Baadhitaanka dhiigga Cortisol

Baaritaanka dhiigga cortisol wuxuu cabiraa heerka cortisol ee dhiiga. Cortisol waa hormoon steroid (glucocorticoid ama corticosteroid) soo saaray qanjirka 'adrenal gland'.

Cortisol sidoo kale waa lagu cabbiri karaa iyadoo la adeegsanayo kaadi ama baaritaanka candhuufta.

Sambal dhiig ayaa loo baahan yahay.

Dhakhtarkaagu waxay u badan tahay inuu kaa qaado baaritaanka subaxa hore. Tani waa muhiim, maxaa yeelay heerka cortisol wuu kala duwan yahay maalintii oo dhan.

Waxaa lagaa codsan karaa inaadan sameyn jimicsi xoog leh maalinta ka horreysa baaritaanka.

Waxaa sidoo kale laguu sheegi karaa inaad si ku meelgaar ah u joojiso qaadashada dawooyinka saamaynta ku yeelan kara baadhitaanka, oo ay ka mid yihiin:

• Daawooyinka ka-hortagga suuxdinta
• Estrogen
• Bini-aadamka lagu sameeyo (synthetic) glucocorticoids, sida hydrocortisone, prednisone iyo prednisolone
• Androgens

Marka irbadda la geliyo si dhiig loo qaado, dadka qaar waxay dareemaan xanuun dhexdhexaad ah. Qaar kale waxay dareemaan oo keliya dharbaaxo ama xaniin. Intaas ka dib, waxaa laga yaabaa in xoogaa wax garaaco ama nabarro yar yeeshaan. Tani dhawaan way tagi doontaa.

Tijaabada waxaa loo sameeyaa si loo hubiyo soosaarka cortisol ee kordhay ama u yaraaday. Cortisol waa hormoon glucocorticoid (steroid) ah oo laga sii daayo qanjirka 'adrenal gland' iyadoo laga jawaabayo hormoonka loo yaqaan 'adrenocorticotropic hormone' (ACTH). ACTH waa hormoon laga sii daayo qanjirka 'pituitary gland' ee maskaxda.

Cortisol wuxuu saameeyaa nidaamyo badan oo jidhka ah. Waxay door ka ciyaareysaa:

• Koritaanka lafaha
• Xakamaynta cadaadiska dhiigga
• Nidaamka difaaca jirka
• Dheef-shiid kiimikaadka dufanka, karbohaydraytyada, iyo borotiinka
• Shaqeynta nidaamka neerfaha
• Jawaabta cadaadiska

Cuduro kala duwan, sida Cushing syndrome iyo Addison disease, waxay u horseedi karaan wax soo saar aad u badan ama aad u yar oo ah cortisol. Cabirka heerka cortisol ee dhiigga ayaa gacan ka geysan kara ogaanshaha xaaladahaas. Waxaa sidoo kale lagu cabiraa si loo qiimeeyo sida wanaagsan ee qanjidhada 'pituitary' iyo 'adrenal gland' ay u shaqeeyaan.

Baaritaanka waxaa badanaa la sameeyaa ka hor iyo 1 saac kadib duritaanka daawo loo yaqaan ACTH (cosyntropin). Qeybtaan baaritaanka waxaa lagu magacaabaa ACTH kicinta tijaabada. Waa baaritaan muhiim ah oo ka caawiya hubinta shaqada qanjirada 'pituitary' iyo 'adrenal gland'.

Shuruudaha kale ee imtixaanka la dalban karo waxaa ka mid ah:

• Dhibaatada adrenal ee daran, xaalad naf-gooyo ah oo dhacda marka la waayo cortisol ku filan
• Cudurka 'Sepsis', oo ah jir uu jidhku jawaab daran ku leeyahay bakteeriyada ama jeermisyada kale
• Cadaadis dhiig oo hooseeya

Qiimaha caadiga ah ee sambal dhiig oo la qaado 8da subaxnimo waa 5 ilaa 25 mcg / dL ama 140 ilaa 690 nmol / L.

Qiimaha caadiga ahi wuxuu ku xidhan yahay waqtiga maalinta iyo xaaladda caafimaad. Heerarka caadiga ahi way ku kala duwanaan karaan shaybaarada kala duwan. Shaybaarada qaarkood waxay isticmaalaan cabbiro kala duwan ama waxay tijaabin karaan tijaabooyin kala duwan. Kala hadal dhakhtarkaaga macnaha natiijooyinka baaritaankaaga gaarka ah.

Heer ka sareeya heerka caadiga ah ayaa tilmaami kara:

• Cudurka 'Cushing', oo qanjirka 'pituitary gland' uu aad uga badan yahay ACTH sababtoo ah koritaanka xad-dhaafka ah ee qanjirka 'pituitary gland' ama buro ku jirta qanjirka 'pituitary gland'
• Ectopic Cushing syndrome, kaas oo buro ka baxsan pituitary ama qanjidhada adrenal ay aad u badan ACTH
• Buro ka mid ah qanjidhada adrenal ee soosaarta cortisol aad u tiro badan
• Cadaadis
• Xanuun daran

Heer ka hooseeya heerka caadiga ah ayaa tilmaami kara:

• Cudurka Addison, kaas oo qanjidhada adrenal aysan soo saarin cortisol ku filan
• Hypopituitarism, taas oo qanjirka pituitary uusan u muujinayn qanjirka 'adrenal gland' inuu soo saaro cortisol ku filan
• Xakamaynta pituitary ama shaqada adrenal ee dawooyinka glucocorticoid oo ay ku jiraan kaniiniyada, kareemada maqaarka, indho fiiqista, neefsashada, irbadaha wadajirka ah, kemotherabi

Khatar yar ayaa ku jirta in dhiigga lagaa qaado. Xididdada iyo halbowlayaasha waxay ku kala duwan yihiin cabirka qof ilaa qof kale iyo dhinac jirka ah ilaa dhinac kale. Qaadashada dhiigga dadka qaar way ka dhib badnaan kartaa kuwa kale.

Khataraha kale ee la xiriira dhiig qaadashada waa yar yihiin, laakiin waxaa ka mid noqon kara:

• Dhiigbax xad dhaaf ah
• Miyir beelid ama dareemid madax-wareer
• Daloollo badan si loo helo xididdada
• Hematoma (dhiig ku ururaya maqaarka hoostiisa)
• Infekshan (halis yar mar kasta oo maqaarku jabo)

Serum cortisol

Chernecky CC, Berger BJ. Cortisol - plasma ama serum. Gudaha: Chernecky CC, Berger BJ, eds. Tijaabooyinka Shaybaarka iyo Nidaamyada Baadhista. 6aad ed. St Louis, MO: Elsevier Saunders; 2013: 388-389.

Stewart PM, Newell-Price JDC. Kiliyaha adrenal. Gudaha: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Buugga Buugga Endocrinology. 13aad. Philadelphia, PA: Elsevier; 2016: cutubka 15.