Tus Sau: Gregory Harris
Hnub Kev Tsim: 15 Lub Plaub Hlis Ntuj 2021
Hloov Hnub: 17 Lub Kaum Ib Hli Ntuj 2024
Anonim
Ntshav qab zib insipidus - Tshuaj Kho Mob
Ntshav qab zib insipidus - Tshuaj Kho Mob

Mob ntshav qab zib insipidus (DI) yog qhov tsis tshua pom muaj nyob rau hauv lub raum tsis tuaj yeem tiv thaiv kom tsis txhob ntxiv dej.

DI tsis zoo tib yam li ntshav qab zib mellitus hom 1 thiab 2. Txawm li cas los xij, tsis siv tshuaj kho mob, DI thiab ntshav qab zib mellitus ua rau nqhis dej tsis so thiab tso zis heev. Cov neeg muaj ntshav qab zib mellitus muaj cov ntshav qab zib ntau ntau (qabzib) vim lub cev tsis muaj peev xwm siv ntshav qab zib cov ntshav rau lub zog. Cov uas DI muaj cov ntshav qab zib cov ntshav ib txwm muaj, tab sis lawv ob lub raum tsis tuaj yeem sib txig sib luag hauv lub cev.

Nruab hnub, koj ob lub raum lim tag nrho koj cov ntshav ntau zaus. Feem ntau, feem ntau ntawm cov dej rov qab yog rov ua dua, thiab tsuas yog qee qhov muaj cov zis muaj zog uas tso zis tawm. DI tshwm sim thaum ob lub raum tsis tuaj yeem tso zis ib txwm muaj, thiab ntau npaum li cas ntawm cov zis ua ke tau nteg tawm.

Tus nqi ntawm cov dej hauv cov zis yog tswj hwm los ntawm antidiuretic hormone (ADH). ADH tseem tseem hu ua vasopressin. ADH tsim nyob rau hauv ib feem ntawm lub hlwb hu ua hypothalamus. Nws yog tom qab ntawd khaws cia thiab tso tawm ntawm lub caj pas pituitary. Qhov no yog cov qog me me hauv qab lub hauv paus ntawm lub paj hlwb.


DI tshwm sim los ntawm qhov tsis muaj ADH yog hu ua kab mob ntshav qab zib insipidus hauv nruab nrab. Thaum DI tau tshwm sim los ntawm qhov ua tsis tau ntawm lub raum tsis teb rau ADH, tus mob hu ua nephrogenic diabetes insipidus. Neesrogenic txhais tau hais tias cuam tshuam nrog lub raum.

Lub hauv paus Nruab Nrab tuaj yeem tshwm sim los ntawm kev puas tsuaj rau hypothalamus lossis pituitary caj pas ua los ntawm:

  • Cov caj ces muaj teeb meem
  • Lub taub hau raug mob
  • Kab mob
  • Teeb meem nrog ADH-tsim cov hlwb vim muaj kab mob autoimmune
  • Poob ntawm cov ntshav mus rau lub caj pas pituitary
  • Kev phais mob thaj chaw thaj chaw ntawm lub caj pas pituitary lossis hypothalamus
  • Cov nqaij hlav nyob rau hauv lossis ze rau lub qog pituitary

Neesrogenic DI cuam tshuam txog lub raum ua haujlwm. Vim li ntawd, ob lub raum tsis teb rau ADH. Zoo li nruab nrab DI, nephrogenic DI yog qhov tsis tshua muaj. Neesrogenic DI yuav tshwm sim los ntawm:

  • Qee yam tshuaj, xws li lithium
  • Cov caj ces muaj teeb meem
  • Qib siab calcium nyob rau hauv lub cev (hypercalcemia)
  • Kab mob rau lub raum, xws li polycystic raum mob

Cov tsos mob ntawm DI suav nrog:


  • Kev nqhis dej ntau dhau uas yuav mob siab lossis tswj tsis tau, feem ntau nrog rau qhov yuav tsum tau haus dej kom ntau lossis nqhis dej rau cov dej khov
  • Cov zis ntau dhau
  • Kev tso zis ntau dhau, feem ntau xav tso zis txhua txhua teev thawm hnub thiab hmo ntuj
  • Heev dilute, daj ntseg tso zis

Tus kws kho mob yuav nug koj li keeb kwm kev kho mob thiab cov tsos mob.

Kev ntsuam xyuas uas yuav raug txiav txim suav nrog:

  • Ntshav sodium thiab osmolality
  • Kev sib tw ntawm Desmopressin (DDAVP)
  • MRI ntawm lub taub hau
  • Mob Lub Hlaus
  • Zis concentration thiab osmolality
  • Zis tso zis

Koj tus kws kho mob tej zaum koj yuav ntsib koj tus kws kho mob uas yog tus tshwj xeeb hauv cov kab mob pituitary los pab kuaj ntshav DI.

Qhov ua rau kis mob yuav raug kho thaum ua tau.

Lub hauv paus DI tuaj yeem tswj tau nrog vasopressin (desmopressin, DDAVP). Koj noj cov vasopressin ua cov tshuaj txhaj, tshuaj txau qhov ntswg, lossis ntsiav tshuaj.

Yog tias nephrogenic DI tshwm sim los ntawm cov tshuaj, txiav cov tshuaj yuav pab rov qab ua haujlwm lub raum. Tab sis tom qab ntau xyoo ntawm kev siv qee cov tshuaj, xws li lithium, nephrogenic DI tuaj yeem mus tas li.


Cov mob muaj keeb nephrogenic DI thiab lithium-induced nephrogenic DI tau kho los ntawm haus dej txaus kom phim cov zis. Cov tshuaj uas tso zis rau kom tsawg dua yuav tsum tau noj.

Nephrogenic DI tau kho nrog cov tshuaj tiv thaiv thiab cov tshuaj diuretics (dej tshuaj).

Qhov tshwm sim yog nyob ntawm qhov kev ntshaus siab. Yog tias raug kho, DI tsis ua rau muaj teeb meem loj lossis ua rau tag sim neej thaum ntxov.

Yog hais tias koj lub cev nqhis dej yog qhov ib txwm thiab koj muaj peev xwm haus dej txaus, tsis muaj kev cuam tshuam loj heev rau lub cev lossis dej qab ntsev.

Tsis haus dej haus txaus yuav ua rau lub cev tsis muaj dej txaus thiab roj ntsha tsis txaus, uas tuaj yeem ua rau txaus ntshai heev.

Yog hais tias DI tau kho nrog vasopressin thiab koj lub cev tswj kev nqhis dej tsis yog ib txwm, haus dej ntau tshaj qhov koj xav tau ntawm lub cev kuj tseem tuaj yeem ua rau cov roj ntsha txaus tsis txaus.

Hu rau koj tus kws khomob yog koj muaj tus mob DI.

Yog tias koj muaj DI, hu rau koj tus kws kho mob yog tias pheej tso zis heev lossis rov qab nqhis dej heev.

  • Cov qog endocrine
  • Kev Ntsuas Osmolality

Hannon MJ, Thompson CJ. Vasopressin, ntshav qab zib insipidus, thiab cov tsos mob ntawm cov antidiuresis tsis tsim nyog. Hauv: Jameson JL, De Groot LJ, de Kretser DM, li al, eds. Endocrinology: Cov Neeg Loj thiab PediatricCov. 7 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 18.

Verbalis JG. Kev tsis haum ntawm dej tshuav. Hauv: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner thiab Rector's RaumCov. 10 tus ed. Philadelphia, PA: Elsevier; 2016: chap 16.

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