Okhawulezileyo Hypogonadotropic: iimpawu, unyango

Njengomgaqo, okhawulezileyo hypogonadotropic ezinxulumene wokungaphuhliswa esini kunye neempawu zesini eziziisekondari. Amafutha kunye protein wotshintshiselwano kwi ngezifo nayo badlwengulwe, nto leyo ebangela ukutyeba, cachexia, ukuphazamiseka kwenkqubo skeletal kunye ukungasebenzi le entliziyweni.

Ngu zodwa ngendlela abaphatha ngayo?

Kufuneka kuqatshelwe ukuba oyindoda ezahlukeneyo nemazi hypogonadotropic okhawulezileyo.

Uxilongo kunye nonyango lwesifo lwenziwa ngokudibeneyo endocrinologists, obstetricians kunye gynecologists, endokrinolongami ukuba isigulana umfazi, kunye Andrology, ukuba isigulana - mntu.

Isiseko yonyango lwe unyango hormone. Ukuba oyifunayo uqhaqho eboniswe, uqhaqho zeplastiki.

Njengoko esi sifo lichazwa?

Okhawulezileyo kunokuba eziziprayimari nezizisekondari. Ifom ephambili izihlunu wamatyhalarha iphula esusa usebenziso ngenxa unesiphene amatyhalarha. kwi chromosomal ukungaqheleki inqanaba ukuze bandiqumbise hypoplasia okanye aplasia wamatyhalarha izihlunu, nto leyo ebonakaliswa engekho okanye ayanelanga secretion of androgens ngenxa imveliso yabo lokusekwa ngokupheleleyo amalungu esini kunye neempawu zesini eziziisekondari.

okhawulezileyo Hypogonadotropic kumadoda luboniswa infantilism izangoma.

Le fom secondary ibangelwa ukugxojwa isakhiwo posa, ukunciphisa umsebenzi gonadotrophic okanye boyise amaziko ayo hypothalamic ukuba ibe nefuthe ingqondo yebhinqa kwaye ilawula umsebenzi wayo. Isifo kuboniswa ukuphazamiseka kwengqondo.

Zombini ifomu eziziiprayimari neziziisekondari inokuba iziphene okanye lufundiwe. Le ngezifo inokuba negalelo ubudlolo oyindoda ngo-40-60% yamatyala.

Izizathu zesi sifo kubantu

izixa aphantsi androgens ezinokubangelwa nokuhla imali emzimbeni eziveliswa yi imeko zophendlo lwezifo okanye amasende ngokwabo, waphula umthetho yobuchopho kunye nomsebenzi yebhinqa.

Ngu umyalezo kubonakaliswa ephambili sifo kuqwalaselwa:

• glands baswele bekhubazekile ngokwesondo, olwenzeka xa ziziphene zemvelo ngesimilo,
• aplasia of amasende.

zinto Predisposing kungabandakanya:

• iphula yokwehla wamatyhalarha;
• Ukwazi izinto eziyityhefu;
• chemotherapy;
• neziphumo nazinkinga ngendlela organic rhoqo, nitrofurans, izinambuzane, utywala, tetracycline, esekelwe kumachiza hormone ngeedosi ephakamileyo, njl.;
• uhlobo esosulelayo isifo (uqilikwane, imasisi, orchitis, vesicles);
• phambi isifo radiation;
• ufumene ngezifo-cofa amatyhalarha;
• linegunya intambo spermatic;
• volvulus-cofa amatyhalarha;
• inkqubo atrophic emva kotyando;
• Ukusikwa le Ithemba;
• usebenzela kwisingxobo samatyhalarha.

Xa okhawulezileyo ukuhla zaseprayimari kumanqanaba androgens egazini uyabonakala. Phuhlisa impendulo zembuyekezo kwamadlala adrenal, kwandisa imveliso gonadotropins.

Ukwenza elikhokelayo ngxenye kunye yebhinqa ukuphazamiseka lesibini (iinkqubo ukudumba, nangezilonda, ukuphazamiseka ngezifo Palsy nemithambo).

