Hypogonadotropic hypogonadism: mgbaàmà, ọgwụgwọ

Dị ka a na-achị, hypogonadotropic hypogonadism jikọtara underdevelopment mmekọahụ akụkụ na sekọndrị mmekọahụ mara. Abụba na protein mgbanwe na daa ọrịa nwekwara merụrụ emerụ, nke na-akpata oké ibu, cachexia, ọrịa nke skeletal usoro na a malfunction nke obi.

Site n'ụzọ ndị dibịa na-emeso?

Ọ ga-kwuru na dị iche iche nwoke na nwaanyị hypogonadotropic hypogonadism.

Nchoputa na ọgwụgwọ nke ọrịa a rụrụ jikotara aka wee endocrinologists, obstetricians na gynecologists, endokrinolongami ma ọ bụrụ na onye ọrịa bụ nwanyị, na andrology, ma ọ bụrụ na onye ọrịa bụ - nwoke.

Ndabere nke ọgwụgwọ nke hormone ọgwụ. Ọ bụrụ na chọrọ gosiri ịwa ahụ, plastic ịwa ahụ.

Dị ka ọrịa a na nkewa?

Hypogonadism nwere ike isi na nke abụọ. The isi ụdị testicular anụ ahụ mebiri kwadoro arụmọrụ ruru ka a nkwarụ na testes. na chromosomal larịị abnormalities nwere ike kpasuo hypoplasia ma ọ bụ aplasia testicular anụ ahụ, nke na-egosipụta na-anọghị ma ọ bụ ezughi oke secretion nke androgens maka ha mmepụta nke zuru guzobe nke Genital akụkụ na abụọ mmekọahụ mara.

Hypogonadotropic hypogonadism na ụmụ nwoke na-kwupụtara psychic infantilism.

The abụọ na ụdị na-kpatara a mebiri nke pituitary gland Ọdịdị, mbenata ya gonadotrophic ọrụ ma ọ bụ imeri hypothalamic emmepe na-enwe mmetụta na pituitary gland na-achịkwakwa ya ọrụ. The ọrịa na-apụta ìhè ọrịa uche.

Ma isi na abụọ ụdị nwere ike congenital ma ọ bụ enwetara. The daa ọrịa nwere ike na-eme ka nwoke infertility na 40-60% nke ikpe.

Na-akpata ọrịa na ndị ikom na

Low ichekwa androgens nwere ike mere site na a ọnụ ke ego nke homonụ mepụtara a enweghị nchịkwa ọnọdụ ma ọ bụ testes onwe ha, mebiri hypothalamus na pituitary ọrụ.

Site etiology isi ediyarade nke ọrịa nwere ike-atụle:

• congenital underdevelopment mmekọahụ glands, nke na-adị mgbe mkpụrụ ndụ ihe nketa ntụpọ nke agwa,
• aplasia nke testicles.

Predisposing ihe ndị nwere ike na-agụnye:

• mebiri testicular ụmụ;
• n'ebe nsi;
• ọgwụ;
• Mgbaze mmetụta na ihe organic ndabere, nitrofurans, pesticides, na mmanya, tetracycline, dabeere na hormone ọgwụ ọjọọ na elu doses, etc.;
• na-efe efe ọdịdị nke ọrịa (mumps, Measles, orchitis, vesicles);
• ọnụnọ nke radieshon ọrịa niile;
• enwetara daa ọrịa nke testes;
• agbagọkwa nke spermatic udo;
• volvulus nke testes;
• atrophic usoro mgbe ịwa ahụ;
• excision nke hainia;
• ịwa ahụ na scrotum.

Na isi hypogonadism iju ke larịị nke androgens n'ime ọbara na-hụrụ. Amalite a compensatory nzaghachi nke adrenal glands, enwekwu mmepụta nke gonadotropins.

Na-etolite abụọ ụzọ hypothalamus na pituitary ọrịa (mkpali Filiks, etuto ahụ, nsogbu nke vaskụla daa ọrịa nwa ebu n'afọ na mmepe).

