Hypogonadotropic hypogonadism: cututtuka, magani

Kamar yadda mai mulkin, hypogonadotropic hypogonadism dangantawa da underdevelopment na jima'i gabobin da sakandare jima'i halaye. Fat da kuma gina jiki musayar a Pathology kuma keta, wanda ya haddasa kiba, cachexia, cuta na kwarangwal tsarin da kuma matsalar aiki na samfur na zuciya.

By hanyar likitoci yi wa?

Ya kamata a lura da cewa daban-daban namiji da mace hypogonadotropic hypogonadism.

Ganewar asali da kuma lura da cuta ne da za'ayi a hade endocrinologists, obstetricians da gynecologists, endokrinolongami idan haƙuri ne da wata mace, da kuma andrology, idan haƙuri ne - mutumin.

Dalili na lura da hormone far. Idan so nuna tiyata, roba tiyata.

Kamar yadda cutar da ake classified?

Hypogonadism iya zama firamare da kuma sakandare. A farko nau'i na testicular nama a take hakkin ƙawãta aiki saboda wani aibi a cikin testes. a chromosomal matakin munanan iya tsokana hypoplasia ko aplasia testicular nama, wanda aka bayyana a cikin rashi ko kasa mugunya androgens domin su samar da cikakken samuwar al'aura gabobin da sakandare jima'i halaye.

Hypogonadotropic hypogonadism a cikin maza da aka bayyana a cikin qwaqwalwa ne qwarai infantilism.

A sakandare nau'i ne ya sa ta a take hakkin da pituitary gland shine yake tsarin, Munã rage ta gonadotrophic aiki ko shan kashi hypothalamic cibiyoyin da suke da wani tasiri a kan pituitary gland shine yake da shirya ta aiki. Cutar da aka nuna a shafi tunanin mutum da cuta.

Duka makarantun firamare da sakandare fom na iya zama nakasar ko samu. A Pathology iya taimakawa wajen namiji rashin haihuwa a 40-60% na lokuta.

A Sanadin cutar a maza

Low yawa na androgens za a iya lalacewa ta hanyar wani karu a cikin adadin hormones samar da wani pathological yanayin, ko testes kansu, take hakkin hypothalamus da pituitary aiki.

By etiology farko bayyanuwar cutar za a iya gani,

• nakasar underdevelopment jima'i gland, wanda ya auku a lokacin da kwayoyin lahani na hali,
• aplasia na golaye.

Predisposing dalilai iya sun hada da:

• take hakkin testicular saukarsa;
• daukan hotuna zuwa mai guba abubuwa.
• jiyyar cutar sankara.
• Sauran ƙarfi effects a kan wani kwayoyin akai, nitrofurans, da magungunan kashe qwari, barasa, tetracycline, bisa hormone kwayoyi a hakan allurai, da dai sauransu.;
• dauke da kwayar cutar yanayin da cuta (mumps, kyanda, orchitis, vesicles).
• gaban radiation cuce-cuce.
• samu Pathology na testes.
• karkatacciyar na spermatic igiyar.
• volvulus na testes.
• atrophic aiwatar bayan tiyata.
• excision na hernia.
• tiyata a Kwalatai (Scrotum).

A farko hypogonadism dakushe matakin androgens a cikin jini da aka kiyaye. Tasowa a compensatory martani na adrenal gland, qara samar da gonadotropins.

Don samar da sakandare gubar hypothalamus da pituitary cuta (kumburi tafiyar matakai, marurai, tashin hankali na jijiyoyin bugun gini Pathology fetal ci gaba).

Karfafa sakandare hypogonadism iya:

• pituitary adenoma, da samar da ci gaban hormone.
• adrenocorticotropic hormone (Cushing ta cutar).
• prolactinoma.
• tabarbarewa na pituitary gland shine yake ko hypothalamus bayan tiyata.
• da tsufa tsari, wanda ya haddasa wani karu na testosterone a cikin jini.

A sakandare form alama akan rage gonadotrophins, sakamakon wani karu androgen samar da testes.

Daya nau'i na cuta, rinjayar maza, shi ne don rage samar da maniyyi da al'ada testosterone index. Da wuya akwai wani karu a testosterone matakan a cikin al'ada matakin da maniyyi.

Symptomatology da cutar a maza

Hypogonadotropic hypogonadism a maza yana da nasa asibiti manifestations. Suna sa ta haƙuri da shekaru da kuma matakin da androgen insufficiency.

Idan golaye an buga da yaron kafin balaga, sa'an nan shi a kafa wani hali ciwo. Kwarangwal haka ne ya zama disproportionately manyan. Wannan shi ne saboda wani bata lokaci ba a cikin ossification na ci gaban yankin. Hanya da kirji ana kuma lagging a baya a ci gaba, da wata gabar jiki ne tsawo, kwarangwal tsoka ne talauci ci gaba.

