimba kuyenera kukonzedwa ndikutanthauziridwa ndi endocrine input.

Ngati muli ndi matenda a shuga pa chithandizo chochepetsa shuga m'magazi

Ngati mwapemphedwa kuti musale kudya, kapena kuti muyezedwe kuti muyesedwe bwino, funsani dokotala pasadakhale momwe mungasamalire insulin kapena sulfonylureas m'mawa umenewo, ndipo nyamulani shuga. Musale kudya kwa nthawi yayitali popanda malangizo amenewo.

Ngati muli ndi matenda a impso osatha

Cortisol yopanda mkodzo kwa maola 24 imakhala yosadalirika pamene ntchito ya impso ikuchepa, ndipo zotsatira zake zingakhale zochepa molakwika. Kambiranani ndi dokotala wanu za mayeso ena.

Ngati muli ndi vuto la mtima kapena muli ndi vuto la madzi m'thupi

Musawonjezere madzi omwe mumamwa kuti mutenge mkodzo. Sonkhanitsani kuchuluka kulikonse komwe mumadutsa nthawi zonse ndipo pitirizani ndi malire anu olembedwa.

ana

Kuyesa kwa cortisol kwa ana, mlingo wa mayeso olimbikitsa komanso kutanthauzira kwake kumasiyana ndi kwa akuluakulu ndipo kuyenera kuyang'aniridwa ndi dokotala wa ana kapena dokotala wa matenda a endocrinologist wa ana. Kusonkhanitsa malovu nthawi zambiri kumakondedwa kuti kuchepetse kupsinjika kwa singano, pogwiritsa ntchito zipangizo zoyenera zaka.

Achikulire achikulire

Mankhwala ambiri, kugona tulo tosakwanira, matenda obwera chifukwa cha nthawi zina komanso kuvutika kumaliza kusonkhanitsa deta yonse kwa maola 24 zonsezi zimapangitsa kuti kutanthauzira kukhale kovuta. Kuyesa kosavuta komanso koyenera nthawi zambiri kumakhala kothandiza kwambiri.

Zomwe zimachitika panthawi yoyezetsa cortisol

• Chitsanzo cha magazi: Kupaka tourniquet, magazi amatengedwa kuchokera mumtsempha womwe uli m'dzanja ndipo nthawi yosonkhanitsa imalembedwa. Kujambulako kumatenga mphindi zochepa.
• Chitsanzo cha malovu a usiku: Mumasonkhanitsa kunyumba nthawi yoikika, nthawi zambiri pafupifupi 11 koloko mpaka pakati pausiku, mwa kutafuna swab kapena kutsanulira madzi mu chubu, kenako musunge ndikubweza monga momwe mwalangizidwira. Chitsanzo chilichonse chimatenga mphindi zochepa.
• Mkodzo wa maola 24: Zosonkhanitsazo zimasungidwa tsiku lonse ndi usiku wonse m'chidebe cholembedwa.
• Mayeso afupi a Synacthen: chitsanzo choyambirira, jakisoni wa ACTH wopangidwa, kenako chitsanzo chimodzi kapena ziwiri zina pakapita nthawi yoikika. Yembekezerani kukhala m'chipinda chosamalira ana kwa mphindi pafupifupi 30-60, nthawi zina kutengera njira yochizira.
• Kuyesa kwa dexamethasone usiku wonse: kumwa piritsi kunyumba nthawi yochedwa kwambiri, kenako n’kuyezedwa magazi m’mawa wotsatira.

Zotsatira zimasiyana malinga ndi momwe matenda alili, ndipo nthawi yofotokozera imadalira ngati mayesowo akuchitika m'nyumba kapena kutumizidwa ku labotale yayikulu. Funsani malo anu osonkhanitsira nthawi yomwe mungayembekezere lipotilo.

