Qhov sib txawv tseem ceeb ntawm Cushings kab mob thiab Cushings syndrome yog Cushing tus kab mob yog vim muaj ntau tshaj cortisol hauv lub cev los ntawm cov qog pituitary nyob rau hauv lub hlwb, thaum Cushing's syndrome yog vim cortisol ntau dhau los ntawm sab nraud. lub cev los ntawm cov tshuaj los yog tsim nyob rau hauv lub cev raws li ib tug tshwm sim ntawm pituitary los yog qog adrenal qog.
ACTH (adrenocorticotropic hormone) yog ib yam tshuaj uas tso tawm los ntawm lub caj pas pituitary, nyob ntawm lub hauv paus ntawm lub hlwb. Nws tswj kev tsim cov tshuaj hormones hu ua cortisol. Cortisol yog tsim los ntawm cov qog adrenal, uas nyob saum lub raum. Cortisol ua lub luag haujlwm tseem ceeb hauv kev pab tib neeg los teb rau kev ntxhov siab, tiv thaiv kab mob, tswj cov ntshav qabzib, thiab tswj cov metabolism. Cushing's disease thiab Cushing's syndrome yog ob qho kev kho mob uas yog vim muaj cov tshuaj cortisol ntau dhau hauv lub cev.
Cushings Disease yog dab tsi?
Cushing's disease yog tus kab mob uas tshwm sim los ntawm cov qog pituitary secreting ACTH ntau dhau lawm. Nws yog ib qho kab mob tsawg uas cuam tshuam txog 10 txog 15 hauv ib lab txhua xyoo. Nws kuj tshwm sim ntau dua rau cov neeg laus hnub nyoog ntawm 20 txog 50 xyoo. Feem ntau, cov poj niam suav txog ntau dua 70 feem pua ntawm cov neeg mob. Cov neeg mob uas muaj tus kab mob Cushing muaj cov qog me me hauv pituitary hu ua pituitary microadenomas (qee zaum cov qog loj lossis macroadenomas). Cushing tus kab mob yog siv los piav qhia txog kev kho mob ntawm ntau tshaj cortisol hauv lub cev tshwm sim los ntawm cov qog pituitary secreting cov tshuaj hormone ACTH.
Daim duab 01: Cushing's Disease
Cov tsos mob muaj xws li puv lossis puag ncig ntawm lub ntsej muag, ntxiv rog nyob tom qab ntawm caj dab, tawv nqaij yooj yim, purplish stretch marks, hnyav hnyav, lub puab tsaig liab, ntau cov plaub hau loj hlob ntawm lub ntsej muag, caj dab, hauv siab, tsis muaj zog, kev coj khaub ncaws tsis zoo, ntshav siab, ntshav qab zib mellitus, kev xav thiab kev coj cwj pwm tsis zoo, thiab lwm yam. Cov qog loj lossis macroadenomas hauv pituitary tuaj yeem ua rau tsis pom kev, hypopituitarism, nce qib ntawm cov ntshav prolactin, thiab lwm yam. Kev kuaj mob ntawm qhov kev kho mob no. Kev kuaj mob yog los ntawm kev kuaj lub cev, kuaj tshuaj hormone, MRI, lossis inferior petrosal sinus sampling. Cov kev kho mob muaj xws li phais tshem tawm pituitary adenomas, tshuaj los txo cov qog adrenal tsim tawm ntawm cortisol, hluav taws xob, lossis ob sab adrenalectomy.
Cushings Syndrome yog dab tsi?
Cushing's syndrome yog vim muaj ntau tshaj cortisol uas tawm los ntawm sab nraud lub cev los ntawm cov tshuaj los yog ntau tshaj cortisol ua nyob rau hauv lub cev raws li tshwm sim los ntawm pituitary los yog qog adrenal qog. Feem ntau ua rau Cushing's syndrome yog kev siv ntev ntawm cov tshuaj cortisol zoo li glucocorticoids. Cov tshuaj no yog siv los kho cov mob xws li mob hawb pob, mob caj dab rheumatoid, thiab lupus. Ntau cov qog nqaij hlav xws li qog pituitary, ectopic ACTH tsim cov qog, lossis qog nqaij hlav qog nqaij hlav tuaj yeem ua rau Cushing's syndrome.