Kiba za a iya lura a kan mace type, gynecomastia, gipogenitalizme cewa an nuna a cikin wani karamin size azzakari, babu wrinkles a Kwalatai (Scrotum), testicular hypoplasia, da underdevelopment na prostate, babu gashi a pubic yankin, da underdevelopment na maƙogwaro, babban sautin na murya.

A wani sakandare bayyanuwar cuta akai-akai lura high jiki nauyi, dagagge adrenal bawo aiki, illa thyroid aiki.

Idan testicular aiki an rage bayan balagarsa, da bayyanar cututtuka da irin cututtuka kamar hypogonadotropic hypogonadism, za a iya gano weaker.

Lura da wadannan mamaki:

• akan rage testes.
• kadan jiki gashi fuska da jiki;
• asarar fata elasticity kuma thinning.
• rage jima'i aiki.
• autonomic cuta.

A karu a testicular size ne ko da yaushe hade tare da rage maniyyi samar. Wannan sa rashin haihuwa, akwai wani komawa da baya daga sakandare jima'i halaye, alama tsoka rauni, gajiya.

Ganewar asali hypogonadism a maza

Ganewar asali da aka yi da anthropometry, dubawa da kuma palpation na al'aurar, kima na asibiti cututtuka digiri mafarki.

X-ray jarrabawa zai taimaka wajen kimanta da kashi shekaru. Domin sanin jikewa na kashi ma'adinai densitometry da ake amfani. Lokacin da x-haskoki na sella turcica ƙaddara da ta size da kuma gaban siffofin maruran.

Hakkin daga kashi shekaru damar domin lokaci na ossification na hadin gwiwa hannu da kuma wuyan hannu domin sanin lokacin da farko na mafarki. Ya kamata ya yi la'akari da yiwuwar wani a baya (ga marasa lafiya haife shi a kudu) da kuma daga baya (ga marasa lafiya haife shi a arewacin) ossification, kazalika da cewa osteogenesis cuta za a iya lalacewa ta hanyar wasu dalilai.

Bincike a kan maniyyi awon ya yale mu mu yi magana game da yanayin kamar nitrogen ko oligospermia.

Nuna ta ciki na irin hormones:

• jima'i gonadotropins.
• total da kuma free testosterone .
• luteinizing hormone.
• GnRH.
• antimyullerovsky hormone.
• prolactin.
• estradiol.

Lokacin da na farko nau'i na cutar index of gonadotropins a jini ya karu da sakandare - downgraded. Wani lokaci su matakin ne a cikin redistribution dokoki.

Tabbatar da dalilin da magani estradiol zama dole lokacin da symptomatic feminization da sakandare bayyanuwar cuta a cikin hali na marurai a cikin testes samar estrogen, ko marurai a cikin adrenal gland.

Index da abun ciki na ketosteroids a cikin fitsari iya zama al'ada, ko a rage. Idan ka zargin gaban Klinefelter ciwo chromosome analysis nuna rike.

Testicular biopsy ba zai iya samar da bayanai ga daidai ganewar asali.

magani

Jiyya na hypogonadotropic hypogonadism ne da nufin kawar da babban dalilin da Pathology. Manufar far ta'allaka rigakafin ayyukan da taimako zuwa ga daidaita jima'i ci gaba, da m rage testicular nama da kuma testicular kashe rasa haihuwa. Far da aka gudanar a karkashin kulawa da urologist da endocrinologist.

Yadda shafe hypogonadotropic hypogonadism a maza? Jiyya dogara da dalilai da dama:

• asibiti nau'i na cuta.
• tsanani daga matsalar aiki na samfur na hypothalamus, da pituitary gland shine yake da haihuwa tsarin.
• kasancewa coexisting pathologies.
• lokacin abin da ya faru na cuta.
• haƙuri da shekaru.

Jiyya na adult lokuta ne ga gyara da matakan da androgens da kuma kawar da jima'i tabarbarewa. Rashin haihuwa, wanda ya tashi a cikin nau'i na nakasar hypogonadism, magani ba zai iya zama.

A cikin hali na farko siffofin nakasar munanan ko samu ciwo a aminci endocrine Kwayoyin a cikin testes amfani stimulants. Boys suna bi ba hormonal jamiái, kuma adult marasa lafiya - kwayoyi bisa hormone (androgen da gonadotropins a kananan allurai).

Idan babu madadin aiki testicular nuna ta androgen maye far da testosterone. Shan hormones da aka kwashe dukan rayuwarsa.

Lokacin da sakandare nau'i na da cuta a cikin yara da manya bukatar amfani da hormone gonadotropin. Idan dole, su ne a hade tare da jima'i ba ji ba gani.

