Cushing's syndrome yog kab mob endocrine cuam tshuam nrog lub cev kis mus rau qib siab ntawm cortisol, ib yam tshuaj zais los ntawm cov qog adrenal. Nws cov yam ntxwv zoo tshaj plaws yog kev rog ntawm lub cev thiab lub ntsej muag ntawm tus neeg mob. Feem ntau ntawm cov xwm txheej, Cushing's syndrome tshwm sim los ntawm kev noj tshuaj tiv thaiv kab mob. Tab sis nws kuj tseem tuaj yeem ua rau muaj keeb kwm keeb kwm yav dhau los, xws li Cushing tus kab mob, uas yog qhov tsawg heev, los ntawm ib txog kaum peb tus neeg mob tshiab rau lab tus tib neeg thiab hauv ib xyoos, raws li cov peev txheej. (1)

Cov qib cortisol siab ntau ntau ua rau muaj tus cim thiab tsos mob. Qhov tseem ceeb tshaj plaws yog qhov hnyav nce thiab qhov kev hloov pauv ntawm tus neeg mob: muaj cov rog ntau nyob hauv lub cev thiab caj dab, lub ntsej muag hloov pauv, puffy thiab liab. Qhov no yog nrog los ntawm kev poob ntawm cov leeg ntawm caj npab thiab txhais ceg, rau qhov uas qhov "atrophy" tuaj yeem cuam tshuam kev txav mus los ntawm tus neeg cuam tshuam.

Lwm cov tsos mob tau pom xws li ua tawv nqaij, pom cov cim ncab (ntawm lub plab, ncej qab, pob tw, caj npab thiab ob lub mis) thiab nqaij tawv ntawm ob txhais ceg. Qhov kev puas siab puas ntsws tseem ceeb vim yog kev ua haujlwm ntawm lub paj hlwb ntawm cortisol yuav tsum tsis txhob hnov ​​qab ib yam: qaug zog, ntxhov siab, chim siab, pw tsaug zog thiab mloog tsis meej pem thiab kev nyuaj siab cuam tshuam rau lub neej zoo thiab tuaj yeem ua rau tua tus kheej.

Cov poj niam tuaj yeem txhim kho pob txuv thiab plaub hau loj hlob ntau ntxiv thiab ua rau muaj kev cuam tshuam kev coj khaub ncaws, thaum txiv neej kev ua poj niam thiab txiv neej poob qis. Osteoporosis, kis kab mob, thrombosis, ntshav siab thiab ntshav qab zib yog cov teeb meem tshwm sim.

Cushing's syndrome yog tshwm sim los ntawm ntau dhau ntawm cov ntaub so ntswg hauv lub cev rau cov tshuaj hormones steroid, suav nrog cortisol. Cushing's syndrome feem ntau tshwm sim los ntawm kev siv cov tshuaj sib xyaw corticosteroids rau lawv cov tshuaj tiv thaiv kab mob hauv kev kho mob hawb pob, mob qog noj ntshav, thiab lwm yam, qhov ncauj, ua tshuaj tsuag lossis ua tshuaj pleev. Nws yog tom qab exogenous keeb kwm.

Tab sis nws cov keeb kwm tuaj yeem ua rau endogenous: tus mob no tshwm sim los ntawm kev tso tawm ntau dhau ntawm cortisol los ntawm ib lossis ob lub qog adrenal (nyob rau saum ob lub raum). Qhov no tshwm sim thaum muaj qog, ua tau zoo lossis tsis zoo, tsim tawm hauv cov qog adrenal, hauv caj pas pituitary (nyob hauv pob txha taub hau), lossis lwm qhov hauv lub cev. Thaum Cushing's syndrome tshwm sim los ntawm cov qog nqaij hlav hauv lub caj pas pituitary (pituitary adenoma), nws hu ua Cushing's disease. Cov qog ua kom zais cov tshuaj corticotropin ntau dhau ACTH uas yuav ua rau cov qog adrenal thiab tsis ncaj qha qhov tso zis ntau dhau ntawm cortisol. Cushing tus kab mob suav txog 70% ntawm tag nrho cov mob endogenous (2)

Feem ntau ntawm Cushing's syndrome tsis tau txais. Txawm li cas los xij, qhov no tuaj yeem tshwm sim vim muaj kev hloov pauv caj ces rau kev loj hlob ntawm cov qog hauv endocrine, adrenal, thiab qog pituitary.

Cov poj niam muaj tsib npaug ntau dua li txiv neej kom tau txais Cushing's syndrome los ntawm qog adrenal lossis qog ntshav. Ntawm qhov tod tes, txiv neej raug peb zaug ntau dua li poj niam thaum qhov ua rau mob qog noj ntshav. (2)

Lub hom phiaj ntawm ib qho kev kho mob rau Cushing's syndrome yog kom rov tswj tau qhov tso zis ntau dhau ntawm cortisol. Thaum Cushing's syndrome raug tshuaj los ntawm tus kws kho mob endocrinologist kho qhov ua rau raug mob. Thaum nws yog qhov tshwm sim ntawm cov qog, kev kho mob los ntawm kev phais (kev tshem tawm ntawm adenoma nyob rau hauv lub caj pas pituitary, adrenalectomy, thiab lwm yam), siv xov tooj cua thiab tshuaj tua kab mob. Thaum nws tsis tuaj yeem tshem tawm cov qog ua kom tiav, cov tshuaj uas inhibit cortisol (anticortisolics) lossis inhibitors ntawm cov tshuaj hormone ACTH yuav raug siv. Tab sis lawv tau siv me me los siv thiab lawv cov kev phiv tuaj yeem ua rau hnyav, pib nrog qhov pheej hmoo ntawm adrenal tsis txaus.