I-insipidus yesifo sikashukela yisifo esidalwa ukukhiqizwa okunganele kwe-antidiuretic hormone vasopressin.
Iziveza njengokoma okhulunywayo ngokukhishwa komthamo omkhulu womchamo ongagxiliwe. Lesi sifo sihlobene ngqo nokuwohloka kwe-neurohypophysis noma i-hypothalamus.
Kuyaqapheleka ukuthi ngesifo sikashukela se-neurogenic kukhona ukwephulwa okukhulu kokuhlanganiswa, ukugcinwa noma ukuhanjiswa kwe-arginine-vasopressin. Lokhu kwamuva, njengoba wazi, kuvame ukuphazamisa ukuqeda uketshezi futhi kukhuphule ukugcwala komchamo.
Ukushoda kwale nto kungaholela ekutheni i-polyuria kanye nokuphelelwa emzimbeni komzimba. Ukuchithwa okwandisiwe kwe-vasopressin kuthobela izigqi ze-circadian, kepha ebusuku, okuqukethwe kwe-ADH kufinyelela isilinganiso. Esikhathini sosuku, ngokuphambene nalokho, lehla laya kumaki omncane.
Kulesi sihloko, ungathola ngezimbangela eziyinhloko zokuvela kokugula okukhulunywa ngakho. Ngakho-ke yini i-insipidus yesifo sikashukela, ziyini izinhlobo, futhi ziyini izibalo zokusabalala kwalesi sifo emhlabeni?
Isifo sikashukela: kuyini?
Isifo esiyingozi empilweni nasempilweni siyisifo esingajwayelekile esixhumene nokungasebenzi kahle kwe-hypothalamus noma i-pituitary gland, ebonakala nge-polyuria (ekhiqiza umchamo kuze kufike kumalitha angama-6- 14 ngosuku) noma i-polydipsia (ukoma).
Lokhu kugula kuqhubeka ngendlela engapheli futhi kwenzeka kubantu bobabili ubulili obuthakathaka futhi obunamandla.
Kuvame ukutholakala ngisho nasezinganeni. Imvamisa lolu hlobo lwesifo sikashukela luthinta kakhulu abantu abancane nabancane - kusuka kwabaneminyaka eyi-17 kuye kwengama-26. Okwamanje, amacala okugula kwezinsana ayaziwa ezinyangeni zokuqala zokuphila.
Kamuva, kuye kwanda ukwenyuka okukhulu kwethamo lamanzi akhipha umchamo, futhi kwabonwa nesomiso esingagculisi. Kubalulekile ukuqaphela ukuthi uma ukulahleka kwamanzi kunganxephezelwe ngokuphelele, khona-ke ukuphuma komzimba (ukukhipha amanzi emzimbeni).
Ukuxilongwa kwalesi sifo kususelwa esithombeni somtholampilo esiphelele nokuzimisela kwenkomba ye-ADH esegazini legazi lesiguli. Ukuthola ngokunembayo imbangela yokuvela kwalolu hlobo lwesifo sikashukela, udinga ukuhlolwa okufanele.
Isifo sikashukela nesifo sikashukela: ukungafani
Njengoba wazi, kunezinhlobo ezimbili eziyinhloko: isifo sikashukela nesifo sikashukela. Lezi zinhlobo zesifo zihlukile ngokuhlukile komunye nomunye.
Umehluko omkhulu ukuthi, ngaphandle kwegama elifanayo, banezimbangela eziphikisana ngokuphelele. Futhi, izimpawu ze-pathologies ziyehluka komunye.
Isifo sikashukela i-mellitus sithathwa njengesifo esivamile, esivame kakhulu ukwedlula isifo sikashukela.Imvamisa, isifo sikashukela i-mellitus ivela ngenxa yendlela engalungile: yonke into isolwa ngokudla okungalinganiseli, ukungasebenzi ngokomzimba, ukucindezela, kanye nokuba khona kwemikhuba emibi. Yilezi zinto ezinomphumela omkhulu kwinqubo ye-metabolic kubantu.