Har ila yau nuna shi ne restorative magani, da kuma motsa jiki.

Operation da cutar ne zuwa dashi da kwai da cryptorchidism, amfani da roba tiyata a underdeveloped azzakari. Tare da kwaskwarima nufi makõma zuwa kwai kafawa roba tushen (a cikin rashi na undescended testis a cikin kogon ciki).

Surgery ake amfani da lokacin yin amfani da microsurgical dabaru, tare da iko da rigakafi da tsarin, hormone matakan, kazalika da aka gina zuciya da sauransu.

A lokacin tsanaki far rage-rage androgen insufficiency, ya dawo da ci gaban sakandare jima'i halaye, partially rage iko, rage manifestations osteoporosis da kashi shekaru fada.

Ta yaya ne da cuta a cikin mata

Hypogonadotropic hypogonadism a mata ne halin da underdevelopment na aikin yin jima'i, kuma Ya ƙãra ovarian gland. Primary nakasar form saboda underdevelopment ko ovarian lalacewa a cikin neonatal lokaci.

An rage samar da jima'i hormones, wanda tsokani wani karuwa a matakin gonadotropins, wanda ta da ovaries.

A cikin bincike na high kudi na hormones da cewa ta da follicles da lutein, kazalika da low matakan estrogen. Rage kudi na estrogen sa atrophy ko underdeveloped mace haihuwa gabobin, mammary gland, babu haila.

Idan ovarian aiki da aka sosai kafin balaga, to, akwai rashin sakandare jima'i halaye.

Hypogonadotropic hypogonadism a mata a makarantun firamare a matsayin nuna a cikin wadannan yanayi:

• Nakasar cuta a kayyade matakin.
• nakasar hypoplasia na ovaries.
• dauke da kwayar cutar matakai (Syphilis, tarin fuka, Mumps, sakawa a iska mai guba, m kau na ovaries).
• da shan kashi na autoimmune yanayi.
• ciwo, testicular feminization .
• polycystic ovaries.

Secondary hypogonadotropic hypogonadism a mata na faruwa a Pathology na pituitary da hypothalamus. An bambanta da wani low abun ciki ko cikakken lõkacin fatara daga samar da gonadotropins tsara ovarian aiki. Wannan tsari ne da jawo da kumburi da kwakwalwa yankin. Wadannan cututtuka da tareda žata tasiri da kuma suna tare da wani karu a matakin na daukan hotuna na gonadotropins zuwa ovaries.

Ta yaya ne irin wannan cututtuka kamar hypogonadotropic hypogonadism a mata, da kuma ciki? M intrauterine ci gaba da tayin kuma za a iya shafa da ya faru na cutar.

Alamun a mata

Bright bayyanar cututtuka na yaro-hali lokaci - a take haila, ko rashin daga gare ta.

A low matakin na mace hormones take kaiwa zuwa underdevelopment na jima'i gabobin, mammary gland, take hakkin da shaida na kitse da kuma ramammu jiki gashi.

Idan cutar ne nakasar a cikin yanayi, secondary jima'i halaye ba bayyana. The mata lura gaban kunkuntar kafafuwa da kuma lebur gindi.

Idan cutar faru kafin balaga, da jima'i halaye da cewa ya bayyana a ci gaba da kasancewa da ceto, amma wata-wata kare al'aura nama atrophy.

Aikin ne

Hypogonadism idan akwai wani karu a estrogen matakan da karuwa matakan gonadotropins. Ta hanyar duban dan tayi saukarwa a rage a cikin size mahaifa kamu ostepoporoz da bata lokaci samuwar kwarangwal.

cuta magani a mata

Yadda shafe hypogonadotropic hypogonadism a mata? Jiyya ya shafi maye far. Mata sanya sami magani da kuma jima'i hormones (ethinyl estradiol).

A cikin hali na farko na haila rubũta baka hana dauke da estrogens da progestins, da kuma shirye-shirye "Triziston", "Trikvilar".

Na nufin "Klimov", "Trisekvens", "klimonorma" wajabta wa marasa lafiya bayan shekaru 40.

Hormone magani ne contraindicated a cikin wadannan yanayi:

• cancerous ƙari a cikin ƙirjinka da al'aurar.
• zuciya da kuma jijiyoyin bugun gini cututtuka.
• koda gazawar da kuma hanta.
• thrombophlebitis.

rigakafin

Irin wannan cututtuka kamar hypogonadotropic hypogonadism, yana da wani m hangen nesa. Rigakafin ne kiwon lafiya da ilimi da yawan jama'a da kuma kula da mata masu haihuwa,, kazalika a kiwon lafiya da ayyukan.