I-Hyperandrogenia yabesifazane: izimbangela, izimpawu, ukwelashwa. Kuyini i-giperandrogenia eyingozi kulabo besifazane

Ezokwelapha, inkinga enjenge-hyperandrogenism kwabesifazane iyaziwa. Izimbangela, izimpawu, ukwelashwa nalokhu kuhloliswa kudinga ukuhlolwa nokubandakanya odokotela abaqeqeshiwe. Futhi nakuba lesi sifo sinzima kakhulu ukunqoba ngokuphelele, ukusebenzisa odokotela kangcono ngaphandle kokulibala.

Okuyinhloko yesifo

Uma kuziwa ngesifo ezifana ne- hyperandrogenism kwabesifazane, izimbangela zezimpawu, ukwelashwa nezinyathelo zokuzivikela zihlale zihlotshaniswa nenkinga njengomphumela wokuzikhukhumeza emzimbeni. Le nqubo iholela ekubukeni kokubonakala kwesifazane kwezici zesilisa nezinye izinto ezingashintshi kakhulu. Ukukhuluma ngokuningiliziwe, sikhuluma ngezibonakaliso ezifana nokubonakala kwezimila ebusweni nasemzimbeni, ngezwi eliphansi, kanye nezinguquko kwezinye izakhi zalesi sibalo.

Kumele kuqashelwe ukuthi le ndlela yokukhubazeka yesistimu ye-endocrine yowesifazane ivamile, futhi ayikwazi ukuholela ekushintsheni kwangaphandle okungajabulisi, kodwa futhi ukuthi ibangele ukungabi nabantwana. Ngakho-ke, uma unezibonakaliso zokuqala ze-hyperandrogenism, kufanele uhlele ngokushesha ukuvakashela udokotela.

Kungani i-pathology ikhula?

Isihloko esithi "hyperandrogenism kwabesifazane: izimbangela zezimpawu, ukwelashwa" Kubaluleke kakhulu kubesifazane, ngoba le nkinga ibonakala kuma-20% weziguli. Ngakho-ke, kunengqondo ukulalela lezo zici nezinqubo eziholela ekuthuthukiseni lesi sifo.

Njengesizathu esiyinhloko, kungenzeka ukunquma i-ACS - syndrome ye-adrenogenital. Okubalulekile ukuthi izigulane ezinamandla ziyakwazi ukukhiqiza amanye amahomoni amaningi, ngaphezu kwezikhangiso, isibonelo, i-glucocorticoids. Lezi zinsuku zivela ngaphansi kwethonya le-enzyme ethile. Isisekelo sokwenzeka kwabo yi-androgens eqoqiwe. Ngezinye izikhathi owesifazane osevele ebelethwe unesici se-enzyme, ngenxa yalokho ama-hormone abesilisa awaguqulwa, kodwa aqoqa ngokugcwele, okwenza izinguquko ezingathandeki emzimbeni wesifazane.

Kunenye inqubo, ngenxa yokuthi i-hyperandrogenia ye-adrenal genesis iyaqala. Sibheka ngezicubu zezinhlayiya ze-adrenal. Zakhiwa futhi ngokumelene nesizinda sokwanda kwe-androgens.

Ingozi yentuthuko ye-pathology okukhulunywe ngenhla ivela nakanjani lapho kuthuthukiswa ama-hormone wesilisa emaqanda omfazi. Ngaphezu kwalokho, amaseli akhiqiza i-adrogens angabangela isisu emanqeni.

I-syndrome ye-hyperandrogenism ngezinye izikhathi yimbangela yemiphumela yokwelapha kwezinye izitho ze-endocrine, isibonelo, i-pituitary gland.

Izimpawu ze-androgens ezingaphezulu

Uma sikhuluma ngezimpawu zomtholampilo zokwanda kwe-hormone yamadoda, zingachazwa kanje:

• I-Acne;
• Ukulahlekelwa izinwele namagqabha e-bald ebunzini (adrogenic alopecia);

• Izithobezi ze-sebaceous ziqala ukhiqiza inani eliyimfihlo ngokweqile, ngenxa yalokho okuqukethwe kwamanoni esikhumba kuphuma;
• Barifony, okusho ukwehlisa izwi lezwi;
• Isisu nesifuba kubonakala izinwele.