Futhi, i-mellitus yesifo sikashukela ihlukile kwisifo sikashukela ngoba ukubukeka kwayo kungavusa isimo esibucayi se-autoimmune emzimbeni wesiguli se-endocrinologist. Umehluko omkhulu phakathi kwezinhlobo zokuqala nezesibili ukuthi owokugcina ubonakala ngenxa yokuba khona kokulimala okusongela impilo kugebhezi nokuvela kwamaseli omdlavuza emzimbeni womuntu.Kodwa i-insipidus yesifo sikashukela ibonakala ngokuba khona kwezifo ezithile ekusebenzeni kohlelo lwe-hypothalamic-pituitary.
Futhi lokhu kungaholela emuva ekunciphiseni okukhulu noma ekuqedeni ngokuphelele kokusungulwa kwe-vasopressin ye-antidiuretic vasopressin.
Le hormone eyingqayizivele ithatha umsebenzi wokusabalalisa uketshezi emzimbeni womuntu. Ngaphezu kwalokho, ubamba iqhaza eliqondile ezinqubweni zokugcina i-homeostasis ngokulawula inani lamanzi akhishwe emzimbeni.
Ngokuphulwa okungathí sina ohlelweni lwe-hypothalamic-pituitary, umthamo we-hormone uba omncane. Futhi lokhu, njengomthetho, akwanele ukuphinda uzuzwe, okuqondile okuphambene nokufakwa emanzini yizakhi zezithonjana zezinso. Lesi simo esingathandeki singaholela ekubukekeni kwe-polyuria.
Indawo ye-hypothalamus ebuchosheni bomuntu
Lapho kunokwephulwa kwe-carbohydrate metabolism, kutholakala isimo lapho kutholakala inani elinganele le-pancreatic hormone, i-insulin emzimbeni womuntu. Kepha unesibopho senqubo yokwenziwa kwe-glucose esegazini legazi lesiguli ngamangqamuzana.
Ukuqonda umehluko phakathi kwezifo ezimbili ezihluke ngokuphelele, kufanele uqale uqonde izimbangela eziphambili zokuqhamuka kwesifo esigulini.
Izinhlobo zesifo
Okwamanje, i-endocrinology yesimanje ihlukanisa lesi sifo okukhulunywa ngaso ngokuya ngezinga lokwephulwa okungathi sína kanye nezinkinga.
Njengoba wazi, izinhlobo eziphakathi nendawo (neurogenic, hypothalamic-pituitary) kanye nezinso zesi sifo zihlukaniswa.
Lapho inkinga yokuqala ivela esigabeni sokukhiqizwa kwe-hormone ye-antidiuretic yi-hypothalamus noma ezingeni lokukhululwa kwayo egazini. Kepha elesibili, kukhona ukwahluka emcabangweni we-ADH kusuka ezinhlakeni zamaselula ezikhulunyiwe ze-distal tubules of nephrons.
Kubalulekile ukuqaphela ukuthi i-insipidus yesifo sikashukela esezingeni eliphakathi ingahlukaniswa nge-idiopathic (isifo esitholakala ngenxa yokuvela kusakhi sofuzo, esibonakala ngokwehla okukhulu kokuqanjwa kwe-ADH) kanye ne-chiratidzo (kungalandelwa ngokuchasene namanye ama-pathologies).
Uhlobo lwesibili, njengomthetho, lungaqala ukukhula ngesikhathi sempilo (etholwayo) ngemuva kokulimala kobuchopho obuyingozi.
Uhlu lwezifo olungacunula ukuvela kwalokhu kugula lungafaka ne-meningoencephalitis.
Lesi sifo singatholakala kusukela kokuzalwa nangokuguqulwa kwezakhi zofuzo ze-ADH.
