Konke Odinga Ukukwazi Nge-Cushing's Syndrome

-Delile

• Ukubuka konke
• Izimpawu zesifo sikaCushing's syndrome
• Ezinganeni
• Kwabesifazane
• Emadodeni
• Izimbangela ze-Cushing's syndrome
• Ama-Corticosteroids
• Izimila
• Isifo sikaCushing
• Ukwelashwa kwe-Cushing's syndrome
• Ukuxilongwa kwe-Cushing's syndrome
• Ukuhlonza imbangela yeCushing’s syndrome
• Ukudla kwe-Cushing's syndrome
• Izici zobungozi be-Cushing's syndrome
• Ukuphathwa kwe-Cushing's syndrome
• Umbono we-Cushing's syndrome

Ukubuka konke

I-Cushing's syndrome noma i-hypercortisolism, yenzeka ngenxa yamazinga aphezulu ngokungajwayelekile we-hormone cortisol. Lokhu kungenzeka ngezizathu ezahlukahlukene.

Ezimweni eziningi, ukuthola ukwelashwa kungakusiza ukuphatha amazinga akho e-cortisol.

Izimpawu zesifo sikaCushing's syndrome

Izimpawu ezivame kakhulu zalesi simo yilezi:

• ukuzuza kwesisindo
• okunamafutha, ikakhulukazi maphakathi nobubanzi, ubuso (obudala ubuso obuzungezayo, obunjengeyenyanga), naphakathi kwamahlombe nangaphezulu emuva (kubangela i-buffalo hump)
• izimpawu ezinsomi ezifubeni, ezingalweni, esiswini nasemathangeni
• isikhumba esinciphayo esilimazayo kalula
• ukulimala kwesikhumba okuphuza ukwelashwa
• induna
• ukukhathala
• ubuthakathaka bemisipha

Ngaphezu kwezimpawu ezivamile ezingenhla, kunezinye izimpawu ezingase zibonakale kwesinye isikhathi kubantu abane-Cushing’s syndrome.

Lokhu kungafaka:

• ushukela ophakeme wegazi
• ukoma okwandisiwe
• ukwanda kokuchama
• ukukhumuzeka kwamathambo
• umfutho wegazi ophezulu (umfutho wegazi ophakeme)
• ikhanda elibuhlungu
• ukushintsha kwemizwelo
• ukukhathazeka
• ukucasuka
• ukudana
• ukwanda kwezifo

Ezinganeni

Izingane zingaba ne-Cushing’s syndrome futhi, yize ziyithuthukisa kancane kunabantu abadala. Ngokuya ngocwaningo lwango-2019, mayelana namacala amasha we-Cushing's syndrome unyaka ngamunye avela ezinganeni.

Ngaphezu kwezimpawu ezingenhla, izingane ezine-Cushing's syndrome nazo zingaba:

• ukukhuluphala ngokweqile
• izinga lokukhula kancane
• umfutho wegazi ophezulu (umfutho wegazi ophakeme)

Kwabesifazane

ICushing’s syndrome ivame kakhulu kubantu besifazane kunabesilisa. NgokweNational Institutes of Health (NIH), abesifazane abaphindwe kathathu baba ne-Cushing’s syndrome uma kuqhathaniswa nabesilisa.

Abesifazane abane-Cushing's syndrome bangakhula izinwele ezengeziwe zobuso nezomzimba.

Lokhu kuvame ukwenzeka ku:

• ubuso nentamo
• isifuba
• isisu
• amathanga

Ngokwengeziwe, abesifazane abane-Cushing’s syndrome nabo bangathola ukuya esikhathini okungajwayelekile. Kwezinye izimo, ukuya esikhathini akukho ngokuphelele. I-Cushing's syndrome engalashwa kubantu besifazane ingaholela ebunzimeni bokukhulelwa.

Emadodeni

Njengoba kunjalo ngabesifazane nezingane, amadoda ane-Cushing's syndrome nawo angathola ezinye izimpawu ezingeziwe.

Amadoda ane-Cushing's syndrome angaba:

• ukungasebenzi kahle kwe-erectile
• ukulahlekelwa intshisekelo yezocansi
• ukuncipha kokuzala

Izimbangela ze-Cushing's syndrome

I-Cushing's syndrome ibangelwa ukweqisa kwe-hormone cortisol. Izindlala zakho ze-adrenal zikhiqiza i-cortisol.