Kumele uqaphele ukuthi i-hirsutism - ukukhula ngokweqile kwezinwele ezibulalayo emzimbeni wesifazane, kutholakala ku-80% weziguli ezinenkinga efana ne-hyperandrogenism syndrome.

Ngesifo esifanayo, abanye besifazane ocansini oluhle kakhulu bangase babe nomjikelezo wokuya esikhathini, ukungabi khona kwesikhathi kokuya esikhathini, kanye nokuphefumula kwe-myocardium, ukukhuluphala, ukungabi namntwana kanye nokucindezeleka komfutho wegazi.

Ukuhlushwa kwama- hormone wesilisa kungabangela ukukhushulwa okukhulu komzimba wesifazane ukutheleleka kwezifo ezihlukahlukene. Kukhona ukukhathala okusheshayo nokuthambekela kokucindezeleka.

Izithobezi ze-acne ne-sebaceous

Ukuze uqonde ngokucacile ukuthi benzeni ngenkinga enjenge-hyperandrogenism kwabesifazane, izimbangela, izimpawu, ukwelashwa nokuxilongwa kufanele kubhekwe ngokucophelela. Njengoba izici ezibangela ukuthuthukiswa kwesifo ziye zacatshangwa ngenhla, kunengqondo ukutadisha izici ze-symptomatology.

Uma uthinta inkinga enjenge-acne, kubalulekile ukuthi uqaphele ukuthi ziwumphumela wekristatini wezindonga ze-follicle nokukhiqizwa kwe-sebum, okwakhuthazwa ukuhlushwa kwe-androgens, kuhlanganise ne-plasma. Njengoba izimpawu ezinjalo, njengombuso, ama-COC noma ama-anti-androgens anqunywe, okwenza kube lula ukuthuthukisa isimo sesiguli.

Futhi, ngaphansi kwethonya lama-hormone wesilisa ezindaweni ezixhomeke ku-androgen, izinwele ezibomvu, ezinamaqabunga, ezinamaqabunga zibonakala esikhundleni sezibhamu. Ngokuvamile kwenzeka ngesikhathi sokukhulelwa. Kulokhu, umphumela we-androgen kumashiya, ama-eyelashes, izingxenye zesikhashana nezesi-occipital zihlala zincane.

I-hyperandrogenism engavamile

Kumele sikhumbule ukuthi izigulane ezinama-adlandal kukhona izigulane ezimbili ze-endocrine eziqondile ngqo nezinso ngokwazo.

Ziwumthombo wama-95% we-androgen evezwayo (i-DEA-sulfate). Ukuncintisana kwe-hyperandrogenism ehambisana nalezi zinhlayiya kuncishiswa ukuthi i-pathology ine-characterate character futhi yenza uzizwe ungemuva kwe-androgenital syndrome. Kuholela ekunciphiseni okubucayi emzimbeni wesifazane wezinga lezinyomi ezidingekayo ekukhiqizeni amahomoni afana ne-glucocorticoids.

I-hyperandrogenism yemvelaphi engavamile ichazwa Leli phutha eliholela ekukhuleni kwamanye ama-hormone - ukukhulelwa, i-progesterone, njll. Izinguquko ezinjalo ziholela ekwenzeni ukwanda kwe-androgen emzimbeni wesifazane.

Ngezinye izikhathi kutholakala ukuthi i-pathology, eyabangelwa izicubu zezinhlayiya ze-adrenal ezifihla i-hormone yesilisa. Ngokwezibalo, leli fomu lesi sifo njengama-hyperandrogenism adrenal lihlelwe ku-30-50% yabesifazane abanenkinga nge-androgen.