Daim duab 02: Cushing's Syndrome
Cov tsos mob tuaj yeem suav nrog qhov hnyav nce, txhais caj npab thiab txhais ceg, lub ntsej muag puag ncig, nce rog nyob ib puag ncig ntawm caj dab, fatty hump ntawm lub xub pwg nyom, yooj yim bruising, dav liab doog stretch marks, thiab cov leeg tsis muaj zog. Kev kuaj mob ntawm tus mob no tuaj yeem ua tau los ntawm 24-teev urinary free cortisol test, lig hmo salivary cortisol test, low dose dexamethasone suppression test (LDDST), dexamethasone-CRH test, ntshav kuaj, MRI scan, CT scan, thiab petrosal sinus. kev ua piv txwv. Cov kev xaiv kho mob suav nrog kev phais tshem tawm cov qog, hluav taws xob, tshem tawm cov qog adrenal, cov tshuaj kom txo qis ntau ntawm cortisol suav nrog ketoconazole, mitotane, metyrapone, mifepristone.
Dab tsi zoo sib xws ntawm Cushings Disease thiab Cushings Syndrome?
- Cushing's disease thiab Cushing's syndrome yog ob yam mob uas yog vim muaj ntau yam tshuaj cortisol hauv lub cev.
- Ob qho xwm txheej no muaj npe tom qab tus kws kho mob neurosurgeon Harvey Cushing, uas thawj zaug tau piav qhia txog cov xwm txheej no hauv xyoo 1912.
- Cov xwm txheej no tuaj yeem tsim cov tshuaj ACTH ntau dhau.
- Ob qho xwm txheej tuaj yeem yog vim muaj kev hloov pauv ntawm caj ces.
- Lawv tsim cov tsos mob zoo sib xws thiab tuaj yeem kho nrog cov kev kho mob zoo sib xws.
- Nyob rau hauv ob qho tib si, poj niam cuam tshuam ntau dua li txiv neej.
Qhov txawv ntawm Cushings Disease thiab Cushings Syndrome yog dab tsi?
Cushing's disease tshwm sim vim muaj ntau tshaj cortisol ua nyob rau hauv lub cev los ntawm cov qog pituitary nyob rau hauv lub hlwb thaum Cushing's syndrome tshwm sim vim ntau tshaj cortisol uas los ntawm sab nraum lub cev los ntawm cov tshuaj los yog ua nyob rau hauv lub cev raws li ib tug tshwm sim. ntawm cov qog pituitary lossis qog adrenal. Yog li, qhov no yog qhov sib txawv tseem ceeb ntawm Cushing's disease thiab Cushing's syndrome. Tsis tas li ntawd, Cushing tus kab mob yog vim muaj kev hloov pauv hauv cov noob xws li Menin 1, NR3C1, AIP, TP53, thiab NR0B1. Ntawm qhov tod tes, Cushing's syndrome yog vim kev hloov pauv hauv cov noob xws li CTNNB1, APC, PRKACA.
Cov duab hauv qab no nthuav tawm qhov sib txawv ntawm tus kab mob Cushings thiab Cushings syndrome nyob rau hauv daim ntawv tabular rau ib sab kev sib piv.
Summary – Cushings Disease vs Cushings Syndrome
Cushing's disease thiab Cushing's syndrome yog ob qho kev kho mob uas yog vim muaj cov tshuaj cortisol ntau dhau hauv lub cev. Cushing's tus kab mob yog vim muaj ntau tshaj cortisol ua nyob rau hauv lub cev los ntawm cov qog pituitary nyob rau hauv lub hlwb thaum Cushing's syndrome yog vim ntau tshaj cortisol uas los ntawm sab nraum lub cev los ntawm cov tshuaj los yog ua nyob rau hauv lub cev raws li ib tug tshwm sim ntawm pituitary los yog adrenal. qog qog. Yog li, qhov no yog qhov sib txawv tseem ceeb ntawm tus kab mob Cushings thiab Cushings syndrome.
