Cutar kaburbura a cikin manya

Glandar thyroid wani ƙananan ƙwayoyin cuta ne na tsarin endocrin da ke ƙarƙashin fata a gaban wuyansa. Babban aikinsa shine sakin hormones na thyroid wanda ke daidaita tsarin metabolism na asali (sakin makamashi don mahimman ayyukan sel da kyallen takarda). Idan, saboda dalilai daban-daban, gland ya fara aiki sosai fiye da yadda aka saba, wannan na iya haifar da cutar Graves a cikin manya.

Wannan sunan ya kasance a al'ada tun zamanin Soviet magani kuma yanzu an dauke shi mara amfani. A cikin wallafe-wallafen duniya da jagororin asibiti, ana amfani da sunan hyperthyroidism ko Cutar kabari. Sauran sunayen da ake amfani da su a ƙasashe daban-daban sun haɗa da waɗannan ma'ana:

• exophthalmic goiter;
• hyperthyroidism;
• Cutar Parry;
• mai guba yaduwa goiter.

Bugu da ƙari, akwai kuma rarrabuwa na ciki na cutar Graves, dangane da fifikon wasu alamomi:

• dermopathy (lokacin da fata ta shafi musamman);
• osteopathy (matsalolin kwarangwal);
• ophthalmopathy (mafi yawan alamun ido).

Menene cutar Basedow

Cutar kabari ko thyroiditis cuta ce da ke shafar glandar thyroid, da fata da idanu.

Glandar thyroid wata gabo ce da ke cikin tsarin endocrine, cibiyar sadarwa na glandan endocrin da kyallen jikin da ke ɓoye hormones waɗanda ke daidaita tsarin sinadarai (metabolism).

Hormones suna shafar mahimman ayyuka na jiki, kuma suna daidaita yanayin zuciya, zafin jiki da hawan jini. Ana fitar da kwayoyin hormones kai tsaye zuwa cikin jini, daga inda suke tafiya zuwa sassa daban-daban na jiki.

Cutar kaburbura tana da alaƙa da haɓakar glandar thyroid (wanda ake kira goiter) da ƙara fitar da hormone thyroid (hyperthyroidism). Hormones na thyroid suna shiga cikin tsarin jiki daban-daban kuma, sakamakon haka, takamaiman alamomi da alamun cutar Graves na iya bambanta sosai a tsakanin mutane na jinsi da shekaru daban-daban. Alamomi na yau da kullun sun haɗa da asarar nauyi ba tare da niyya ba, rashin haƙuri na zafi na al'ada tare da yawan gumi, raunin tsoka, gajiya, da fitowar ƙwallon ido. Cutar kabari a zahiri cuta ce ta autoimmune.

Hotuna kafin da kuma bayan cutar Graves

Abubuwan da ke haifar da cutar Basedow a cikin manya

Ana daukar cutar kabari a matsayin cuta mai saurin kamuwa da cuta, amma wasu dalilai, gami da kwayoyin halitta, muhalli, ko abubuwan muhalli, na iya taimakawa wajen ci gabanta. Cututtukan autoimmune suna faruwa lokacin da tsarin garkuwar jiki ya yi kuskure ya kai hari ga kyallen takarda.

Tsarin rigakafi yakan samar da sunadaran na musamman da ake kira antibodies. Waɗannan ƙwayoyin rigakafi suna amsawa ga kayan waje (misali ƙwayoyin cuta, ƙwayoyin cuta, gubobi) a cikin jiki, suna haifar da lalata su. Kwayoyin rigakafi na iya kashe ƙwayoyin cuta kai tsaye ko kuma su yi musu sutura ta yadda farin jini ya fi wargaje su cikin sauƙi. Ana ƙirƙira takamaiman ƙwayoyin rigakafi don mayar da martani ga wasu abubuwa ko abubuwan da ke motsa samar da ƙwayoyin rigakafi. Ana kiran su antigens.

