Acromegaly

Izimpawu ze-acromegaly zihlanganisa ubuso obukhulu nezandla. Ukushintsha ebusweni kungabangela ukuba ithambo lempumulo nethambo eliphansi lomlomo zikhule, futhi ikhala nemihlathi zikhule.

I-Acromegaly iwukugula kwe-hormonal okuvela lapho i-pituitary gland yakho ikhiqiza i-growth hormone eningi kakhulu phakathi nobukhulu.

Uma une-growth hormone eningi, amathambo akho akhula ngobukhulu. Ebuntwaneni, lokhu kuholela ekukhuleni komuntu, futhi kubizwa ngokuthi i-gigantism. Kodwa ebukhulwini, ukushintsha kokuphakama akwenzeki. Esikhundleni salokho, ukwanda ngobukhulu bamathambo kuhlanganiswe namathambo ezandla zakho, izinyawo nobuso, futhi kubizwa ngokuthi i-acromegaly.

Ngenxa yokuthi i-acromegaly ayivamile futhi ukushintsha komzimba kwenzeka kancane eminyakeni eminingi, ngezinye izikhathi isimo sithatha isikhathi eside ukuqaphela. Uma ingaphathwa, amazinga aphezulu e-growth hormone angathinta ezinye izingxenye zomzimba, ngaphezu kwamathambo akho. Lokhu kungabangela izinkinga zempilo ezinzima - ngezinye izikhathi ezisongela impilo - kodwa ukwelashwa kunganciphisa ingozi yezinkinga futhi kuthuthukise kakhulu izimpawu zakho, kuhlanganise nokukhula kwezici zakho.

Uphawu oluvamile lwacromegaly ukukhula kwezandla nezinyawo. Ngokwesibonelo, ungase uqaphele ukuthi awukwazi ukugqoka izihwayi ezazilokhu zifanela, nokuthi usayizi wakho wezibuko ukhule kancane kancane. I-Acromegaly ingabangela futhi ukushintsha kancane kancane esimweni sobuso bakho, njengoba kube khona umgubhu olukhulu oluphansi lomlomo nempondo, ikhala elikhulu, izindebe eziqine kakhulu, nokuhlukaniswa okukhulu phakathi kwamazinyo akho. Ngenxa yokuthi i-acromegaly ivame ukukhula kancane, izimpawu zokuqala zingase zingabonakali iminyaka eminingi. Ngezinye izikhathi, abantu baqaphela ukushintsha komzimba kuphela ngokuqhathanisa izithombe zakudala nezintsha. Ngokuphelele, izimpawu nezimpawu ze-acromegaly zivame ukwahluka komunye umuntu komunye, futhi zingafaka noma yikuphi okulandelayo: Izandla nezinyawo ezinkulu. Izici zobuso ezinkulu, kufaka phakathi amathambo obuso, izindebe, ikhala nolimi. Isikhumba esikhulu, esinamanzi, esihlwempu. Ukubila okukhulu nokungahambi kahle komzimba. Izithombo ezincane zesikhumba (izikhumba zezikhumba). Ukukhathala nobuthakathaka bezingqondo noma bemisipha. Ubuhlungu nokunciphisa ukunyakaza kwamajozi. Izwi elikhulu, elihlwempu ngenxa yokukhula kwamakhodi okucula nemisipha. Ukugqolozela okukhulu ngenxa yokuphazamiseka komoya ophezulu. Izinkinga zobuso. Izinhlungu zikhanda, ezingase ziqhubeke noma zibe nzima. Ukungahambi kahle kwesikhathi somjikelezo wesifazane kwabesifazane. Ukuphazamiseka kokwakha kwabesilisa. Ukwehluleka kokuthanda ubulili. Uma unezimpawu nezimpawu ezihlotshaniswa ne-acromegaly, xhumana nodokotela wakho ukuze uhlolwe. I-Acromegaly ivame ukukhula kancane. Ngisho namalungu omndeni wakho angase angaqapheli ukushintsha komzimba okuqhubekayo okuvela kuleli gciwane ekuqaleni. Kodwa ukuxilongwa kwasekuqaleni kubalulekile ukuze uqale ukuthola ukunakekelwa okufanele. I-Acromegaly ingabangela izinkinga zempilo ezinzima uma ingaphathwa.

Uma unezimpawu ezihambisana ne-acromegaly, xhumana nodokotela wakho ukuze uhlolwe.

