Prolactinoma pituitary indlala: izimbangela, izimpawu, ukuxilongwa kanye nokwelashwa. Indlala pituitary kufanele aphendule ngalokho?

Lapho umuntu ubona yigama lezokwelapha eziyinkimbinkimbi, uqala ukuqaqa kube izingxenye zalo ukuze baqonde isifo sabo. Ngakho-ke, umbuzo wakhe wokuqala awubuza wena: "Yini ihlangabezana pituitary?". Ngemva bacwaninge nzulu Imininingwane esibona ukuthi le ndlala endocrine, elawula ukusebenza kwazo zonke ezinye izindlala emzimbeni. Irhubhululo elingezelelako kuzoholela isiguli ohlwini ezivezwa hormone yabo futhi zazaziwa izitho. Futhi kuphela emva kwalokho wanquma ekugcineni ukuthola ukuthi yini lisho ukuthini inkulumo ethi "prolactinoma pituitary." Lena isimila okuveza-hormone amaningi kakhulu, umzimba ungakwazi ukuzisingatha. prolactin okweqile kanye kubangela izimpawu zokwelashwa isici. Kodwa izinto zokuqala kuqala.

Uyini indlala pituitary?

Indlala pituitary kufanele aphendule ngalokho? Pituitary indlala - kuyinto ingxenye ubuchopho obuphakathi, esisogwini ebusweni basal e bone ekwakhekeni, ngokuthi "sehhashi Turkish." Le ndlala bukhipha ama-hormone elawula ukukhula komuntu, izinga lokugayeka kokudla nokukhiqizwa siyinzalo. Pituitary indlala - umbhidisi uhlelo endocrine. Ukuhlanganyela hypothalamus, ndawonye ilawula umzimba, ukuhlinzeka imisebenzi yalo ebalulekile.

Esikhathini indlala pituitary kukhona izingxenye ezintathu noma ukwabelana:

1. Lobe anterior amahomoni utho. Basuke abizwa kanjalo ngenxa ezisithintayo izitho ezithile futhi amakhemikhali ubukele ezicutshini zawo. Lezi zihlanganisa:
   - yegilo inkanuko i-hormone (elihlobene ne-ndlala yegilo);
   - i-hormone adrenocorticotropic (kuvusa nezindlala adrenal);
   - follicle-inkanuko i-hormone (Izilawuli umsebenzi zocansi, ntombazane ekukhuleni kwamangqamuzana oocytes);
   - luteinizing i-hormone (kuvusa nge-ovulation);
   - i-hormone Ukukhula ukwanda;
   - i-hormone luteotrophic noma prolactin (ulawula ukubukeka colostrum nobisi abesifazane abakhulelwe, obangela isazela komama). Prolactinoma pituitary yokuzenzela, namanoni aphezu anterior, ke "onakalisa" umsebenzi i-hormone luteotrophic.
2. I posterior Lobe we vasopressin ethakwa (ubophezelekile ukunakekela evamile wegazi nezicubu liquid ingcindezi), kanye oxytocin, okuyinto edingekayo ukuze ngesikhathi sokukhulelwa nabancelisayo ingane. It enza imisipha bushelelezi, yawanciphisa.
3. Ingxenye isilinganiso hormone kwemiqondo ukufukula ngokusebenzisa amangqamuzana esikhumba somuntu - melanocytes.

Imisebenzi lula ukuqagela, pituitary ezihlukahlukene. It ulawula cell division and amaprotheni Kuhlanganisa ukwakha izicubu ezintsha. Ngaphezu kwalokho, ulawula nokuvuthwa kwamaqanda isidoda, kanye ukusabela komzimba nama-hormone ocansini. It kuphazamisa isimiso somzimba sokuzivikela by inkanuko noma ezivimbela umsebenzi kule ndlala. It ulawula amazinga wegazi imithambo yegazi, inani mass amanoni nobuthongo. Indlala pituitary ayitholakali amahora angu-24 ngosuku, izinsuku ezingu-7 ngesonto, zonke ekuphileni kwethu.

