Cushing mob

Cushing syndrome yog ib qho kev tsis sib haum xeeb uas tshwm sim thaum koj lub cev muaj cov ntshav cortisol ntau ntau.

Feem ntau ua rau Cushing syndrome yog noj ntau dhau glucocorticoid lossis corticosteroid tshuaj. Daim ntawv ntawm Cushing syndrome no yog hu ua exogenous Cushing syndrome. Prednisone, dexamethasone, thiab prednisolone yog cov piv txwv ntawm hom tshuaj no. Glucocorticoids ua yam ntxwv ntawm lub cev hauv lub cev cortisol lub cev. Cov tshuaj no yog siv los kho ntau yam mob xws li hawb pob, mob rau daim tawv, mob qog, mob plab hnyuv, mob pob txha, thiab mob caj dab.

Lwm tus neeg muaj tus mob Cushing vim lawv lub cev tsim cortisol ntau dhau. Qhov tshuaj hormones no yog tsim nyob rau hauv cov qog adrenal. Cov ua rau mob ntau dhau heev yog:

• Cushing disease, uas tshwm sim thaum lub caj pas pituitary ua rau ntau dhau ntawm hormone adrenocorticotrophic hormone (ACTH). ACTH tom qab ntawd teeb liab cov qog adrenal los tsim ntau dhau cortisol. Lub qog ua haujlwm pituitary caj pas tuaj yeem ua rau tus mob no.
• Lub qog ntawm cov qog adrenal
• Cov qog lwm qhov hauv lub cev uas ua rau corticotropin-tso cov tshuaj hormones (CRH)
• Cov qog ua nyob rau lwm qhov hauv lub cev uas ua rau mob ACTH (mob ectopic Cushing syndrome)

Cov tsos mob txawv. Tsis yog txhua tus neeg muaj tus mob Cushing muaj cov tsos mob no zoo ib yam. Qee tus neeg muaj ntau cov tsos mob thaum lwm tus tsis tshua muaj cov tsos mob.

Feem coob cov neeg muaj tus mob Cushing muaj:

• Hloov, liab, tag nrho lub ntsej muag (lub ntsej muag lub hli)
• Qeb kev loj hlob qeeb (hauv menyuam yaus)
• Lub cev hnyav nrog cov rog ntau nyob rau ntawm pob tw, tab sis rog rog los ntawm caj npab, ceg, thiab pob tw (nruab nrab rog)

Cov tawv nqaij pauv tuaj yeem suav nrog:

• Cov kab mob ntawm daim tawv nqaij
• Ntshav ua xim daj (1/2 nti lossis 1 centimeter lossis ntau dua) hu ua striae ntawm daim tawv nqaij ntawm lub plab, caj npab sab saud, ncej puab, thiab mis mis
• Tawv tawv nqaij nrog lub doog yooj yim (tshwj xeeb yog ntawm caj npab thiab tes)

Hloov nqaij thiab pob txha muaj xws li:

• Mob caj pas, uas tshwm sim nrog cov kev ua ub no
• Mob leeg los yog rhiab
• Sau cov roj ntawm lub xub pwg thiab saum pob txha pob txha
• Cib thiab txha nraub qaum ua rau pob txha lov
• Cov leeg tsis muaj zog, tshwj xeeb ntawm lub duav thiab lub xub pwg nyom

Lub cev thoob plaws (hloov raws chaw) muaj xws li:

• Yam 2 ntshav qab zib mellitus
• Ntshav siab (tawg)
• Cov roj (cholesterol) thiab triglycerides ntau ntxiv (hyperlipidemia)

Cov poj niam mob Cushing syndrome tej zaum yuav muaj:

• Kev hle plaub hau ntau dhau ntawm lub ntsej muag, caj dab, hauv siab, plab, thiab ncej puab
• Lub sijhawm ua haujlwm tsis meej lossis nres

Tus txiv neej yuav muaj:

• Tsawg lossis tsis muaj siab rau kev sib deev (tsis tshua muaj libido)
• Teeb meem Erection

Lwm tus tsos mob uas yuav tshwm sim nrog tus kab mob no:

• Hloov pauv hlwb, xws li kev nyuaj siab, ntxhov siab lossis hloov tus cwj pwm
• Nkees
• Mob taub hau
• Nce nqhis dej thiab tso zis

Tus kws kho mob yuav kuaj ib ce thiab nug txog koj cov tsos mob thiab cov tshuaj koj noj. Qhia tus kws khomob paub txog txhua yam tshuaj koj tau siv nyob rau ntau lub hlis dhau los. Thiab qhia tus kws khomob txog cov kev txhaj tshuaj uas koj tau txais ntawm chaw khomob.