Kumvetsetsa lipoti lanu la cortisol

Werengani zotsatira za cortisol pamodzi ndi zinthu zitatu zosindikizidwa kapena zolumikizidwa ku lipotilo: mtundu wa chitsanzo, nthawi yeniyeni yotolera, ndi nthawi yowunikira ya labotale. Mayeso a Cortisol amasiyana malinga ndi nsanja, kotero nthawi zowunikira zimakhala zogwirizana ndi labotale ndipo zotsatira kuchokera ku ma labotale awiri sizingafanane mwachindunji. Musayerekeze nambala yanu ndi mitundu yomwe imapezeka pa intaneti kapena mu lipoti lakale kuchokera ku labotale ina.

Mwachidule:

• Zotsatira zabwino kwambiri Zimawonjezera mwayi woti cortisol ichuluke, kuchokera ku mankhwala a steroid, pituitary adenoma (matenda a Cushing), chotupa cha adrenal, kapena kupanga ACTH yochokera ku ectopic. Zingasonyezenso matenda oopsa, ululu, mimba, chithandizo cha oestrogen kapena kupsinjika kwakukulu panthawi yopereka mankhwala.
• Zotsatira zotsika kwambiri, makamaka m'mawa kwambiri ndi zizindikiro zofanana, zimawonjezera mwayi wa adrenal insufficiency, yoyamba (adrenal) kapena yachiwiri (pituitary/hypothalamic), kuphatikizapo kuletsa kulandira mankhwala a steroid.
• Zotsatira zapakati ndizofala ndipo nthawi zambiri sizipereka chidziwitso chokha. Apa nthawi zambiri ndi pomwe mayeso amphamvu amawonjezeredwa.

Kuyezetsa kwa cortisol sikuti kokha kumapereka chidziwitso. Kutanthauzira ndi kwa dokotala amene anakupemphani, malinga ndi zizindikiro zanu, mayeso anu ndi mankhwala anu.

Pamene zotsatira za cortisol zingakhale zosokeretsa

Zotsatira zomwe zingatchulidwe molakwika

• Mankhwala oletsa kubereka okhala ndi estrogen, mankhwala a mahomoni ndi mimba: Kuchulukitsa cortisol-binding globulin, kotero cortisol yonse ya m'magazi imakwera ngakhale cortisol yaulere komanso yogwira ntchito ndi yachibadwa.
• Matenda oopsa, sepsis, opaleshoni, kuvulala, kupweteka kwambiri, khunyu losalamulirika: kukwera kwenikweni kwa nkhawa komwe sikusonyeza matenda a Cushing.
• Kuvutika maganizo, kumwa mowa nthawi zonse, matenda a shuga osalamulirika bwino, matenda oletsa kupuma m'tulo: akhoza kupanga mayeso ocheperako a cortisol wochuluka komanso mayeso oletsa kupsinjika kwachilendo popanda matenda a Cushing.
• Ntchito yausiku kapena maulendo ataliatali posachedwapa: Chitsanzo cha "usiku kwambiri" chikhoza kumwedwa m'mawa wa thupi la munthuyo.
• Kuipitsidwa kwa chitsanzo cha malovu: Ma steroids creams, zotsalira za inhaler, fodya/paan, chakudya kapena magazi ochokera mkamwa amatha kusokoneza kuwerenga kwa malovu.
• Mankhwala omwe amachepetsa kuchotsedwa kwa dexamethasone mwachangu (rifampicin, phenytoin, carbamazepine, phenobarbitone) zingapangitse kuti mayeso oletsa kutsekeka awoneke ngati osatsekeredwa.

