Vim li cas ntshav qab zib insipidus tuaj yeem tshwm sim hauv cov menyuam yaus, cov hau kev ntawm nws txoj kev kho mob

Nruab nrab mob ntshav qab zib insipidus rau cov menyuam yaus tshwm sim los ntawm kev puas tsuaj rau ib qho ntawm lub hlwb qauv:

supraoptic nuclei ntawm hypothalamus,
ua txhaum ntawm cov tshuaj hormones vasopressin los ntawm hypothalamus mus rau lub caj pas pituitary los ntawm kev lom zem ntawm lawv,
posterior pituitary caj pas.

Lub hauv paus yog qhov kis tau tus mob nyob hauv thaj av pituitary-hypothalamic.

O kev mob tshwm sim thaum me nyuam kev loj hlob lossis tam sim ntawd tom qab yug menyuam tas. Thaum hnub nyoog qis dua ib qho kev xav tsis txaus ntseeg yog qhov ua rau muaj mob rau lub hlwb, muaj kev nyuaj siab lossis kev sib deev tsis txaus rau thaum hluas. Ib qho ntawm cov laj thawj tseem ceeb hauv txhua lub caij nyoog – o tuajCov. Nws lub hlwb tuaj yeem rhuav tshem cov hypothalamus thiab pituitary caj pas, nrog rau kev ua txhaum zoo sib xws nrog kev phais mob hauv lub hlwb cov qauv, kev kho hluav taws xob.

Kev loj hlob ntawm lub xub ntiag tshwm sim nrog tus mob muaj keeb - Kab mob ntsws. Cov tub hluas feem ntau raug kev txom nyem los ntawm nws.

Idiopathic daim ntawv - muaj mob thaum tseem tsis tau tuaj yeem tshawb pom tus tsim. Kev soj ntsuam ntev ntev qhia tau hais tias dhau sijhawm, cov neeg mob tau mob qog nqaij hlav hauv lub chaw ua kua lossis chaw nyob hauv thaj chaw hypothalamic. Ntawm thawj theem, vim lawv qhov loj me me, lawv tsis pom. Yog li, kev tshuaj xyuas cov neeg mob raws sijhawm yog qhov kev pom zoo.

Nrog daim ntawv nephrogenic hauv cov menyuam yaus, kev tsim cov vasopressin txaus yog tsim, tab sis lub raum hlaws tsis teb rau nws, cov kua dej hauv lub cev tsis yws. Nws yog yug los yog nrhiav. Qhov tom kawg yog ntau dua, pom hauv pyelonephritis, polycystosis, urolithiasis, hydronephrosis.

Feem ntau, ntshav qab zib insipidus tshwm sim ntau xyoo tom qab kis kab mob, raug mob, lossis phais. Tsawg li tsawg tau, tus kab mob muaj kev loj hlob hauv 2-3 lub lis piam. Tus me nyuam pib thov kom haus rau nws tas liCov. Hauv cov dej no yooj yim, tshwj xeeb tshaj yog sov, tsis nqhis dej txhua. Ua raws li qhov nqhis dej tso zis ua ntau dhau lawm, nws lub ntim nceCov. Kev tswj tsis tau tshwm nyob rau txhua lub sijhawm ntawm hnub ntawd. Zis hloov xim tsis muaj xim, nwsqhov ntau npaum li cas hauv ib hnub tuaj yeem ze 15 litres.

Tus me nyuam tsis zoo, chim siab tshwm sim, tsis kam noj zaub mov. Insomnia tshwm sim vim nquag tso zis heev. Txawm hais tias qhov kev nqus dej tau yog qhov tseem ceeb, cov cim ntawm lub cev qhuav dej tau sau tseg. Yog hais tias tus me nyuam haus dej tsawg dua cov ntaws hauv cov zis, ces tus mob sai sai. Cov tsos mob hauv qab no tshwm sim:

lub plawv dhia fluctuations, tachycardia, arrhythmia,
pw tsis tsaug zog, ntxhov siab,
mob tej pob txha, mob taub hau,
kiv taub hau
xeev siab, ntuav,
tsis nco qab zoo
lub cev qhov kub sib txawv.

Kab mob ntshav qab zib hauv plawv rau menyuam yaus feem ntau ua ke nrog lwm cov teeb meem:

kev loj hlob qeeb (dwarfism),
qaug zog lossis rog dhau,
kev loj hlob qeeb,
lub ntsej muag yam ntxwv ntawm kev sib deev theem ob,
tsis ua haujlwm ntawm lub cev ntas rau cov menyuam ntxhais.

Cov yam mob loj tshaj plaws ntawm tus kabmob yog mob ntshav qab zib rau lub raum.Cov. Kev tso zis rau tus menyuam mos txog li ob liv. Kev tshwm sim ntawm cov dej ntsev-ntsev metabolism tshwm sim: ntuav, kub cev, tawm tsam tsis tu ncua, cramps, siab poob, vascular poob, poob phaus.

Kab Mob Ntshav Qab Zib Congenital

Kev kuaj mob ntawm tus kabmob mus rau theem:

Txheeb xyuas cov dej muaj txiaj ntsig ntau (raws li kev tshawb fawb ntawm menyuam yaus lossis nws cov neeg txheeb ze).
Kev kuaj pom ntawm cov zis tawm tso zis txhua hnub nrog kev ntom ntom (qhov tshwj xeeb ntawm 1001 txog 1005), Zimnitsky txoj kev kuaj pom pom tias yuav luag muaj nuj nqis sib luag ntawm txhua ntu (ntsuas 1010-1025).
Kev txiav txim siab ntawm osmotic lub siab ntawm cov kua roj ntsha (nce hauv cov ntshav, txo hauv cov zis).
Kev kuaj ntshav biochemical - sodium yog nce, thiab qab zib, urea thiab creatinine yog qhov qub.
Kuaj-qhuav (qhia tsuas yog tom qab 7 xyoo nyob rau hauv chaw puag): tus menyuam yuav tsum tsis haus dej thaum hmo ntuj (tsis pub dhau 6 teev). Tom qab kev kuaj zis yog nqa tawm, nrog cov kab mob ntshav qab zib insipidus, nws qhov ntom ntuag tsis nce piv nrog uas ntsuas ua ntej ntsuas.
Teb rau vasopressin analog (desmopressin). Yog tias qhov ua rau poob qis hauv kev tsim cov tshuaj hormones, tom qab ntawd nws txoj kev tswj hwm los ntawm sab nraud nres tso zis. Nrog lub raum mob ntshav qab zib, tsis muaj kev hloov pauv.
Qhov tob kuaj kom paub cov nqaij hlav.

Rau kev tshawb fawb hlwb Xoo hluav taws xob xoo pob txha taub hau, tomography (MRI lossis CT), kuaj los ntawm tus kws kho keeb, tus kws kho paj hlwb, electroencephalography tau sau tseg.

Kev kawm txog cov tshuaj hormones pituitary hauv nruab nrab yog nqa tawm: somatostatin, thyrotropin, corticotropin, prolactin. Hauv lub raum nrog txoj kev kuaj tsis zoo rau desmopressin, yuav tsum kuaj raum.

Kev kho mob ntshav qab zib insipidus hauv cov menyuam yaus:

Kev noj zaub mov nrog kev txwv ntsev. Rau cov menyuam yaus hnub nyoog kawm ntawv, kev tsis kam siv cov zaub mov kaus poom, marinades, khoom noj txom ncauj, khoom lag luam uas muaj dyes thiab khaws cia yog qhov tseem ceeb.
Txog kev kho, kev siv tshuaj tiv thaiv kab mob antidiuretic yog siv. Desmopressin (Presinex, Uropres, Minirin) txo cov zis tso zis nrog lub hauv nruab nrab lossis idiopathic variant ntawm tus kab mob. Nws muaj lub luag haujlwm ntev, uas tso cai rau nws siv ob zaug ib hnub, tsis tshua muaj muab kev fab tshuaj. Nws muaj nyob rau hauv daim ntawv ntawm qhov ntswg tshuaj txau lossis tso tshuaj rau hauv qhov ntswg, nrog mob khaub thuas, nws yog tshuaj hauv ntsiav tshuaj. Qhov hno tshuaj thaum pib yog 0.1 mg nrog qhov nce me ntsis rau ib qho nyiaj uas pab tswj cov zis tawm zoo. Nws yog ib qho tseem ceeb uas yuav tsum tsis txhob muab cov tshuaj sib xyaw thiab cov khoom nojCov. Lub sijhawm nruab nrab ntawm lawv yog tsawg kawg 2 teev, ua ntej noj mov nws muaj peev xwm coj desmopressin hauv 40 feeb.

Yog tias kuaj pom qog, nws txoj kev tshem tawm yog pom zoo, kev kho mob hluav taws xob. Yog tias ntshav qab zib insipidus tau tshwm sim vim kev kis kab mob, ces cov tshuaj tua kab mob thiab anti-inflammatory yog qhia. Yog hais tias tus kab mob tau ua ntej los ntawm autoimmune pathologies, thiab lawv cov tshuaj tsis dhau ib xyoos, tom qab ntawd Prednisolone muab cov txiaj ntsig zoo.
Hauv daim ntawv mob raum, kev kho kev mob tshwm sim: cov tshuaj diuretics los ntawm pab pawg thiazides (Hypothiazide), tsis siv tshuaj tiv thaiv kev tsis haum tshuaj (Metindol), kev sib xyaw ua ke - kev siv hydrochlorothiazide thiab indomethacin tib lub sijhawm.

Nyeem kab lus no

Nruab Nrab

Ua los ntawm qhov yeej ntawm ib qho ntawm cov qauv hauv lub hlwb:

supraoptic nuclei ntawm hypothalamus,
ua txhaum ntawm cov tshuaj hormones vasopressin los ntawm hypothalamus mus rau lub caj pas pituitary los ntawm kev lom zem ntawm lawv,
posterior pituitary caj pas.

Tus qauv thiab nuclei ntawm hypothalamus

Qhov ua rau hauv thaum yau yog tus txheej txheem sib kis hauv thaj chaw pituitary-hypothalamic. Feem ntau, tus mob pib tom qab kev txom nyem:

mob npaws
mob qa,
qhua pias
cytomegalovirus,
herpes
mob hnoos hawb pob
mob qog
mob meningococcal.

Xws li kev cia siab ntawm cov txhab txhab txhab tshwm los ntawm qhov muaj ntshav ntau txaus rau thaj tsam hypothalamic-pituitary, muaj kev cuam tshuam ntau ntawm cov ntshav-hlwb teeb meem thiab cov leeg ntshav hauv lub network. Cov mob o tshwm sim thaum menyuam txoj kev loj hlob lossis tam sim ntawd tom qab yug tus menyuam.

Thaum lub hnub nyoog tom qab, qhov kev xav tsis txaus ntseeg yog lub taub hau raug mob, kev ntxhov siab hnyav, lossis kev tsis txaus ntseeg hauv lub cev thaum tseem hluas. Ib qho tseem ceeb ua kom mob ntshav qab zib insipidus hauv ib lub caij nyoog twg yog cov qog. Nws lub hlwb tuaj yeem rhuav tshem cov hypothalamus thiab pituitary caj pas, nrog rau kev ua txhaum zoo sib xws nrog kev phais mob hauv lub hlwb cov qauv, kev kho hluav taws xob.

Kev loj hlob ntawm lub xub ntiag tshwm sim nrog tus mob muaj keeb - Kab mob ntsws. Cov tub hluas feem ntau raug kev txom nyem los ntawm nws. Daim ntawv nthuav dav ntawm pathology suav nrog mob ntshav qab zib, ntshav qab zib insipidus, lag ntseg, thiab tsis pom kev.

Thiab ntawm no yog ntau txog kev kho mob hyperparathyroidism.