Imiphumela kuma-ovari

I-hormone yesilisa ephakeme ingathinta ukusebenza kwama-ovari. Ezimweni eziningi, le nkinga ibonakala ngezindlela ezimbili: hypertecosis kanye ne-polycystosis. Kubalulekile ukuba uqaphele ukuthi ingozi yokuthuthukisa lokhu kuphila kwabafazi iyanda ngokuzivocavoca njalo ngemidlalo yamandla.

I-ovarian hyperandrogenia yimbangela yokukhula kancane kwezintambo ezitholakala ngaphansi kwe-androgens. Ngenxa yalokho ama-ovari ahlanganiswa, umphumela walezo zinqubo ukutheleleka kwalokhu okulandelayo. Igama lezokwelapha le nkinga yi-follicular atresia.

Kodwa akuzona zonke izinkinga ezihambisana ne-hyperandrogenia yama-ovaries genesis. Okubalulekile ukuthi i-hormone yesilisa idlala indima yenkinga lapho kuhlanganiswa khona izicubu ezinomzimba ezinomzimba, okuholela e-polycystosis. Kulesi simo, izindaba ezinhle ukuthi abesifazane abangu-5 kuphela ababhekene nale nkinga.

Kumele futhi kuqaphele ukuthi leli fomu le-hyperandrogenism emzimbeni wesilisa ohle kakhulu yimbangela yokuhluleka komthetho ophakathi kwezinga le-androgen. Le nqubo ivela emazingeni e-hypothalamic ne-pituitary. Ngenxa yalokho, isizinda se-hormonal sishintsha ngokuphawulekayo.

Izimpawu okufanele uzinake

Kunezimbonakaliso eziningi ezibonisa ukubukeka kwenkinga echazwe ngenhla. Iqiniso lokuthi kunezifo ezifana ne-hyperandrogenia yama-ovaries we-genesis angafundiswa ekuboniseni okulandelayo:

• I-osteoporosis;
• I-Seborrhea;
• Ebusweni, ngaphezu kwe-acne, kukhona ukucubungula nokuvuvukala, okuyinto okunzima ukuyiqeda ngezindlela ezivamile ze-cosmetology;
• I-muscle atrophy;
• Ukuqapha ngokweqile;
• Ukushintsha ukulingana komzimba wesifazane - imasculinization;
• Izwi elibi (ibhonfony);
• Izinwele zikhula kuwo wonke umzimba, ngisho nasesimweni;
• Ukwakhiwa kwamabala ekhanda ekhanda.

Ngaphezu kwalokho, kunezimbonakaliso eziningi eziyisibili, ezifana nezinga legazi legazi, ukukhulelwa komfutho wegazi, ukunciphisa umzimba, njll.

Isisindo esiningi

Ukukhuluphala kwabesifazane kungabangela i-hyperandrogenia echazwe ngenhla ye-ovarian. Ngalolu hlobo lwe-pathology, ukwanda kwezinga le-estradiol kuvame ukuqoshwa.

Odokotela baqhuba ucwaningo ngokuvumelana nalokhu okulandelayo okuqinisekisiwe okuqinisekisiwe: kokubili izinga eliphezulu le-hormone yesilisa ne-estrogen eyenza ngaphansi kwethonya layo, kube nomphumela oqondile ekuthuthukiseni ukukhuluphala okuhambisana nohlobo lwesilisa.

Izinqubo ezinjalo zibangelwa ukwanda kwesifo se-insulin kanye nokwanda okwenziwe ekuhlungeni kwe-hormone yesilisa emzimbeni wabesifazane abanobuchopho obuchazwe ngenhla. Kwezinye izimo, i-androgens ayithonywanga isisindo somuntu ngesistimu yenzwa yomphakathi.

Ifomu elixubile

Odokotela abanezikhathi ezithile kufanele babhekane nokubonakaliswa kwezinhlobo eziningana ze-hyperandrogenism. Lesi simo sichazwa yiqiniso lokuthi ngesikhathi esifanayo kukhona ukwephulwa kwemisebenzi ye-adrenal kanye ne-ovarian.