Zotsatira zomwe zingatsitsidwe molakwika

• Kupezeka kulikonse kwa glucocorticoid, kuphatikizapo mankhwala opumira, a m'mphuno, amkati mwa m'mimba, a pakhungu kapena obisika omwe ali mu zowonjezera zosalembedwa ndi mankhwala ena achikhalidwe.
• Kuyesa masana kapena madzulo, Pamene cortisol ili yochepa m'thupi, "cortisol yotsika" nthawi zambiri sikutanthauza kanthu.
• Mapuloteni omangirira pang'ono: Matenda a nephrotic syndrome, matenda aakulu a chiwindi, kuchepa kwa mapuloteni komanso matenda oopsa amachepetsa cortisol yonse pomwe cortisol yaulere ikhoza kukhala yokwanira.
• Kusonkhanitsa mkodzo kosakwanira kwa maola 24: chifukwa chofala kwambiri cha cortisol yochepa yopanda mkodzo.
• Matenda a impso, zomwe zimachepetsa kutulutsa kwa cortisol m'thupi.
• Mankhwala omwe amaletsa kupanga kwa steroid kapena kusokoneza mayeso enaake, ndi zowonjezera za biotin, zomwe zingasokoneze mayeso ena a chitetezo chamthupi.

Ngati zotsatira sizikugwirizana ndi chithunzi chachipatala, kubwereza mayesowo pansi pa mikhalidwe yolamulidwa nthawi zambiri kumakhala kothandiza kwambiri kuposa kuchitapo kanthu pa nambala yoyamba.

Zoopsa ndi chitetezo

Kuyesa magazi

Zoopsa zake ndi zazing'ono ndipo makamaka zapafupi: kupweteka kwakanthawi, kuvulala, mutu wopepuka, komanso nthawi zina kutupa pang'ono kwa magazi kapena, nthawi zina, matenda pamalo obowoledwa. Uzani dokotala wa phlebotomist ngati mwatenga mankhwala ochepetsa magazi kapena munakomokapo panthawi yoyezetsa magazi kale.

Kusonkhanitsa malovu ndi mkodzo

Izi sizikutanthauza singano kapena chiopsezo chakuthupi. Vuto lalikulu ndi kulakwitsa poyesa zitsanzo osati kuvulaza.

Mayeso afupi a Synacthen (ACTH stimulation)

Kawirikawiri zimaloledwa bwino. Kusamba m'manja, kukoma kwachitsulo kapena nseru yosakhalitsa zimatha kuchitika. Matenda a ziwengo ku ACTH yopangidwa ndi anthu ndi osowa koma zanenedwapo, kotero mayesowa amachitika komwe kuli antchito ndi malo opumulirako odwala.

Kuyesa kwa Dexamethasone

Mlingo umodzi wochepa wa steroid nthawi zambiri umakhala wosayembekezereka. Kusowa tulo kwakanthawi, kusintha kwa malingaliro kapena kukwera kwa shuga m'magazi kumatha kuchitika, zomwe ndizofunikira kwambiri ngati muli ndi matenda a shuga. Uzani dokotala wofunsayo ngati muli ndi matenda a shuga, matenda opatsirana kapena matenda amisala musanayesedwe.

Mayeso olekerera insulin

Nthawi zina amagwiritsidwa ntchito m'malo ochitira kafukufuku kuti aone ngati HPA axis ndi yolondola. Kuyesaku kumayambitsa hypoglycemia mwadala, kumakhala ndi chiopsezo chenicheni, ndipo kumachitika pokhapokha ngati dokotala akuyang'anira komanso ngati pali zinthu zina monga matenda a mtima kapena khunyu.

Zinthu zapadera

Pregnancy

Cortisol, cortisol-binding globulin ndi cortisol yopanda mkodzo zonse zimawonjezeka pamene mimba ikupita patsogolo. Kuyezetsa kwa dexamethasone sikuchita bwino pa nthawi ya mimba. Kuzindikira matenda pa nthawi ya mimba kumadalira kutanthauzira kwa akatswiri, ndipo kusankha zithunzi kumasinthidwanso.

ana

Kulephera kukula, kuchedwa kutha msinkhu kapena kusintha kwa kulemera kosaneneka ndi zizindikiro zofunika kwambiri mwa ana. Nthawi zofotokozera, kuchuluka kwa mayeso olimbikitsa, ndi kuchuluka kwa zitsanzo zimasiyana malinga ndi zaka zawo.