Idiopathic

Yog li hu ua cov kab mob thaum tseem tsis tuaj yeem nrhiav lawv qhov ua rau. Muaj ntau tsis ntseeg txog hom mob ntshav qab zib no. Kev soj ntsuam ntev ntev qhia tau hais tias dhau sijhawm, cov neeg mob tau mob qog nqaij hlav hauv lub chaw ua kua lossis chaw nyob hauv thaj chaw hypothalamic. Ntawm thawj theem, vim lawv qhov loj me me, lawv tsis pom. Yog li no, kev tshuaj xyuas qee lub sijhawm ntawm cov neeg mob raug pom zoo kom tsis txhob nco lub sijhawm rau kev phais mob ntawm lub neoplasm.

Neesrogenic

Nrog rau daim foos no, tsim cov vasopressin txaus tsim nyob hauv cov menyuam yaus, tab sis lub raum plab hlaws tsis teb rau nws, cov kua dej hauv lub cev tsis yws. Nws yog yug los yog nrhiav. Thawj zaug yog txuam nrog kev mob lub cev tsis zoo hauv lub raum, cov tsos ntawm lub cev tsis muaj zog, lossis kev hloov pauv pathological hauv cov menyuam. Txais daim ntawv yog ntau dua. Nws muaj nyob hauv pyelonephritis, polycystosis, urolithiasis, hydronephrosis.

Cov cim thiab tsos mob ntawm tus kab mob

Feem ntau, ntshav qab zib insipidus tshwm sim ntau xyoo tom qab kis kab mob, raug mob, lossis phais. Tsawg tsawg zaus, tus kab mob pib loj hlob hauv 2-3 lub lis piam. Tus me nyuam pib thov kom haus rau nws tas li. Tib lub sijhawm, dej dawb, tshwj xeeb tshaj yog dej sov, tsis nqhis dej txhua lub sijhawm. Tom qab nqhis dej, tso zis tawm ntau dua thiab nws lub ntim nce. Cov menyuam yaus tsis tuaj yeem tuav cov zis thaum hmo ntuj lossis nruab hnub. Zis yuav tsis muaj xim, nws cov nyiaj ib hnub tuaj yeem mus txog 15 litres.

Tus me nyuam tsis zoo, chim siab tshwm sim, tsis kam noj zaub mov, vim nws tsuas xav haus dej txhua lub sijhawm. Insomnia tshwm sim vim nquag tso zis heev. Txawm hais tias qhov kev nqus dej tau yog qhov tseem ceeb, cov cim ntawm lub cev qhuav dej tau sau tseg:

qhuav ntawm daim tawv nqaij thiab cov qog ua kua,
lub cev yuag yuag
qaug zog,
tsis qab los noj mov
mob plab
enteritis
cem quav.

Cov tsos mob ntawm mob caj dab hauv cov menyuam

Yog hais tias tus me nyuam haus dej tsawg dua cov ntaws hauv cov zis, ces tus mob sai sai. Cov tsos mob hauv qab no tshwm sim:

qhov tsis ua haujlwm ntawm lub plawv - hloov pauv hauv lub siab, tachycardia, arrhythmia,
pw tsis tsaug zog, ntxhov siab,
mob tej pob txha, mob taub hau,
kiv taub hau
xeev siab, ntuav,
tsis nco qab zoo
lub cev qhov kub sib txawv.

Cov ntshav qab zib ua kom mob ntshav qab zib rau menyuam yaus feem ntau tsis tshua yog tus kab mob kev ywj pheej rau kev kis mob rau lub hlwb cov ntaub so ntswg. Nws feem ntau yog ua ke nrog lwm cov tshuaj hormonal:

kev loj hlob qeeb (dwarfism),
qaug zog lossis rog dhau,
kev loj hlob qeeb,
lub ntsej muag yam ntxwv ntawm kev sib deev theem ob,
tsis ua haujlwm ntawm lub cev ntas rau cov menyuam ntxhais.

Cov menyuam rog

Cov yam mob loj tshaj plaws ntawm tus kabmob yog mob ntshav qab zib rau lub raum. Kev tso zis rau tus menyuam mos txog li ob liv. Muaj cov tsos mob ntawm kev ua txhaum ntawm cov dej ntsev ntsev:

ntxhoo
npaws
cem quav
cramps
siab poob
leeg vau,
poob phaus.

Saib cov lus qhia txog kab mob ntshav qab zib insipidus:

Kev kuaj mob ntawm tus kabmob

Txhawm rau kom paub tseeb qhov kev xav ntawm cov ntshav qab zib insipidus, kev kuaj mob tshawb nrhiav tau nyob hauv theem:

Txheeb xyuas cov dej muaj txiaj ntsig ntau (raws li kev tshawb fawb ntawm menyuam yaus lossis nws cov neeg txheeb ze).
Kev kuaj pom ntawm cov zis tawm tso zis txhua hnub nrog kev ntom ntom (qhov tshwj xeeb ntawm 1001 txog 1005), Zimnitsky txoj kev kuaj pom pom tias yuav luag muaj nuj nqis sib luag ntawm txhua ntu (ntsuas 1010-1025).
Kev txiav txim siab ntawm osmotic lub siab ntawm cov kua roj ntsha (nce hauv cov ntshav, txo hauv cov zis).
Kev kuaj ntshav biochemical - sodium yog nce, thiab qab zib, urea thiab creatinine yog qhov qub.
Qhuav-xeem - qhia tsuas yog tom qab 7 xyoo nyob rau hauv nyob ruaj ruaj chaw. Tus menyuam yuav tsum tsis haus dej thaum hmo ntuj (tsis pub dhau 6 teev). Thaum kawg ntawm lub sijhawm no, kev tshawb xyuas zis yog nqa tawm, nrog ntshav qab zib insipidus, nws qhov ntom ntuag tsis nce piv nrog uas tau coj ua ntej kev sim.
Cov tshuaj tiv thaiv rau ib qho piv txwv ntawm vasopressin (desmopressin) tso cai rau kom paub qhov txawv ntawm daim ntawv los ntawm raum. Yog tias qhov ua rau poob qis hauv kev tsim cov tshuaj hormones, tom qab ntawd nws txoj kev tswj hwm los ntawm sab nraud nres tso zis. Nrog lub raum mob ntshav qab zib, tsis muaj kev hloov pauv.
Qhov tob kuaj kom paub cov nqaij hlav.

MRI ntawm lub paj hlwb

Txhawm rau kawm lub hlwb, X-ray ntawm lub pob txha taub hau, tomography (MRI lossis CT), tshuaj xyuas los ntawm tus kws kho pob ntseg, kws kho paj hlwb, electroencephalography yog tshuaj. Lub xub ntiag ntawm cov txheej txheem volumetric yog qhia los ntawm:

kev txav chaw nruab nrab ntawm lub hlwb ntawm EEG,
nce siab intracranial raws li radiography,
focal neurological ntshawv siab,
muaj kev hloov pauv ntau hauv cov nyiaj,
kuaj pom ntawm neoplasm rau ntawm ib lub thermogram, qhov tsis muaj qhov ci ntawm cov posterior pituitary caj pas.

Rau cov menyuam yaus nrog daim ntawv tseem ceeb ntawm cov kabmob, cov tshuaj hormones pituitary tau kawm: somatostatin, thyrotropin, corticotropin, prolactin. Hauv daim ntawv mob raum nrog qhov kuaj tsis zoo rau desmopressin, yuav tsum kuaj lub raum:

Ultrasound scan
tsom xam cov creatinine hauv ntshav thiab zis,
excretory urography,
kev txiav txim siab ntawm qhov muaj leukocytes, ntshav liab nyob rau hauv cov zis,
kev tshuaj ntsuam genetic analysis.

Kev Sab Laj Optometrist

Kev kho mob ntshav qab zib insipidus hauv cov menyuam yaus

Kev noj zaub mov nrog kev txwv ntsev. Tsis kam siv cov zaub mov kaus poom, marinades, khoom noj txom ncauj, zaub mov nrog cov xim da dej thiab tshuaj lom yog qhov tseem ceeb rau cov menyuam hnub nyoog kawm ntawv, vim tias lawv tsim ib qho ntxiv rau lub raum.

Txog kev kho, kev siv tshuaj tiv thaiv kab mob antidiuretic yog siv. Desmopressin (Presinex, Uropres, Minirin) txo cov zis tso zis nrog lub hauv nruab nrab lossis idiopathic variant ntawm tus kab mob. Nws muaj lub luag haujlwm ntev, uas tso cai rau nws siv ob zaug ib hnub, tsis tshua muaj muab kev fab tshuaj.

Nws muaj nyob rau hauv daim ntawv ntawm qhov ntswg tshuaj txau lossis tso tshuaj rau hauv qhov ntswg, nrog mob khaub thuas, nws yog tshuaj hauv ntsiav tshuaj. Qhov hno tshuaj thaum pib yog 0.1 mg nrog qhov nce me ntsis rau ib qho nyiaj uas pab tswj cov zis tawm zoo. Nws yog ib qho tseem ceeb uas tsis tau muab sib xyaw ua ke ntawm kev siv tshuaj thiab noj zaub mov. Lub sijhawm nruab nrab ntawm lawv yog tsawg kawg 2 teev, ua ntej noj mov nws muaj peev xwm coj desmopressin hauv 40 feeb. Kev noj ntau dhau yog pom qhov o ntawm lub ntsej muag, ntau npaum li cas hauv cov ntaub ntawv no yuav tsum raug txo kom tsawg.

Yog tias kuaj pom qog, nws txoj kev tshem tawm yog pom zoo, kev kho mob hluav taws xob. Yog tias ntshav qab zib insipidus tau tshwm sim vim kev kis kab mob, ces cov tshuaj tua kab mob thiab anti-inflammatory yog qhia. Yog hais tias tus kab mob tau ua ntej los ntawm autoimmune pathologies thiab lawv cov tshuaj tsis dhau ib xyoos, tom qab ntawd Prednisolone muab cov txiaj ntsig zoo.

Lub raum daim ntawv yog kho mob ntau dua li qhov nruab nrab. Vim tias tsis muaj tshuaj uas tuaj yeem rov qab rhiab rau cov vasopressin uas tsim tawm, Cov tsos mob kho yog kho:

diuretics los ntawm thiazide pab pawg los ua kom haum sodium reabsorption thiab txo cov kua dej ntxiv (hypothiazide),
cov tshuaj tsis muaj tshuaj steroidal ua kom tsis txhob muaj tshuaj (Metindol) txhawm rau txo cov ntim ntawm cov zis kom nteg tawm,
cov txheej txheem sib xyaw - kev siv hydrochlorothiazide thiab indomethacin tib lub sij hawm ua tau zoo.

Pej xeem sawv daws los kho sawv daws

Tus kab mob no ib txwm kho tsis tau txawm tias yog tshuaj kho, thiab tshuaj ntsuab los yeej tseem tsis tau zoo. Lawv siv tsuas yog siv rau cov nroj tsuag, uas tuaj yeem txo qhov kev xav txog kev nqhis dej ntawm cov keeb kwm ntawm kev siv tshuaj yaj yeeb. Rau qhov no, nws raug pom zoo:

blackcurrant berries (kua txiv),
rosehips, hawthorn (Txoj kev lis ntshav ntawm tus nqi ntawm ib diav ntawm ib khob ntawm dej npau),
lingonberry, blackberry, viburnum (txiv hmab txiv ntoo haus),
txiv qaub, kua txiv kab ntxwv.

Txhua tus tuaj yeem ntxiv rau dej haus lossis haus ib leeg.

Thiab ntawm no yog ntxiv txog Addison tus kab mob.

Ntshav qab zib insipidus hauv cov menyuam yaus tshwm sim tawm tsam keeb kwm ntawm kev kis lossis mob qog ntawm lub paj hlwb hauv qhov tshis lossis hypothalamus. Ntxiv nrog rau daim ntawv hauv nruab nrab, lub raum thiab idiopathic tau pom. Cov tsos mob tseem ceeb ntawm tus kab mob yog nce nqhis dej, tso zis ntau dhau thiab tsis ntom ntawm cov zis.