Prolactin - kuyini?

nokuqonda okuncane mayelana anatomy futhi izitho zomzimba kohlelo endocrine, ungakwazi uqhubekele ukuhlaziywa yayo olunemininingwane ethe xaxa. Yiqiniso, esegijima, ngaphandle ukuqeqeshwa okukhethekile ke ngeke kube lula, kodwa ungakwazi okungenani zama. Ngo uphethwe, ngaphezu igama elithi "pituitary" kwakuseneziyaluyalu prolactin. Kuyini lokhu?

Prolactin - ingenye hormone ethakwa amangqamuzana acidophilic we pituitary anterior. Nge oyiyo chemical libhekisela amaprotheni izakhiwo. Ososayensi bathola umndeni wonke izidakamizwa kokuba izici yamangqamuzana efanayo. Lezi zihlanganisa:

- prolactin;
- proliferin (Izilawuli division of zezinzwa izicubu amaseli);
- ozokusebenzisa;
- lactogen esinomhlapho (ethakwa ngesikhathi sokukhulelwa).

Okwamanje aziwa izakhiwo prolactin ngokuqondile noma ngokungaqondile obhekene umsebenzi zocansi nasekuvezeni izithombo zaso ezintsha. Target isitho kukhona, njengoba leli gama lisikisela, le nezindlala mammary. Hormone ezizokhuthaza ukukhiqizwa kwamangqamuzana colostrum futhi ukuguqulwa ku ubisi. Ngalesi sikhathi futhi ngesikhathi sokukhulelwa unesibopho ukukhula nokuthuthuka nezindlala mammary, inani lobules futhi mapayipi. Eqinisweni ezithakazelisayo: I-receptor ngoba prolactin batholakala cishe zonke kwezitho nezicubu zomzimba womuntu, kodwa lokho nomphumela kubo ayikaziwa.

prolactinoma pituitary kuphakama ngenxa ukuguquka kwezakhi zofuzo kumaseli we pituitary anterior. It kuphakamisa ukukhiqizwa ngokweqile prolactin futhi sithuthukisa impahla yayo, esithinta inhlalakahle kanye nokuvela nesineke. Ngenhlanhla, ukuxilongwa kanye nokwelashwa yalesi sifo aziwayo kakade futhi lwahlolwa ngempumelelo, ngakho uphethwe - hhayi umusho.

prolaktinoma

pituitary prolactinoma libhekisela kaningi isifo ingozi ye pituitary anterior (wezibalo, 30 per cent of bonke izimila kwatholakala ukuthi nginesifo). Common kwabesifazane yokuzala. Lihlela isilinganiso phakathi kwama abaqinile ubulili fair - 1 kuya 6.

Ubukhulu ngakho, njengoba umthetho, musa idlule amamilimitha angu ezimbili noma ezintathu, kodwa ungahlangana amadoda nemfundo ezinkulu - ngaphezu sentimutha ububanzi. Lezi izimila kukhona hormonally asebenzayo, njengoba nayo iveza prolactin. Ngokuvamile it is kuhlelwe zabo bobubili ubulili. Prolactin ingaba nomthelela iziphathimandla ngokwalo noma ngokuhlanganyela luteinizing futhi i-hormone follicle-inkanuko. Ikakhulukazi kungani leso senzo sabo sivezwe phakathi nokukhulelwa kanye lactation. Kodwa ngalé kwalokho, bona alawule umjikelezo wokuya esikhathini kanye nge-ovulation.

esiningi ngokweqile hormone has nomphumela ohlukile. Owesifazane uba ie nenzalo ayikwazi uzale ingane. Amadoda kufanele titers eliphezulu prolactin unezinkinga potency ukwakhiwa uphawu subjective futhi umgomo webele ukukhulisa.

izizathu

Ososayensi baye hhayi esiphethweni ngokuqinisekile ukuthi kungani umuntu has kuyinto neoplasm, kodwa ngaphawula ezinye izici ezivamile, evame ukubuzwa yibo bonke iziguli ezine kokutshelwa ngokukhubazeka kwengane.