Kuaj hauv tsev kuaj mob uas yuav ua kom kuaj mob Cushing syndrome thiab txheeb xyuas qhov ua rau yog:

• Qib cortisol qib ntshav
• Ntshav qab zib
• Qaub cortisol qib
• Kev Tshuaj Ntsuam Kev Tshuaj Ntsuam Dexamethasone
• 24-teev zis rau cortisol thiab creatinine
• QIB ACTH
• Kev kuaj ntshav ACTH (thaum tsis tshua muaj)

Kev ntsuam xyuas los txiav txim qhov ua rau lossis xwm txheej yuav muaj xws li:

• Hauv plab CT
• Qhov tshij MRI
• Cov pob txha ua haujlwm

Kev kho yog nyob ntawm qhov laj thawj.

Cushing mob los ntawm kev siv corticosteroid:

• Koj tus kws kho mob yuav qhia koj kom maj mam txo cov tshuaj kho mob. Tsum cov tshuaj dheev tuaj yeem yog ib qho txaus ntshai.
• Yog tias koj tsis tuaj yeem tsis noj tshuaj vim muaj kab mob, koj cov piam thaj hauv ntshav siab, cov roj (cholesterol) ntau, thiab cov pob txha los yog txha pob txha yuav tsum tau ua tib zoo saib xyuas thiab kho.

Nrog Cushing mob los ntawm lub caj pas los yog lub qog ua tawm ACTH (Cushing disease), koj yuav tsum:

• Kev phais kom tshem tawm cov qog
• Ruam tom qab tshem tawm ntawm lub qog pituitary (hauv qee kis)
• Cortisol hloov txoj kev kho tom qab kev phais mob
• Tshuaj kho mob los hloov cov tshuaj hormones pituitary uas ua tsis txaus
• Tshuaj noj kom tiv thaiv lub cev los ntawm kev ua kom cortisol ntau dhau

Nrog Cushing mob vim yog qog pituitary, qog adrenal, lossis lwm yam qog:

• Koj yuav tsum muaj kev phais kom tshem tawm cov qog.
• Yog tias lub qog tshem tawm tsis tau, koj yuav tsum muaj tshuaj los pab thaiv kev tso tawm ntawm cortisol.

Tshem tawm cov qog tuaj yeem ua rau tag nrho rov qab, tab sis muaj txoj hmoo tias qhov mob rov qab.

Ciaj sia rau cov neeg mob Cushing mob los ntawm qog nyob ntawm seb cov qog.

Yog tsis kho, Cushing syndrome tuaj yeem tsim kev puas tsuaj rau lub neej.

Cov teeb meem kev noj qab haus huv uas tuaj yeem yog los ntawm Cushing syndrome suav nrog ib qho ntawm cov hauv qab no:

• Mob ntshav qab zib
• O Ntawm cov qog pituitary
• Cov pob txha lov vim yog osteoporosis
• Ntshav siab
• Raum pob zeb
• Muaj mob hnyav

Hu rau koj tus kws kho mob yog tias koj muaj cov tsos mob ntawm Cushing syndrome.

Yog tias koj noj lub corticosteroid, paub cov cim thiab tsos mob ntawm tus mob Cushing. Tau txais kev kho ntxov ntxov tuaj yeem pab tiv thaiv ib qho kev mob tshwm sim mus ntev los ntawm tus mob Cushing. Yog tias koj siv cov tshuaj nqus pa, koj tuaj yeem txo qhov kev raug rau cov tshuaj steroids ntau dua los ntawm kev siv lub raj tshuaj thiab los yaug koj lub qhov ncauj tom qab ua pa ntawm cov tshuaj steroid.

Hypercortisolism; Cortisol ntau dhau; Glucocorticoid ntau dhau - Cushing syndrome

• Cov qog endocrine

Nieman LK, Biller BM, Nrhiav JW, li al; Endocrine Kev Ua Neej. Kev Kho Mob ntawm Cushing's syndrome: ib qho ntawm Endocrine Society cov chaw coj los soj ntsuam. J Clin Endocrinol MetabCov. Xyoo 2015; 100 (8): 2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

Stewart PM, Newell-Nqe JDC. Lub adrenal cortex. Hauv: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Phau Ntawv ntawm EndocrinologyCov. 13th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 15.