Kepha ngokuqondene nefomu le-renal, lingalandelelwa kakhulu ngokungaxakanisi kwe-anatomical ye-nephron noma i-senseptivity ephazamisekile ye-antidiuretic hormone. Lezi zinkinga zingaba ukuzalwa kabusha noma ukuthuthuka ngenxa yomonakalo wezidakamizwa noma we-metabolic kwizitho ezibalulekile zohlelo lwe-excretory.
Izimbangela zokwenzeka
Njengoba kuphawuliwe ngaphambili, kuyindlela eyinhloko yalesi sifo ehlobene ngqo nokubhujiswa kwe-hypothalamic-pituitary esivame ukutholakala kakhulu.
Lesi sifo singenzeka njengesisekelo se-metastatic tumor neoplasms.
Esinye isigaba sezimbangela ezivusa ukubukeka kwalesi sifo sihlanganisa ukungenelela okuthile kokuhlinzwa, izilonda ze-vascular, isifo sofuba sezitho ezithile zomzimba, umalaleveva kanye ne-syphilis. Ngesifo sikashukela se-idiopathic, i-organic lesion ye-hypothalamic-pituitary system ayikho ngokuphelele. Futhi isizathu ukuvela okungazelelwe kwama-antibodies kuma-cell akhiqiza amaseli.
Izinhlobonhlobo zezinso zemvelo yesifo sikashukela i-insipidus zingachazwa ngezifo ezizalwa noma ezitholwayo zezitho zohlelo lwe-excretory.Njengomthetho, zifaka ukwehluleka kwe-renal, amyloidosis kanye ne-hypercalcemia. Imvamisa, isici esidale ukubonakala kwalolu hlobo lwalesi sifo ubuthi obunobuthi be-lithium ngezidakamizwa.
Ukwehluleka kwangempela
Imvamisa, izinhlobo zesifo sikashukela esitholakala ngokuzalwa zivame ukuvela ngokutholwa kwe-Wolfram syndrome ngezimpawu zayo, okungahle kube yinkimbinkimbi (ngokuxilongwa kanyekanye kwe-opicophy ye-opic, kanye nokuba yisithulu) noma ingxenye (ehlanganisa isifo sikashukela i-mellitus ne-insipidus yesifo sikashukela).
Izizathu zokuthuthuka kwesifo sikashukela yilezi ezilandelayo:
- ukubonakala kwesakhiwo esibi ku-hypothalamus noma i-pituitary gland;
- ukwakheka kwama-metastases weseli lomdlavuza esifundeni se-hypothalamic-pituitary;
- izinkinga ezinkulu ekusebenzeni kohlelo lwe-hypothalamic-pituitary;
- ukulimala ekhanda kakhulu nasongela impilo yakho;
- ukuba khona komzimba womuntu okubizwa ngokuthi yi-genetic predisposition ekuthuthukiseni i-pathology okukhulunywa ngayo;
- izinkinga ngokusebenza kwezicubu zezinso lapho kuphendulwa i-vasopressin;
- ukwakheka kwe-aneurysm engafuneki noma ukugoqeka kwemithambo yegazi, emikhulu nemincane;
- ukubonakala esigulini sezinhlobo ezithile zokuvuvukala kolwelwesi lobuchopho noma i-encephalitis;
- I-Hend-Schuller-Christian syndrome, ebonakala ngokwanda kwe-pathological emsebenzini wama-histocytes.
Izibalo
Ngokwezibalo zezokwelapha, ukuthuthuka kwalesi sifo akuxhomekile ebulilini nakubudala bomuntu. Njengomthetho, lesi sifo sitholakala kubantu abaneminyaka engama-21 kuye kwengama-45.
Ukubuyekezwa
Ngokulashwa okufanele, ngokuya ngezibuyekezo zeziguli, kungenzeka ukunciphisa ukubonakaliswa kwalesi sifo.
Izimpawu
Izimpawu ezishiwo kakhulu zalesi sifo yi-polyuria ne-polydipsia.
