Gigantism imayamba chifukwa chobisa kwambiri mahomoni okula muubwana, zomwe zimabweretsa kutalika kwakukulu. Matenda osowa kwambiri nthawi zambiri amalumikizidwa ndikukula kwa chotupa chosaopsa cha pituitary gland, pituitary adenoma. M'zaka zaposachedwa, kafukufuku wavumbula kutengera komwe kumachitika chifukwa cha majini. Chithandizo ndi chovuta ndipo nthawi zambiri chimakhala chamitundu yambiri.

Gigantism ndi mtundu wosowa kwambiri wa acromegaly, vuto lomwe limayamba chifukwa chobisa kwambiri kukula kwa mahomoni, otchedwanso GH (chifukwa kukula kwa hormone), mahomoni a somatotrope (STH). 

Zikafika msinkhu wosatha msinkhu (achinyamata ndi akhanda acromegaly), pomwe mafupa a mafupa sanagwirizane, kukula kwa mahomoni kumeneku kumatsagana ndikukula kwamfupa kwakanthawi komanso thupi lonse. ndipo amatsogolera ku gigantism.

Ana omwe ali ndi vutoli ndi aatali kwambiri, pomwe anyamata amafika 2 mita kapena kupitilira apo ali ndi zaka zopitilira XNUMX.

Nthawi zambiri, hormone yakukula imatulutsidwa m'magazi ndi kansalu kakang'ono kumapeto kwa ubongo kotchedwa pituitary gland. Kwa ana, udindo wawo waukulu ndikulimbikitsa kukula. Kupanga kwa kukula kwa hormone ndimatenda a pituitary kumayendetsedwa ndi GHRH (hormone yakukula-yotulutsa hormone), hormone yopangidwa ndi hypothalamus yapafupi.

Hormone yakukula kwa ana omwe ali ndi gigantism nthawi zambiri imawoneka chifukwa cha chotupa chosaopsa m'matumbo a pituitary, chotchedwa pituitary adenoma: kuchuluka kwa maselo opangira mahomoni kumafotokozera kukula kwake modabwitsa.

Pazaka zosachepera 1%, gland ya pituitary imagwira ntchito kwambiri chifukwa imalimbikitsidwa ndi GHRH, yomwe imapangidwa mopitilira muyeso ndi chotupa chomwe chimapezeka paliponse mthupi.

matenda

Gigantism imaganiziridwa kuti ikukula mwachangu (kutalika kwakukula kumafaniziridwa ndi kupindika kwapakati), pomwe mwanayo ndi wamtali kwambiri poyerekeza ndi ena am'banja lake. Kuyesedwa kwachipatala kumawulula zovuta zina zokhudzana ndi gigantism (onani zizindikiro).

Matendawa amatsimikiziridwa ndi kuyezetsa magazi, komwe kumaphatikizapo kuchuluka kwa kukula kwa mahomoni komanso kuyesa kusweka kwa shuga - kukwera kwa magazi m'magazi kutsata kuyamwa kwa chakumwa cha shuga kumapangitsa kuchepa kwa kutulutsa kwa mahomoni okula, osawonedwa m'mitu ndi kusilira.

Kuyesa kuyerekezera kumachitika kuti apeze chotupacho chomwe chimayambitsa gigantism:

• MRI (magnetic resonance imaging) ndikuwunika kosankha kuti muwone za pituitary adenoma;
• sikani imagwiritsidwa ntchito kwambiri kufunafuna zotupa zobisa GHRH m'mapiko, mazira kapena ma adrenal gland;
• radiography imapangitsa kuti zizindikire zovuta za kukula kwa mafupa.

Kupezeka kwa adenoma ya pituitary kumatha kusokoneza magwiridwe antchito a pituitary pamlingo wosiyanasiyana. Kuphatikiza pa kukula kwa mahomoni, imatulutsa ma prolactin (lactation hormone) komanso mahomoni ena omwe gawo lawo limayambitsa kutulutsa kwa ma adrenal gland, gland and gland gland. Kuyeza kwathunthu kwa mahomoni ndikofunikira.

Chotupacho chimatha kupondereza mitsempha yamawonedwe ndikupangitsa kusokonekera kwamaso, chifukwa chake kufunika kofufuzidwa bwino ndi ophthalmologic.