Umbuzo wokuqala, yebo, kuyinto iziyaluyalu azalwa naso zofuzo kohlelo endocrine. Ngokuvamile, lokhu neoplasia amaningi (ie, isimila has cishe yonke nezindlala we uketshezi yangaphakathi). Kukhona ukukhiqizwa okweqa prolactin, hhayi kuphela, kodwa futhi amahomoni yendlala nezindlala parathyroid, amanyikwe, izindlala adrenal, pituitary indlala futhi khona izilonda esiswini.

Kuyaziwa ukuthi izihlobo ithuba ukuze uthole le zokugula ingaphezu kwe-avareji for labantu ezaziwayo. isayensi yezakhi zofuzo yanamuhla akayikhiphi futhi ifuna zofuzo ukushintsha izici anterior pituitary kumaseli, kodwa impumelelo kuze kube manje kule nsimu alikho.

ngezigaba

Pituitary adenoma (prolactinoma) ziyahlukahluka kuye ngendawo ngaphakathi sella. Izimila secrete amaqembu amabili:

1. Intrasellyarnye prolactinomas ukuthi musa idlule eyodwa isentimitha ngobukhulu futhi abeqeli ngalé kwemingcele ithambo pituitary fossa.
2. Ekstrasellyarnye prolactinoma nge esikhulu elikhulu ngaphesheya sella.

Usayizi yesimila incike kobukhulu izimpawu. Lokhu awasebenzi kuphela isenzo ezithile kule hormone. Ukuvuvukala volumetric ekucindezela nezinye izakhiwo okubangela jikelele futhi ebalulekile symptomatology zezinzwa ubuchopho,. Lokhu kungaba ubumpumputhe, ukulahlekelwa iphunga, ukulahlekelwa nezinye emsipheni cranial (trigeminal, ebusweni, oculomotor). izimpawu ezivamile zibandakanya ubuhlungu bekhanda, isimo sokucindezeleka, ukukhathazeka, ukucasuka kanye lability ngokomzwelo.

Prolactinoma pituitary: izimpawu kwabesifazane

Kwaphela isikhathi eside, lona wesifazane singase singakuboni izinguquko okwethusayo umzimba wakho, ikakhulukazi uma kufanele, futhi lesi sifo babenezinkinga nomjikelezo wokuya esikhathini. In iziguli waphawula nokuncipha kwenani lezinsuku zokwehlukaniswa, ukuntuleka uketshezi noma engekho. Ladies abafisa ukuba ingane ingeke ikwazi ukwenza kanjalo, njengoba ukukhiqizwa kwamaqanda ingekho.

Yiziphi ezinye izimpawu zenzeka abesifazane? prolactinoma pituitary ezizokhuthaza ukukhiqizwa kwamangqamuzana colostrum nobisi, ngisho nabobulili fair abangekho ukulungele aba omama. amaconsi Liquid kungenzeka ezikhishwe kokucindezelwa mechanical ingono noma ekunqandeni wedwa (ngokuvamile ngenxa semali ubisi). Abesifazane kanye ukubukeka lezi zimpawu kwasekuqaleni cabanga yomdlavuza webele noma ezinye izinguquko zendawo, kodwa ukuhlolisisa ungathola umnyombo wenkinga.

Izimpawu ze-pituitary prolactinoma kwabesifazane - akuyona nje ukukhethwa colostrum nobisi, kubuye kube ukwenyuka ithambo fragility kuze kube kwamathambo. Ngaphezu kwalokho, kwamaphutha kwezinye hormone, ezifana estrogen kubangela nokugcinwa uketshezi emzimbeni, futhi ngokushesha kwesisindo. Lokho esikubonayo kungase ukushintsha kakhulu - polymorphic induna amawala, kukhuphuke hairiness udebe eliphezulu eziqongweni ezindlebeni. Konke lokhu kufanele uthinte nomqondo likadokotela kuwuphawu lwesimila pituitary.

Izimpawu ezingabantu

pituitary prolactinoma ezingabantu uveta ukwehla kwamazinga testosterone futhi kahle igciwane kwamangqamuzana nokwakheka kwamanye ingaphazamiseki. Lokho futhi inzalo. Kodwa nge aspermia elahlekile i ukwakhiwa, encishisiwe ubulili drive, potency incipha.