Isimpawu sokuqala sibonisa ngokwanda okukhulu kwenani lomchamo okhiqizwa ngosuku. Njengomthetho, umthamo wayo ungasukela kumalitha amane kuya kwayi-12. Kwezinye izimo ezinzima kakhulu, inani lomchamo wesikhathi sasemini lingafinyelela kumalitha angama-20 noma angama-30.
Ngaphezu kwalokho, umthetho, awunawo umbala futhi ubonakala ngokuqukethwe okuphansi kosawoti we-sodium. Ngaphezu kwalokho, isiguli asishiyi umuzwa wokoma okukhulu. Ngale hlobo lwalesi sifo, umuntu uyaphoqelelwa ukuthi aphuze inani elikhulu lamanzi nolunye uketshezi. Ubunzima balesi sifo okukhulunywa ngaso bunqunywa ukungabi bikho kwama-antidiuretic hormone.
Isifo sikashukela se-idiopathic imvamisa sikhula kakhulu ngendlela. Ezimweni ezingavamile kakhulu, lithuthuka kancane. Kuyaqapheleka ukuthi ukuzala ingane kungaholela ekubonakalisweni kwesifo.
Ukunxenxa njalo ethoyilethi kungaholela ekuphazamiseni kakhulu ukulala, i-neurosis, kanye nokukhathala okwandayo. Ngenxa yalokho, umuntu uba olinganiselayo ngokomzwelo.
Ezinganeni, izimpawu zokuqala zesifo sikashukela zifaka i-envesis.
Ngemuva kwesikhashana, le miphumela elandelayo ihlangana naye: ukubambezeleka okukhulu ekukhuleni komzimba, kanye nokuthomba. Kepha izimpawu zakamuva zalokhu kugula yilezi ezilandelayo: ukwanda okukhulu kwe-pelvis yezinso, i-ureters kanye nesinye. Ngemuva kwalokho, ngenxa yokugcwala kwamanzi, ukwelulwa ngokweqile nokwanda kwesisu kuyaphawulwa.
Kamuva, umuntu uhlakulela i-dyskinesia ye-biliary. Futhi, iziguli zikhononda ngokucasulwa kolwelwesi lwama-mucous emathunjini, olunefomu eliphikelelayo eliqhubekayo. Kubantu abanalesi sifo, isikhumba sivame ukoma kakhulu futhi siphelelwe ngamanzi. Ukuthukuthela kanye namathe cishe akuvelele.
Isifiso sokudla sincishiswa kakhulu. Ngemuva kwesikhashana, iziguli zaphawula ukuphuma komzimba, ukulahleka okubukhali nokushesha kwamakhilogremu angeziwe, isifiso sokuhlanza, izinhlungu ezingabekezeleleki ekhanda, kanye nokukhula kwezinkinga zemizwa eziyingozi.
Iziguli zisene-pituitary insuffuff.
Emadodeni, kutholakala ukuwohloka okukhulu kwe-potency, kepha kwabesifazane, kutholakala ukungahambi kahle kokuya esikhathini okungaka kokuya esikhathini.
Amavidiyo ahlobene
Izimpawu zesifo sikashukela kuthelevishini ku-TV ethi "Live Healthy!" no-Elena Malysheva:
Kubalulekile ukuqaphela ukuthi ukugula okukhulunywa ngakho kuyingozi enkulu kubantu, ngoba kukhona ubungozi bokuphelelwa ngamanzi emzimbeni. Njengomthetho, ukulahleka kwamanzi ngomchamo akuvamile ukunxeshezelwa.
Ngaphezu kwalokho, ukomisa kuphawulwa ngobuthakathaka obujwayelekile, i-tachycardia, ukugabha, ukuphazamiseka kwengqondo okungathi sína, kanye nokuqina kwe-serum yegazi. Akunakusetshenziswa noma yikuphi uma kufanele ukuzindla, ngoba lokhu kungaholela ekwandeni kwesimo somzimba. Kubalulekile ukubonana nodokotela wakho ngesikhathi esifanele.