A cikin cutar Graves, tsarin garkuwar jiki yana samar da maganin rigakafi mara kyau wanda ake kira thyroid-stimulating immunoglobulin. Wannan antibody yana kwaikwayon aikin thyroid-stimulating hormone na al'ada (wanda pituitary gland shine yake ɓoye). Wannan sinadari mai kwaikwaiyo yana haɗe saman sel ɗin thyroid kuma yana haifar da sel don samar da hormones na thyroid, yana haifar da wuce gona da iri a cikin jini. Akwai hyperactivity na thyroid gland shine yake, inganta shi, aiki mai yawa. A cikin ophthalmopathy na Graves, waɗannan ƙwayoyin rigakafi na iya shafar ƙwayoyin da ke kewaye da ƙwallon ido.

Mutanen da abin ya shafa na iya samun takamaiman ƙwayoyin halitta marasa lahani ko kuma ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙwayoyin cuta ga cutar Graves. Mutumin da ya kamu da cutar yana ɗauke da kwayar halitta (ko kwayoyin halitta) don wannan cuta, amma ilimin halittar jiki ba zai iya bayyana kansa ba idan kwayar halitta ba ta jawo ko "kunna" a wasu yanayi ba, alal misali, saboda canjin yanayi da sauri. (wanda ake kira multifactorial heredity).

An gano kwayoyin halitta iri-iri da ke da alaƙa da cutar Graves, ciki har da waɗanda:

• raunana ko gyara martanin tsarin rigakafi (immunomodulators),
• waɗanda ke da alaƙa kai tsaye da aikin thyroid, kamar thyroglobulin (Tg) ko thyroid stimulating hormone receptor (TSHR).

Gene Tg yana samar da thyroglobulin, furotin da ake samu kawai a cikin nama na thyroid kuma yana taka rawa wajen samar da hormones.

Farashin TSHR yana samar da furotin wanda shine mai karɓa kuma yana ɗaure zuwa hormone mai motsa thyroid. Ba a fahimci ainihin tushen hulɗar kwayoyin halitta da abubuwan muhalli waɗanda ke haifar da cutar Graves ba.

Ƙarin abubuwan kwayoyin halitta, waɗanda aka sani da kwayoyin halitta masu gyara, na iya taka rawa wajen haɓaka ko bayyanar cutar. Abubuwan muhalli waɗanda zasu iya haifar da haɓakar hyperthyroidism sun haɗa da matsananciyar motsin rai ko damuwa ta jiki, kamuwa da cuta, ko ciki. Mutanen da ke shan taba suna cikin haɗarin haɓaka cutar Graves' da ophthalmopathy. Mutanen da ke da wasu cututtukan cututtukan da ke haifar da rashin aiki na tsarin rigakafi, irin su nau'in ciwon sukari na 1 ko arthritis na rheumatoid, suna cikin haɗarin haɓaka cutar Graves.

Wanene ya fi kamuwa da cutar Graves?

Cutar kaburbura tana shafar mata sau da yawa fiye da maza, a cikin rabo na 10: 1. Yawanci cutar tana tasowa ne a tsakiyar shekaru tare da mafi girman kamuwa da cuta tsakanin shekaru 40 zuwa 60, amma kuma tana iya shafar yara, matasa, da tsofaffi. Cutar kaburbura tana faruwa a kusan kowane yanki na duniya. An kiyasta cewa kashi 2-3% na yawan jama'a na fama da shi. Af, cutar Graves ita ce mafi yawan abin da ke haifar da hyperthyroidism.

Sauran matsalolin lafiya da tarihin iyali ma suna da mahimmanci. Mutanen da ke da cutar Graves sau da yawa suna da tarihin wasu 'yan uwa da ke da matsalolin thyroid ko cututtuka na autoimmune. Wasu dangi na iya samun hyperthyroidism ko thyroid marasa aiki, wasu na iya samun wasu cututtuka na autoimmune, ciki har da launin toka na gashi (farawa a cikin 20s). Ta hanyar kwatankwacin, majiyyaci na iya haɗawa da matsalolin rigakafi a cikin iyali, gami da ciwon sukari na yara, cutar anemia (saboda rashi na bitamin B12), ko facin fari mara zafi a fata (vitiligo).