Achikulire achikulire

Zizindikiro za kuchuluka kwa cortisol kapena kusowa kwake zimagwirizana kwambiri ndi matenda ena okhudzana ndi ukalamba komanso polypharmacy. Kuwunikanso mosamala mankhwala ndi gawo la kutanthauzira.

Anthu omwe amatenga mankhwala a steroid kwa nthawi yayitali

Ma steroid a nthawi yayitali a mphumu, nyamakazi, matenda a pakhungu, matenda a nephrotic syndrome kapena kuyika m'malo enaake amaletsa HPA axis. Cortisol yotsika panthawiyi nthawi zambiri imasonyeza mankhwala, osati matenda atsopano a adrenal. Dokotala ayenera kukonzekera kuchepetsa ma steroid, ndipo mungafunike dongosolo la mlingo wa tsiku lomwe mukudwala.

Matenda ovuta

Kutanthauzira kwa Cortisol mu chisamaliro cha odwala kwambiri ndi lingaliro lapadera; malire wamba ndi malingaliro omangirira mapuloteni sagwira ntchito.

Kuyesa kwa cortisol m'dziko la India

• Kupezeka kwa ma steroid osatchulidwa ndi chinthu chosokoneza kwambiri komanso chofala. Mafuta odzola a steroid omwe amagulitsidwa kunja kwa ofesi ya dokotala a matenda a pakhungu, jakisoni wolumikizana ndi ma steroid, zowonjezera zakudya zolimbitsa thupi zosaloledwa komanso mankhwala ena osalembedwa a AYUSH kapena "kuchepetsa ululu" amatha kuletsa cortisol kapena kuyambitsa matenda a Cushing's iatrogenic. Bweretsani mankhwala aliwonse omwe mumagwiritsa ntchito, kuphatikizapo phukusi, kukaonana ndi dokotala.
• Zonena za malonda: Lamulo la ku India (Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954) limaletsa malonda omwe amalonjeza machiritso a matenda otere. Musakayikire ma phukusi a "adrenal reset" kapena "cortisol detox" omwe amagulitsidwa mwachindunji kwa ogula.
• Chifuwa chachikulu chikadali chifukwa chachikulu cha kulephera kwa adrenal ku India, M'mbuyomu, ndi chinthu chofunikira kwambiri, ndipo kuchuluka kwa calcium m'thupi kumatha kuwoneka pa kujambula zithunzi. Chithandizo chotsutsana ndi chifuwa chachikulu chimafunikanso poyesa: rifampicin imathandizira kagayidwe ka steroid ndipo imatha kusokoneza kuyezetsa kwa dexamethasone ndikuwonjezera kufunikira kwa ma steroid.
• Matenda a kagayidwe kachakudya omwe ali ndi BMI yotsika: Anthu aku South Asia amadwala matenda a shuga ndi kuthamanga kwa magazi pamlingo wotsika wa thupi, kotero kuphatikiza matenda a shuga oyambirira, kuthamanga kwa magazi ndi kufalikira kwa mafuta pakati ndi kofala ndipo nthawi zambiri si matenda a Cushing. Kuyezetsa kwa Cortisol ndikofunikira ngati pali zizindikiro zinazake zosiyanitsa, monga kuvulala kosavuta, kufooka kwa minofu yapafupi kapena striae yofiirira.
• Kusiyanasiyana kwa mayeso: Ma laboratories ku India konse amagwiritsa ntchito njira zosiyanasiyana zowunikira ndi kusanthula. Kuyesa kotsatira ku laboratori komweko kumapangitsa kufananiza kukhala kofunika kwambiri.
• Chitetezo cha data: Zambiri zaumoyo zomwe zasonkhanitsidwa kuti zikayesedwe zikutsatira lamulo la India la Digital Personal Data Protection Act, 2023. Funsani momwe malipoti anu ndi zambiri zanu za umwini zimasungidwira ndikugawidwa.

