Akromegali

Ko ngā tohu o te acromegaly e whakaatu ana i te mata me ngā ringa kua nui ake. Ko ngā huringa ki te mata ka āhei te whakakī i te iwi o te arero me te iwi o raro o te kauae, me te nui ake o te ihu me ngā ngutu.

Ko te Acromegaly he mate pūngao e puta mai ana i te wā e nui rawa ana te homoni tipu e whakaputahia ana e tō pūngao pituitary i te wā o te pakeketanga.

Ina nui rawa te homoni tipu, ka nui ake te rahi o ō wheua. I te tamarikitanga, ka āhei tenei ki te nui ake o te teitei, ā, e kiia ana ko te gigantism. Engari i te wā o te pakeketanga, kāore he huringa i te teitei. Engari, ko te nui ake o te rahi o te wheua ka āhei ki ngā wheua o ō ringa, o ō waewae, me ō mata, ā, e kiia ana ko te acromegaly.

Nō te mea he mea onge te acromegaly, ā, ko ngā huringa tinana ka puta haere mō ngā tau maha, ka roa pea te wā e mohiotia ai te āhuatanga. Ki te kore e rongoā, ko ngā taumata teitei o te homoni tipu ka pā ki ētahi atu wāhanga o te tinana, i tua atu i ō wheua. Ka āhei tenei ki te arahi ki ngā raruraru hauora nui — ā, i etahi wā ka mate ai —. Engari ka taea e te rongoā te whakaiti i tō tūponotanga o ngā raruraru, ā, ka pai ake ngā tohu, tae atu ki te nui ake o ō āhuatanga.

He tohu noa o te acromegaly ko te nui haere o nga ringa me nga waewae. Hei tauira, ka kite pea koe kaore e taea e koe te kakahu i nga mowhiti i mau ai i mua, a kua nui haere ano hoki to rahi hu. Ka taea hoki e te acromegaly te whakaputa i nga huringa ataata i te ahua o tou mata, penei i te kauae o raro me te iwi o te arero e puta mai ana, te ihu nui ake, nga ngutu matotoru, me te whanui o te waahi i waenga i o niho. Na te mea ka tino puea haere te acromegaly, kaore pea e kitea nga tohu o mua mo nga tau. I etahi wa, ka kite nga tangata i nga huringa tinana ma te whakataurite i nga whakaahua tawhito ki nga mea hou. I te nuinga, ka rereke nga tohu me nga tohu o te acromegaly mai i tetahi tangata ki tetahi, a, ka uru pea ki tetahi o enei: Nga ringa me nga waewae nui ake. Nga ahuatanga mata nui ake, tae atu ki nga wheua mata, nga ngutu, te ihu me te arero. Te kiri kikokiko, hinu, matotoru. Te wera nui me te kakara o te tinana. Nga tipu iti o te kiri (nga tohu kiri). Te ngenge me te ngoikore o nga hononga, o nga uaua ranei. Te mamae me te iti o te nekehanga o nga hononga. He reo hohonu, he reo ngutu na te nui haere o nga aho reo me nga sinuses. Te ngenge nui na te aukatinga o te huarahi hau o runga. Nga raruraru tirohanga. Nga mamae o te mahunga, ka taea te mau tonu, te kino ranei. Nga koretake o te huringa marama i nga wahine. Te ngoikoretanga erectile i nga tane. Te ngaro o te hiahia mo te moepuku. Ki te mea he tohu me nga tohu kei a koe e hono ana ki te acromegaly, waea atu ki to taakuta mo te whakamatautau. Ka tino puea haere te acromegaly. Ahakoa to whanau pea kaore e kite i nga huringa tinana ataata e puta mai ana i tenei mate i te timatanga. Engari he mea nui te taatai wawe kia taea ai e koe te timata ki te whiwhi i te tiaki tika. Ka taea e te acromegaly te arahi ki nga raruraru hauora nui ki te kore e rongoa.

Mēnā kei a koe ngā tohu me ngā pūāhua e hono ana ki te acromegaly, whakapiri atu ki tō tākuta mō te whakamātautau.