Rau kev kuaj mob, kev pom tseeb ntawm cov tsos mob tseem ceeb thiab tshem tawm cov txheej txheem qog ntawm lub hlwb yog qhov tsim nyog. Hauv daim ntawv hauv nruab nrab, ib qho tshuaj rau kev hloov pauv hloov kho yog tsim nyog - desmopressin, thiab nyob rau hauv lub raum, kev siv cov tsos mob ntawm thiazide diuretics thiab tshuaj siv los tiv thaiv yog qhia.

Lub luag haujlwm ntawm cov kua dej hauv lub cev yog vasopressin - cov pituitary hormone, tseem hu ua antidiuretic (ADH). Kev ua txhaum ntawm kev ua haujlwm, ib tus neeg mloog zoo li nqhis dej tas li. Cov nyhuv ntawm lub cev ua ke yog tag nrho. Kev ntsuam xyuas tuaj yeem pab qhia qhov txawv ntawm ntshav qab zib.

Yog tias hyperparathyroidism tau tsim, kev kho yuav txawv raws ntawm tus neeg mob puas muaj mob lossis lub cev puas ntsoog. Nws tshwm sim thawj thiab theem nrab, qhia hauv cov menyuam yaus. Kev kuaj mob muaj txhij txhua.

Tus mob ntshav qab zib muaj teeb meem tiv thaiv tsis hais hom twg. Nws yog qhov tseem ceeb hauv cov menyuam thaum cev xeeb tub. Muaj thawj thiab theem nrab, mob hnyav thiab mob lig rau hom 1 thiab ntshav qab zib hom 2.

Cov kab mob Addison (tooj daj) muaj cov tsos mob uas nthuav dav uas tsuas yog qhov kev kuaj mob ntxaws nrog tus kws kho mob uas paub dhau los yuav pab nrhiav cov kev kuaj mob. Cov laj thawj rau poj niam thiab menyuam yaus sib txawv, kev tsom xam yuav tsis muab duab. Kev kho yog muaj lub neej kev coj noj tshuaj. Kab mob Addison Birmer yog ib qho kab mob txawv tag nrho los ntawm B12 tsis muaj peev xwm.

Subclinical toxicosis feem ntau tshwm sim hauv thaj chaw tsis zoo ntawm cov ntsiab lus iodine. Cov tsos mob hauv cov poj niam, suav nrog thaum cev xeeb tub, yog lubricated. Tsuas yog lub sijhawm tsis xwm yeem tuaj yeem qhia qhov teeb meem ntawm nodular goiter.

Cov chaw kab mob hauv tus kab mob

Cov tsos mob ntawm tus mob ntshav qab zib insipidus feem ntau tshwm sim dheev, tab sis tuaj yeem txhim kho maj mam thiab maj mam. Ntshav qab zib insipidus los ntawm kev raug mob, kis tus kab mob, feem ntau nws ua tau nws tus kheej tam sim ntawd tom qab kis tus kab mob pathogenic lossis tom qab 2-4 lub lis piam. Cov kab mob sib kis ntev ntev ua rau muaj ntshav qab zib insipidus, feem ntau yog tom qab 1-2 xyoos.

Rau feem ntau ntawm cov menyuam yaus, thawj zaug thiab thawj tus tsos mob ntawm tus kabmob yog qhov nqhis dej tas li (polydipsia), nquag tso zis thiab tso zis ntau ntau (pollaki thiab polyuria). Cov menyuam yaus tuaj yeem haus txog 8-15 litres ntawm cov kua dej ib hnub. Cov kua dej tsawg, tshwj xeeb yog sov, tsis txhob nqhis koj lub nqhis dej. Zis feem ntau raug tawm ntawm qhov loj (500-800 ml txhua qhov), pob tshab, xim tsis muaj xim, nws tsis muaj protein thiab qab zib, muaj cov dej nag tsis zoo thiab tsis tshua muaj peev xwm tshwj xeeb (1000–1005). Ntau zaus muaj nruab hnub tsis hais nruab hnub thiab hmo ntuj.

Cov menyuam yaus muaj kev npau taws, chim siab, tsis kam noj zaub mov thiab xav tau dej nkaus xwb. Qhov tshwm sim ntawm polyuria tsis yog tsuas yog nqhis dej xwb, tab sis kuj tseem muaj cov tsos mob ntawm lub cev qhuav dej (poob phaus, qhuav ntawm daim tawv nqaij thiab cov leeg ua paug). Hauv kev sib txuas nrog polydipsia thiab enuresis, insomnia tshwm. Txawm hais tias thaum mob polyuria tau them nyiaj txaus los ntawm kev haus dej haus ntau, kev tshem tawm cov qaub ncaug thiab cov kua txiv hauv lub cev yuav txo qis, uas ua rau lub cev tsis zoo rau lub plab, txoj kev loj hlob ntawm txoj hnyuv, mob plab, thiab ib txwm nyiam cem quav. Kev ncab thiab mob hnyav lub plab yuav tshwm sim. Hloov pauv ntawm cov hlab plawv feem ntau tsis tuaj lawm, qee zaum muaj lub zog ntawm cov mem tes, tachycardia. Qee tus menyuam yaus muaj chilliness, mob pob qij txha, hypochromic anemia. Nrog cov qhov chaw nqhis dej hauv lub cev, tsis pom cov tsos mob lub cev qhuav dej. Nrog rau cov pa tshuaj ua kom tsis haum nrog rau cov kua txwv, uas feem ntau yog cov menyuam yaus, lub cev qhuav dej yog qhov ua tau, tshwm sim los ntawm mob taub hau, xeev siab, ntuav, ntxhov siab thiab pom kev tsis meej, lub zog ntawm lub cev kub, thiab tachycardia tuaj yeem tshwm sim. Nyob rau tib lub sijhawm, kev tso zis tsis zoo yog tswj, tus menyuam lub cev qhuav dej nrog lub siab tsis zoo tso zis tawm ntawm nws tus kheej.

Nrog cov ntshav qab zib insipidus ntawm cov hauv paus chiv keeb organic, cov tsos mob ntawm kev ua txhaum ntawm lwm cov haujlwm hauv endocrine tuaj yeem pom: kev rog, cachexia, dwarfism, gigantism, ncua kev tsim kho lub cev thiab kev sib deev, lub cev tsis ua haujlwm.

Cov ntshav qab zib raum insipidus ntawm lub cev ua lub cev thaum yug los feem ntau ua rau nws tus kheej twb muaj nyob hauv thawj lub hlis ntawm lub neej nrog profuse diuresis, uas tsis tuaj yeem kho nrog ADH, ib qho nyiam ua quav tawv, ntuav, thiab kub cev. Qhov ntim ntawm cov zis txhua hnub hauv cov menyuam mos tuaj yeem ncav cuag 2 litres, qee zaum muaj "ua npaws ntsev", ua mob, nrog rau lub cev qhuav dej, lub cev qhuav dej yuav tshwm sim. Feem ntau, nrog lub raum ntshav qab zib insipidus, cov dej hauv cov zis yuav tsawg dua li hauv daim ntawv hauv nruab nrab. Txhaum cai ntawm cov dej-ntsev sib npaug maj ua rau kev txhim kho ntawm kev noj zaub mov tsis zoo, ncua kev lub cev thiab lub hlwb.

Mob ntshav qab zib insipidus tuaj yeem ua ke nrog ntau yam mob muaj keeb: Kab Mob Tshav Ntuj - Tshav - Beadle syndrome, tsev neeg DIDMOAD syndrome.

Kev txheeb xyuas tus kab mob ntshav qab zib insipidus yog tsim nyob rau hauv lub hauv paus ntawm lub xub ntiag ntawm loj polyuria, polydipsia thiab ib txwm tsis tshua muaj kev hnyav (1000-1005). Cov keeb kwm yuav tsum tau txiav txim siab: lub sijhawm ntawm qhov pib ntawm cov tsos mob, lawv txoj kev sib raug zoo nrog tus txheeb xyuas etiological (mob, raug mob), qhov mob ntawm nqhis dej thiab mob polyuria, tus nqi nce rau hauv cov tsos mob, kev paub mob.

Yog tias koj xav tias muaj ntshav qab zib insipidus, cov kev tshawb fawb hauv qab no xav tau: cov zis txhua hnub, tso zis, kuaj Zimnitsky, kev txiav txim siab ntawm cov piam thaj thiab electrolytes hauv kev tso zis txhua hnub, ntshav chemistry (electrolytes, urea, creatinine, cholesterol, glucose), acid-base balance (tab.).

Cov kev ntsuam xyuas tshwj xeeb yog siv los ua pov thawj rau kev kuaj mob ntshav qab zib insipidus, ntxiv rau txiav txim siab nws daim ntawv.

Kev ntsuas qhuav (ntsuas qhov ntsuas) - nrog rau kev tshem tawm cov kua los ntawm cov zaub mov thiab kev nce ntshav hauv cov ntshav osmolality, qhov feem pua ntawm cov zis hauv ntshav qab zib insipidus tseem tsawg. Qhov kev ntsuas no yuav tsum tau nqa tawm hauv tsev kho mob thiab nws lub sijhawm yuav tsum tsis pub tshaj 6 teev.
Hauv cov menyuam yaus, vim qhov ua tsis tau zoo, kev sim tsis tuaj yeem ua.
Ntsuas nrog minirin (vasopressin). Tom qab nws cov lus qhia, hauv cov neeg mob hypothalamic mob ntshav qab zib insipidus, lub nqus ntawm cov zis nce thiab nws qhov ntim tsawg dua, thiab nrog rau daim ntawv nephrogenic, cov zis tsis hloov.

Thaum txheeb xyuas lub hauv nruab nrab lossis idiopathic daim ntawv mob ntshav qab zib insipidus, nws yog ib qho tsim nyog yuav tau ua rau ntau cov kev tshawb fawb ntxiv, feem ntau tsis suav cov txheej txheem qog:

Xoo hluav taws xob ntawm lub pob txha taub hau thiab lub eeb Turkish,
xam thiab cov duab hluav taws xob resonance imaging - kom tsis suav cov volumetric formations ntawm lub hauv nruab nrab lub paj hlwb,
kev sab laj ntawm tus kws kho qhov muag, kws kho mob hlwb, neurosurgeon,
echoencephalography.

Kev txiav txim siab hauv pob nyiaj, txoj kev nqaim ntawm cov liaj teb ntawm lub zeem muag, lub paj hlwb hloov pauv, xoo duab hluav taws xob ntawm kev mob siab ntxiv ntawm lub siab, kev txav chaw ntawm cov txheej txheem nruab nrab ntawm lub echoencephalogram yog txhua tus yam ntxwv ntawm lub qog hlwb. Qhov raug mob ntawm cov pob txha tiaj tiaj, exophthalmos qhia pom dav dav xanthomatosis.

Tsis tas li ntawd, txij li nws muaj peev xwm koom ua ke hauv cov txheej txheem pathological uas zais cov hypothalamic tso tawm yam, cov haujlwm ntawm lub caj pas pentreary yuav tsum raug ntsuas, txawm tias qhov tsis muaj lwm yam tshwm sim ntawm kev puas tsuaj rau hypothalamic-pituitary system.

Hauv daim ntawv mob raum, kev sim nrog minirin yog qhov tsis zoo. Hauv qhov xwm txheej no, kev kuaj mob tob tob urological yog qhov tsim nyog: kev kuaj mob ultrasound ntawm lub raum, excretory urography, kev txiav txim siab ntawm kev ua kom pom kev los ntawm endogenous creatinine, Addis - kev kuaj mob Kakovsky. Tam sim no, cov kev tshawb fawb tab tom ua tiav ntawm kev muab cov noob hloov mus rau vasopressin ntawm lub cev puas ntawm cov leeg ntawm lub raum khaws cov hlab, qhov twg dej reabsorption tshwm sim.