Yana da mahimmanci don kawar da wasu abubuwan da ke haifar da hyperthyroidism. Sun haɗa da nodular mai guba ko goiter multinodular, wanda ke da nau'in nodules ko fiye da yawa a cikin glandar thyroid wanda ke girma a hankali kuma yana ƙara yawan aikin su ta yadda jimillar fitar da hormone thyroid a cikin jini ya wuce ka'ida.

Har ila yau, mutane na iya haifar da alamun hyperthyroidism na dan lokaci idan suna da yanayin da ake kira thyroiditis. Wannan yanayin yana faruwa ne ta hanyar matsala tare da tsarin rigakafi ko kamuwa da cutar hoto wanda ke sa gland ya zubar da hormone thyroid da aka adana. Nau'in thyroiditis sun hada da subacute, shiru, cututtuka, radiation far-jawowa, da kuma postpartum thyroiditis.

Da wuya, wasu nau'o'in ciwon daji na thyroid da wasu ciwace-ciwacen daji, irin su TSH-samar da adenomas pituitary, na iya haifar da bayyanar cututtuka irin waɗanda aka gani a cikin cutar Graves. Da wuya, alamun hyperthyroidism kuma ana iya haifar da su ta hanyar ɗaukar hormone thyroid da yawa a cikin nau'in kwaya.

Alamomin cutar Basedow a cikin manya

Alamomin da ke da alaƙa da cutar Basedow yawanci suna fitowa a hankali a hankali, wani lokacin har ma ga mutumin da kansa (suna iya zama farkon fara lura da dangi). Suna ɗaukar makonni ko watanni don haɓakawa. Alamun na iya haɗawa da sauye-sauyen ɗabi'a kamar matsananciyar tsoro, fushi, damuwa, rashin natsuwa, da wahalar barci (rashin barci). Ƙarin alamun sun haɗa da asarar nauyi ba tare da niyya ba (ba tare da bin tsayayyen abinci ba da sauye-sauyen abinci mai gina jiki), raunin tsoka, rashin haƙuri na zafi na al'ada, ƙara yawan gumi, sauri, bugun zuciya mara kyau (tachycardia), da gajiya.

Cutar kaburbura galibi tana hade da cututtukan da ke shafar idanu, galibi ana kiranta da ophthalmopathy. Wani nau'i mai laushi na ophthalmopathy yana samuwa a cikin mafi yawan mutanen da ke da hyperthyroidism a wani lokaci a cikin cutar, kasa da 10% na marasa lafiya suna da mahimmancin sa hannun ido wanda ke buƙatar magani mai aiki. Alamun ido na iya tasowa kafin, a lokaci guda, ko bayan haɓakar hyperthyroidism. Da wuya, mutanen da ke da alamun ido ba su taɓa haɓaka hyperthyroidism ba. A wasu lokuta, lalacewar ido na iya fara bayyana ko kara tsananta bayan jiyya don hyperthyroidism.

Korafe-korafe a cikin ophthalmopathy suna da bambanci sosai. Ga wasu mutane, za su iya zama ba su canzawa na shekaru da yawa, yayin da wasu, yanayin zai iya inganta ko ya yi muni cikin watanni biyu kacal. Canje-canje kuma na iya bin tsarin: ƙayyadaddun tabarbarewa (haɓaka), sannan kuma ingantaccen haɓakawa (remission). A yawancin mutane, cutar tana da sauƙi kuma ba ta ci gaba.

Abubuwan da ake yawan bayyanar da alamun ido shine kumburin kyallen da ke kewaye da ƙwallon ido, wanda zai iya haifar da kumburi daga cikin kewayawa, yanayin da ake kira proptosis (bulging eyes). Har ila yau, marasa lafiya na iya lura da bushewar idanu mai tsanani, kumburin fatar ido da rashin cikar rufewarsu, ruɗewar fatar ido, kumburi, jajaye, zafi da haushin idanu. Wasu mutane suna kwatanta yanayin yashi a idanunsu. Mafi ƙanƙanta, hangen nesa ko hangen nesa biyu, hankali ga haske, ko duhun gani na iya faruwa.