Te nuinga o te wā ka tupu haere māmā te acromegaly. Āe rawa pea ka kore o whānau e kite i ngā huringa tinana tītino e puta ana me tēnei mate i te tīmatanga. Engari he mea nui te whakamātautau wawe kia taea ai e koe te tīmata ki te whiwhi i te tiaki tika. Ka taea e te acromegaly te arahi ki ngā raruraru hauora nui mena kaore i te whakaora.

Ko te acromegaly e puta ana ina nui rawa te homoni tipu (GH) e whakaputahia ana e te pūngāwerewere pituitary mō te wā roa. Ko te pūngāwerewere pituitary he pūngāwerewere iti kei raro i tō roro, kei muri i te awa o tō ihu. Ka whakaputa ia i te GH me te maha atu o ngā homoni. He mahi nui te GH ki te whakahaere i tō tipu tinana. Ina tukuna e te pūngāwerewere pituitary te GH ki roto i tō toto, ka whakaohooho i tō ate kia whakaputa i te homoni e kiia nei ko te insulin-like growth factor-1 (IGF-1) — i etahi wā ka kiia hoki ko te insulin-like growth factor-I, ko te IGF-I rānei. Ko te IGF-1 te mea e whakapakari ai ō wheua me ētahi atu kiko. Ko te nui rawa o te GH ka nui rawa te IGF-1, ka taea te whakaohooho i ngā tohu, ngā tohu me ngā raruraru o te acromegaly. I roto i ngā tāngata pakeke, ko te mate pukupuku te take tino nui o te nui rawa o te whakaputanga o te GH: Ngā mate pukupuku pituitary. Ko te nuinga o ngā keehi acromegaly e puta mai ana i te mate pukupuku kore-mate pukupuku (benign) (adenoma) o te pūngāwerewere pituitary. Ka whakaputa te mate pukupuku i ngā nui o te homoni tipu, e whakaohooho ana i te maha o ngā tohu me ngā tohu o te acromegaly. Ko etahi o nga tohu o te acromegaly, penei i nga mamae o te upoko me te ngoikore o te tirohanga, e puta mai ana i te mate pukupuku e pehi ana i nga kiko o te roro e tata ana. Ngā mate pukupuku kore-pituitary. I roto i etahi atu tangata e pangia ana e te acromegaly, ko nga mate pukupuku kei etahi atu wahi o te tinana, penei i nga ngakau, i te pancreas ranei, te take o te mate. I etahi wa, ka tukuna e enei mate pukupuku te GH. I etahi atu keehi, ka whakaputahia e nga mate pukupuku he homoni e kiia nei ko te growth hormone-releasing hormone (GH-RH), e tohu ana i te pūngāwerewere pituitary kia hanga atu i te GH.

Ko te hunga e pangia ana e te mate tuku iho onge e kiia nei ko te multiple endocrine neoplasia, momo 1 (MEN 1), he nui ake te tūponotanga o te whanake i te acromegaly. I roto i te MEN 1, ko ngā ngongo endocrine—he maha ngā parathyroid glands, pancreas me te pituitary gland—e tupu ana ngā pūngāwerewere, ā, ka tukuna atu ngā homoni. Ka taea e aua homoni te whakaoho i te acromegaly.

Ki te kore e rongoatia, ka taea e te acromegaly te arahi ki nga raruraru hauora nui. Ko nga raruraru pea ka uru atu ki:

• Te kolesterol teitei.
• Nga raruraru o te ngakau, ina koa te nui haere o te ngakau (cardiomyopathy).
• Te osteoarthritis.
• Te mate huka momo 2.
• Te nui haere o te kohanga tairoirangi (goiter).
• Nga tipu i mua i te mate pukupuku (polyps) i runga i te paparinga o tou kōtore.
• Te moe apnea, he āhuatanga e mutu ana, ka tīmata anō te manawa i roto i te moe.
• Te mate huha o te ringa (Carpal tunnel syndrome).
• Te nui haere o te tūponotanga o nga mate pukupuku.
• Te huringa o te tirohanga, te ngaro ranei o te tirohanga.

Ka taea e te rongoa wawe o te acromegaly te aukati i enei raruraru kei te whanake, kei te kino ake ranei. Ki te kore e rongoatia, ka taea e te acromegaly me ona raruraru te arahi ki te mate wawe.