Yog li, peb tuaj yeem paub qhov txawv hauv qab no hauv qab ntawm kev kuaj mob tshawb nrhiav cov kab mob ntshav qab zib insipidus.

Kev kuaj pom tus menyuam muaj mob polydipsia, polyuria thiab tsis tshua muaj nqus ntawm cov zis.
Kev ntsuas cov kua dej thiab kev nthuav dav, kev txiav txim siab osmotic siab ntawm cov zis thiab ntshav, cov tshuaj electrolytes hauv nws, sim nrog minirin thiab lwm yam kev tshawb fawb kom paub meej txog kev kuaj mob thiab txiav txim siab daim ntawv ntawm ntshav qab zib insipidus.
Txoj kev kawm tob txog kev cais tawm cov txheej txheem qog.

Kev kuaj mob sib txawv

Nws yog qhov yuav tsum tau ua kom sib txawv ntawm cov ntshav qab zib insipidus thiab cov kab mob nrog polydipsia thiab polyuria (mob hlwb polydipsia, ntshav qab zib mellitus, mob raum tsis ua haujlwm, Fanconi nephronophysis, mob ntsws tubular acidosis, hyperparathyroidism, hyperaldosteronism).

Nrog rau kev mob hlwb (thawj) polydipsia, chaw kho mob thiab kuaj cov ntaub ntawv sib luag nrog cov ntshav qab zib insipidus. Polydipsia-kev hloov pauv nyob rau hauv lub hlwb txheej ntawm ob lub raum ("leach ntawm hyperosmotic tsam") nyob rau hauv cov neeg mob no yog qhov laj thawj tsis muaj osmotic gradient tsim nyog rau kev txhim kho ntawm ADH nruab nrab ntawm cov lumen ntawm cov leeg, uas nyob ntawm ib sab tes, thiab lub hlwb txheej, ntawm lwm qhov. Qhov thaiv ntawm dej tsis ua haujlwm los ntawm kev tswj hwm lub sijhawm ntev ntawm ADH ua rau rov kho kho hypertonic cheeb tsam ntawm lub hlwb cov tshuaj. Ib qho kev sim nrog kev noj mov qhuav ua rau peb sib txawv ntawm cov kabmob no: nrog kev mob hlwb (psychogenic polydipsia), cov kab mob diuresis tsawg, qhov feem pua ntawm cov zis nce ntxiv, qhov mob ntawm cov neeg mob tsis raug kev txom nyem. Nrog rau ntshav qab zib insipidus, tso zis thiab tso zis ntawm lub ntiajteb txawj nqus tsis hloov pauv ntau; cov tsos mob ntawm lub cev qhuav dej nce.

Mob ntshav qab zib mellitus yog tus yam ntxwv tsis tshua pom cov mob polyuria thiab polydipsia, feem ntau tsis pub dhau 3-4 litres ib hnub, muaj qhov hnyav ntawm cov zis, glucosuria, thiab nce ntshav qab zib. Hauv kev siv tshuaj, kev sib txuam ua ke tiv thaiv ntshav qab zib thiab ntshav qab zib insipidus yog tsawg. Qhov no tshwm sim yuav tsum nco ntsoov nyob rau hauv muaj cov hyperglycemia, glucosuria thiab tib lub sijhawm tsis tshua muaj kev sib tsoo ntawm cov zis thiab polyuria, uas tsis txo qis nrog kev kho tshuaj insulin.

Polyuria tuaj yeem hais tawm nrog lub raum tsis ua haujlwm, tab sis rau ntau qhov tsawg dua li muaj ntshav qab zib insipidus, thiab lub zog tshwj xeeb tseem nyob hauv thaj tsam ntawm 1008–1010, cov protein thiab lub tog raj kheej muaj nyob hauv cov zis. Ua haujlwm siab thiab ntshav ntshav urea yog nce.

Cov duab ua pov thawj, zoo ib yam li cov kab mob ntshav qab zib insipidus, raug pom nrog Fanconi nephronophysis. Tus kab mob no tau txais los ntawm ib hom kev tawm dag zog thiab nthuav qhia nws tus kheej hauv thawj 1-6 xyoos ntawm cov tsos mob hauv qab no: polydipsia, polyuria, hypoisostenuria, lag hauv kev tawm dag zog thiab qee zaum kev loj hlob. Tus mob loj zuj zus, uremia maj mam loj tuaj. Qhov tsis muaj kev cuam tshuam ntawm cov leeg ntshav yog cov yam ntxwv, qhov kev tshem tawm ntawm endogenous creatinine raug txo, acidosis thiab hypokalemia yog qhia.

Nrog lub raum tubular acidosis (Albright syndrome), polyuria, poob qis tsis qab los yog sau tseg. Qhov tseem ceeb ntawm cov calcium thiab phosphorus yog ploj hauv cov zis, hypocalcemia thiab hypophosphatemia tshwm sim hauv cov ntshav. Kev poob calcium ua rau rickets-xws li kev hloov pauv ntawm lub cev pob txha.

Hyperparathyroidism feem ntau yog nrog cov mob polyuria hauv nruab nrab, qhov nqus ntawm cov zis tau qis me ntsis, thiab kev nce qib hauv calcium yog teev hauv cov ntshav thiab zis.

Rau thawj aldosteronism (Conn's syndrome), ntxiv rau lub raum tshwm sim (polyuria, tso zis tsawg dua ntawm lub ntiajteb txawj nqus, proteinuria), cov tsos mob neuromuscular (leeg tsis muaj zog, cramps, paresthesias) thiab mob ntshav liab tseem muaj cov yam ntxwv. Cov Hypokalemia, hypernatremia, hypochloremia, alkalosis yog qhia nyob rau hauv cov ntshav. Cov poov tshuaj ntau nyob hauv cov zis, sodium excretion tsawg dua.

Cov kws kho mob cov lus

Ntshav qab zib insipidus yog ib qho mob tshwm sim los ntawm qhov tsis txaus los yog tus txheeb ze tsis txaus ntseeg ntawm cov tshuaj tiv thaiv kab mob, yam ntxwv yog los ntawm polyuria thiab polydipsia.

Antidiuretic hormone stimulates reabsorption ntawm cov dej hauv kev sib sau ntawm lub raum thiab tswj cov dej metabolism hauv lub cev.

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Ua rau muaj ntshav qab zib insipidus hauv ib tus menyuam

Mob ntshav qab zib insipidus hauv cov menyuam yaus yog hais txog nws tus ntawv hu ua idiopathic, uas tuaj yeem pib thaum muaj hnub nyoog rau txiv neej thiab poj niam. Lwm qhov kev mob tshwm sim ntawm kev ua haujlwm ntawm hypothalamic kawg thiab pituitary kawg lossis tom qab tau txais ntawm hypothalamic-pituitary dysfunctions qhia tias nyob hauv daim id idathathic, qhov tsis txaus ntawm antidiuretic hormone nyob ntawm kev ua haujlwm ntawm hypothalamic-pituitary axis. Feem ntau cov yuav muaj, muaj lub cev tsis ua haujlwm biochemical kho tsis zoo hauv thaj chaw no, uas ua rau nws tus kheej kho mob nyob rau hauv kev cuam tshuam ntawm ntau yam cuam tshuam ib puag ncig.

Cov kab mob ntshav qab zib insipidus hauv cov menyuam yaus tuaj yeem tshwm sim los ntawm kev raug mob hauv ib cheeb tsam saum toj pob txha caj qaum thaum raug mob pob txha taub hau nrog pob txha taub ntawm lub pob txha taub hau thiab lub duav ntawm lub caj pas pituitary lossis tom qab kev tiv thaiv neurosurgical.

Qee zaum polyuria mus tas li tuaj yeem tshwm sim txawm 1-2 xyoo tom qab raug mob. Hauv cov xwm txheej zoo li no, nws yog ib qho tsim nyog kom rov soj ntsuam cov neeg mob lub sijhawm dhau los nrog kev sim ua kom tiav lub sij hawm luv luv ntawm kev kho mob. Qhov kawg yuav ua rau kev kuaj mob tom qab qhov mob txha caj qaum txhim khu kev qha.

Nws yuav tsum raug qhia txog tias mob ntshav qab zib insipidus vim kev raug mob los ntawm pob txha taub hau yog ib qho mob uas tsis tshua muaj mob.

Qhov ua rau lub cev tsis muaj txiaj ntsig ntawm antidiuretic hormone (txo qis hauv cov tshuaj lom neeg tso zis) yuav yog qhov ua tiav ntawm neurohypophysis ntawm ib qho keeb kwm:

cov qog hauv zos ua ntej thaj chaw ntawm Turkish ua ke thiab hauv thaj chaw thaj chaw ntawm kev sib tshuam ntawm optic.
histiocytosis (vim yog histiocyte infiltration ntawm hypothalamus thiab pituitary caj pas),
mob (mob rau daim tawv, mob ntsws),
raug mob (puas ntawm pob txha pob txha, phais)
cov kab mob ua keeb kwm (autosomal hom thiab tsis thas, txuas nrog X chromosome),
Tungsten syndrome (ua ke nrog mob ntshav qab zib mellitus, kho qhov muag ntawm cov leeg ntshav thiab qhov muag tsis pom kev).

Feem ntau, qhov tseeb ua rau muaj tus neeg tsis txaus ntseeg ntawm cov tshuaj tiv thaiv kab mob ua tsis tau, thiab cov ntshav qab zib insipidus hauv cov menyuam yaus tau txheeb tias yog idiopathic. Txawm li cas los xij, ua ntej xa nws mus rau idiopathic daim ntawv, kev kuaj ntxiv ntawm tus menyuam yog qhov tsim nyog, txij li ntawm ib nrab ntawm cov neeg mob morphologically pom cov kev hloov hauv hypothalamus lossis pituitary caj pas vim kev txhim kho ntawm cov txheej txheem volumetric tshwm sim ib xyoos tom qab pom tus kab mob, thiab hauv 25% ntawm cov neeg mob, qhov kev hloov pauv tuaj yeem nrhiav tau tom qab 4 xyoo.

Ib daim foos tshwj xeeb yog ntshav qab zib insipidus hauv cov menyuam yaus, uas qhov tshuaj tiv thaiv antidiuretic hormone (txheeb ze cov tshuaj tiv thaiv hormone) yog pom. Tus kab mob no tsis cuam tshuam nrog kev tso pa tsis haum ntawm vasopressin lossis nws qhov kev rhuav tshem ntau ntxiv, tab sis tshwm sim los ntawm kev muaj mob tsis huv ntawm lub raum receptors rau vasopressin.

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Mob ntshav qab zib mellitus hauv cov menyuam yaus yog cuam tshuam nrog kev tsis zoo ntawm vasopressin (ADH). Feem ntau, qhov no yog qhov tshwm sim ntawm kev tsis muaj zog ntawm cov hlwb neurosecretory hauv qhov supraoptic thiab kom tsawg dua paraventricular nuclei ntawm hypothalamus. Kev tshem tawm ntawm cov dej uas ua los ntawm qhov tsis txaus ntawm cov tshuaj tiv thaiv antidiuretic ua rau muaj ntshav plasma osmolarity, uas ua rau lub cev nqhis dej ntau zuj zus thiab ua rau polydipsia. Hauv txoj kev no, qhov sib npaug ntawm qhov kev zam thiab kev siv dej yog rov qab, thiab lub siab osmolar ntawm lub cev kua tshaj tawm yog ruaj khov nyob rau theem tshiab, qee qhov nce. Txawm li cas los xij, polydipsia tsis yog tsuas yog muaj kev tiv thaiv kev ua haujlwm thib ob ntawm ntau cov polyuria. Nrog rau qhov no, muaj lub cev tsis ua ntawm lub nruab nrab ntawm kev nqhis dej.Yog li, raws li qee tus sau phau ntawv, qhov pib ntawm tus kab mob yog tus cwj pwm los ntawm kev nqhis dej ntawm qhov nqhis dej, uas tom qab ntawd tau koom nrog polyuria nrog tus txheeb ze tsawg ntawm cov zis.