Da wuya, mutanen da ke fama da cutar Graves suna samun raunin fata wanda aka sani da pretibial dermopathy ko myxedema. Wannan yanayin yana nuna bayyanar fata mai kauri, ja a gaban kafafu. Yawancin lokaci yana iyakance ga shins, amma wani lokacin kuma yana iya faruwa akan ƙafafu. Da wuya, kumburin kyallen hannu da kumburin yatsu da yatsu (acropachia) kamar gel suna faruwa.

Ƙarin alamun da ke da alaƙa da cutar Graves sun haɗa da:

• cardiopalmus;
• ƙananan girgiza (firgita) na hannaye da / ko yatsunsu;
• asarar gashi;
• ƙusoshin ƙusa;
• ƙara yawan reflexes (hyperreflexia);
• yawan cin abinci da yawan hawan hanji.

Mata masu fama da cutar kaburbura na iya samun canje-canje a al'adarsu. Maza na iya fuskantar tabarbarewar karfin mazakuta (rashin ƙarfi).

A wasu lokuta, cutar Graves na iya ci gaba, yana haifar da gazawar zuciya ko rashin ƙarfi na ƙasusuwa (osteoporosis), yana sa su tashe da haifar da karaya daga ƙananan rauni ko motsi mara kyau.

Maganin cutar Basedow a cikin manya

Ganewa da maganin cutar Basedow yana nunawa a cikin ka'idojin ƙasa da ƙasa da jagororin asibiti na ƙasa. An tsara shirin jarrabawa daidai da tsarin da aka tsara kuma ana aiwatar da shi a matakai.

kanikancin

Ana yin ganewar cutar ta kaburbura a kan cikakken tarihin mai haƙuri da danginsa (binciken idan dangi na kusa suna da matsalolin irin wannan yanayi), cikakken kima na asibiti, gano alamun halayen halayen, da dai sauransu Bayan bayyanar cututtuka na asibiti. an gano, an tsara gwaje-gwajen dakin gwaje-gwaje da gwaje-gwajen kayan aiki.

Ana nuna gwaje-gwaje na gaba ɗaya (jini, fitsari, biochemistry) da gwaje-gwaje na musamman kamar gwajin jini waɗanda ke auna matakan hormone thyroid (T3 da T4) da kuma thyroid stimulating hormone (TSH matakan). Don tabbatar da ganewar asali, ana iya yin gwajin jini don gano kasancewar takamaiman ƙwayoyin rigakafi ga thyrogloulin da thioperoxidase waɗanda ke haifar da cutar Graves, amma wannan yawanci ba lallai bane.

Magungunan zamani

Magani ga cutar kabari yawanci ya ƙunshi ɗayan hanyoyi uku:

• antithyroid kwayoyi (danne aikin thyroid gland shine yake a kan kira na hormones);
• yin amfani da iodine radioactive;
• tiyata

Takamammen nau'in magani da aka ba da shawarar na iya dogara da shekarun majiyyaci da girman cutar.

Jagororin asibiti

Ana aiwatar da duk matakan jiyya daidai da shawarwarin ka'idojin Clinical

Mafi ƙarancin magani ga cutar Graves shine amfani da kwayoyi waɗanda ke rage sakin hormone thyroid (maganin antithyroid). An fi son su musamman don kula da mata masu juna biyu, waɗanda ke da hyperthyroidism mai laushi, ko marasa lafiya da ke buƙatar gaggawar maganin hyperthyroidism. Likitan ya zaɓi takamaiman kwayoyi, dangane da shekarun mai haƙuri, yanayinsa da ƙarin dalilai.

Tabbatattun magungunan cutar Graves sune wadanda ke lalata glandar thyroid, wanda ke haifar da hypothyroidism. Maganin rediyoaktif iodine shine maganin da aka fi sani da cutar Graves a ƙasashe da yawa. Iodine wani sinadari ne da glandon thyroid ke amfani dashi don ƙirƙirar (ƙirƙira) hormones thyroid. Kusan dukkanin aidin da ke cikin jikin mutum yana sha ne da kyallen jikin glandar thyroid. Marasa lafiya sun hadiye maganin da ke ɗauke da iodine radioactive, wanda zai bi ta cikin jini kuma ya taru a cikin glandar thyroid, inda zai lalata da lalata nama. Wannan zai rage glandar thyroid kuma ya rage yawan samar da hormones. Idan matakan hormone thyroid sun ragu sosai, ana iya buƙatar maganin hormone don mayar da isasshen matakan hormone thyroid.