Akwalite mmepe nke abụọ hypogonadism nwere ike:

• pituitary adenoma, na-amụba ibu hormone;
• adrenocorticotropic hormone (Cushing ọrịa);
• prolactinoma;
• dysfunction nke pituitary gland ma ọ bụ hypothalamus mgbe ịwa ahụ;
• ịka nká, nke na-akpata a ọnụ nke testosterone ke iyịp.

Sekọndrị ụdị akara Mbelata gonadotrophins, dapụtara na a ọnụ androgen mmepụta site testes.

Otu ụdị nke ọrịa, na-emetụta ndị ikom, bụ iji belata mmepụta nke spam na nkịtị testosterone index. Adịkarịghị e a ọnụ ke testosterone etoju na nkịtị larịị nke semen.

Symptomatology nke ọrịa na ndị ikom na

Hypogonadotropic hypogonadism na ndị ikom na nwere ya na-adakarị n'obiọma. Ha na-mere site ọrịa afọ na larịị nke androgen insufficiency.

Ọ bụrụ na ndị testicles na-gburu site na nwa na-enweghị tupu mmalite oge uto, mgbe ahụ, ọ kpụrụ a typical syndrome. Ọkpụkpụ otú a ghọọ disproportionately nnukwu. Nke a bụ n'ihi na a na-egbu oge na osifikeshịọn nke ibu mpaghara. Jirinụ na obi na-anaghị agasi na mmepe, aka na ụkwụ na-ogologo, skeletal muscle na-agụghị oké mepụtara.

Ibu pụrụ hụrụ na ndị inyom na ụdị, gynecomastia, gipogenitalizme nke na egosi na a obere size amụ, dịghị wrinkles na scrotum, testicular hypoplasia, na underdevelopment nke prostate, enweghị ntutu na pubic ebe, underdevelopment nke nkọlọ, akwa ụda olu.

Na a sekọndrị pụta ìhè nke ọrịa ugboro ugboro hụrụ elu arọ ahụ, elu adrenal cortex ọrụ, mkpọchị thyroid ọrụ.

Ọ bụrụ na testicular ọrụ na-ebelata mgbe mmalite oge uto, ihe mgbaàmà nke ọrịa ndị dị ka hypogonadotropic hypogonadism, ike deere azu.

Echeta ndị na-esonụ phenomena:

• Mbelata testes;
• obere ajị ahụ ihu na ahu;
• ọnwụ nke anụ ekwedo na thinning;
• ebelata mmekọahụ ọrụ;
• autonomic ọrịa.

The ọnụ ke testicular size na-mgbe jikọtara belatara spam mmepụta. Nke a na-akpata infertility, e nwere a nlaghachi azụ nke abụọ mmekọahụ e ji mara, akara muscle adịghị ike, ike ọgwụgwụ.

Diagnosis nke hypogonadism na ndị ikom na

Diagnosis a mere anthropometry, nnyocha ma palpation nke kenwe, ntule nke na-adakarị mgbaàmà ogo-eto eto.

X-ray nnyocha ga-enyere inwale ọkpụkpụ afọ. Iji chọpụta saturation nke ọkpụkpụ ịnweta densitometry na-eji. Mgbe x-ụzarị nke sella turcica kpebisiri ike site ya size na ọnụnọ nke etuto ahụ.

Ọnu nke ọkpụkpụ afọ na-enye ohere maka oge osifikeshịọn nke nkwonkwo aka na nkwojiaka-ekpebi mgbe mmalite nke-eto eto. Ọ ga-gaa na akaụntụ ekwe omume nke mbụ (maka ọrịa mụrụ na ndịda) na mgbe e mesịrị (maka ọrịa mụrụ na ugwu) osifikeshịọn, nakwa dị ka eziokwu na osteogenesis aghara nwere ike mere site na ihe ndị ọzọ.

Research na semen laabu enye ohere ka anyị na-ekwu okwu banyere ọnọdụ ndị dị otú ahụ dị ka nitrogen ma ọ bụ oligospermia.

Gosiri site na ọdịnaya nke ndị dị otú ahụ homonụ:

• mmekọahụ gonadotropins;
• ngụkọta na free testosterone ;
• luteinizing hormone;
• GnRH;
• antimyullerovsky hormone;
• prolactin;
• estradiol.