Ukukhuthaza uphuhliso okhawulezileyo sesibili:

• yebhinqa adenoma, ovelisa hormone ukukhula;
• hormone adrenocorticotropic (disease Cushing yakhe);
• prolactinoma;
• kwekhono lo ingqondo yebhinqa okanye yobuchopho emva kotyando;
• inqubo yokuguga, nto leyo ebangela ukwehla kwe testosterone egazini.

Xa uhlobo zasesekondari ephawulwe ukuncitshiswa gonadotrophins, nto leyo kwimveliso ukuhla androgen yi amatyhalarha.

Enye indlela yesi sifo, ichaphazela abantu, kukunciphisa imveliso isidoda kunye index testosterone yesiqhelo. Ayifane kukho ukuhla kumanqanaba testosterone kwinqanaba eqhelekileyo yobudoda.

Symptomatology zesi sifo kubantu

okhawulezileyo Hypogonadotropic emadodeni ibonwa yayo clinical. Bona zibangelwa ubudala yomguli kunye neqondo insufficiency androgen.

Ukuba amasende boyiswa yi inkwenkwe phambi lokufikisa, ngoko kwasekwa esiveza syndrome. Amathambo siba uhlasela enkulu. Oku kungenxa ukulibaziseka kwamathambo ommandla lokukhula. Gxalaba kunye nesifuba ukuba usesemva naye ngasemva kuphuhliso, imilenze zinde, izihlunu skeletal ayiqondakali kuphuhliswa.

Ukutyeba singabonakala kwi kuhlobo nemazi, gynecomastia, gipogenitalizme ukuba siboniswa incanca ubungakanani elincinane, akukho imibimbi apha kwisingxobo samatyhalarha, hypoplasia wamatyhalarha, lokungaphuhliswa yesinye, ukungabikho iinwele kwindawo zikawonke wonke, yokungaphuhliseki kwingqula, ithowuni eliphezulu ngelizwi.

Xa imbonakaliso yesibini lwesifo rhoqo waphawula ubunzima bomzimba phezulu, ophezulu umsebenzi neuron adrenal, ukusebenza kakuhle lengqula.

Ukuba umsebenzi wamatyhalarha lifinyele emva ukufikisa, iimpawu izifo ezifana hypogonadotropic okhawulezileyo, kwasuka ngokuncipha.

Ababona nesenzeko zilandelayo:

• Ukwehla amasende;
• ubuso noboya obuninzi emzimbeni okubonisa encinane nomzimba;
• ukulahlekelwa luthambe ulusu kunye hedge;
• yehle iintshukumo zesondo;
• izifo yawo.

Ukwehla ubungakanani wamatyhalarha usoloko ezinxulumene nemveliso sperm kuyehla. Oku kubangela nenzalo, kukho Isemantiki iimpawu zesini zasesekondari, ephawulwe buthathaka kwezihlunu, ukudinwa.

Uxilongo lwe okhawulezileyo ngabantu

Uxilongo senziwa anthropometry, uhlolo kunye Ngokucofa zangasese, uvavanyo lokufikisa isidanga iimpawu zonyango.

iimviwo X-ray kuya kunceda ukuvavanya yobudala ithambo. Ukuze ubone Ukwanda yezimbiwa bone densitometry iyasetyenziswa. Xa-x-reyi ye turcica sella emiselwe ubungakanani kunye ubukho yamathumba yayo.

Uqikelelo ubudala ithambo ivumela ngamaxesha kwamathambo kwesandla ngokudibeneyo kwaye kwisihlahla ukujonga xa lokufikisa. Kufuneka uthathe ingqalelo amathuba ngaphambili (kwizigulana azalelwe ngezantsi) yaye kamva (kwizigulana wazalelwa ngasentla) Ukuqina, kwakunye nenyaniso yokuba kweyi disorder ezinokubangelwa ezinye izinto.

Uphando isidoda zaselebhu ivumela ukuba bathethe malunga neemeko ezifana nitrogen okanye oligospermia.

Kuboniswe yi umxholo hormone ezinjalo:

• gonadotropins ngokwesondo;
• iyonke kunye testosterone free ;
• luteinizing hormone;
• GnRH;
• hormone antimyullerovsky;
• prolactin;
• estradiol.