I-Acromegaly ivame ukuqhubeka kancane. Ngisho nabantu bakho bomndeni bangase bangaphawuli utshintsho oluqondile lomzimba oluvela kuleli gciwane ekuqaleni. Kodwa ukuxilongwa kwasekuqaleni kubalulekile ukuze uqale uthole ukunakekelwa okufanele. I-Acromegaly ingabangela izinkinga ezinkulu zempilo uma ingaphathwa.

I-acromegaly iveza lapho i-pituitary gland ikhiqiza khona i-growth hormone (GH) eningi kakhulu isikhathi eside. I-pituitary gland iyisisindo esincane esisekelweni sengqondo lakho, ngemuva kwesilayidi sekhala lakho. Ikhiqiza i-GH kanye nezinye izinhlobo ze-hormones. I-GH idlala indima ebalulekile ekulawuleni ukukhula kwakho komzimba. Uma i-pituitary gland ikhipha i-GH egazini lakho, iqhuba isibindi sakho ukuba sikhiqize i-hormone ebizwa nge-insulin-like growth factor-1 (IGF-1) — ngezinye izikhathi ibizwa nangokuthi i-insulin-like growth factor-I, noma i-IGF-I. I-IGF-1 yilokho okubangela ukukhula kwama-bone akho nezinye izicubu. I-GH eningi kakhulu iholela e-IGF-1 eningi kakhulu, okungabangela izimpawu, izimpawu nezinhlungu ze-acromegaly. Kubantu abadala, i-tumor yimbangela evamile kakhulu yokukhiqizwa kwe-GH eningi kakhulu: Ama-Pituitary tumors. Iningi lamacala e-acromegaly libangelwa yi-tumor engathandeki (benign) (adenoma) ye-pituitary gland. I-tumor ikhiqiza amazinga amaningi e-growth hormone, okubangela izimpawu eziningi ze-acromegaly. Ezinye zezimpawu ze-acromegaly, njengezinhlungu zikhanda nokubona okuphazamisekile, kubangelwa yi-tumor ecindezela izicubu zengqondo eziseduze. Ama-Nonpituitary tumors. Kubantu abambalwa abane-acromegaly, ama-tumors ezingxenyeni zomzimba, njengemiphunga noma i-pancreas, abangela leyo ngxaki. Ngezinye izikhathi, la ma-tumors akhipha i-GH. Kwezinye izimo, ama-tumors akhiqiza i-hormone ebizwa nge-growth hormone-releasing hormone (GH-RH), ebonisa i-pituitary gland ukuba yenze i-GH eningi.

Abantu abane-multiple endocrine neoplasia, uhlobo 1 (MEN 1), okuyisimo esingavamile sezofuzo, banengozi enkulu yokuthuthukisa i-acromegaly. Ku-MEN 1, amagxathu okukhipha ama-hormone — ngokuvamile amagxathu e-parathyroid, i-pancreas ne-pituitary gland — akhula ama-tumors futhi akhiphe ama-hormone engeziwe. Lawo ma-hormone angabangela i-acromegaly.

Uma ingaphathwa, i-acromegaly ingabangela izinkinga ezinkulu zempilo. Izinhlungu zingafaka:

• Ukuphakama kwe-kolesterol.
• Izinkinga zenhliziyo, ikakhulukazi ukukhula kwenhliziyo (cardiomyopathy).
• I-Osteoarthritis.
• I-Type 2 diabetes.
• Ukukhula kwe-gland ye-thyroid (goiter).
• Ukukhula okungaphambi komdlavuza (i-polyps) ekuqaleni kwesisu sakho.
• I-Sleep apnea, isimo lapho ukuphefumula kuye kuyeke futhi kuqale ngesikhathi sokulala.
• I-Carpal tunnel syndrome.
• Ubungozi obukhulu be-tumors yomdlavuza.
• Ukushintsha kokubona noma ukulahlekelwa ukubona.

Ukuphathwa kwasekuqaleni kwe-acromegaly kungavimbela lezi zinkinga ekuthuthukiseni noma ekuwohlokeni. Uma ingaphathwa, i-acromegaly kanye nezinhlungu zayo zingabangela ukufa kwangaphambi kwesikhathi.