Mtengo ndi inshuwalansi ku India

Mitengo imasiyana kwambiri pakati pa zipatala za boma, ma laboratories odziyimira pawokha ndi mayunitsi a endocrine omwe ali m'zipatala, komanso pakati pa mizinda. M'malo motchula chiwerengero, funsani kuti muwerengere mtengo musanagule. Zinthu zomwe zimapangitsa kuti mtengo usinthe ndi izi:

• Mtundu wa chitsanzo: Cortisol imodzi m'magazi ndiye njira yotsika mtengo kwambiri; cortisol ya m'malovu ndi ya mkodzo ya maola 24 nthawi zambiri imakhala yokwera mtengo chifukwa cha zida, chithandizo ndi mayeso apadera.
• Chiwerengero cha zitsanzo: Mayeso osinthika amafunika kukoka kangapo, kotero mtengo umachulukana.
• Mtengo wa mankhwala olimbikitsa kapena oletsa (ACTH yopangidwa, dexamethasone) ndi ndalama zolipirira chisamaliro cha tsiku ndi tsiku kapena zowonera.
• Njira yoyesera: Kuyesa kwa cortisol kochokera ku mass spectrometry nthawi zambiri kumawononga ndalama zambiri kuposa kuyesa kwa immunoassay wamba ndipo kumatha kutumizidwa ku labotale yowunikira.
• Mayeso owonjezera: ACTH, ma electrolyte, DHEAS, plasma renin/aldosterone, mayeso a chithokomiro ndi kujambula zithunzi zimawonjezera kwambiri.
• Kufunsana ndi kutsatira: Kuwunikanso kwa endocrinology, kuyesa mobwerezabwereza ndi kujambula zithunzi nthawi zambiri ndi gawo la njira imeneyi.

Kachitidwe ka inshuwalansi kamasiyananso: mayeso ozindikira matenda akunja nthawi zambiri saphimbidwa pokhapokha ngati akugwirizana ndi kulowa muchipatala kapena ndondomeko yokhala ndi phindu lodziwika bwino la OPD. Funsani kampani yanu ya inshuwalansi kapena ofesi ya inshuwalansi ya chipatala musanayese mayeso, ndipo sungani mankhwala omwe akufotokoza zizindikiro zachipatala.

Nthano ndi mfundo zenizeni

MAFUNSO OFUNSIDWA KAWIRIKAWIRI

Kodi mayeso a cortisol amawunika chiyani kwenikweni?

Mayeso a cortisol amayesa kuchuluka kwa mahomoni a cortisol m'magazi, malovu kapena mkodzo. Madokotala amagwiritsa ntchito mayeso a cortisol kuti awone ngati ma adrenal glands akupanga cortisol yochuluka kapena yochepa, komanso ngati njira yowongolera pituitary-adrenal ikugwira ntchito momwe amayembekezera.

Kodi ndiyenera kusala kudya kuti ndipeze mayeso a cortisol?

Kusala kudya sikofunikira nthawi zonse poyesa cortisol m'ma laboratories ambiri, koma zofunikira zimasiyana malinga ndi unit ndi momwe mayeso ena amalembedwera nayo. Tsimikizirani ndi malo omwe mukutenga. Ngati mutenga insulin kapena sulfonylureas ndipo mwapemphedwa kuti musala kudya, funsani kaye dokotala.

N’chifukwa chiyani magazi ayenera kutengedwa m’mawa?

Cortisol imatsatira kamvekedwe ka tsiku ndi tsiku, ndipo imafika pachimake m'mawa kwambiri. Chitsanzo cha m'mawa ndicho chidziwitso chachikulu pamene mukukayikira kuti adrenal insufficiency ndi yotsika kwambiri, chifukwa chakuti m'mawa muli ndi tanthauzo, pomwe madzulo muli ndi tanthauzo lochepa komanso losathandiza.

Kodi ntchito yonseyi imatenga nthawi yayitali bwanji?

