Akromegali

Ibimenyetso bya acromegaly birimo isura n'amaboko byaguruye. Impinduka ku isura zishobora gutuma umusaya wo hejuru n'umunwa wo hasi birushaho kugaragara, kandi izuru n'iminwa bikaba binini. Acromegaly ni indwara y'imisemburo itera iyo umusemburo wawe wa pituitary ukora imisemburo myinshi y'ubukure mu gihe cy'ubukure. Iyo ufite imisemburo myinshi y'ubukure, amagufa yawe arushaho kuba manini. Mu bwana, ibi bituma umuntu arushaho kuba muremure kandi bita gigantism. Ariko mu gihe cy'ubukure, impinduka mu kurekura ntibibaho. Ahubwo, kwiyongera k'ubunini bw'amagufa bigabanyijwe ku magufa y'amaboko, amaguru n'isura, kandi bita acromegaly. Kubera ko acromegaly idakunze kugaragara kandi impinduka z'umubiri ziba buhoro buhoro mu myaka myinshi, rimwe na rimwe iyi ndwara iramara igihe kinini kugira ngo imenyekane. Iyo idakize, urwego rwo hejuru rw'imisemburo y'ubukure rushobora kugira ingaruka ku bindi bice by'umubiri, uretse amagufa yawe. Ibi bishobora gutera ibibazo bikomeye by'ubuzima - rimwe na rimwe bikaba byahitana ubuzima. Ariko ubuvuzi bushobora kugabanya ibyago byo kugira ibibazo kandi bugatera imbere cyane ibimenyetso byawe, harimo no kwiyongera kw'ibice byawe.

Ikimenyetso gisanzwe cya akromegali ni ukugira intoki n'ibirenge binini. Urugero, ushobora kubona ko udashobora kwambara impeta zakoreshwaga, kandi ko umunaniro w'inkweto zawe wiyongereye buhoro buhoro. Akromegali ishobora kandi gutera impinduka buhoro buhoro mu isura yawe, nko kugira umunwa wo hasi ugaragara cyane n'igitugu cy'umutwe, izuru rinini, iminwa yoroheje, n'ikibazo kinini hagati y'amenyo yawe. Kubera ko akromegali ikunda gutera buhoro buhoro, ibimenyetso bya mbere bishobora kudasobanuka mu myaka myinshi. Rimwe na rimwe, abantu babona impinduka z'umubiri gusa hagereranywa amafoto ya kera n'ayashya. Muri rusange, ibimenyetso n'ibibazo bya akromegali bikunda gutandukana uhereye ku muntu umwe ku wundi, kandi bishobora kuba birimo ibyo bikurikira: Ibiganza n'ibirenge binini. Ibice by'isura binini, birimo amagufwa y'isura, iminwa, izuru n'ururimi. Uruhu rukaze, rurerure, rukomeye. Gusohora ibyuya byinshi n'umunuko mubi w'umubiri. Ibice bito by'umubiri by'uruhu (ibimenyetso by'uruhu). Uburwayi n'intege nke z'ingingo cyangwa imikaya. Kubabara no kugorana kw'ingingo. Ijwi riremereye, rirerure kubera amajwi manini n'ibinyabuzima. Kurara cyane kubera ikibazo cyo mu muhogo wo hejuru. Ibibazo by'ububone. Uburwayi bw'umutwe, bushobora kuba buhoraho cyangwa bukabije. Impinduka mu mihango mu bagore. Kudakora imibonano mpuzabitsina mu bagabo. Kubura ubushake bwo gukora imibonano mpuzabitsina. Niba ufite ibimenyetso n'ibibazo bifitanye isano na akromegali, hamagara muganga wawe kugira ngo akore isuzuma. Akromegali isanzwe itera buhoro buhoro. Ndetse n'abagize umuryango wawe bashobora kutamenya impinduka z'umubiri buhoro buhoro ziba kuri iyi ndwara. Ariko kuvura hakiri kare ni ingenzi kugira ngo ubone ubufasha bukwiye. Akromegali ishobora gutera ibibazo bikomeye by'ubuzima niba idakuweho.