Mgbe isi ụdị ọrịa index nke gonadotropins ọbara ụba na abụọ - downgraded. Mgbe ụfọdụ, ha larịị bụ na redistribution iwu.

Mkpebi siri ike nke ọbara estradiol mkpa mgbe symptomatic feminization na sekọndrị pụta ìhè nke ọrịa na ikpe nke etuto ahụ na testes amị estrogen, ma ọ bụ etuto ahụ na adrenal glands.

Index ọdịnaya nke ketosteroids na mmamịrị nwere ike nkịtị ma ọ bụ belata. Ọ bụrụ na ị na-enyo ọnụnọ nke Klinefelter syndrome chromosome analysis gosiri ekenyenede.

Testicular biopsy gaghị enwe ike nye ihe ọmụma maka ezi nchoputa.

ọgwụgwọ

Ọgwụgwọ nke hypogonadotropic hypogonadism a bụ ịkwụsị isi kpatara nke daa ọrịa. Ihe mgbaru ọsọ nke usoro ọgwụgwọ idu ke mgbochi omume ndị na-eme ka normalisation mmekọahụ mmepe, ụdi Mbelata testicular anụ ahụ na testicular kpochapụ infertility. Agwọ Ẹnịm n'okpuru nlekọta nke urologist na endocrinologist.

Olee tutu amama hypogonadotropic hypogonadism na ndị ikom? Ọgwụgwọ na-adabere ọtụtụ ihe:

• adakarị ụdị ọrịa;
• ogo malfunction nke hypothalamus, na pituitary gland na omumu usoro;
• nnweta ibikọ pathologies;
• oge nke omume nke ọrịa;
• onye ọrịa ahụ afọ.

Ọgwụgwọ nke okenye ikpe bụ iji dozie etoju nke androgens na iwepụ mmekọahụ dysfunction. Infertility, nke bilie n'ụdị congenital hypogonadism, ọgwụgwọ nwere ike ịbụ.

N'ihe banyere ihe bụ isi forms of congenital abnormalities ma ọ bụ enwetara ọrịa na nchekwa endocrine mkpụrụ ndụ na testes eji akpali akpali. Boys na-emeso ndị na-abụghị mmiri ọgwụ mmadụ, na okenye ọrịa - ọgwụ ọjọọ eme ihe dabere na hormone (androgen na gonadotropins na obere doses).

Ọ bụrụ na ọ dịghị ndabere ọrụ testicular gosiri androgen nnọchi ọgwụ na testosterone. Inweta homonụ na-rụrụ ná ndụ.

Mgbe nke abụọ ụdị nke ọrịa na ụmụaka na ndị okenye mkpa iji hormone gonadotropin. Ọ bụrụ na ọ dị mkpa, ha na-achọkwa na-mmekọahụ homonụ.

Ọzọkwa gosiri bụ ume ọhụrụ ọgwụgwọ, na-emega ahụ.

Operation na ọrịa bụ iji bufee na ovary na cryptorchidism, ji plastic ịwa ahụ na underdeveloped amụ. Na ịchọ mma nzube eme ka egg nkunye sịntetik dabeere (na-anọghị nke undescended testis na abdominal uji eze).

Surgery na-eji mgbe eji microsurgical usoro, tinyere akara nke dịghịzi usoro, hormone etoju, nakwa dị ka akwụnyere ngwa.

N'oge Ịhazi ọgwụ mbelata androgen insufficiency, malitegharịa mmepe nke abụọ mmekọahụ e ji mara, ikpe belata potency, belata ngosipụta nke osteoporosis na ọkpụkpụ afọ lag.

Olee otú ọrịa na ndị inyom

Hypogonadotropic hypogonadism inyom e ji underdevelopment nke mmekọahụ ọrụ na ụba ovarian glands. Primary congenital ụdị ruru underdevelopment ma ọ bụ ovarian mmebi na neonatal oge.

Ọ na-ẹsụhọde mmepụta nke mmekọahụ homonụ, nke na-akpalite na-abawanye na larịị nke gonadotropins, nke na-akpali ndị ovaries.

