Ukuhlolwa kwegazi leCortisol

Ukuhlolwa kwegazi kwe-cortisol kukala izinga le-cortisol egazini. ICortisol iyi-hormone ye-steroid (i-glucocorticoid noma i-corticosteroid) ekhiqizwa yi-adrenal gland.

ICortisol nayo ingalinganiswa kusetshenziswa ukuhlolwa komchamo noma kwamathe.

Kudingeka isampula yegazi.

Udokotela wakho cishe uzokwenza isivivinyo ekuseni kakhulu. Lokhu kubalulekile, ngoba izinga le-cortisol liyahlukahluka usuku lonke.

Ungacelwa ukuthi ungenzi noma ikuphi ukuzivocavoca ngamandla ngosuku olwandulela ukuhlolwa.

Ungatshelwa futhi ukuthi uyeke ukuthatha imishanguzo okwesikhashana okungathinta ukuhlolwa, kufaka phakathi:

• Izidakamizwa ezilwa nokuquleka
• I-Estrogen
• I-glucocorticoids eyenziwe ngabantu (i-hydrocortisone, i-prednisone ne-prednisolone)
• I-Androgens

Lapho inaliti ifakwa ukudonsa igazi, abanye abantu bezwa ubuhlungu obulinganiselayo. Abanye bazizwa beshaywa noma betinyelwa kuphela. Ngemuva kwalokho, kungahle kube nokushaywa okuthile noma ukulinyazeka okuncane. Lokhu maduzane kuyaphela.

Isivivinyo senziwa ukuhlola ukukhiqizwa kwe-cortisol okwandisiwe noma okunciphile. ICortisol iyi-hormone ye-glucocorticoid (steroid) ekhishwe kwi-adrenal gland ekuphenduleni i-adrenocorticotropic hormone (ACTH). I-ACTH iyi-hormone ekhishwa endlala yobuchopho ebuchosheni.

ICortisol ithinta izinhlelo eziningi ezahlukene zomzimba. Idlala indima ku:

• Ukukhula kwamathambo
• Ukulawulwa kwengcindezi yegazi
• Umsebenzi wesistimu yomzimba
• I-metabolism yamafutha, ama-carbohydrate, namaprotheni
• Ukusebenza kwesistimu yezinzwa
• Impendulo yengcindezi

Izifo ezahlukahlukene, ezinjenge-Cushing syndrome nesifo i-Addison, zingaholela ekukhiqizeni kakhulu noma okuncane kakhulu kwe-cortisol. Ukukala izinga le-cortisol yegazi kungasiza ukuxilonga lezi zimo. Kukalwa futhi ukubheka ukuthi zisebenza kahle kanjani izindlala ze-pituitary ne-adrenal.

Ukuhlolwa kuvame ukwenziwa ngaphambi nangehora eli-1 ngemuva kokujovwa komuthi obizwa nge-ACTH (cosyntropin). Le ngxenye yokuhlolwa ibizwa ngokuthi yi-ACTH test stimulation test. Kuyisivivinyo esibalulekile esisiza ukuhlola ukusebenza kwezindlala ze-pituitary ne-adrenal.

Eminye imibandela ukuhlolwa okunga-odwa kuyo ifaka:

• Inkinga ye-adrenal, isimo esisongela impilo esenzeka lapho ingekho i-cortisol eyanele
• I-Sepsis, ukugula lapho umzimba uphendula kanzima kubhaktheriya noma amanye amagciwane
• Umfutho wegazi ophansi

Amanani ajwayelekile esampula yegazi athathwe ngo-8 ekuseni angama-5 kuye ku-25 mcg / dL noma ngo-140 kuya ku-690 nmol / L.

Amanani ajwayelekile ancike esikhathini sosuku nomongo womtholampilo. Izilinganiso ezijwayelekile zingahluka kancane phakathi kwamalabhorethri ahlukene. Amanye amalebhu asebenzisa izilinganiso ezahlukahlukene noma angahlola izinhlobo ezihlukile. Khuluma nodokotela wakho mayelana nencazelo yemiphumela yakho ethile yokuhlolwa.

Izinga eliphakeme kunokujwayelekile lingaveza:

• Isifo se-Cushing, lapho i-pituitary gland yenza i-ACTH eningi kakhulu ngenxa yokukhula okweqile kwendlala ye-pituitary noma isimila endleni ye-pituitary
• I-Ectopic Cushing syndrome, lapho isimila esingaphandle kwezindlala zepituitary noma i-adrenal senza i-ACTH eningi kakhulu
• Isigaxa se-adrenal gland esikhiqiza i-cortisol eningi kakhulu
• Ukucindezeleka
• Ukugula okunamandla

Izinga eliphansi kunokujwayelekile lingaveza:

• Isifo i-Addison, lapho izindlala ze-adrenal zingakhiqizi i-cortisol eyanele
• I-Hypopituitarism, lapho i-pituitary gland ingakhombisi i-adrenal gland ukuthi ikhiqize i-cortisol eyanele
• Ukucindezelwa komsebenzi ojwayelekile wesibeletho noma we-adrenal ngemithi ye-glucocorticoid kufaka phakathi amaphilisi, okhilimu besikhumba, ama-eyedrops, ama-inhalers, imijovo ehlangene, i-chemotherapy

Kunengozi encane ethintekayo ekuthatheni igazi lakho. Imithambo nemithambo yegazi kuyahluka ngosayizi komunye umuntu kuya kolunye uhlangothi lomzimba kuya kolunye. Ukuthatha igazi kwabanye abantu kungaba nzima kakhulu ukwedlula kwabanye.

Ezinye izingozi ezihambisana nokudonswa igazi zincane, kepha zingafaka:

• Ukopha ngokweqile
• Ukuquleka noma uzizwe unekhanda elincane
• Ukubhoboza okuningi ukuthola imithambo
• I-hematoma (ukuqoqwa kwegazi ngaphansi kwesikhumba)
• Ukutheleleka (ingozi encane noma kunini lapho isikhumba siphukile)

I-serum cortisol

IChernecky CC, iBerger BJ. ICortisol - i-plasma noma i-serum. Ku: IChernecky CC, iBerger BJ, ama-eds. Ukuhlolwa Kwelabhoratri Nezinqubo Zokuxilonga. Umhlaka 6. ISt Louis, MO: Elsevier Saunders; 2013: 388-389.

UStewart PM, iNewell-Price JDC. I-adrenal cortex. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 15.