Niba ufite ibimenyetso n'ibibonwa bifitanye isano na akromegali, hamagara muganga wawe kugira ngo akumenye. Akromegali isanzwe itera buhoro buhoro. Ndetse n'abagize umuryango wawe bashobora kutamenya impinduka z'umubiri buhoro buhoro ziba kuri iyi ndwara. Ariko kuvura hakiri kare ni ingenzi kugira ngo ubone ubufasha bukwiye. Akromegali ishobora gutera ibibazo bikomeye by'ubuzima niba idakurikiranwe.

Akamegali ibaho iyo umusemburo w’ubwonko (glande pituitaire) utanga imisemburo myinshi y’ubukure (GH) mu gihe kirekire. Uwo musemburo w’ubwonko ni umusemburo muto uri hasi y’ubwonko, inyuma y’ikibuno cy’izuru. Utanga imisemburo y’ubukure n’izindi misemburo myinshi. Iyo misemburo y’ubukure igira uruhare runini mu gutuma umubiri ukura. Iyo umusemburo w’ubwonko ushyize imisemburo y’ubukure mu maraso, bituma umwijima utanga imisemburo yitwa insulin-like growth factor-1 (IGF-1) — rimwe na rimwe yitwa insulin-like growth factor-I, cyangwa IGF-I. IGF-1 ni yo ituma amagufa n’utundi tugize umubiri bikura. Imisemburo myinshi y’ubukure itera IGF-1 myinshi, ibyo bikaba bishobora gutera ibimenyetso, ibipimo n’ingaruka mbi za akamegali. Mu bakuru, ibinini ni cyo kintu gikunze gutera umubiri gutanga imisemburo myinshi y’ubukure: Ibinini byo mu musemburo w’ubwonko. Ibyinshi mu bwandu bwa akamegali biterwa n’ibinyini bitatera kanseri (benign) (adenoma) byo mu musemburo w’ubwonko. Ibinini bitanga imisemburo myinshi y’ubukure, bituma habaho ibimenyetso byinshi n’ibipimo bya akamegali. Bimwe mu bimenyetso bya akamegali, nko kubabara umutwe no kubura ubwenge, biterwa n’ibinyini byo mu bwonko bikanda ku tundi tugize ubwonko. Ibinini bitari mu musemburo w’ubwonko. Mu bantu bake bafite akamegali, ibinini biri mu bindi bice by’umubiri, nko mu bihaha cyangwa mu mpyiko, bituma iyo ndwara ibaho. Rimwe na rimwe, ibyo binini bitanga imisemburo y’ubukure. Mu bindi bihe, ibinini bitanga imisemburo yitwa growth hormone-releasing hormone (GH-RH), ibyo bigatuma umusemburo w’ubwonko utanga imisemburo myinshi y’ubukure.

Abantu bafite uburwayi bwa gene butoroshye bwitwa multiple endocrine neoplasia, ubwoko bwa 1 (MEN 1), bafite ibyago byinshi byo kurwara acromegaly. Muri MEN 1, iby'imisemburo — ubusanzwe imisemburo ya parathyroid, ipaki na gland pituitary — bikuraho udukoko kandi bigasohora imisemburo yiyongereye. Iyo misemburo ishobora gutera acromegaly.

Niba idakuweho, acromegaly ishobora gutera ibibazo bikomeye byubuzima. Ingaruka zishobora kuba:

• Cholesterol nyinshi.
• Ibibazo byumutima, cyane cyane kubyimba kwumutima (cardiomyopathy).
• Osteoarthritis.
• Diabete yo mu bwoko bwa 2.
• Kubyimba kw'umwijima (goiter).
• Udukoko twa kanseri (polyps) ku rukuta rw'amara.
• Apnea yo mu buriri, uburwayi aho guhumeka guhagarara kandi bigatangira kenshi mu gihe cyo kuryama.
• Syndrome ya Carpal tunnel.
• Icyago cyo kurwara kanseri.
• Impinduka z'ububone cyangwa guhomba ububone.