Ngaphezu kwalokho, abameleli nengxenye enamandla wabona ukwanda kanye ushintsho ukuma ebeleni - gynecomastia. Njengomthetho, kuvamile e abadlali professional, igxile iqoqo yemisipha, futhi umuntu ayemukeli steroid, kufanele kube uphawu yingozi. Ngezinye izikhathi ngenxa webele anda angase avuze ubisi.

Ngaphezu kwalokho, amadoda ekugcineni yoma we nezindlala ocansini, elingekho izinhlamvu ngokobulili yesibili, livela fragility ngokweqile amathambo ukuba buthakathaka kwezicubu.

ukuhlola

Pituitary isimila (prolactinoma) uvame kunqunywa emva neuroimaging luhlolo (magnetic resonance imaging). Futhi hhayi nje ngifuna shot panoramic, kanye nomthelela yokusesha pituitary zokugula usebenzisa ejenti Ngokuphambene - gadolinium, tropic neuroendocrine izicubu. MRI kungacacisa ukuthi ubukhulu nendawo izimila.

Lapho nengcosana isimila, elilodwa isentimitha, kubalulekile ukusebenzisa computed tomography, ngoba ngaphezulu ulwazi. CT kuyabonakala amathambo aqatha futhi ushintsho yabo ngokuhamba ukukhula adenoma.

Kodwa ngaphezu izindlela nowezinsimbi bayadingeka ngokuqondile uqinisekise uphethwe okulungiselela ukuhlinzwa, kukhona laboratory izindlela zokuxilonga. Esokuqala kutholakale izinga prolactin egazini. Uhlaziyo kufanele sigcwaliswe kathathu, ngezinsuku ezahlukene umjikelezo wokuya esikhathini wokuthi yadalwa Imiphumela zamanga-HIV noma amanga-negative nawukucindezeleka noma iyehla iyenyuka bokuphila. Umphumela okubonisa ezingaphezu kuka-200 nanograms ngemililitha ngamunye, cishe sasiyikhulu namashumi amaphesenti kubonisa khona lwesimila.

Uma amazinga prolactin zazisuka nanograms 40 kuya ku-100, kungenzeka ukuthi lezi zibalo zibangelwa ukwehla umsebenzi yegilo, esifubeni ukuhlukumezeka, noma ukungasebenzi kwezinso. Yiqiniso, lezi izifo nazo ithemba.

Ukwambulwa kakhulu yokuhlola thyrotropin. Ngemva kokuphathwa emthanjeni e isigamu sehora kukhona belilokhu ziyanda prolactin. i-hormone lokuhlushwa okungenani kabili lekufa. Uma iziguli prolaktinome inani prolactin egazini akashintshi noma sinyukile kancane. Uma hormone ezingeni Ukwanda okungavamile akuyona ngenxa isimila, nezinye izinto, zasabela kanjani thyroliberine kuyoba eduze evamile.

Ungakhohlwa uthintane ochwepheshe ezihlobene nekubuta imibuto ngokucophelela wonke umzimba wesiguli. Ukuze zokugula umsolwa, ngezinye izikhathi kwanele ukubuza imibuzo efanele.

ukwelashwa

Ukwelashwa nokuvikelwa pituitary prolactinomas ngokuvamile imithi. Engamakhambi okuhloswe ngazo ukunciphisa amazinga hormone kanye nemiphumela engemihle yayo yokululama. Ukukhethwa kwemithi kanye umthamo lwemithi yabo endocrinology wenziwa kuphela ngaphansi kokulawula uphethwe laboratory. Ngezinye arsenal likadokotela kunemithi ezifana "Bromkriptin", "L-dopa", "Cyproheptadine", "Cabergoline" nabanye. Iziguli eziningi kusiza isiqu esithi "bromocriptine". Umthelela ephawuleka phakathi namasonto ambalwa. Kepha has a lot of imiphumela eminingi engemihle njengezindlela ngakho ukhetho best kuyinto 'Cabergoline'. Ngaphezu kwalokho, kulula ukuyisebenzisa (nje lesitigamu letimbili ngeliviki).