Udokotela wakho uzokubuza ngomlando wakho wezokwelapha futhi enze ukuhlolwa komzimba. Ngemuva kwalokho angase aqhubekele kulezi zinyathelo ezilandelayo: Ukulinganisa i-IGF-1. Ngemva kokuthi uziqinisile ubusuku bonke, udokotela wakho uzothatha isampula legazi ukuze alinganise amazinga e-IGF-1 egazini lakho. Amazinga aphezulu e-IGF-1 abonisa i-acromegaly. Ukuhlolwa kokucindezelwa kwe-growth hormone. Lena yindlela engcono kakhulu yokuqinisekisa ukuxilongwa kwe-acromegaly. Phakathi nalesi sihloko, amazinga e-GH egazini lakho alinganisiwe kokubili ngaphambi nangemva kokuba uphuze ukulungiselela ushukela (glucose). Kubantu abangenayo i-acromegaly, isiphuzo se-glucose ngokuvamile sibangela ukwehla kwamazinga e-GH. Kodwa uma une-acromegaly, amazinga akho e-GH azohlala aphezulu. Izithombe. Udokotela wakho angase acebise ukuhlolwa kwezithombe, njengokuhlolwa kwe-magnetic resonance imaging (MRI), ukuze usize ukubona indawo nobukhulu bomdlavuza esigxotsheni sakho se-pituitary. Uma kungabonakali izigxobo ze-pituitary, udokotela wakho angase ayalele ezinye izivivinyo zezithombe ukuze afune izigxobo ezingaphandle kwe-pituitary. Olunye Ulwazi Ukuhlolwa kwe-CT Ukuhlolwa kwe-MRI