Xa uhlobo iphambili index sifo of gonadotropins kwi yegazi eyonyukileyo kunye aphakamileyo - zehliselwa. Ngamanye amaxesha inqanaba labo kwimithetho komhlaba.

Ukubekwa serum estradiol eziyimfuneko xa feminization kwangumqondiso nokubonakalaliswa yesibini izifo kwimeko yamathumba kwi amatyhalarha ezivelisa estrogen, okanye nangezilonda kwi adrenal.

Index umxholo ketosteroids kwi umchamo inokuba eqhelekileyo okanye lincitshiswe. Ukuba ukrokrela phambi uhlalutyo Klinefelter syndrome chromosome eboniswe ubambe.

biopsy wamatyhalarha akanako ukunika ulwazi uxilongo oluchanekileyo.

unyango

Unyango okhawulezileyo hypogonadotropic lujoliswe ekuyekisweni esiyintloko okubangele ngezifo. Injongo unyango kuxhomekeke kwimisebenzi zothintelo enegalelo kuqheleke uphuhliso ngokwesondo, ukuncitshiswa ezilandelayo yezihlunu wamatyhalarha kunye wamatyhalarha ukuphelisa ukungachumi. Uthomalaliso eziqhutywa phantsi kweliso womchamo kunye endocrinologist.

Njani neengcambu hypogonadotropic okhawulezileyo ngabantu? Unyango kuxhomekeke kwizinto ezininzi:

• uhlobo kwe izifo;
• ebukhulwini ukungasebenzi le ngxenye, ingqondo yebhinqa kunye nenkqubo lokuzala;
• Ubukho zihlala ezimbi;
• ixesha isahlakalo izifo;
• ubudala yesigulane.

Unyango amatyala omdala ukulungisa amanqanaba androgens kwaye ukuphelisa kwekhono ngokwesondo. Nenzalo, ezivele ngohlobo okhawulezileyo awazalwa enaso, akakwazi ukuba unyango.

Kwimeko iintlobo eziphambili ukungaqheleki iziphene okanye isifo ezifunyenwe iiseli ezidalwe wokhuseleko amatyhalarha kusetyenziswa mziba. Boys baphathwa arhente non-hormone izigulane abadala - iziyobisi ezisekelwe hormone (androgen kunye gonadotropins ngeedosi ezincinane).

Ukuba akukho umsebenzi wamatyhalarha elilalela kuboniswa therapy replacement androgen kunye testosterone. Ukuthatha hormone owenziwa ubomi.

Xa uhlobo yesibini sifo abantwana kunye nabantu abadala kufuneka usebenzise hormone gonadotropin. Ukuba kuyimfuneko, baya kuhlanganiswa kunye hormone ngesondo.

Kwakhona ziboniswa unyango bembuyekezo, kunye umthambo.

Ukusebenza kunye sifo lokususa yamaqanda kunye cryptorchidism, kusetyenziswa uqhaqho yeplastiki incanca ngokwaneleyo. Kunye izithambiso injongo abe egg umzila eyenziweyo esekelwe (engekho iba lityhalarha amdaka kwi kwisisu).

Surgery kusetyenziswa xa usebenzisa iindlela microsurgical, kunye kolawulo amajoni omzimba, amanqanaba hormone, kwakunye liqumrhu elimiselweyo kuni.

Ngexesha unyango ngendlela kunciphisa androgen insufficiency, iyaqala uphuhliso neempawu zesini zasesekondari, ngokomkhethe kunciphise amandla, obubonakala kuncitshiswa kwamathambo kunye nobudala bone ukubambezeleka.

Njani na esi sifo abafazi

okhawulezileyo Hypogonadotropic kwabasetyhini luphawulwa wokungaphuhliswa umsebenzi ngokwesondo kunye nokwanda namadlala ovarian. ifomu Primary bekhubazekile ngenxa umonakalo wokungaphuhliswa okanye ovarian kwithuba lweentsana.