Kutenga magazi kumatenga mphindi zochepa. Kutenga malovu kumatenga mphindi ziwiri kapena zisanu kunyumba. Kutenga mkodzo kwa maola 24 kumatenga tsiku lonse. Kuyesa kwakanthawi kwa Synacthen nthawi zambiri kumatanthauza mphindi pafupifupi 30 mpaka 60 m'chipinda chosamalira ana, nthawi zina kutengera njira yakumaloko.

Kodi mayeso a cortisol m'malovu amasiyana bwanji ndi mayeso a magazi?

Cortisol ya m'malovu usiku kwambiri imafunsa ngati cortisol yomwe imapezeka nthawi zonse usiku yatayika, kotero imafufuza ngati cortisol yachuluka. Cortisol ya m'magazi m'mawa imafunsa ngati kupanga koyambirira kuli kokwanira. Kuyesa kwa malovu sikungagwiritsidwe ntchito kuzindikira cortisol yotsika.

Kodi mankhwala angasinthe zotsatira za cortisol yanga?

Inde, ndipo mbali zonse ziwiri. Mapiritsi okhala ndi estrogen ndi mimba zimakweza cortisol yonse; ma steroid amtundu uliwonse, kuphatikizapo mafuta odzola, ma inhalers ndi ma steroid obisika m'ma supplements ena, amachepetsa. Rifampicin ndi ma antiepileptics ena amasokoneza mayeso a dexamethasone. Lembani zonse zomwe mumamwa.

Cortisol yanga inali yolakwika pang'ono koma ndikumva bwino. Kenako, ndi chiyani?

Kuchuluka kwa cortisol kosazolowereka pang'ono ndi kofala ndipo nthawi zambiri kumasonyeza nthawi, mankhwala, momwe munthu amagona kapena matenda ena. Gawo lachizolowezi ndi kuwunikiranso ndi dokotala wopempha, nthawi zina ndi mayeso obwerezabwereza kapena amphamvu pansi pa mikhalidwe yolamulidwa, m'malo molandira chithandizo mwachangu.

Kodi mayeso a cortisol amagwiritsidwa ntchito pozindikira mavuto a chithokomiro kapena PCOS?

Ayi. Matenda a chithokomiro amayesedwa pogwiritsa ntchito mayeso a ntchito ya chithokomiro, ndi polycystic ovary syndrome yokhala ndi zizindikiro zachipatala, kuchuluka kwa androgen ndi ultrasound. Kuyezetsa kwa Cortisol nthawi zina kumawonjezedwa pamene zizindikiro zikusonyeza matenda a Cushing, omwe angafanane ndi PCOS.

Kodi ana angayesedwe mayeso a cortisol?

Inde. Kuyezetsa kwa cortisol kwa ana kumagwiritsidwa ntchito poyesa kulephera kwa adrenal, kutsatira kwa congenital adrenal hyperplasia komanso kuletsa kwa steroid. Mlingo wa mayeso olimbikitsa, kuchuluka kwa zitsanzo, ndi nthawi zomwe zingagwiritsidwe ntchito zimatengera zaka ndipo ziyenera kuyang'aniridwa ndi dokotala wa ana kapena dokotala wa endocrinologist wa ana.

magwero

• Malangizo a Endocrine Society pa matenda a Cushing's syndrome
• Malangizo a Endocrine Society pa matenda ndi chithandizo cha kulephera kwa adrenal koyambirira
• European Society of Endocrinology ndi malangizo a ENSAT pa kasamalidwe ka adrenal incidentallyomas
• Chidziwitso cha odwala a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) chokhudza matenda a Cushing ndi kulephera kwa adrenal
• Lamulo la Mankhwala Osokoneza Bongo ndi Mankhwala Amatsenga (Zotsatsa Zosavomerezeka), 1954, Boma la India
• Lamulo la Chitetezo cha Deta Yaumwini la Digito, 2023, Boma la India