Kuyasiza ngemisebenzi eminingi yomzimba wakho, kufaka phakathi:

• elawula umfutho wegazi kanye nenhliziyo nemithambo yegazi
• ukunciphisa impendulo yokuvuvukala kwamasosha omzimba
• kuguqula ama-carbohydrate, amafutha, namaprotheni abe amandla
• kulinganisa imiphumela ye-insulin
• ephendula ukucindezeleka

Umzimba wakho ungakhiqiza amazinga aphezulu we-cortisol ngezizathu ezahlukahlukene, kufaka phakathi:

• amazinga aphezulu okucindezeleka, kufaka phakathi ukucindezeleka okuhlobene nokugula okunamandla, ukuhlinzwa, ukulimala, noma ukukhulelwa, ikakhulukazi ku-trimester yokugcina
• ukuqeqeshwa kwezemidlalo
• ukungondleki
• ukuphuza ngokweqile
• ukudana, ukukhathazeka, noma amazinga aphezulu okucindezeleka ngokomzwelo

Ama-Corticosteroids

Isizathu esivame kakhulu se-Cushing's syndrome ukusetshenziswa kwemithi ye-corticosteroid, njenge-prednisone, ngemithamo ephezulu isikhathi eside. Abahlinzeki bezokunakekelwa kwempilo bangakunikeza lokhu ukwelapha izifo ezivuthayo, njenge-lupus, noma ukuvimbela ukwenqatshwa kwesitho esifakelwe kabusha.

Ukweqiwa okuphezulu kwama-steroid anokujova ekwelashweni kobuhlungu beqolo nakho kungadala iCushing's syndrome. Kodwa-ke, ama-dose aphansi ama-steroid ngesimo se-inhalants, njengaleso esisetshenziselwa i-asthma, noma ama-cream, njengalezo ezinqunyelwe i-eczema, ngokuvamile azanele ukudala isimo.

Izimila

Izinhlobo eziningana zamathumba nazo zingaholela ekukhiqizweni okuphezulu kwe-cortisol.

Ezinye zazo zifaka:

• Izimila zezindlala ze-pituitary. Indlala ye-pituitary ikhipha i-hormone ye-adrenocorticotropic eningi kakhulu (i-ACTH), evuselela ukukhiqizwa kwe-cortisol kuzindlala ze-adrenal. Lokhu kubizwa ngesifo sikaCushing.
• Izimila ze-Ectopic. Lezi yizicubu ezingaphandle kwepituitary ezikhiqiza i-ACTH. Imvamisa zivela emaphashini, amanyikwe, igilo, noma i-thymus gland.
• Ukungajwayelekile kwe-adrenal gland noma isimila. Ukungajwayelekile kwe-adrenal noma isimila kungaholela emaphethini angavamile okukhiqizwa kwe-cortisol, okungadala iCushing's syndrome.
• I-Familial Cushing's syndrome. Yize i-Cushing's syndrome ingajwayelekile njengefa, kungenzeka ukuba nokuthambekela okuzuzwe njengefa kokuthuthukisa izicubu zezindlala ze-endocrine.

Isifo sikaCushing

Uma i-Cushing's syndrome ibangelwa yindlala ye-pituitary ekhiqiza ngokweqile i-ACTH nayo eba yi-cortisol, ibizwa ngokuthi isifo sikaCushing.

Njenge-Cushing's syndrome, isifo sikaCushing sithinta abesifazane abaningi kunabesilisa.

Ukwelashwa kwe-Cushing's syndrome

Inhloso ephelele yokwelashwa kwe-Cushing's syndrome ukwehlisa amazinga e-cortisol emzimbeni wakho. Lokhu kungafezwa ngezindlela eziningana. Ukwelashwa okutholayo kuzoya ngokuthi yini ebanga isimo sakho.

Umhlinzeki wakho wezokunakekelwa kwempilo angakunikeza umuthi ozosiza ukuphatha amazinga e-cortisol. Eminye imishanguzo inciphisa ukukhiqizwa kwe-cortisol kuzindlala ze-adrenal noma yehlise ukukhiqizwa kwe-ACTH kundlala ye-pituitary. Eminye imithi ivimba umphumela we-cortisol ezicutshini zakho.

Izibonelo zifaka:

• ketoconazole (Nizoral)
• i-mitotane (Lysodren)
• i-metyrapone (Metopirone)
• i-pasireotide (Signifor)
• mifepristone (Korlym, Mifeprex) kubantu abane-type 2 yesifo sikashukela noma ukungabekezelelani kwe-glucose

Uma usebenzisa i-corticosteroids, kungadingeka ushintsho emithini noma kumthamo. Ungazami ukushintsha umthamo ngokwakho. Lokhu kufanele ukwenze ngaphansi kweso elibukhali lezokwelapha.