Ukwelapha i-acromegaly kuyahlukahluka ngumuntu. Uhlelo lokwelapha lwakho cishe luzoxhomeka endaweni nobukhulu be-tumor yakho, ubukhulu bezimpawu zakho, nobudala bakho nempilo yakho jikelele. Ukuze usize ekuphuculeni amazinga akho e-GH ne-IGF-1, izinketho zokwelapha zivame ukufaka ukuhlinzwa noma ukukhishwa kweradieysheni ukususa noma ukunciphisa ubukhulu be-tumor ebangela izimpawu zakho, kanye neyeza lokusiza ekuqondiseni amazinga ehormone yakho. Uma ubhekene nezinkinga zempilo ngenxa ye-acromegaly, udokotela wakho angase akukhuthazelele ezinye izindlela zokwelapha ukuze usize ukuphatha izinkinga zakho. Ukuhlinzwa Ukuhlinzwa kwe-Endoscopic transnasal transsphenoidal Khulisa isithombe Vala Ukuhlinzwa kwe-Endoscopic transnasal transsphenoidal Ukuhlinzwa kwe-Endoscopic transnasal transsphenoidal Ekwenzeni ukuhlinzwa kwe-transnasal transsphenoidal endoscopic, ithuluzi lokuhlinzwa libekwa ngesikhumba futhi eduze kwe-septum yempumulo ukuze kufinyelelwe i-tumor ye-pituitary. Odokotela bangasusa iningi le-tumors ze-pituitary usebenzisa indlela ebizwa ngokuthi ukuhlinzwa kwe-transsphenoidal. Phakathi nalesi senzakalo, udokotela wakho usebenza ngempumulo yakho ukususa i-tumor evela e-pituitary gland yakho. Uma i-tumor ebangela izimpawu zakho ingatholakali e-pituitary gland yakho, udokotela wakho uzokukhuthazelela olunye uhlobo lokuhlinzwa ukususa i-tumor. Ezimweni eziningi - ikakhulukazi uma i-tumor yakho incinyane - ukususa i-tumor kubuyisela amazinga akho e-GH ezingeni elijwayelekile. Uma i-tumor yayicindezela izicubu ezizungezile i-pituitary gland yakho, ukususa i-tumor kusiza futhi ekuqedeni izikhathi zokukhathazeka nokushintsha kokubona. Ezimweni ezithile, udokotela wakho angase angakwazi ukususa yonke i-tumor. Uma kunjalo, usengaba namazinga aphezulu e-GH ngemuva kokuhlinzwa. Udokotela wakho angase akukhuthazelele olunye ukuhlinzwa, imithi noma ukwelashwa kweradieysheni. Imithi Udokotela wakho angase akukhuthazelele enye yemithi elandelayo - noma ukuxuba kwemithi - ukuze usize amazinga ehormone yakho abuyele ezingeni elijwayelekile: Imithi eunciphisa ukukhiqizwa kwe-growth hormone (somatostatin analogues). Emzimbeni, i-hormone yengqondo ebizwa nge-somatostatin isebenza ngokumelene (ivimba) ukukhiqizwa kwe-GH. Imithi i-octreotide (Sandostatin) ne-lanreotide (Somatuline Depot) yizinguquko ezenziwe ngabantu (synthetic) ze-somatostatin. Ukuthatha enye yale mithi kubonisa i-pituitary gland ukuba ikhiqize i-GH encane, futhi kungase kunciphisa ubukhulu be-pituitary tumor. Ngokuvamile, le mithi ihlonzwa emiphini yemisipha yakho (imisipha ye-gluteal) kanye ngenyanga yisazi sezempilo. Imithi yokunciphisa amazinga ehormone (dopamine agonists). Imithi yomlomo i-cabergoline ne-bromocriptine (Parlodel) ingase isize ekuphuculeni amazinga e-GH ne-IGF-1 kwabanye abantu. Le mithi ingase isize futhi ekuphuculeni ubukhulu be-tumor. Ukuze welaphe i-acromegaly, le mithi ivame ukudingeka ithathwe ngamathani aphezulu, okuyanda ingozi yemiphumela emibi. Imipumela emibi evamile yale mithi ihlanganisa isicanucanu, ukugabha, impumulo evaliwe, ukukhathala, ukukhathazeka, izinkinga zokulala nokushintsha kwemizwelo. Iyeza lokuvimba ukusebenza kwe-GH (growth hormone antagonist). Iyeza i-pegvisomant (Somavert) livimba umphumela we-GH ezicubeni zomzimba. I-Pegvisomant ingase ibe usizo ngokukhethekile kwabantu abangazange babe nempumelelo enhle ngezinye izindlela zokwelapha. Inikezwa njengokuhlonzwa kwansuku zonke, le mithi ingasiza ekuphuculeni amazinga e-IGF-1 nokunciphisa izimpawu, kodwa ayinciphisi amazinga e-GH noma ukunciphisa ubukhulu be-tumor. Ukukhishwa Kweradieysheni Uma udokotela wakho engakwazanga ukususa yonke i-tumor ngesikhathi sokuhlinzwa, udokotela wakho angase akukhuthazelele ukwelashwa kweradieysheni. Ukwelashwa kweradieysheni kubhubhisa noma yiziphi izicubu ze-tumor ezisele futhi kunciphisa kancane amazinga e-GH. Kungathatha iminyaka ukuze lokhu kwelashwa kuthuthukise ngokucacile izimpawu ze-acromegaly. Ukwelashwa kweradieysheni kuvame ukunciphisa amazinga wezinye i-hormones ze-pituitary, futhi - hhayi i-GH kuphela. Uma uthola ukwelashwa kweradieysheni, cishe uzodinga ukuvakashela njalo udokotela wakho ukuqinisekisa ukuthi i-pituitary gland yakho isebenza kahle, nokuhlola amazinga ehormone yakho. Lokhu kunakekelwa okulandelayo kungase kuqhubeke impilo yakho yonke. Izinhlobo zokwelashwa kweradieysheni zihlanganisa: Ukwelashwa kweradieysheni okuvamile. Lolu hlobo lokwelashwa kweradieysheni ngokuvamile lunikezwa yonke ilanga leviki phakathi nesikhathi sezinyanga ezine kuya kweziyisithupha. Ungase ungaboni umphumela ophelele wokwelashwa kweradieysheni okuvamile iminyaka eyi-10 noma ngaphezulu ngemuva kokwelashwa. I-Stereotactic radiosurgery. I-Stereotactic radiosurgery isebenzisa isithombe se-3D ukuletha umthamo ophezulu weradieysheni ezicubeni ze-tumor, ngenkathi ibeka umkhawulo omningi weradieysheni ezicubeni ezijwayelekile ezizungezile. Ngokuvamile inganikezwa ngomthamo owodwa. Lolu hlobo lokwelashwa lungaletha amazinga e-GH ezingeni elijwayelekile phakathi kweminyaka emihlanu kuya kweyi-10. Ulwazi Olwengeziwe Ukwelashwa kweradieysheni I-Stereotactic radiosurgery Cela i-aphoyintimenti