Kuvura acromegaly hakiri kare bishobora gukumira izi ngaruka ziturukaho cyangwa zigakomeza kuba mbi. Iyo idakuweho, acromegaly n'ingaruka zayo zishobora gutera urupfu ruturutse ku kuba utarageze igihe cyo gupfa.

Muganga wawe azakubaza amateka yawe y'ubuzima akakora n'iperereza ku mubiri wawe. Hanyuma ashobora kugutegurira ibi bikurikira: Gupima IGF-1. Nyuma yo kwikanga ijoro ryose, muganga wawe azakurura amaraso kugira ngo apime urwego rwa IGF-1 mu maraso yawe. Urwego rwa IGF-1 rwo hejuru rugaragaza akromegali. Ikizamini cyo kugabanya hormone yo gukura. Iyi ni yo nzira nziza yo kwemeza uburwayi bwa akromegali. Muri iki kizamini, urwego rwa GH mu maraso rurapimirwa mbere na nyuma yo kunywa umuti w'isukari (glucose). Ku bantu badafite akromegali, ibinyobwa by'isukari bisanzwe bituma urwego rwa GH rugabanuka. Ariko niba ufite akromegali, urwego rwa GH rwawe ruzaguma hejuru. Amashusho. Muganga wawe ashobora kugutegurira ikizamini cy'amashusho, nko gukoresha ikoranabuhanga rya magnetic resonance imaging (MRI), kugira ngo afashe kumenya aho igihumyo kiri no kumenya ingano yacyo kuri gland yawe ya pituitary. Niba nta tumors za pituitary ziboneka, muganga wawe ashobora gutegeka ibindi bipimo by'amashusho kugira ngo ashake tumors zitari iz'i pituitary. Amakuru Aturajwe CT scan MRI

