Teko ea ts'usumetso ea ACTH

Teko ea ts'ebetso ea ACTH e lekanya hore na litšoelesa tsa adrenal li arabela joang ho adrenocorticotropic hormone (ACTH). ACTH ke hormone e hlahisoang ke tšoelesa ea pituitary e susumetsang litšoelesa tsa adrenal ho ntša hormone e bitsoang cortisol.

Teko e etsoa ka tsela e latelang:

• Mali a hao a huletsoe.
• Ebe o fumana thunya (ente) ea ACTH, hangata e kenang mosifeng lehetleng la hao. ACTH e kanna ea ba sebopeho se entsoeng ke motho (synthetic).
• Kamor'a metsotso e 30 kapa e 60, kapa ka bobeli, ho latela hore na u amohela ACTH e kae, mali a hao a huloa hape.
• Lab e hlahloba boemo ba cortisol disampoleng tsohle tsa madi.

U kanna oa ba le liteko tse ling tsa mali, ho kenyeletsoa ACTH, joalo ka karolo ea tlhahlobo ea mali ea pele. Hammoho le liteko tsa mali, o kanna oa ba le tlhahlobo ea moroto ea cortisol kapa urine ea 17-ketosteroids, e kenyeletsang ho bokella moroto ka nako ea lihora tse 24.

U kanna ua hloka ho lekanyetsa mesebetsi le ho ja lijo tse nang le lik'habohaedreite lihora tse 12 ho isa ho tse 24 pele ho tlhahlobo. U ka kopuoa ho itima lijo lihora tse 6 pele ho tlhahlobo. Ka linako tse ling, ha ho hlokahale boitokiso bo khethehileng. O ka kopuoa ho emisa ho noa meriana ka nakoana, joalo ka hydrocortisone, e ka sitisang tlhahlobo ea mali ea cortisol.

Ha nale e kentsoe ho hula mali, batho ba bang ba utloa bohloko bo itekanetseng. Ba bang ba ikutloa feela ho hlaba kapa ho hlaba. Kamora moo, ho kanna ha ba le ho longoa kapa ho longoa hanyenyane. Haufinyane sena sea fela.

Ho entoa lehetleng ho ka baka bohloko bo hlabang kapa ho hlaba.

Batho ba bang ba ikutloa ba ferekane, ba tšohile kapa ba nyekeloa ke pelo kamora ho entoa ha ACTH.

Teko ena e ka thusa ho tseba hore na litšoelesa tsa hau tsa adrenal le pituitary li tloaelehile. E sebelisoa khafetsa ha mofani oa tlhokomelo ea bophelo a nahana hore o na le bothata ba tšoelesa ea adrenal, joalo ka lefu la Addison kapa khaello ea pituitary. E boetse e sebelisetsoa ho bona hore na litšoelesa tsa hau tsa pituitary le adrenal li folile ho tloha ts'ebelisong e telele ea meriana ea glucocorticoid, joalo ka prednisone.

Ho lebelletsoe keketseho ea cortisol kamora ho tsosoa ke ACTH. Boemo ba Cortisol kamora ts'ebetso ea ACTH bo lokela ho ba holimo ho 18 ho 20 mcg / dL kapa 497 ho 552 nmol / L, ho latela tekanyetso ea ACTH e sebelisitsoeng.

Mekhahlelo e tloaelehileng ea boleng e ka fapana hanyane hara lilaboratori tse fapaneng. Li-lab tse ling li sebelisa litekanyo tse fapaneng kapa li ka leka mefuta e fapaneng. Bua le mofani oa hau ka moelelo oa sephetho sa hau sa liteko.

Teko ena e na le thuso ho fumana hore na u na le:

• Tlokotsi e matla ea adrenal (boemo bo sokelang bophelo bo hlahang ha ho se na cortisol e lekaneng)
• Boloetse ba Addison (litšoelesa tsa adrenal ha li hlahise cortisol e lekaneng)
• Hypopituitarism (tšoelesa ea pituitary ha e hlahise lihormone tse lekaneng joalo ka ACTH)

Ha ho na kotsi e kholo ea ho nkuoa mali a hau. Methapo le methapo li fapana ka boholo ho tloha ho motho e mong ho ea ho o mong, le ho tloha lehlakoreng le leng la 'mele ho ea ho le leng. Ho nka mali ho batho ba bang ho ka ba thata ho feta ho ba bang.

Likotsi tse ling tse amanang le ho huloa mali li nyane, empa li ka kenyelletsa:

• Ho tsoa mali a mangata
• Ho akheha kapa ho ikutloa o le hlooho e boima
• Li-punctures tse ngata ho fumana methapo
• Hematoma (mali a bokellanang ka tlasa letlalo)
• Tšoaetso (kotsi e nyane neng kapa neng ha letlalo le robehile)

Teko ea polokelo ea adrenal; Teko ea ho hlohlelletsa Cosyntropin; Teko ea ho hlohlelletsa Cortrosyn; Teko ea ts'usumetso ea Synacthen; Teko ea ts'oaetso ea Tetracosactide

Barthel A, Willenberg HS, Gruber M, Bornstein SR. Ho se lekane ha adrenal. Ka: Jameson JL, De Groot LJ, oa Kretser DM, et al, eds. Endocrinology: Batho ba baholo le bana. La 7th. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 102.

CC ea Chernecky, Berger BJ. Teko ea ts'usumetso ea ACTH - ho hlahloba. Ka: Chernecky CC, Berger BJ, bahlophisi. Liteko tsa Laboraro le Mekhoa ea Tlhatlhobo. La 6th. St Louis, MO: Elsevier Saunders; 2013: 98.

Stewart PM, Newell-Price JDC. Karolo ea adrenal cortex. Ka: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, bahlophisi. Buka ea Williams ea Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: khaolo ea 15.