Izicubu zingaba yingozi, okusho ukuthi unomdlavuza, noma ubungozi, okusho ukuthi awunomdlavuza.

Uma isimo sakho sibangelwa isimila, umhlinzeki wakho wezokunakekelwa kwempilo angafuna ukususa isimila ngokuhlinzwa. Uma isimila singeke sisuswe, umhlinzeki wakho wezokunakekelwa kwempilo futhi angancoma ukwelashwa ngemisebe noma i-chemotherapy.

Ukuxilongwa kwe-Cushing's syndrome

I-Cushing's syndrome ingaba nzima kakhulu ukuxilongwa. Lokhu kungenxa yokuthi eziningi zezimpawu, njengokuzuza kwesisindo noma ukukhathala, zingaba nezinye izimbangela. Ngokwengeziwe, i-Cushing’s syndrome uqobo ingaba nezimbangela eziningi ezahlukene.

Umhlinzeki wakho wezokunakekelwa kwempilo uzobuyekeza umlando wakho wezokwelapha. Bazobuza imibuzo mayelana nezimpawu, noma yiziphi izimo zezempilo ongahle ube nazo, kanye nanoma yimiphi imithi ongayinikezwa.

Bazophinda futhi benze izivivinyo zomzimba lapho bezobheka khona izimpawu ezinjengezinyathi, kanye nama-stretch marks nemihuzuko.

Okulandelayo, banga-oda izivivinyo zaselebhu, kufaka phakathi:

• Ukuhlolwa kwamahhala kwe-cortisol kwamahora angama-24: Kulesi sivivinyo, uzocelwa ukuthi uqoqe umchamo wakho esikhathini esingamahora angama-24. Kuzobe sekuvivinywa amazinga e-cortisol.
• Isilinganiso se-salivary cortisol: Kubantu abangenayo i-Cushing’s syndrome, amazinga e-cortisol ehla kusihlwa. Lokhu kuhlolwa kukala izinga le-cortisol kusampula yamathe eqoqwe ebusuku kakhulu ukubona ukuthi amazinga e-cortisol aphezulu kakhulu yini.
• Isivivinyo sokucindezela i-dexamethasone esilinganiselwe kakhulu: Kulesi sivivinyo, uzonikezwa umthamo we-dexamethasone kusihlwa. Igazi lakho lizohlolwa amazinga e-cortisol ekuseni. Imvamisa, i-dexamethasone ibangela ukuthi amazinga e-cortisol ehle. Uma une-Cushing's syndrome, lokhu ngeke kwenzeke.

Ukuhlonza imbangela yeCushing’s syndrome

Ngemuva kokuthola ukuxilongwa kwe-Cushing's syndrome, umhlinzeki wakho wezokunakekelwa kwempilo kusamele anqume imbangela yokukhiqizwa okweqile kwe-cortisol.

Ukuhlolwa okusiza ukuthola imbangela kungafaka:

• Ukuhlolwa kwegazi i-adrenocorticotropin (ACTH): Kukalwa amazinga e-ACTH egazini. Amazinga aphansi e-ADTH namazinga aphezulu we-cortisol angakhombisa ukuba khona kwesimila kuzindlala ze-adrenal.
• Isivivinyo sokukhuthaza i-Corticotropin-releasing hormone (CRH): Kulesi sivivinyo, kudutshulwa i-CRH. Lokhu kuzokhuphula amazinga e-ACTH ne-cortisol kubantu abanezicubu ze-pituitary.
• Ukuhlolwa kokucindezela kwe-dexamethasone yedosi ephezulu: Lokhu kuyefana nokuhlolwa komthamo ophansi, ngaphandle kokuthi kusetshenziswa umthamo ophakeme we-dexamethasone. Uma amazinga e-cortisol ehla, ungaba nesimila sepituitary. Uma kungenjalo ungaba nesimila se-ectopic.
• Isampula yesono sikaPetrosal: Igazi likhishwa emthanjeni oseduze ne-pituitary futhi futhi kusuka emthanjeni okude kakhulu ne-pituitary. Kudutshulwa i-CRH. Izinga eliphakeme le-ACTH egazini eliseduze ne-pituitary lingakhombisa isimila se-pituitary. Amazinga afanayo avela kuwo womabili amasampula akhombisa isimila se-ectopic.
• Ukucwaninga izifundo: Lokhu kungafaka izinto ezifana nokuskena kwe-CT ne-MRI. Zisetshenziselwa ukubona ngeso lengqondo izindlala ze-adrenal ne-pituitary ukufuna izicubu.