Ntshav qab zib insipidus hauv cov menyuam yaus ntawm keeb kwm neurogenic yog tus kab mob nrog pathology ntawm hypothalamic-neurohypophysial axis.

Kev tsis txaus ntawm cov tshuaj tiv thaiv kab mob ua rau cov tshuaj tiv thaiv polyuria nrog cov txheeb ze ntawm cov zis tsis zoo, nce ntxiv ntawm ntshav osmolality, thiab polydipsia. Lwm yam kev tsis txaus siab thiab tsos mob yog txiav txim siab los ntawm cov xwm txheej ntawm tus txheej txheem pathological.

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Cov tsos mob ntawm tus mob ntshav qab zib insipidus hauv ib tus menyuam

Ib qho ntawm cov tsos mob tseem ceeb ntawm tus kab mob yog qhov nce ntxiv hauv kev nthuav dav ntawm tso zis zis. Kev nquag tso zis thiab tsis tso zis yog pom nyob rau nruab hnub thiab hmo ntuj. Diuresis nyob hauv qee kis tau nce mus txog 40 l / hnub., Feem ntau cov zis tso zis ib hnub nyob ntawm 3 txog 10 litres. Qhov txheeb ze ntuas ntawm cov zis yog txo qis - thaj tsam mus txog 1005, pathological yam thiab qab zib tsis tuaj yeem nyob hauv. Lub cev tsis tuaj yeem ua rau cov zis muaj zog thiab polyuria, raws li txoj cai, nrog cov nqhis dej heev hauv nruab hnub thiab yav hmo ntuj. Kev ua rau cov neeg mob tsis zoo ua rau lub cev ua rau muaj ntshav ntau dua hypovolemia thiab ntshav plasma hyperosmolarity, vim qhov tshwm sim ntawm kev soj ntsuam mob hnyav dhau los - ntxhov siab, kub taub hau, hyperpnoea, stupor, tsis nco qab, thiab txawm tias tuag (lub cev qhuav dej hauv lub cev) yog tau.

Tsis tshua muaj txiaj ntsig, ntshav qab zib insipidus tuaj yeem pom nyob rau hauv cov menyuam yaus tsis muaj nqhis dej heev. Ntxiv mus, yog tias polyuria muaj kev hais tawm, thiab tsis muaj kev nqhis dej los them cov ntaub so ntswg ntawm cov kua dej, kev txhim kho lub cev qhuav dej ntawm cov tsos mob lub cev tau piav qhia saum toj no tuaj yeem xav tau.

Feem ntau ntshav qab zib insipidus tshwm sim yam tsis muaj kev kuaj mob hauv lub chaw kuaj mob thiab kuaj tau thaum kuaj ntshav (kuaj ntshav dhau li ntawm ntshav, tsis tshua muaj pes tsawg tus zis). Cov duab hauv tsev kho mob feem ntau yog sib xyaw nrog cov mob neuro-endocrine xws li kev coj khaub ncaws tsis xwm yeem hauv poj niam, ua tsis tiav, thiab ua kom muaj kev sib daj sib deev hauv cov txiv neej. Ntau zaus, muaj qhov qab los noj mov thiab lub cev nyhav, tshwj xeeb yog nqhis dej me me. Cov tsos mob ntawm tus kab mob ntshav qab zib insipidus tuaj yeem tshawb pom nyob rau hauv lub moj khaum ntawm panhypopituitarism, cov ntaub ntawv ntawm lub cev nqaij daim tawv rog rog, acromegaly. Nrog kev sib xyaw ua ke no, cov cim tsho feem ntau hnav tawm.

Psychopathological kev nthuav qhia yog nquag heev thiab raug pom nyob rau hauv daim ntawv ntawm asthenic thiab ntxhov siab-depressive syndromes.

Ntshav qab zib insipidus hauv cov menyuam yaus muaj qhov tsis txaus ntshai me ntsis. Lawv feem ntau muaj kev thaj yeeb mus tas li, txawm hais tias kev noj qab nyob zoo los ntawm kev nthuav qhia kev txawj xav feem ntau kuj yuav tshwm sim. Cov teeb meem ua rau lub cev muaj mob ua rau lub siab tsis txaus ua rau muaj kev tawm hws, daim tawv nqaij qhuav thiab cov leeg ua paug thiab feem ntau nrog cov tsos mob ntawm ntshav qab zib insipidus. Ntxiv rau lawv, feem ntau pom lability ntawm cov ntshav nrog ib tug me ntsis kom nws thiab ib tug nyiam mus tachycardia. Txoj kev ntsuam xyuas neurological qhia tsuas yog pom cov tsos mob ntawm tus mob ntshav qab zib insipidus. Ntawm craniograms, feem ntau koj tuaj yeem pom cov duab tiaj tus ntawm lub hauv paus ntawm lub pob txha taub hau nrog lub me me ntawm Turkish eeb, uas feem ntau yuav hais txog cov cim qhia ntawm dysraphic xwm txheej. EEG cuam tshuam zoo sib xws rau cov uas rau lwm cov kab mob neuro-pauv-endocrine.

, , , , , ,

Ntshav qab zib insipidus hauv me nyuam yog dab tsi -

Mob ntshav qab zib insipidushauv menyuam yaus - Tus kab mob uas tshwm sim los ntawm luv luv ntawm antidiuretic hormone hauv lub cev, thiab uas tau tswj hwm los ntawm polyuria thiab polydipsia.

Antidiuretic hormone txhawb kev nqus dej los ntawm thawj zis mus rau hauv cov ntshav hauv kev khaws cov raum thiab tswj cov dej hauv lub cev hauv cov menyuam yaus, cov hluas thiab cov laus.

Dab tsi ua / Ua rau muaj ntshav qab zib insipidus hauv cov menyuam yaus:

Ntshav qab zib mellitus hauv ib tus menyuam raug txwv li idiopathic. Nws tuaj yeem pib thaum twg los tau. Nrog rau daim id idathathic, qhov tsis muaj txhij txhua ntawm cov tshuaj tiv thaiv antidiuretic yog nyob ntawm qhov ua tsis tiav ntawm hypothalamic-pituitary axis. Nws ntseeg tau tias hauv thaj chaw no muaj cov kab mob ua rau lub cev txhawm rau lub plab hnyuv siab raum, uas tau tshwm sim los ntawm cov tsos mob yog tias cuam tshuam ib puag ncig cuam tshuam rau lub cev.

Ntshav qab zib insipidus hauv cov menyuam yaus tuaj yeem muaj tus mob post-traumatic etiology. Nws tuaj yeem tshwm sim los ntawm kev raug mob uas tshwm sim sab saud qws txhaws thaum lub pob txha taub hau nrog pob txha taub hau ntawm lub pob txha taub hau thiab tawg ntawm lub duav pituitary lossis tom qab kev ua haujlwm neurosurgical thiab kev siv dag zog.

Polyuria mus tas li tuaj yeem tshwm sim tau ntev tom qab raug mob - 1-2 xyoos. Hauv cov xwm txheej zoo li no, cov kws kho mob tshawb pom tus menyuam tus mob nyob rau lub sijhawm no, sim nrhiav sijhawm luv thaum cov tsos mob tshwm sim tuaj yeem tshwm sim. Kev raug mob pob txha taub hau yog ib qho ua kom ntshav qab zib insipidus tsawg tsawg.

Qhov ua rau tsis txaus ntseeg ntawm antidiuretic hormone tej zaum yuav muaj qhov pom ntawm neurohypophysis ntawm ib qho ntawm cov laj thawj hauv qab no:

histiocytosis
qog hlav hla lub Turkish eeb thiab hauv thaj chaw ntawm optic hlab hla
pob txha pob txha pob txha, phais mob
mob (tuberculosis, mob txha caj qaum)
tungsten syndrome
ntawv qhia hom mob

Hauv kev siv tshuaj kho mob, muaj ntau kis uas qhov tseeb ntawm tsis txaus tus tshuaj tiv thaiv kab mob antidiuretic tseem tsis meej, thiab yog li cov ntshav qab zib insipidus hauv menyuam yaus raug xa mus ua idiopathic daim ntawv. Tab sis ua ntej ntawd, koj yuav tsum rov kuaj tus me nyuam dua, tej zaum ob peb zaug. Vim hais tias nyob rau hauv ½ cov neeg mob morphologically pom hloov ntawm hypothalamus lossis pituitary caj pas vim kev loj hlob ntawm cov txheej txheem volumetric tshwm sim tsuas yog tom qab ib xyoos tom qab thawj zaug tshwm sim ntawm tus kab mob, thiab nyob rau hauv peb lub hlis twg ntawm cov menyuam mob, qhov kev hloov pauv no tsuas yog tshwm sim tom qab 4 xyoos.

Muaj ib daim ntawv tshwj xeeb ntawm cov ntshav qab zib insipidus hauv cov hluas thiab cov menyuam yaus uas muaj qhov tsis kam tiv thaiv tshuaj tiv thaiv kab mob, uas yog suav tias yog tus txheeb ze tsis muaj cov tshuaj tiv thaiv. Tus kab mob no tsis cuam tshuam nrog kev tsim tawm tsis txaus ntawm vasopressin lossis nws qhov kev rhuav tshem ntau ntxiv, tab sis tshwm sim vim kev muaj mob tsis huv ntawm lub raum txais rau nws.

Pathogenesis (muaj dab tsi tshwm sim?) Thaum mob ntshav qab zib insipidus hauv cov menyuam yaus:

Pathogenesis yog kev tsim khoom tsis txaus ntawm vasopressin (ADH) hauv lub cev. Feem ntau, qhov tsis txaus no tshwm sim los ntawm qhov tsis muaj peev xwm ntawm cov hlwb neurosecretory hauv qhov supraoptic thiab kom tsawg dua qhov tsis muaj zog ntawm cov kab mob hypothalamus. Lub cev tau txais cov dej me me vim tias tsis muaj cov tshuaj tiv thaiv kabmob (antidiuretic hormone), uas ua rau muaj kev nce ntshav ntau ntxiv ntshav osmolarity. Thiab qhov no nyeg stimulates lub mechanisms ntawm kev nqhis dej thiab ua rau polydipsia.

Yog li lub cev tab tom sim los kho qhov sib npaug ntawm kev faib thiab kev siv dej, thiab osmolar siab ntawm lub cev lub cev nyob ruaj khov ntawm qhov tshiab, nce qib siab ntxiv. Tab sis polydipsia tsis yog tsuas yog muaj kev tiv thaiv kev ua haujlwm thib ob ntawm polyuria ntau dhau. Nrog rau qhov no, nyob rau hauv pathogenesis ntawm kev ua tsis tiav ntawm lub hauv paus nruab nrab ntawm kev nqhis dej.

Qee cov kws tshawb nrhiav ntseeg tau hais tias qhov pib ntawm tus kabmob yog cim los ntawm kev nce ntxiv ntawm kev nqhis dej, thiab tom qab ntawd tus menyuam tsim kho cov mob polyuria nrog cov ntshav tsawg kawg ntawm cov zis. Ntshav qab zib insipidus hauv cov menyuam yaus ntawm keeb kwm neurogenic yog tus kab mob nrog pathology ntawm hypothalamic-neurohypophysial axis.

Cov tsos mob ntawm tus mob ntshav qab zib insipidus hauv cov menyuam yaus:

Cov tsos mob feem ntau ntawm tus mob ntshav qab zib insipidus hauv cov menyuam yaus yog qhov nce ntxiv ntawm cov zis ntawm qhov mob tso zis. Kev tso zis ntawm tus menyuam yog muaj ntau, feem ntau tshwm sim, tsis hais thaum nruab hnub thiab hmo ntuj. Diuresis (tso zis tawm) tuaj yeem ncav 40 litres hauv 24 teev. Qhov nruab nrab txhua hnub tso zis tawm yog 3-10 litres. Cov txheeb ze ceev ntawm cov zis yog tsawg dua li nws yuav tsum. Qhov nruab nrab, qhov ntsuas pom yog 1005. Nws tsis muaj suab thaj thiab hloov kab mob.