Oku yandisa imveliso hormone ngesondo, nto leyo evusa ukwanda kwinqanaba gonadotropins, leyo ukuvuselela zamaqanda.

Ekuhlalutyeni izinga eliphezulu hormone ezivuselela zoboya lutein, kwakunye namanqanaba asezantsi estrogen. izinga Ukuncipha estrogen kubangela yoma okanye ngokwaneleyo amalungu ababhinqileyo okuzala, namadlala mammary, ukungabikho sexesheni.

Ukuba umsebenzi ovarian iye kakuhle phambi ekufikiseni, ngoko kukho ukunqongophala neempawu zesini eziziisekondari.

okhawulezileyo Hypogonadotropic phakathi kwabafazi eziziiprayimari njengoko kubonisiwe kule miqathango ilandelayo:

• nokuphazamiseka bekhubazekile kwinqanaba genetic;
• hypoplasia azalwa ngayo amaqanda;
• iinkqubo ezosulelayo (IGcushuwa, isifo sephepha, uqilikwane, zokukhanya, ukususwa zoqhaqho zamaqanda);
• ekubulaleni uhlobo sokuhlasela;
• syndrome, feminization wamatyhalarha ;
• zamaqanda polycystic.

okhawulezileyo hypogonadotropic Secondary kwabasetyhini kwenzeka ngezifo le yebhinqa kunye ngxenye. Le bazibalula yi kumiwe ophantsi umxholo okanye epheleleyo imveliso gonadotropins elawula umsebenzi ovarian. Le nkqubo kubangelwa ukudumba kummandla zobuchopho. Ezi zifo nempembelelo eyonakalisayo kwaye zihamba nokuhla kwinqanaba sesichengeni gonadotropins ukuya zamaqanda.

Njani na izifo ezifana okhawulezileyo hypogonadotropic kwabasetyhini, nokukhulelwa? Uphuhliso esibi intrauterine yosana olungekazalwa nako kungachaphazeleka kukwenzeka izifo.

Iimpawu kwabasetyhini

Iimpawu Bright kwethuba ngokuzala - Kukuyihlambela esexesheni, okanye ukungabikho.

Inqanaba aphantsi iihomoni ababhinqileyo kukhokelela wokungaphuhliswa esini, namadlala mammary, waphula isimemezelo kwamafutha kunye ezinqinileyo noboya obuninzi emzimbeni.

Ukuba isifo awazalwa enaso ngokwendalo, iimpawu zesini eziziisekondari Awuveli. Abafazi waphawula ukuba kukho isinqe ezivaliweyo izinqe flat.

Ukuba isifo kwenzeka phambi ukufikisa, iimpawu zesini wabonakala ukuhlala kusindiswa, kodwa upheliswe ngenyanga angasese ijwabu yome.

isevisi ayikho

Okhawulezileyo xa kukho ukuhla kumanqanaba estrogen kunye yokwanda kwamanqanaba gonadotropins. Ngenxa ultrasound ityhileke kubani zancitshiswa kangakanani wesibeleko ngoxilongo ostepoporoz kunye nokubambezeleka ukuyilwa asemzimbeni.

unyango sifo besifazane

Njani neengcambu hypogonadotropic okhawulezileyo in amabhinqa? Unyango ibandakanya therapy replacement. Abafazi eyabelwe ukufumana amayeza kunye hormone sex (ethinyl estradiol).

Kwimeko xa uqala ukuba sexesheni amisele zokucwangcisa yomlomo equlathe estrogen kunye progestins, kunye namalungiselelo "Triziston", "Trikvilar".

Lithetha "Klimov", "Trisekvens", "klimonorma" emiselweyo kwizigulana emva kweminyaka engama-40.

unyango hormone contraindicated kule miqathango ilandelayo:

• wayenomhlaza emabeleni nobuni;
• izifo sentliziyo yegazi;
• ukusilela kwezintso wesibindi;
• thrombophlebitis.

ukuvimbela

izifo ezifana hypogonadotropic okhawulezileyo, uye abane kakuhle. Ukuthintela imfundo impilo yabantu kunye esweni abasetyhini abakhulelweyo, ngokunjalo izinto zempilo.