Kaore he uara (NaN)

Ka ui atu tō tākuta ki ōu hītori hauora ka whakahaere i te whakamātautau tinana. Katahi ka taea e ia te tūtohutia ngā kaupae e whai ake nei: Te ine i te IGF-1. I muri i tō nohopuku i te po katoa, ka tangohia e tō tākuta he tauira toto hei ine i te taumata IGF-1 i roto i tō toto. Ko te taumata IGF-1 kua piki ake te tohu o te acromegaly. Te whakamātautau whakakore i te homoni tipu. Koinei te huarahi pai hei whakau i te taatai ​​acromegaly. I te wa o tēnei whakamātautau, ka inehia tō taumata toto GH i mua i muri i to inu i tetahi whakamahere o te huka (glucose). I roto i te hunga kaore e pangia e te acromegaly, ka tikanga ka puta te inu huka i te hekenga o te taumata GH. Engari ki te pangia koe e te acromegaly, ka noho teitei tonu tō taumata GH. Whakaahua. Ka taea e tō tākuta te tūtohutia he whakamātautau whakaahua, penei i te whakaahua pūmanawa maikuku (MRI), hei awhina i te tohu i te waahi me te rahi o te mate pukupuku i runga i tō pūngāwerewere pituitary. Ki te kore e kitea he mate pukupuku pituitary, ka taea e tō tākuta te tono atu i ētahi atu whakamātautau whakaahua hei kimi i ngā mate pukupuku kore-pituitary. Ētahi atu mōhiohio CT scan MRI

