Uvavanyo lokukhuthaza i-ACTH

Uvavanyo lokukhuthaza i-ACTH luthatha amanyathelo ngendlela amadlala adrenal aphendula ngayo kwihomoni yeadrenocorticotropic (ACTH). I-ACTH yincindi yedlala eveliswa kwincindi yebhinqa evuselela amadlala adrenal ukuba akhuphe ihomoni ebizwa ngokuba yi-cortisol.

Uvavanyo lwenziwa ngale ndlela ilandelayo:

• Igazi lakho litsaliwe.
• Emva koko ufumana ifoto (inaliti) ye-ACTH, ihlala isisihlunu egxalabeni lakho. I-ACTH inokuba yifom eyenziwe ngumntu (eyenziweyo).
• Emva kwemizuzu engama-30 okanye imizuzu engama-60, okanye zombini, kuxhomekeke kubungakanani be-ACTH oyifumanayo, igazi lakho liyatsalwa kwakhona.
• Ilebhu ijonga inqanaba le-cortisol kuzo zonke iisampulu zegazi.

Unokuba nolunye uvavanyo lwegazi, kubandakanya i-ACTH, njengenxalenye yovavanyo lokuqala lwegazi. Kunye novavanyo lwegazi, unokufumana uvavanyo lwe-cortisol yomchamo okanye uvavanyo lwe-urine ye-17-ketosteroids, ebandakanya ukuqokelela umchamo ngaphezulu kweeyure ezingama-24.

Kuya kufuneka ukuba unciphise imisebenzi kwaye utye ukutya okuphezulu kwiicarbohydrate iiyure eziyi-12 ukuya kwezi-24 ngaphambi kovavanyo. Unokucelwa ukuba uzile ukutya iiyure ezingama-6 ngaphambi kovavanyo. Ngamanye amaxesha, akukho lungiselelo lukhethekileyo luyafuneka. Unokucelwa ukuba uyeke okwethutyana amayeza, anjengehydrocortisone, enokuphazamisa uvavanyo lwegazi lwe-cortisol.

Xa kufakwa inaliti ukutsala igazi, abanye abantu baziva iintlungu eziphakathi. Abanye baziva behlaba okanye behlaba kuphela. Emva koko, kunokubakho ukubetha okanye ukutyumza kancinci. Oku kuya kuhamba kungekudala.

Inaliti egxalabeni inokubangela iintlungu okanye ukubetha okuphakathi.

Abanye abantu baziva begungxulile, benovalo, okanye benesicaphucaphu emva kwenaliti ye-ACTH.

Olu vavanyo lunokunceda ekuboneni ukuba ingaba iadrenal kunye ne-pituitary gland ziqhelekile. Ihlala isetyenziswa xa umboneleli wakho wezempilo ecinga ukuba unengxaki ye-adrenal gland, enjengesifo iAddison okanye ukungoneli kwepituitary. Kukwasetyenziselwa ukubona ukuba i-pituitary kunye ne-adrenal gland yakho ifunyenwe ekusebenziseni ixesha elide kwamayeza e-glucocorticoid, anje nge-prednisone.

Ukonyuka kwe-cortisol emva kokuvuselelwa yi-ACTH kulindeleke. Inqanaba leCortisol emva kovuselelo lwe-ACTH kufuneka lube ngaphezulu kwe-18 ukuya kwi-20 mcg / dL okanye i-497 ukuya kwi-552 nmol / L, kuxhomekeke kwidosi ye-ACTH esetyenzisiweyo.

Amaxabiso esiqhelo ahluka kancinci phakathi kweelebhu ezahlukeneyo. Ezinye iilebhu zisebenzisa imilinganiselo eyahlukeneyo okanye zinokuvavanya iisampulu ezahlukeneyo. Thetha nomboneleli wakho malunga nentsingiselo yeziphumo zakho zovavanyo.

Olu vavanyo luncedo ekufumaneni ukuba unayo:

• Ingxaki ye-adrenal (imeko esongela ubomi eyenzeka xa kungekho cortisol eyaneleyo)
• Isifo iAddison (iincindi zamadlala azivelisi ngokwaneleyo i-cortisol)
• I-Hypopituitarism (i-pituitary gland ayivelisi iihormoni ezaneleyo ezinjenge-ACTH)

Akukho mngcipheko ubandakanyekileyo ekuthatheni igazi lakho. Imithambo kunye nemithambo iyahluka ngobukhulu ukusuka komnye umntu ukuya komnye, kwaye ukusuka kwelinye icala lomzimba ukuya kwelinye. Ukuthatha igazi kwabanye abantu kunokuba nzima ngakumbi kunabanye.

Eminye imingcipheko enxulumene nokutsalwa kwegazi incinci, kodwa inokubandakanya:

• Ukopha kakhulu
• Ukufa isiqaqa okanye ukuziva ungenantloko
• Ukugqobhoza okuninzi ukufumana imithambo
• I-Hematoma (igazi eliqokelela phantsi kwesikhumba)
• Usulelo (umngcipheko omncinci nangaliphi na ixesha ulusu lwaphukile)

Uvavanyo lwe-adrenal reserve; Uvavanyo lokukhuthaza lweCosyntropin; Uvavanyo lokukhuthaza lweCortrosyn; Uvavanyo lokuvuselela iSynacthen; Uvavanyo lokukhuthaza itetracosactide

UBarthel A, uWillenberg HS, uGruber M, uBornstein SR. Ukungabikho kwe-adrenal. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahl. 102.

IChernecky CC, iBerger BJ. Uvavanyo lokukhuthaza i-ACTH-isifo. Ku: IChernecky CC, iBerger BJ, ii-eds. Iimvavanyo zaselebhu kunye neenkqubo zokuqonda isifo. Umhla wesi-6. ISt Louis, MO: Elsevier Saunders; Ngo-2013: 98.

Stewart PM, Newell-Price JDC. I-adrenal cortex. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-13. IPhiladelphia, PA: Elsevier; 2016: isahluko 15.