Nrog polyuria thiab qhov tsis tuaj yeem tsim cov zis muaj zog, cov tsos mob xws li nqhis dej yuav loj tuaj. Tus menyuam xav haus nruab hnub thiab hmo ntuj. Yog tias nws tsis raug tso cai haus, hypovolemia thiab ntshav ntshav hyperosmolarity yuav nce ntxiv. Qhov tshwm sim yog cov tsos mob hnyav dua:

npaws
arousal
neeg ruam
hyperpnea
coma
kev tuag

Mob ntshav qab zib insipidus tuaj yeem tshwm sim hauv cov menyuam yaus uas tsis muaj qhov nqhis dej hnyav, tab sis cov xwm txheej zoo li no tsis tshua muaj rau kev kho mob. Thaum zoo li no, polyuria hais tau zoo heev, tsis muaj nqhis dej, koj tuaj yeem cia siab tias yuav muaj kev txhim kho ntawm cov tsos mob saum toj no ntawm lub cev qhuav dej. Muaj cov kis mob thaum tus kabmob kis tau hla yam tsis muaj tus tsos mob, thiab nws tuaj yeem kuaj pom tsuas yog los ntawm kev soj ntsuam hauv chav kuaj. Cov kws kho mob pom qhov tsis tshua muaj txheeb ze ntawm cov zis, ntau cov diuresis. Cov tsos mob feem ntau yog ntxiv nrog neuro-endocrine mob xws li kev coj khaub ncaws tsis xwm yeem hauv cov ntxhais, ua tsis taus txiv, thiab kev sib daj sib deev hauv cov tub hluas.

Feem ntau tus me nyuam lub siab thiab lub cev qhov hnyav dua, tshwj xeeb yog thaum pom cov tsos mob xws li nqhis dej tsis tau hais tawm. Cov tsos mob ntawm ntshav qab zib insipidus tuaj yeem nrhiav tau nyob rau hauv lub moj khaum ntawm cerebral cov ntaub ntawv ntawm kev rog, panhypopituitarism, acromegaly. Yog tias muaj kev sib txuam ua ke, tom qab ntawd ces txoj kev cia siab tuaj yeem lwv (tawm tsam sab nrauv) hauv qhov xwm txheej.

Kuj muaj ntau psychopathological qhia ntawm ntshav qab zib insipidus: asthenic thiab ntxhov siab-depressive syndromes. Kev noj haus tsis zoo yuav tsis muaj suab hais. Lawv tuaj yeem tshwm sim tsis tseg, txawm hais tias kev noj qab nyob zoo ntawm kev hais tsis sib haum feem ntau kuj tseem yuav tshwm sim. Cov neeg muaj mob ua rau lub cev muaj mob ua rau cov tawv nqaij qhuav, tsis muaj tawm hws, tsis muaj qhov txhab ntawm cov nqaij mos, feem ntau lawv tshwm sim nrog lwm cov tsos mob ntawm tus mob ntshav qab zib insipidus hauv cov menyuam yaus.

Tsis tas li, nyob rau qee zaus, kuaj pom ntshav ntawm lub ntsej muag kuaj pom, muaj qhov nyiam ua rau nws ntau ntxiv, tus menyuam muaj tachycardia. Neurological soj ntsuam tuaj yeem tsuas pom mob me ntsis. Ntawm craniograms, feem ntau koj tuaj yeem pom cov duab tiaj tus ntawm lub hauv paus ntawm lub pob txha taub hau nrog qhov ntau thiab tsawg ntawm Turkish eeb, uas, feem ntau yuav hais txog cov cim ntawm qhov tsis txaus ntseeg. EEG cuam tshuam yog qhov zoo ib yam li hauv lwm cov kab mob neuro-pauv-endocrine.

Mob ntshav qab zib insipidus yog dab tsi?

Idiopathic syndrome cuam tshuam nrog kev tsis muaj peev xwm ntawm cov tshuaj vasopressin muaj cov kev faib tawm tsawg thiab cov tsos mob hais tawm. ADH tsim tawm los ntawm hypothalamus, thiab zais rau hauv cov ntshav los ntawm lub caj pas pituitary hauv qhov nyiaj uas yuav tsum tau tswj cov dej-ntsev sib npaug. Ntshav qab zib insipidus yog ib qho kev tsis sib haum xeeb hauv lub cev lub cev cov dej vim qhov ua kom tsis haum los yog paub txog ADH los ntawm lub raum hlwb. Mob ntshav qab zib tej zaum yuav yog neurogenic lossis nephrogenic.

Cov ntshav qab zib raum insipidus

Mob ntshav qab zib, uas qhov kev txwv tsis pub lub raum ua tshwm sim, raug cais raws li lub raum daim ntawv ntawm tus kab mob no. Muaj ib daim ntawv mob ntshav qab zib insipidus vim yog qhov tsis hnov mob ntawm lub raum hlwb mus rau ADH. Thaum hais txog cov ntshav qab zib nephrogenic, thawj qhov ua rau tubulopathy raug kuaj - txoj hlab ntsws txoj hlab ntsws uas ua nrog cov mob polyuria. Tus kab mob tuaj yeem yog roj ntsha, qhov tshwm sim ntawm pathology kuj ua tau vim kev kho mob tshuaj yeeb, uas ua rau lub thauj cov leeg puas tsuaj.

Nruab nrab hauv ntshav qab zib insipidus

Ib qho kev tsis sib haum xeeb uas tau muab faib ua qhov tseem ceeb ntawm cov ntshav qab zib insipidus tshwm sim nyob rau hauv ob kis: hauv qhov tsis zoo ntawm ADH synthesis lossis kev ua txhaum ntawm kev zais ntawm cov tshuaj no los ntawm lub caj pas pituitary. Ib qho tuaj yeem paub qhov txawv ntawm neurogenic (hauv nruab nrab) hom ntawm tus kabmob yog tias kev sim tshuaj yog ua los ntawm kev noj-qhuav (txwv tsis pub haus dej rau 5-6 teev) - qhov no ua rau lub cev qhuav dej sai sai.

Cov tsos mob ntawm tus mob ntshav qab zib insipidus hauv cov poj niam

Lub cev qhuav dej ntawm tus poj niam lub cev ua rau muaj kev phom sij loj dua. Cov tsos mob ntawm tus mob ntshav qab zib insipidus hauv cov poj niam zoo ib yam li cov tsos mob ib txwm, txawm li cas los xij, tiv thaiv keeb kwm ntawm lub cev qhuav dej ntawm lub cev, tus poj niam muaj lub siab ntsws tsis txaus vim lub cev tsis ua hauj lwm lawm, tso zis heev thiab cia li poob ceeb thawj. Thaum cev xeeb tub, tus kab mob no tuaj yeem ua rau nchuav menyuam.

Cov tsos mob ntawm tus mob ntshav qab zib insipidus rau tus txiv neej

Ib qho kab mob xws li mob ntshav qab zib insipidus rau tus txiv neej tsis yog tsuas yog ua nrog los ntawm cov tsos mob yav tas los piav qhia. Nquag tso zis, polyuria, enuresis, insomnia thiab nqhis dej tas li nrog cov poob hauv libido thiab txo qis dua potency. Nrog rau ntshav qab zib, lub cev qhuav dej tawm ntawm lub cev, tus txiv neej plam qhov kev ua tau zoo, nws tau poob kev txaus siab ntawm qhov rov qab sib deev, thiab nws cov xwm txheej dav dav dua.

Cov tsos mob ntawm tus mob ntshav qab zib insipidus hauv cov menyuam yaus

Thaum muaj hnub nyoog sib txawv, mob ntshav qab zib insipidus hauv cov menyuam yaus nws ua rau nws tus kheej muaj peev xwm sib txawv. Cov menyuam mos mus txog rau ib xyoos tsis tuaj yeem nthuav qhia kev nqhis dej ntau dua, yog li ntawd lawv cov kev mob hnyav zuj zus. Ib tug menyuam yaus txog ib xyoos nyob rau hauv lub xub ntiag ntawm tus kabmob no yuav ua rau muaj kev ntxhov siab ntau ntxiv, ntuav tshwm, nws sai sai poob phaus, tso zis me ntsis. Mob ntshav qab zib yog qhov phem tshaj rau kev kho cov hluas, vim tias cov tsos mob yuav mob sib khuav. Hauv tus menyuam yaus thaum tiav hluas, vim tsis muaj dej tsis tu ncua, qhov tshwm sim qeeb zuj zus tshwm sim. Tus menyuam yaus tuaj yeem nce phaus, poob qis hauv kev txhim kho.

Kev kuaj mob ntshav qab zib insipidus

Tus kws kho mob tuaj yeem kho kho kom raug thiab paub qhov txawv ntshav qab zib ntawm qee yam ntawm cov kab mob polydipsia los ntawm kev kuaj mob hauv ntau theem. Kev kuaj pom tus mob ntshav qab zib insipidus raws tus neeg mob sab nrauv pib nrog kev soj ntsuam ntawm tus neeg mob thiab qhia meej ntxiv cov hauv qab no:

cov dej koj haus, tso zis ib hnub,
lub xub ntiag ntawm hmo ntuj nqhis dej thiab nocturnal enuresis,
muaj qhov ua rau lub hlwb ua rau nqhis dej, ntiag tug yaum kom tso zis (thaum tus neeg tsis mloog lus, cov tsos mob ploj),
puas muaj cov kab mob provocative (qog, raug mob, endocrinology cuam tshuam).

Yog tias tom qab kev tshawb fawb txhua qhov tsos mob qhia tias muaj tus kab mob, tom qab ntawd yuav tsum tau kuaj mob, raws li cov ntsiab lus tau los ntawm kev kuaj thiab kho tus mob. Daim ntawv tshuaj ntsuam suav nrog:

Ultrasound ntawm ob lub raum
tsom xam cov ntshav, zis (osmolarity, density),
xam tomography ntawm lub hlwb,
sim Zimnitsky
dej ntshiab sodium, poov tshuaj, nitrogen, qabzib, urea yog txiav txim siab.

Kev kho mob ntshav qab zib insipidus pej xeem tshuaj

Nrog rau kev kuaj pom tus kab mob raws sij hawm, cov tshuaj ntsuab rau ntshav qab zib insipidus yuav pab kom rov zoo li qub. Ua ke nrog kev kho mob rau pej xeem nrog cov zaub mov tshwj xeeb, uas lawv txwv cov ntsev tsawg, qab zib. Hauv pej xeem cov tshuaj, tshuaj ntsuab tshwj xeeb tau siv uas txo kev nqhis dej, muaj lub siab zoo rau lub paj hlwb, thiab txhim kho cov zaub mov ntawm lub hlwb hlwb. Rau cov lag luam tshuaj infusions siv: Walnut nplooj, elderberry paj, burdock hauv paus, plhaw cones, valerian hauv paus. Cov khoom siv dav siv beekeeping:

propolis (hauv ntawv dawb lossis rho tawm),
muaj koob muaj npe jelly
zib ntab
siv quav ciab
purg
zabrus
paj ntoos.

Nyob rau hauv parallel, beekeeping yuav siv tau rau 2 qhib rau ob peb lub lis piam. Txawm li cas los xij, kev kho mob zoo li no yuav tsum nrog kev saib xyuas ntawm tus kws kho mob koom, vim hais tias kev fab tshuaj tsis haum yuav tshwm sim rau ib qho kev sib pauv tshuaj twg lossis cov khoom beekeeping. Kev kho mob rau cov menyuam yaus nrog cov kev siv tshuaj ib txwm muaj peev xwm yog qhov txaus ntshai, vim tias cov khoom siv hauv lub cev tuaj yeem ua rau muaj kev tsis haum. Beekeeping khoom rau cov menyuam yaus hnub nyoog qis dua 3 xyoos yog contraindicated.