Ubuvuzi bwa Akromegali butandukanye bitewe n'umuntu. Igishushanyo mbonera cyanyu cyo kuvura gishobora kuba gishingiye ku gice n'ingano y'ibibyimba byanyu, uburemere bw'ibimenyetso byanyu, n'imyaka yanyu n'ubuzima muri rusange. Kugira ngo tugabanye urwego rwa GH na IGF-1, uburyo bwo kuvura busanzwe burimo kubaga cyangwa kurasa kugira ngo bakureho cyangwa bagabanye ingano y'ibibyimba bitera ibibazo byanyu, hamwe n'imiti ifasha mu gutunganya urwego rw'imisemburo yanyu. Niba ufite ibibazo by'ubuzima bitewe na akromegali, muganga wawe ashobora kugutegurira ubundi buryo bwo kuvura kugira ngo afashe gucunga ibibazo byawe. Kubaga Ibibujijwe transnasal transsphenoidal kubaga Agasanduku ifoto Gufunga Ibibujijwe transnasal transsphenoidal kubaga Ibibujijwe transnasal transsphenoidal kubaga Mu kubaga kwa transnasal transsphenoidal endoscopic, igikoresho cya chirugical gishyirwa mu mazuru kandi hafi y'umwanya wa nasal kugira ngo hagerwe ku kibyimba cya pituitary. Abaganga bashobora gukuraho ibintu byinshi bya pituitary bakoresheje uburyo bwitwa transsphenoidal surgery. Muri uyu muhango, umuganga wawe akora mu mazuru yawe kugira ngo akureho ibintu byo mu gice cyawe cya pituitary. Niba ibintu bitera ibibazo byawe bitari mu gice cyawe cya pituitary, muganga wawe azagutegurira ubundi bwoko bwo kubaga kugira ngo akureho ibintu. Mu bihe byinshi - cyane cyane niba ibintu byawe ari bito - gukuraho ibintu bisubiza urwego rwa GH mu buryo busanzwe. Niba ibintu byashyiraga igitutu ku mitsi yo hafi y'igice cyawe cya pituitary, gukuraho ibintu bifasha kandi kugabanya umutwe n'impinduka z'ubuzima. Mu bihe bimwe na bimwe, umuganga wawe ashobora kutakora gukuraho ibintu byose. Niba ari uko bimeze, ushobora kugira urwego rwa GH rwo hejuru nyuma yo kubaga. Muganga wawe ashobora kugutegurira ubundi kubaga, imiti cyangwa uburyo bwo kurasa. Imiti Muganga wawe ashobora kugutegurira imwe muri iyi miti - cyangwa imiti ihuriweho - kugira ngo urwego rw'imisemburo yawe rusubire mu buryo busanzwe: Imiti igabanya umusaruro w'imisemburo y'ubukure (somatostatin analogues). Mu mubiri, imisemburo y'ubwonko yitwa somatostatin ikora (ihagarika) umusaruro wa GH. Imiti ya octreotide (Sandostatin) na lanreotide (Somatuline Depot) ni verisiyo zikorerwa mu ruganda (synthetic) za somatostatin. Gufata imwe muri iyi miti bituma igice cya pituitary gikora GH nke, kandi bishobora kugabanya ingano y'ibintu bya pituitary. Ubusanzwe, iyi miti iterwa mu mitsi y'amaguru yawe (imitsi ya gluteal) rimwe mu kwezi n'umuhanga mu buvuzi. Imiti igabanya urwego rw'imisemburo (dopamine agonists). Imiti yo kunywa ya cabergoline na bromocriptine (Parlodel) ishobora kugabanya urwego rwa GH na IGF-1 mu bantu bamwe. Iyi miti ishobora kandi kugabanya ingano y'ibintu. Kugira ngo uvure akromegali, iyi miti isanzwe igomba gufatwa mu bihe byinshi, ibyo bishobora kongera ibyago by'ingaruka mbi. Ingaruka mbi zisanzwe z'iyi miti harimo isesemi, kuruka, amazuru afunze, umunaniro, gucika intege, ibibazo byo kuryama n'impinduka z'imitekerereze. Imiti ibuza igikorwa cya GH (umwanzi w'imisemburo y'ubukure). Imiti ya pegvisomant (Somavert) ibuza ingaruka za GH ku mitsi y'umubiri. Pegvisomant ishobora kuba ifite akamaro cyane ku bantu batarabashije kugira amahirwe meza mu bindi bivuriro. Iyi miti iterwa buri munsi, ishobora kugabanya urwego rwa IGF-1 no kugabanya ibibazo, ariko ntigabanya urwego rwa GH cyangwa kugabanya ingano y'ibintu. Kurasa Niba umuganga wawe atarabashije gukuraho ibintu byose mu kubaga, muganga wawe ashobora kugutegurira uburyo bwo kurasa. Uburyo bwo kurasa burasenya ibindi bibyimba kandi buragabanya urwego rwa GH buhoro buhoro. Bishobora kumara imyaka kugira ngo ubu buryo bwo kuvura bugire ingaruka nziza ku bimenyetso bya akromegali. Uburyo bwo kurasa bugabanya urwego rw'izindi misemburo ya pituitary, atari GH gusa. Niba uhabwa uburyo bwo kurasa, uzakenera gusura muganga wawe buri gihe kugira ngo ube wizeye ko igice cyawe cya pituitary gikora neza, no kugenzura urwego rw'imisemburo yawe. Ubu buvuzi bw'inyuma bushobora kumara ubuzima bwawe bwose. Ubwoko bw'uburyo bwo kurasa harimo: Uburyo bwo kurasa busanzwe. Ubwoko bw'uburyo bwo kurasa busanzwe buhabwa buri munsi mu gihe cy'ibyumweru bine kugeza ku cyenda. Ushobora kutareba ingaruka zuzuye z'uburyo bwo kurasa busanzwe mu myaka 10 cyangwa irenga nyuma yo kuvurwa. Stereotactic radiosurgery. Stereotactic radiosurgery ikoresha amashusho ya 3D kugira ngo itange umwanya munini w'uburyo bwo kurasa ku bibyimba, mugihe igabanya umwanya w'uburyo bwo kurasa ku mitsi isanzwe yo hafi. Ishobora guhabwa mu gice kimwe. Ubwoko bw'uburyo bwo kurasa bushobora gusubiza urwego rwa GH mu buryo busanzwe mu myaka itanu kugeza ku icumi. Amakuru y'inyongera Uburyo bwo kurasa Stereotactic radiosurgery Gusaba gahunda