Therapy encishisiwe usayizi isimila, le uketshezi of prolactin esebuyela umbono ovamile, ayeke ukuvuza colostrum. Ngo abesifazane yokuzala ivele kokuya esikhathini, umsebenzi zokuzala kubuyiselwa. Abesilisa ayeka ukuba khona oyinyumba, ukubuyela libido.

Uma, ngemuva Yiqiniso eside yokwelapha ngoludala, isimo ayikashintshi zibe ngcono, noma kwakukhona mkhuba omubi, le ohlinza izinzwa nge endocrinology ucabangela kokungenela kuhlinzwa. Ezigulini ezine-contraindications ukuhlinzwa, likhona elinye - radiotherapy. Kodwa-ke has nemiphumela ethile engathandeki: ekuthuthukiseni pituitary esingamahlalakhona, futhi kudingeka impilo yonke replacement therapy.

Ukudla prolaktinome pituitary okuhloswe ngazo ukunciphisa isisindo okweqile, eyabonakala ku isizinda ukwehluleka hormone. Endocrinologist noma okunomsoco kungasiza iqhinga ukudla ezokwenza aqukethe zonke macro- ezidingekayo futhi microelements, kanye abe okuqukethwe okusezingeni eliphezulu calcium ne phosphorus ezidingekayo ukuze kuvikelwe kwamathambo. Ukudla okunomsoco, ungakwazi unamathele futhi emva isifo tshoda.

Ukwelashwa nokuvikelwa pituitary prolactinoma amakhambi abantu akuyona kuyancomeka ngochwepheshe njengoba infusions kanye Iziphungo Ungasingenisi umphumela oyifunayo, kodwa ngesikhathi esifanayo zivimbela umsebenzi ndlala nezindlala adrenal. Lokhu kungase zibulale isimo lesiguli zempilo, kanye izibikezelo mayelana yokutakula. Uma kangaka ufuna ahlupha ngokwami zokupheka kagogo, ungakhohlwa kudokotela.

Ukubikezela kanye nokuvinjelwa

Ngingaba lokulungisa prolactinoma pituitary indlala? Imiphumela zokukhiqiza ngokweqile kwama-hormone emzimbeni abanjalo ukuthi, ngisho noma isimila bungasekho, abantu isazoqhubeka eside ukuba ngilulame imisebenzi elahlekile. Ngaphezu kwalokho, odokotela awukho izibikezelo mayelana izinga yokutakula nokwelashwa impumelelo.

Lapho inkinga iphinde ibuya cishe ngemva kwengxenye iziguli nangemva izibalo ukuhlinzwa kukhona ngisho aphansi - amaphesenti amathathu kuphela abantu babelapheka.

Kufana nesigwebo ukuxilongwa "prolactinoma pituitary?" Izibikezelo ukunikeza kanzima. Ukwelashwa kungase kuthathe iminyaka engu-hhayi ukunikeza noma yimuphi imiphumela. Njalo ngemva kweminyaka embalwa, odokotela belulekwa ukuba bathathe ikhefu phakathi izifundo imithi ukuze akhulule nezinso isibindi. Kodwa ngesikhathi esifanayo, ekususweni izidakamizwa kungabangela umdlavuza futhi isimila ukukhula.

Iziguli ukusungula saziso wezokwelapha isheke-up. Minyaka yonke banayo ukwenza ikhompyutha noma resonance kazibuthe a imaging zobuchopho, uthintane kudokotela wezifo zamehlo, udokotela wezifo zabesifazane kanye endocrinology, futhi kumelwe bavivinywe ngeleveli prolactin. a Ukuzihlola okunjalo olunzulu, Ukuqhathanisa ukusebenza ngokuhamba kwesikhathi, futhi ukulungisa ngesikhathi esifanele ukwelashwa enze kube nokwenzeka ukuba wenze ezinye ezicatshangwayo mayelana nokuvulwa iziguli.