Ukubheka okunzima ukubhekana nalokhu kubalulekile ukucabangela lapho ufunda ukuthi iyiphi i-hyperandrogenism eyingozi kwabesifazane. Eqinisweni, yilokho okwenzekayo: i-adrenal androgens, igxile emigqumeni ye-adrenal, ngaleyo ndlela ikwandisa izinga le-hormone yamadoda kuma-ovari. Le nqubo ivela egazini, okuholela ekwenzeni ukwanda kwe-hormone yokuqondisa. Lezi zinsuku ziphinde zenze ukuthi i-hyperandrogenic syndrome ibonakale.

Ukuvela kohlobo oluxubene lwe-pathology kungase kubangele ukuhlukunyezwa okukhulu, ukudakwa kobuchopho noma isisu se-pituitary.

Izifo

Ekuqaleni, udokotela kumele ahlukanise i-hyperandrogenia kwezinye izifo, lapho iqala khona (i-acromegaly, i- Cushing's syndrome, isifo sesibindi, njll). Isinyathelo esilandelayo ukucacisa izinga le-hormonal. Le nqubo kufanele yenziwe ngesisu esingenalutho ekuseni. Ukuhlaziywa okunjalo kufanele kwenziwe kathathu, njengoba isizinda se-hormone esinamahlumela aphakeme a-androgen sashintsha njalo.

Ukunakekelwa kudonsela ezingeni lika dehydroepiandrosterone, okuqukethwe okuphezulu okuyobe kubonisa ukuthi i-hyperandrogenism eyingozi. Okunye okubalulekile izinga le-ketosteroids kumchamo. Uma okuqukethwe kwalo kudlula okungavamile, ngakho-ke kunengqondo ukusola ukuthuthukiswa kwezifo.

Izindlela zokwelapha

I-Hyperandrogenism yinkinga enkulu kakhulu ukungazinaki usizo lwezokwelapha ezifanelekile. Futhi uma sihlaziya yonke inkambo yokwelashwa, singaphetha ngokuthi kuhloswe ukufeza izinjongo ezine eziyinhloko:

• Ukuqedwa kwezibonakaliso esikhumbeni;
• Ukujwayelekile komjikelezo wokuya esikhathini;
• Ukuphathwa kokwelashwa, okubangelwa ukugcoba;
• Ukuqedwa kanye nokuvimbela izifo ezibangelwa isifo sezinyosi ezihambisana nesifo esiyisisekelo.

Ukudla kwe-hyperandrogenia kwabesifazane kunqunywe uma kunesisindo esibalulekile. Kulesi simo, kubalulekile ukulandela zonke izincomo zedokotela ngokuqondile, kuphela uma lokhu kutholakala ungathola umphumela oyifunayo.

Lezo ziguli ezihlose ukuba nengane, ezimweni eziningi, zibizwa ngokuthi i-hormone therapy, ezinganikeza ukuvuthwa okugcwele.

Abesifazane abangacabangi ukukhulelwa baphathwa, kuhlanganise nokukhulelwa komlomo, futhi kwezinye izimo ukuxilongwa kwamakha ama-ovari.

Izidakamizwa zokwelashwa kwe-hyperandrogenism kwabesifazane nazo zisetshenziselwa ukusebenza uma umzimba ungakwazi ukunciphisa izinga eliphezulu le-androgen yedwa. Sibheka ngezindlela ezinjengalezi "Metipred", "Dexamethasone", njll. Ukungenelela kokuhlinzekwa kungenziwa uma kunqunywe ukuthi isifo sikhathwe yisisu.

Imiphumela

Ukuxilongwa okuphezulu kwe-hormone yesilisa emzimbeni wesifazane akuyona inkinga enkulu, evame ukuvela ngesimo sezifo ezingekho ngaphansi kwesifo. Ngakho-ke, lapho izimpawu zokuqala zivela, ukuxilongwa kanye nokwelashwa kufanele kwenziwe ngokuzenzakalelayo.