Tswvyim thiab tus yam ntxwv

Ntshav qab zib insipidus yog ib txoj kev kho uas nws txoj kev loj hlob nrog tseem ceeb cuam tshuam ntawm dej-electrolyte tshuav nyob rau hauv lub cev ntawm tus menyuam.

Kev loj hlob ntawm tus kabmob tuaj yeem tshwm sim thaum hnub nyoog li cas.

Pathology yog ntawm cov kab mob endocrine thiab nyob rau qee kis ua pub.

ntshav qab zib insipidus yuav tshwm sim ua ke nrog polyuria (nce zis zis ib hnub),
tus kab mob tuaj yeem ua ke nrog polydipsia (muaj kev nqhis dej tas li).

rau cov ntsiab lus ↑

Cov pab pawg thiab cov raug pheej hmoo

Qee qhov xwm txheej, cov kab mob ntshav qab zib insipidus tsis tuaj yeem txiav txim tau ntev ntev. Qhov tshwj xeeb ntawm tus kabmob vim qhov muaj muaj keeb thiab caj ces yam.

Ib pawg neeg muaj kev pheej hmoo tshwj xeeb suav nrog cov menyuam yaus muaj lub hlwb tsis zoo, uas tuaj yeem tsis tsuas yog los ntawm cov kab mob, tab sis los ntawm kev cuam tshuam nrog lwm yam sab nraud (kev mob, phais, thiab lwm yam).

Ua rau muaj tus kabmob Cov hauv qab no yam yuav dhau los:

kev vam meej ntawm cov qog hlwb,
cov kab mob loj uas cuam tshuam nrog lub xeev ntawm cov hlab ntsha,
kev nce qib ntawm histiocytosis,
mob plab yug me nyuam tsis zoo,
lub txim ntawm kev raug mob rau lub pob txha taub hau thiab lub hlwb,
muaj teeb meem tom qab phais mob hauv paj hlwb,
mob ntshav qab zib
kev mob plab yug los ntawm lub caj pas pituitary thiab hypothalamus,
muaj teeb meem tom qab kis tau tus kab mob.

Nyeem txog cov tsos mob thiab kho mob qa foob rau cov menyuam nyob ntawm no.

Kev faib tawm

Ntau hom mob ntshav qab zib insipidus hauv cov menyuam yaus muaj cov tsos mob zoo sib xws, tab sis kev paub ntawm cov mob no txawv. Kab mob yuav yug tau losCov. Raws li qib kev loj hlob, tus kab mob tau muab faib ua peb yam.

Nyob rau thawj theem, qhov tso zis ntau ntxiv rau 6-8 litres ib hnub. Ntawm theem ob mob zuj zus, qhov tso zis ntau ntxiv mus txog 8-14 litres ib hnub.

Qeb thib peb ntawm kev txhim kho kabmob yog pom tus kabmob nce ntxiv rau hauv lub cev ntawm qhov zis txhua hnub nyob rau hauv tshaj 14 litres.

Hom mob ntshav qab zib hom insipidus:

neurogenic (lossis hauv nruab nrab) daim ntawv - ua txhaum ntawm theem ntawm antidiuretic hormone nyob rau hauv tus ntawm pathologies ntawm lub pituitary lossis hypothalamus,
lub raum (lossis nephrogenic) daim ntawv - tsis kam mus vasopressin yog tsim,
iatrogenic daim ntawv - kev loj hlob tiv thaiv keeb kwm yav dhau los ntawm kev siv tshuaj ntau dhau los ntawm cov pab pawg diuretic,
kev xa tsis tau zoo daim ntawv - cim tau los ntawm kev nce ntxiv ntawm cov kua dej uas tus menyuam haus tiv thaiv keeb kwm ntawm kev ntshaus siab,
haumxeeb daim ntawv - tus kab mob tshwm sim rau hauv feem ntau ntawm cov menyuam yaus txog li ib xyoos.

Thaum ua yeeb tshuaj kho mob ntshav qab zib insipidus, kab mob tau cais mus rau peb theem. Thawj (kev them nyiaj) yog cim los ntawm tus nqi ntxiv ntawm cov zis tawm thiab cov tsis nqhis dej.

Qhov theem ob (subcompensation) manifests nws tus kheej hauv daim ntawv ntawm cov ntshav nce ntxiv ntawm cov zis thiab nqhis dej me me. Qeb thib peb (decompensation) yog kev sib txuas ntawm kev nqhis dej tsis tu ncua thiab cov zis muaj ntxiv.

Cov tsos mob thiab cov tsos mob

Nws muaj peev xwm kom paub txog cov kab mob ntshav qab zib insipidus hauv tus menyuam los ntawm kev hloov nws tus cwj pwm thiab cov tsos mob ntawm kev hloov pauv hauv lub dav dav ntawm lub cev. Yog tus me nyuam poob koj qab los noj movnws ua kev chim siab thiab feem ntau yws ntawm kev nqhis dejTom qab ntawv koj yuav tsum ua qhov kev kuaj mob sai li sai tau.

Cov tsos mob ntawm ntshav qab zib ntawm daim ntawv no yuav vam meej thiab pib nrog tus mob tachycardia, ua kom ntshav liab thiab qaug zog ntawm lub cev.

Cov tsos mob kab mob yog yam mob li nram no:

muaj kev ntxhov siab ntau ntxiv ntawm cov menyuam,
lwm yam kev xav ntawm lub hlwb
ntshav siab
tsis qab los noj mov
tas li qhuav lub qhov ncauj
mob taub hau
kev nce sai hauv lub cev kub
mob hauv cov pob qij txha,
nyiam zes khoo qhov quav,
muaj kua ntau heev thaum tso zis,
nyiam kom ib txwm tsis nco qab,
lub teeb lossis yuav luag pob tshab xim tso zis,
cov tsos mob ntawm lub plab zom mov.

rau cov ntsiab lus ↑

Teeb meem thiab txim

Thaum tsis muaj kev kho mob sijhawm, mob ntshav qab zib insipidus kev loj hlob sai. Lub cev lub cev qhov hnyav poob rau qib tseem ceebCov. Qhov ua kom muaj teeb meem tsis yog tsuas yog kho kev kho mob lig, tab sis kuj yog qee qhov kev ua yuam kev ntawm niam txiv.

Piv txwv li, yog tias koj tso cov dej kom tsawg dua thiab ua tiav qhov no yuav txo cov zis tso tawm, tom qab ntawd qhov kev kho mob ntawm kev kho mob yuav tsawg zuj zus, thiab qhov mob ntawm tus menyuam yuav mob heev ntxiv.

Lub txim ntshav qab zib insipidus tuaj yeem dhau los ua cov hauv qab no:

lag hauv kev loj hlob ntawm lub cev,
cov leeg kab mob loj,
ncua kev sib deev,
lub cev lub cev qhuav dej
kev nyuaj siab mob
dwarfism
enuresis
ntev li ntawm thinness.

Kev phais mob nrog ntshav qab zib insipidus hauv cov menyuam yaus yog nqa tawm tsuas yog thaum muaj xwm txheej ceev.

Cov txheej txheem kev phais tshem tawm qhov ua rau ntawm tus mob lossis qhov tshwm sim.

Hauv lwm qhov xwm txheej, kev kho mob yog nqa tawm tsuas yog hloov pauv kev kho mob.

Kev nqus tau cov tshuaj yog qhov tsim nyog ntxiv los ntawm kev ua raws li kev noj haus tshwj xeeb. Hauv cov menyuam yaus ntawv qhia zaub mov, nws yog ib qho tsim nyog kom txo cov protein ntau, kev nce siab cov zaub mov, thiab cov khoom noj yuav tsum yog ib feem me me.

Cov lus pom zoo ntawm cov kws kho menyuam yaus txog kev kho dystrophy hauv menyuam yaus tuaj yeem nrhiav tau ntawm peb lub vev xaib.

Kev kuaj mob thiab tshuaj xyuas

Kev kuaj mob ntshav qab zib insipidus hauv cov menyuam yaus yog nqa tawm nkag siabCov. Thaum kuaj thawj zaug, tus kws kho mob pom cov ntaub ntawv txog ntau npaum li cas cov dej haus rau ib tus menyuam noj ib hnub, ntau npaum li cas cov txheej txheem ntawm nws tshem tawm tau cuam tshuam rau kev noj, thiab tseem ntsuam xyuas lub xeev kev noj qab haus huv.

Raws li cov ntaub ntawv khaws tseg, kev sim tshwj xeeb hauv chaw sim thiab kev sab laj nrog cov kws tshaj lij tshwj xeeb tau hais tseg.

Rau kev kuaj mob Cov txheej txheem hauv qab no siv rau:

Kev kuaj Zimnitsky (qhov ntom thiab cov qauv ntawm cov zis yog kawm),
kuaj nrog vasopressin,
ua kua qauv
tsom xam ntawm cov ntsiab lus ntawm antidiuretic hormone hauv cov ntshav,
sib txawv nrog psychogenic polydipsia (kev nqhis dej tawm tsam tshwm sim hauv tus menyuam tawm tsam keeb kwm ntawm qhov tsis txaus siab),
Kev ntsuam xyuas xoo hluav taws xob ntawm lub pob txha taub hau,
MRI thiab CT ntawm lub paj hlwb.

rau cov ntsiab lus ↑

Kev txuag tshwj tseg

Cov chav kawm ntawm kev kho mob ntshav qab zib insipidus raug xaiv rau menyuam yaus tus kheej.

Nrog rau cov kab mob ua ntej txhua lub sijhawm, yuav tsum tau muaj kev saib xyuas cov ntshav qabzib nrog lub cev kom tso ntshav txhaws. Cov txheej txheem zoo li no tau sau tseg rau cov menyuam yaus hnub nyoog qis dua 3 xyoos.

Hloov kho kev kho mob qhov no yog tsis nqa tawm. Lwm yam tshuaj yog siv los kho cov menyuam mos hnub nyoog qis dua peb xyoos. Thaum muaj kev nyuaj siab, yuav tsum muaj kev phais.

Kev Npajsiv nyob rau hauv kev kho mob ntshav qab zib insipidus hauv cov menyuam yaus:

Kev tswj hwm ntawm cov tshuaj vasopressin hloov chaw (Desmopressin) tshuaj pleev ib ce.
Kev Kho Mob nrog cov tshuaj uas txhawb kev tsim cov tshuaj hormone vasopressin (chlorpropamide).
Kev kho mob nrog cov tshuaj uas txo cov ntsev hauv cov ntshav (clopamide, indapamide).
Txais tos ntawm analogues ntawm antidiuretic hormone (Vasomirin, Minirin, Adiuretin SD).

Qhov phom sij ntawm tus mob glomerulonephritis raug rau menyuam yaus li cas? Tshawb nrhiav lo lus teb tam sim no.

Txoj kev twv yuav yog dab tsi?

Qhov pom tias muaj ntshav qab zib insipidus zoo tshaj yog muaj yog tias muaj kho txhua tus kab mob.

Feem ntau, tus mob tuaj yeem kho kom zoo, thiab nws cov tsos mob yuav tsum thab tus menyuam, txawm tias yog neeg laus los xij.

Tsis muaj kev kho mob, tsis ua raws li cov lus pom zoo tshwj xeeb lossis kev kuaj pom lig kev qhia kev phemCov. Mob ntshav qab zib insipidus tsis tuaj yeem tsuas yog hloov pauv lub neej zoo ntawm cov menyuam yaus, tab sis kuj tuaj yeem ua rau tuag taus.

Kev Tiv Thaiv

Ntshav qab zib insipidus, feem ntau, tshwm sim nyob hauv qab ntawm qee yam.