Ko te rongoā mo te acromegaly e rerekē ana i te tangata. Ko tō mahere rongoā pea ka whakawhirinaki ki te wāhi me te rahi o tō mate pukupuku, te kaha o ō tohu, me tō tau me tō hauora whānui. Hei awhina i te whakaheke i ō taumata GH me IGF-1, ko ngā kōwhiringa rongoā e whakauruhia ana e te tikanga te pokanga, te whakamahinga rā, ki te tango atu, ki te whakaiti rānei i te rahi o te mate pukupuku e pā ana ki ō tohu, me te rongoā hei awhina i te whakaū i ō taumata homoni. Ki te pā ana koe ki ngā raruraru hauora hei hua o te acromegaly, ka taea e tō tākuta te tūtohutia ētahi atu rongoā hei awhina i te whakahaere i ō raruraru. Pokanga Pokanga endoscopic transnasal transsphenoidal Whakawhānuihia te whakaahua Kati Pokanga endoscopic transnasal transsphenoidal Pokanga endoscopic transnasal transsphenoidal I roto i te pokanga endoscopic transnasal transsphenoidal, ka whakanohoia he taputapu pokanga mā te ihu me te taha o te septum ihu ki te uru atu ki te mate pukupuku pituitary. Ka taea e ngā tākuta te tango i te nuinga o ngā mate pukupuku pituitary mā te whakamahi i tētahi tikanga e kiia nei ko te pokanga transsphenoidal. I te wā o tēnei mahi, ka mahi tō kairangi pokanga mā tō ihu ki te tango i te mate pukupuku i tō pūngāwerewere pituitary. Ki te kore te mate pukupuku e pā ana ki ō tohu kei runga i tō pūngāwerewere pituitary, ka tūtohu tō tākuta i tētahi atu momo pokanga hei tango i te mate pukupuku. I roto i te maha o ngā take—inā, ki te iti tō mate pukupuku—ka whakahokia ngā taumata GH ki te noa. Ki te tukinotia te mate pukupuku i ngā kiko kei te taha o tō pūngāwerewere pituitary, ka awhina te tango i te mate pukupuku ki te whakaora i ngā mamae o te upoko me ngā huringa tirohanga. I ētahi wā, ka kore pea e taea e tō kairangi pokanga te tango i te mate pukupuku katoa. Ki te pēnei, ka nui pea ngā taumata GH i muri i te pokanga. Ka taea e tō tākuta te tūtohu i tētahi atu pokanga, rongoā, rānei ngā maimoatanga whakamahinga rā. Rongoā Ka taea e tō tākuta te tūtohu i tētahi o ngā rongoā e whai ake nei—rānei he whakakotahitanga o ngā rongoā—hei awhina i ō taumata homoni ki te hoki ki te noa: Ngā rongoā e whakaiti ana i te whakaputa homoni tipu (ngā analo somatostatin). I roto i te tinana, he homoni roro e kiia nei ko te somatostatin e mahi ana ki te whakaheke (te aukati) i te whakaputa GH. Ko ngā rongoā octreotide (Sandostatin) me lanreotide (Somatuline Depot) he putanga hanga-tangata (synthetic) o te somatostatin. Ko te tango i tētahi o ēnei rongoā ka tohu ki te pūngāwerewere pituitary kia iti ake te whakaputa GH, ā, ka taea pea te whakaiti i te rahi o te mate pukupuku pituitary. Ko te tikanga, ka werohia ēnei rongoā ki ngā uaua o ō huha (ngā uaua gluteal) kotahi i te marama e te kaimahi hauora. Ngā rongoā hei whakaheke i ngā taumata homoni (ngā agonist dopamine). Ko ngā rongoā waha cabergoline me bromocriptine (Parlodel) ka taea te awhina i te whakaheke i ngā taumata o te GH me te IGF-1 i ētahi tangata. Ka taea hoki e ēnei rongoā te awhina i te whakaiti i te rahi o te mate pukupuku. Hei whakaora i te acromegaly, ko te tikanga me tango ēnei rongoā i ngā rā nui, ka taea te whakapiki i te tūponotanga o ngā pānga taha. Ko ngā pānga taha noa o ēnei rongoā ko te ruaki, te ruaki, te ihu kōkō, te ngenge, te māuiui, ngā raruraru moe me ngā huringa ngākau. Rongoā hei aukati i te mahi a te GH (te kaitukino homoni tipu). Ko te rongoā pegvisomant (Somavert) e aukati ana i te pānga o te GH ki ngā kiko o te tinana. Ka tino awhina pea te Pegvisomant mō ngā tāngata kaore i angitu pai ki ētahi atu maimoatanga. I te hoatu hei wero i te rā, ka taea e tēnei rongoā te awhina i te whakaheke i ngā taumata IGF-1 me te whakaora i ngā tohu, engari kāore e whakaheke i ngā taumata GH, kāore rānei e whakaiti i te rahi o te mate pukupuku. Whakamahinga rā Ki te kore e taea e tō kairangi pokanga te tango i te mate pukupuku katoa i te wā o te pokanga, ka taea e tō tākuta te tūtohu i te maimoatanga whakamahinga rā. Ka whakangaro te rongoā whakamahinga rā i ngā pūtau mate pukupuku e toe ana, ā, ka whakaiti haere i ngā taumata GH. Ka roa pea ngā tau mō tēnei maimoatanga kia pai ake ngā tohu acromegaly. Ko te tikanga ka whakaheke te maimoatanga whakamahinga rā i ngā taumata o ētahi atu homoni pituitary, kāore i te GH anake. Ki te whiwhi koe i te maimoatanga whakamahinga rā, ka hiahia pea koe ki ngā toro atu ki tō tākuta kia mau ai te mahi tika o tō pūngāwerewere pituitary, me te tirotiro i ō taumata homoni. Ka roa pea tēnei tiaki whai muri mō te toenga o tō oranga. Ko ngā momo rongoā whakamahinga rā e whai ake nei: Rongoā whakamahinga rā noa. Ko tēnei momo rongoā whakamahinga rā e hoatuia ana i ngā rā mahi katoa i roto i te wā e whā ki te ono wiki. Kaore pea koe e kite i te hua katoa o te rongoā whakamahinga rā noa mō te 10 tau neke atu i muri i te maimoatanga. Stereotactic radiosurgery. Ka whakamahi te Stereotactic radiosurgery i te whakaahua 3D hei tuku i te rā nui o te whakamahinga rā ki ngā pūtau mate pukupuku, me te whakaiti i te nui o te whakamahinga rā ki ngā kiko noa e karapoti ana. Ka taea te tuku i te nuinga o te wā i roto i tetahi rā kotahi. Ka taea e tēnei momo whakamahinga rā te whakahoki i ngā taumata GH ki te noa i roto i ngā tau e rima ki te tekau. Ētahi atu mōhiohio Rongoā whakamahinga rā Stereotactic radiosurgery Tono i tētahi whakatau

Kaore he uauatanga