Indima ye-hormone ye-ADH ukuhlola ukulahleka kwamanzi yizinso, ngakho-ke kubalulekile ekusebenzeni kahle kwayo. Ngeshwa, uketshezi kwale hormone ngezikhathi ezithile akwenzeki kahle. Ziyini izimbangela? Kungenzeka yini ukuthi i-hormone ephezulu kakhulu noma ephansi kakhulu ibe nemiphumela?

I-hormone elwa ne-antidiuretic ebizwa nangokuthi i-vasopressin, kwesinye isikhathi ebizwa nangokuthi isifinyezo se-AVP ye-Arginine-vasopressin, iyi-hormone eyenziwe ngamakhemikhali e-hypothalamus. Ngokuvumela ukubuyiselwa kwamanzi kabusha ngumzimba, i-hormone ADH isebenza isenzo sayo ezinso.

Ngokushesha nje lapho ifihliwe yi-hypothalamus, izogcinwa endlaleni yebhande ngaphambi kokukhishwa uma kwenzeka iphelelwa amanzi emzimbeni. I-hypothalamus ne-pituitary kutholakala ezansi kobuchopho.

Indima ye-ADH ukuqapha ukulahleka kwamanzi ezinso (diuresis) ukuqinisekisa ukuthi izinga le-sodium egazini lihlala lisezingeni elijwayelekile. Lapho amazinga e-sodium enyuka, i-ADH ifihliwe ukukhawulela ukulahleka kwamanzi ezinso, okwenza umchamo ube mnyama kakhulu.

Umthamo wayo kuhloswe ngawo ukunquma nokuhlukanisa i-nephrogenic diabetes insipidus kusuka enkabeni yesifo sikashukela i-insipidus noma ukutholakala kwesifo semfihlo esingafanele.

Izinga eliphansi le-antidiuretic hormone lingaxhunyaniswa ne:

• Isifo sikashukela insipidus : izinso zehluleka ukonga amanzi bese kuthi umuntu ngamunye akhiqize umchamo omningi kakhulu futhi ohlanjululwe (i-polyuria) okumele bawunxephezele ngokuphuza amanzi amaningi (i-polydipsia). Kunezinhlobo ezimbili zesifo sikashukela i-insipidus, i-central diabetes insipidus (CDI), esivame kakhulu futhi esibangelwa ukuntuleka kwe-ADH, nephrogenic diabetes insipidus, i-hormone ikhona kodwa ayisebenzi.

Izinga eliphakeme le-antidiuretic hormone lingahlotshaniswa ne:

• ISIADH : Isifo soketshezi olungafanele lwe-hormone elwa nama-antidiuretic sichazwa yi-hyponatremia ebangelwa ukwanda kwamanzi egazini ngokuncipha kwezinga le-sodium. Imvamisa ye-hypothalamic (isimila, ukuvuvukala), isimila (umdlavuza wamaphaphu) imvelaphi. Izimpawu ze-hyponatremia yisicanucanu, ukuhlanza, ukudideka;
• Izilonda zesimiso sezinzwa: izifo, ukuhlukumezeka, ukopha, izicubu;
• I-Meningoencephalitis noma i-polyradiculoneuritis;
• Ukuhlukumezeka kwe-craniocerebral;
• Isithuthwane noma ukuqubuka okukhulu kwengqondo.

Ngesikhathi sesampula segazi, i-hormone elwa ne-diuretic iyalinganiswa. Ngemuva kwalokho, isampula lifakwa kwi-centrifuge ku-4 ° futhi ekugcineni iqandiswe ngokushesha ngo -20 °.

Ukuba esiswini esingenalutho akusizi ngalokhu kuhlolwa.

Ngaphandle kokuvinjelwa kwamanzi, amanani ajwayelekile ale hormone kufanele abe ngaphansi kuka-4,8 pmol / l. Ngokuvinjelwa kwamanzi, amanani ajwayelekile.

Ngokuya ngezifo, kunezindlela zokwelapha ezihlukile:

Ukwelashwa kwesifo sikashukela insipidus

Ukwelashwa kwenziwa ngokuya ngesizathu esikhonjiwe, futhi kufanele kwelashwe uma kukhona. Kunoma ikuphi, akufanele uvumele umuntu aphelelwe amanzi emzimbeni noma angene emzimbeni futhi uzame ukulinganisela ngokudla kasawoti okuphansi.

• Endabeni yesifo sikashukela esiphakathi, insipidus, ukwelashwa kusekelwe ekudleni kwe-hormone efana ne-hormone elwa namagciwane, i-desmopressin, isenzo sayo sokulwa nesibindi sinamandla. Ukuphatha kuvame ukuphela kwe-endonasal kanye noma kabili ngosuku. Ukunakekelwa kufanele kuthathwe kungadluli umthamo obekwe udokotela wakho ngoba ukweqisa kungaholela ekugcineni amanzi futhi kwesinye isikhathi kudlikizise;
• Endabeni yesifo sikashukela i-nephrogenic insipidus, lokhu kwelashwa kwamahomoni akusebenzi. Ngakho-ke isifo sezinso esibandakanyekayo sizodinga ukwelashwa.

Ukwelashwa Kwe-Syndrome Ye-Antidiuretic Hormone Secretion Engafanele:

Ukuvinjelwa kokudla uketshezi nokwelashwa kwesizathu uma kungenzeka. Abantu abane-SIADH badinga ukwelashwa kwe-hyponatremia isikhathi eside.

Ngezinye izikhathi kunikezwa uketshezi olungena ngaphakathi, ikakhulukazi uketshezi olunezinga eliphakeme kakhulu le-sodium (i-hypertonic saline). Lezi zindlela zokwelashwa kufanele zinikezwe ngokucophelela ukuvimbela ukukhuphuka okusheshayo kakhulu kwe-serum sodium (ukugxila kwe-sodium egazini).

Uma i-serum yegazi iqhubeka nokuwa noma ingakhuphuki naphezu kokunciphisa uketshezi, odokotela bangabeka imishanguzo eyehlisa umphumela we-vasopressin ezinso, noma izidakamizwa ezivimba ama-vasopressin receptors futhi zivimbele izinso. phendula ku-vasopressin.