Kev tiv thaiv kabmob tshem tawm cov ua txoj kev loj hlob pathology.

Tshwj xeeb yuav tsum them rau lub xeev ntawm tus me nyuam lub hlwb. Qhov tshwm sim ntawm kev raug mob thiab doog ntshav ntawm lub pob txha taub hau yuav tsum tau kuaj xyuas nyob rau hauv cov tsev kho mob.

Yog hais tias tus kab mob yog xeeb, ces tiv thaiv tsis tau nwsCov. Lub luag haujlwm tseem ceeb hauv kev kho thiab kev ntsuas yuav raug ua si los ntawm lub sijhawm ua haujlwm ntawm kev kuaj mob.

Cov kev tiv thaiv kev tiv thaiv suav nrog hauv qab no cov lus pom zoo:

Kev kho kom sai thiab kis kab mob hauv cov menyuam yaus.
Kev tiv thaiv ntawm pob txha taub hau kev raug mob (nyob rau hauv muaj cov kev raug mob, kev kho yuav tsum ua tiav).
Tus me nyuam cov khoom noj yuav tsum ua kom sib npaug (cov khoom noj mis nyuj, zaub tshiab thiab txiv hmab txiv ntoo, nqaij, txiv hmab txiv ntoo qhuav thiab txiv ntoo yuav tsum muaj nyob hauv cov zaub mov).
Kev nquag muaj cov vitamins hauv tus menyuam lub cev nrog kev pab ntawm cov vitamins.
Kev tswj hwm tus me nyuam cov ntsev kom tsawg (nrog ntshav qab zib insipidus, cov khoom no tsis suav nrog hauv pluas noj los yog muaj nyob hauv qhov tsawg kawg nkaus).
Tus me nyuam txoj kev ua neej yuav tsum nquag (ua si kis las, nyob hauv cov huab cua ntshiab, sab nraum zoov thiab kis las ua si, thiab lwm yam).
Kev muab cov cai haus dej (ua kom lub cev qhuav dej ntawm tus menyuam lub cev yuav tsum tsis pub ua teeb meem).

Koj tuaj yeem tuaj yeem kuaj ntshav qab zib insipidus los ntawm kev kuaj xyuas tus menyuam yaus nrog tus kws kho mob endocrinologist tsis tu ncua.

Kev raug tshem tawm ntawm kev txhim kho tus kabmob tus kws kho mob yuav tshwm sim thaum ntxov ntawm txheej txheem pathogenic, thaum nws cov tsos mob rau cov niam txiv yuav tsis pom tseeb.

Hauv kev xyaum kho mob, muaj ntau yam piv txwv ntawm kev kho kom tiav cov ntshav qab zib insipidus, yog li tsis txhob xav tias nws tsis yooj yim sua kom rov qab los ntawm kev mob nkeeg.

Oh lub luag haujlwm ntawm tus kws kho menyuam yaus hauv kev kuaj mob thiab kev kho mob ntshav qab zib insipidus hauv tus menyuam hauv qhov yeeb yaj kiab no:

Peb zoo thov koj tsis txhob muab tshuaj rau tus kheej. Sau npe tus kws kho mob!

Kev tshawb fawb kuaj

Kev kuaj pom tias yog polypsy thiab polyuria, thiab qhov ntsuas tus txheeb ze ntawm qhov tso zis yog los ntawm 1001 txog 1005. Kev kuaj sim, tsis suav cov kua rau peb teev. Hauv qhov no, tus txheeb ze ntom ntim ntawm cov zis tseem nyob qis, thiab lub osmolality ntawm lub ntshav yuav ntau dua. Yog hais tias tus txheeb ze ntuas ntawm cov zis nce ntxiv, thiab lub osmolality ntawm ntshav muaj qhov qub, qhov no qhia tau tias yog polydipsia psychogenic, uas tuaj yeem ua rau menyuam yaus.

Ib qho kev sim yog ua nrog vasopressin - 5 ED yog tswj hwm hauv qab daim tawv nqaij. Nrog rau cov tsis muaj txhij txhua ntawm cov tshuaj tiv thaiv kab mob (uas qhia tau tias cov ntshav qab zib insipidus), cov zis ntawm cov zis muaj ntau dua. Yog tias tus me nyuam muaj kev tawm tsam cov tshuaj tiv thaiv kab mob, uas tshwm sim nrog nephrogenic ntshav qab zib insipidus, qhov txheeb ze ntawm cov zis tseem tsawg.

Kev kuaj mob sib txawv ntawm cov ntshav qab zib insipidus hauv cov menyuam yaus

Ntshav qab zib insipidus zoo ib yam nyob rau hauv kev tshwm sim nrog kev siv dej ntau dhau los yog thawj polydipsia, uas tau piav qhia los ntawm nws cov keeb kwm psychogenic. Hauv cov neeg mob uas muaj tus mob schizophrenia, polydipsia kuj yuav tshwm sim, uas yuav tsum tau txiav txim siab thaum txiav txim siab mob.

Yog tias tus me nyuam muaj mob hlwb psychogenic polypsidia, ces ib qho kev sim nrog kev noj mov qhuav ua rau qhov tseeb hais tias diuresis tsawg zuj zus, cov txheeb ze ntawm cov zis yuav rov qab zoo li qub (xws li hauv cov menyuam muaj kev noj qab haus huv - 1020), tus menyuam tus mob tseem nyob, thiab tsis muaj cov tsos mob ntawm lub cev qhuav dej.

Cov theem tom ntej ntawm kev kuaj mob txawv yog cais tawm ntawm daim ntawv nephrogenic ntawm tus kab mob, nyob rau hauv lub raum hlab yog insensitive rau vasopressin. Cov ntawv ntawm nephrogenic mob ntshav qab zib insipidus:

tsev neeg daim ntawv nrog lub cev tsis sib xws hauv kev txhim kho cov hlab ntsha hlaus
nrhiav daim ntawv ua los ntawm kev somatic, kis kab mob thiab intoxications

Txheeb xyuas qhov txawv txav ntawm tus mob ntshav qab zib mellitus nrog lwm cov kab mob pathological, nws yog ib qho tsim nyog yuav tsum ua qhov kev kawm txog kev ua haujlwm ntawm lub raum, urogenital system, ntshav system, thiab ua cov kev ntsuas tau hais saum toj no.

Kev kho mob ntshav qab zib insipidus hauv cov menyuam yaus:

Thawj kauj ruam hauv kev kho qhov tshwm sim ntawm ntshav qab zib insipidus hauv menyuam yaus yog tshem tawm qhov ua rau. Siv tshuaj tua hluav taws xob lossis phais mob txhawm rau tshem tawm cov qog. Hloov pauv kev kho mob yog nqa tawm siv vasopressin npaj. Cov kws kho mob tau sau ntawv tswj hwm ntawm Desmopressin 3 zaug hauv ib hnub. Qhov tshuaj yog ib leeg, nws yog tsawg kawg 100, ntau kawg yog 600 mcg ib hnub, yuav tsum tau tswj qhov ntsuas ntawm qhov nruab nrab ntawm cov zis.

Cov menyuam muaj mob yuav tsum zam qee qhov xwm txheej uas muaj teeb meem ntawm kev muab dej, vim tias kev txwv cov dej tsawg tuaj yeem ua rau lub cev tsis muaj zog thiab lub cev qhuav dej.

Kev twv ua ntej yuav mob ntshav qab zib insipidus hauv cov menyuam yaus

Tsis muaj kev phom sij rau lub neej yog hais tias kev haus dej haus cawv dawb xwb. Ib qho txiaj ntsig pom tseeb rau lub neej thiab muaj peev xwm ua haujlwm yog tias hloov tshuaj los kho nrog antidiuretic cov tshuaj hormones ua haujlwm. Yog tias muaj qhov teeb tsa volumetric hauv thaj av hypothalamic-pituitary, tom qab kev kuaj mob nyob ntawm nws qhov chaw thiab nyob ntawm kev kho mob.

Cov kws kho mob twg yuav tsum tau sab laj yog tias koj muaj ntshav qab zib insipidus hauv menyuam yaus:

Ib yam dab tsi yog thab koj? Koj puas xav paub cov ncauj lus ntxaws ntxaws txog kab mob ntshav qab zib insipidus hauv menyuam yaus, nws qhov tshwm sim, cov tsos mob, kev kho mob thiab kev tiv thaiv, cov chav kawm ntawm tus kab mob thiab kev noj haus tom qab nws? Lossis koj puas xav tau tshuaj xyuas? Koj ua tau teem sijhawm nrog tus kws kho mob - chaw kho mob Euro lab ib txwm nyob ntawm koj qhov kev pabcuam! Cov kws kho mob zoo tshaj plaws yuav kuaj koj, tshuaj xyuas cov cim sab nraud thiab pab txiav txim tus kab mob los ntawm cov tsos mob, qhia koj thiab muab kev pab tsim nyog thiab ua kev kuaj mob. Koj tuaj yeem ua tau hu kws kho mob tom tsevCov. Chaw Kho Mob Euro lab qhib rau koj ib ncig ntawm lub moos.

Yuav hu rau lub tsev kho mob li cas:
Xov tooj ntawm peb lub tsev kho mob hauv Kiev: (+38 044) 206-20-00 (muaj ntau txoj kev). Tus teev ntawv hauv chaw kho mob yuav xaiv koj ib hnub yooj yim thiab teev ntawm kev mus ntsib kws kho mob. Peb cov haujlwm thiab kev coj ua qhia nyob ntawm no. Saib rau hauv kev nthuav dav ntxiv txog txhua yam kev pabcuam ntawm tsev kho mob ntawm nws tus kheej nplooj ntawv.

Yog tias koj tau tshawb nrhiav yav dhau los, Nco ntsoov nqa lawv cov txiaj ntsig rau kev sab laj nrog koj tus kws kho mob. Yog tias cov kev tshawb fawb tsis tau ua tiav, peb yuav ua txhua yam tsim nyog hauv peb lub tsev kho mob lossis nrog peb cov npoj yaig hauv lwm cov chaw kho mob.

Nrog koj? Koj yuav tsum ceev faj txog koj kev noj qab haus huv tag nrho. Cov neeg tsis mloog txaus cov tsos mob thiab lawv tsis paub tias cov kab mob no tuaj yeem tsim kev tuag taus. Muaj ntau yam kab mob uas thaum xub thawj tsis pom lawv tus kheej hauv peb lub cev, tab sis thaum kawg nws hloov tawm tias, hmoov tsis, nws lig dhau los kho lawv. Txhua tus kabmob muaj nws tus kheej tshwj xeeb cov cim, yam ntxwv sab nraud ua pov thawj - qhov thiaj li hu ua cov tsos mob ntawm tus kab mobCov. Kev txheeb xyuas cov tsos mob yog thawj kauj ruam hauv kev kuaj mob feem ntau. Ua li no, nws tsuas yog tsim nyog ob peb zaug hauv ib xyoos soj ntsuam los ntawm kws kho mob, tsis tsuas yog txhawm rau tiv thaiv kab mob txaus ntshai, tab sis kuj tseem ua kom muaj lub siab xav hauv lub cev thiab lub cev kom zoo.

Yog tias koj xav nug tus kws kho mob ib lo lus nug - siv cov lus sib tham hauv online, tej zaum koj yuav pom cov lus teb rau koj cov lus nug nyob ntawd thiab nyeem cov lus qhia txog kev saib xyuas tus kheejCov. Yog tias koj xav paub txog qhov chaw kuaj mob thiab kws kho mob, sim nrhiav cov ntaub ntawv koj xav tau ntawm Txhua ntu tshuaj. Kuj sau npe rau ntawm kev kho mob portal Euro labtxhawm rau saib xyuas cov xov xwm tshiab thiab cov ntaub ntawv hloov tshiab ntawm lub vev xaib, uas yuav raug xa ncaj qha rau koj tus e-mail.