Mayeso ena owonjezera atha kupemphedwa kuti awunike zovuta zosiyanasiyana zomwe zimatha kuphatikizidwa ndi gigantism.

Anthu okhudzidwa

Gigantism ndiyosowa kwambiri kuposa acromegaly yomwe imakhudza akulu, ngakhale izi sizimachitika kawirikawiri (3 mpaka 5 milandu yatsopano pa miliyoni miliyoni pachaka). Ku United States, milandu zana yokha yodziwika bwino yomwe yadziwika.

Gigantism imadziwika kwambiri mwa anyamata, koma mitundu ina yoyambirira kwambiri ndi akazi

Zowopsa

Gigantism imadziwonetsera ngati yokhayokha komanso yopanda tanthauzo m'thupi, ndiye kuti imachitika kunja kwa cholowa chilichonse. Koma pali zochitika zina zapabanja za pituitary adenomas, gigantism amathanso kukhala chimodzi mwazigawo za cholowa cha multitumor syndromes, monga McCune-Albrigh syndrome, mtundu wa 1 multiple endocrine neoplasia (NEM1) kapena neurofibromatosis. .

Zovuta zingapo za majini ndi genomic zokhudzana ndi pituitary gigantism, cholowa kapena ayi, zadziwika m'zaka zaposachedwa. Kafukufuku wamkulu wobwezeretsanso wapadziko lonse wolumikizidwa ndi a Belgian endocrinologist Albert Beckers, wokhudza milandu 208 ya gigantism, motero adawonetsa kukhudzidwa kwa majini mu 46% ya milandu. 

Kuphatikiza pa kukula kwawo kwakukulu, ana ndi achinyamata omwe ali ndi gigantism amatha kuwonetsa mawonekedwe ena okhudzana ndi kudwala kwawo:

• kunenepa kwambiri (pafupipafupi),
• Kukula mokokomeza kwa chigaza (macrocephaly), cholumikizidwa kapena ayi ndi mawonekedwe ena a nkhope (prognathism, mabampu akutsogolo, ndi zina zambiri)
• zosokoneza zowoneka monga kusintha kwa masomphenya kapena masomphenya awiri,
• manja ndi mapazi akulu modabwitsa, ndi zala zochepa,
• zotumphukira za m'mitsempha,
• matenda amtima,
• zotupa zabwino,
• Matenda a mahomoni ...

Kuwongolera ana omwe ali ndi gigantism kumayang'anira kuwongolera kwawo kuchuluka kwa mahomoni okula, omwe amafunikira kukhazikitsa njira zingapo zamankhwala.

Chithandizo cha opaleshoni

Kuchotsa opaleshoni ya pituitary adenoma kumakonda ngati mankhwala oyamba. Uku ndi ntchito yovuta, yomwe imatha kuchitidwa m'mphuno ngakhale kuli kofunika kutsegula crani pamene adenoma ndi yayikulu (macroadenoma).

Ngati chotupacho ndi chachikulu kwambiri kapena chili pafupi kwambiri ndi zinthu zofunika muubongo, sichingathe kuchitidwa opareshoni.

Radiotherapy

Magetsi a X-ray atha kulimbikitsidwa kuphatikiza pakuchita opaleshoni kuti awononge chotupa chilichonse chotsalira ndikuchiza zotupa zowonjezeranso (pafupifupi magawo makumi atatu). Njirayi siyopweteka koma imatha kuyambitsa kusamvana kwama mahomoni komwe kumayambitsa zovuta zosiyanasiyana.

Posachedwa, njira ya Gamma Knife radiosurgery yakhazikitsidwa. M'malo mwa scalpel, imagwiritsa ntchito radiation ya gamma, yamphamvu kwambiri komanso yolondola kwambiri kuposa ma x-ray, kuti iwononge chotupacho nthawi imodzi. Amasungidwira zotupa zazing'ono.

Mamolekyu othandiza kuchepetsa kukula kwa kutulutsa kwa mahomoni atha kulembedwa molumikizana ndi opaleshoni ndi mankhwala a radiation, makamaka ngati kuchotsa chotupa sikukwanira. Chithandizo chamankhwala chimaphatikizapo zofanana za somatostatin ndi dopamine, zomwe ndizothandiza kwambiri koma zimatha kukhala ndi zovuta zina.