Ukudla kwe-Cushing's syndrome

Yize izinguquko zokudla zingaselaphi isimo sakho, zingasiza ukugcina amazinga akho e-cortisol ukuthi angakhuphuki kakhulu noma asize ukuvimbela ezinye izinkinga.

Amanye amathiphu wokudla kulabo abane-Cushing's syndrome afaka:

• Qapha ikhalori lakho lokudla. Ukugcina ithrekhi yokudla kwakho ikhalori kubalulekile njengoba ukuzuza kwesisindo kungenye yezimpawu eziyinhloko ze-Cushing's syndrome.
• Zama ukugwema ukuphuza utshwala. Ukusetshenziswa kotshwala kuye kwaxhunyaniswa nokukhuphuka kwamazinga e-cortisol, ikakhulukazi, ngokusho kocwaningo lwango-2007.
• Buka ushukela wegazi lakho. I-Cushing's syndrome ingaholela ku-glucose ephezulu yegazi, ngakho-ke zama ukungakudli ukudla okungadala ukwanda kukashukela egazini. Izibonelo zokudla okuzogxila ekudleni zifaka imifino, izithelo, okusanhlamvu okuphelele nenhlanzi.
• Nciphisa i-sodium. ICushing’s syndrome iphinde ihlotshaniswe nomfutho wegazi ophezulu (umfutho wegazi ophezulu). Ngenxa yalokhu, zama ukukhawulela i-sodium yakho. Ezinye izindlela ezilula zokwenza lokhu zifaka ukungafaki usawoti ekudleni nokufunda ngokucophelela amalebula okudla ukuze uhlole okuqukethwe kwe-sodium.
• Qiniseka ukuthi uthola i-calcium eyanele novithamini D. ICushing’s syndrome ingenza buthaka amathambo akho, ikwenze uthambekele ekuqhekekeni. Kokubili i-calcium nevithamini D kungasiza ekuqiniseni amathambo akho.

Izici zobungozi be-Cushing's syndrome

Isici esiyinhloko sengozi yokuthuthukisa i-Cushing's syndrome kuthatha ama-corticosteroids aphezulu kakhulu isikhathi eside. Uma umhlinzeki wakho wezokunakekelwa kwezempilo enqume ama-corticosteroids ukuthi alaphe isimo sempilo, babuze ngomthamo nokuthi uzozithatha isikhathi esingakanani.

Ezinye izinto ezinobungozi zingabandakanya:

• uhlobo-2 sikashukela olungaphethwe kahle
• umfutho wegazi ophezulu (umfutho wegazi ophakeme)
• ukukhuluphala ngokweqile

Ezinye izimo ze-Cushing's syndrome zibangelwa ukwakheka kwesimila. Yize kungaba nokuthambekela kofuzo kokuthuthukisa izicubu ze-endocrine (i-familial Cushing's syndrome), ayikho indlela yokuvimbela izicubu ekubunjweni.

Ukuphathwa kwe-Cushing's syndrome

Uma une-Cushing's syndrome, kubalulekile ukuthi iphathwe kahle. Uma ungakutholi ukwelashwa ngayo, i-Cushing's syndrome ingaholela ezinhlotsheni ezahlukahlukene ezingaba yinkinga enkulu yezempilo.

Lokhu kungafaka:

• i-osteoporosis, engakhuphula ubungozi bokuqhekeka kwamathambo
• ukulahleka kwemisipha (i-atrophy) nobuthakathaka
• umfutho wegazi ophezulu (umfutho wegazi ophakeme)
• thayipha 2 sikashukela
• ukutheleleka okuvamile
• isifo senhliziyo noma isifo sohlangothi
• ukudana noma ukukhathazeka
• ubunzima bokuqonda njengenkinga yokugxila noma izinkinga zememori
• ukukhulisa isimila esivele sikhona

Umbono we-Cushing's syndrome

Uma uqala ngokushesha ukwelashwa, iba ngcono imiphumela elindelekile. Kubalulekile ukuqaphela ukuthi umbono wakho ngamunye uncike kwisizathu esithile kanye nokwelashwa okutholayo.

Kungathatha isikhathi ukuthi izimpawu zakho zithuthuke. Qiniseka ukuthi ubuza umhlinzeki wakho wezokunakekelwa kwezempilo imihlahlandlela yokudla enempilo, gcina ama-aphoyintimenti wokulandelela, futhi wandise izinga lomsebenzi wakho kancane.

Amaqembu okusekela angakusiza ukubhekana ne-Cushing's syndrome. Isibhedlela sangakini noma umhlinzeki wezokunakekelwa kwempilo angakunika imininingwane ngamaqembu ahlangana endaweni yangakini.