Na analysis nke elu nke homonụ na-akpali follicles na lutein, nakwa dị ka ala etoju nke estrogen. Belata ọnụego nke estrogen akpata atrophy ma ọ bụ underdeveloped nwanyi omumu akụkụ, mammary glands, enweghị nsọ ya.

Ọ bụrụ na ovarian ọrụ e isi tupu mmalite oge uto, mgbe e nwere ụkọ nke abụọ mmekọahụ mara.

Hypogonadotropic hypogonadism na ndị inyom na isi dị ka e gosiri ndị na-esonụ ọnọdụ:

• Congenital ọrịa na mkpụrụ ndụ ihe nketa larịị;
• congenital hypoplasia nke ovaries;
• na-efe efe Filiks (Syphilis, ụkwara nta, Mumps, irradiation, ịwa ahụ mwepụ nke ovaries);
• e meriri autoimmune okike;
• syndrome, testicular feminization ;
• polycystic ovaries.

Secondary hypogonadotropic hypogonadism inyom pụtara na daa ọrịa nke pituitary na hypothalamus. Ọ na-akwanyere ya ùgwù site a ala ọdịnaya ma ọ bụ zuru ezu cessation nke mmepụta nke gonadotropins mezie ovarian ọrụ. Usoro a na-triggered site mbufụt nke ụbụrụ mpaghara. Ọrịa ndị a nwere a jọgburu mmetụta na-ebu a ọnụ ke larịị nke ikpughe gonadotropins na ovaries.

Olee otú ọrịa ndị dị ka hypogonadotropic hypogonadism na ndị inyom, na ime? Oghom intrauterine mmepe nke nwa ebu n'afọ nwekwara ike na-emetụta omume nke ọrịa.

Mgbaàmà ndị inyom

Bright mgbaàmà nke nwa-amị oge - bụ imebi ịhụ nsọ, ma ọ bụ enweghị ya.

The ala ozo nke nwanyi homonụ na-eduga ná underdevelopment mmekọahụ akụkụ, mammary glands, mebiri nke deposition nke abụba na dabere ajị ahụ.

Ọ bụrụ na ọrịa ahụ bụ congenital na ọdịdị, sekọndrị mmekọahụ ji mara adịghị egosi. Ndị inyom ahụ kwuru ọnụnọ nke a warara pelvis na ewepụghị ike.

Ọ bụrụ na ọrịa ahụ mere tupu mmalite oge uto, mmekọahụ ji mara na pụtara aka-azọpụta, ma kwa ọnwa kwụsị Genital anụ ahụ atrophy.

-arụ ọrụ bụ

Hypogonadism mgbe e nwere ọnụ ke estrogen etoju na-abawanye na-etoju nke gonadotropins. Site ultrasound ayarade ebelata ke size akpanwa chọpụtara ostepoporoz na-egbu oge guzobe nke ọkpụkpụ.

ọrịa ọgwụgwọ na ndị inyom

Olee tutu amama hypogonadotropic hypogonadism nwanyi? Ọgwụgwọ-agụnye nnọchi ọgwụ. Women kenyere na-enweta ọgwụ na mmekọahụ homonụ (ethinyl estradiol).

N'ihe banyere mmalite nke oge ịhụ nsọ nwaanyị nye iwu okwuonu ọzọ gbochie afọ nwere estrogens na progestins, na preparations "Triziston", "Trikvilar".

Pụtara "Klimov", "Trisekvens", "klimonorma" kenyere ọrịa mgbe afọ 40.

Mmiri ọgwụ ọgwụgwọ a na contraindicated na-esonụ na ọnọdụ:

• akpụ cancer kpatara na ara na kenwe;
• obi na vaskụla ọrịa;
• gbasara akụrụ odida na imeju na;
• thrombophlebitis.

mgbochi

Ọrịa ndị dị ka hypogonadotropic hypogonadism, nwere a mma prognosis. Mgbochi bụ ike mmụta nke ndị bi na nlekota nke ime ndị inyom, nakwa dị ka na ahụ ike na-eme.