Wani farfesa mai tsaurin ra'ayi shine tiyata don cire duka ko sashin glandar thyroid (thyroidectomy). Wannan hanyar maganin cutar yawanci ana tanadar wa mutanen da wasu nau'ikan jiyya ba su yi nasara ba ko kuma an hana su, ko kuma a gaban ci gaban nama na gland zuwa babban girman. Bayan tiyata, hypothyroidism sau da yawa yakan faru - wannan shine sakamakon da ake so, wanda aka gyara ta hanyar daidaitaccen kashi na hormones daga waje.

Baya ga jiyya guda uku da aka ambata a sama, ana iya rubuta magungunan da ke toshe hormone thyroid wanda ke yawo a cikin jini (beta-blockers) daga yin aikinsa. Ana iya amfani da masu hana beta irin su propranolol, atenolol, ko metoprolol. Lokacin da matakin hormones na thyroid ya daidaita, ana iya dakatar da jiyya tare da beta-blockers.

A lokuta da yawa, bin diddigin rayuwa da binciken dakin gwaje-gwaje ya zama dole. A wasu lokuta, ana iya buƙatar maganin maye gurbin hormone na tsawon rai.

Za a iya kula da ƙananan cututtukan ophthalmopathy tare da tabarau, man shafawa, hawaye na wucin gadi. Za a iya bi da mafi tsanani lokuta tare da corticosteroids kamar prednisone don rage kumburi a cikin kyallen takarda da ke kewaye da idanu.

A cikin lokuta masu tsanani, ana iya buƙatar tiyatar lalata orbital da kuma maganin radiation na orbital. A lokacin tiyatar lalatawar orbital, likitan fiɗa yana cire kashi tsakanin kwas ɗin ido (orbit) da sinuses. Wannan yana ba da damar ido ya koma matsayinsa na halitta a cikin soket. Wannan tiyata yawanci ana keɓe shi ne ga mutanen da ke cikin haɗarin hasarar hangen nesa saboda matsin lamba akan jijiyar gani ko waɗanda wasu zaɓuɓɓukan magani ba su yi aiki ba.

Rigakafin cutar Basedow a cikin manya a gida

Yin tsinkayar ci gaban cutar a gaba da hana shi yana da wahala. Amma akwai matakan rage haɗarin rikitarwa da ci gaban hyperthyroidism.

Idan an gano cutar ta Graves, sanya lafiyar hankali da ta jiki fifiko.

Daidaitaccen abinci mai gina jiki da motsa jiki na iya inganta wasu alamun bayyanar cututtuka yayin jiyya kuma ya taimake ka ka ji daɗi gaba ɗaya. Misali, saboda glandar thyroid yana sarrafa metabolism, hyperthyroidism na iya zama mai cikawa da raguwa bayan an gyara hyperthyroidism, kuma motsa jiki na juriya na iya taimakawa wajen kula da girman kashi da nauyi.

Rage damuwa na iya zama mai fa'ida kamar yadda zai iya haifar da ko kuma ta'azzara cutar kabari. Kiɗa mai daɗi, wanka mai dumi ko tafiya zai taimaka muku shakatawa da inganta yanayin ku.

Kin amincewa da munanan halaye – kar a sha taba. Shan taba yana kara tsananta ciwon ido na Kabari. Idan cutar ta shafi fata (dermopathy), yi amfani da mayukan kan-da-counter ko man shafawa mai ɗauke da hydrocortisone don rage kumburi da ja. Bugu da ƙari, ƙuƙwalwar ƙafar ƙafafu na iya taimakawa.

Shahararrun tambayoyi da amsoshi

Tambayoyin da suka shafi cutar Basedow, mun tattauna da su babban likita, endoscopist, shugaban kungiyar da methodological ofishin Lidia Golubenko.