Tau qhov ntim thiab muaj pes tsawg leeg ntawm cov kua hauv lub cev kom txaus yog ua tau ua tsaug rau cov tshuab uas tswj cov dej kom tsawg thiab tso zis. Thaum cov txheej txheem tswj hwm no hloov pauv, polyuria (nce zis ntau lawm) thiab polydipsia (nce dej kom tsawg) tshwm sim. Polyuria thiab polydipsia yog cov tsos mob tshwm sim tuaj yeem tshwm sim hauv cov kab mob sib txawv, yog li ntawd, nws yuav tsum tau kuaj xyuas tus kab mob uas ua rau lawv txhawm rau kho lawv.
Yog koj xav paub tias yog dab tsi ua rau polyuria thiab polydipsia hauv dev thiab yuav ua li cas rau txhua kis, nyeem ntawv no tsab xov xwm ntawm peb qhov chaw.
polyuria hauv dev yog dab tsi?
Polyuria muaj qhov nce hauv diuresis tshaj li ib txwm, lossis qhov zoo ib yam, nce zis ntau lawm Polyuria hauv dev yog suav tias yog muaj nyob thaum lawv tsim ntau tshaj 50 ml ntawm cov zis ib kilogram ntawm qhov hnyav ib hnub (50 ml / kg / hnub). Hauv lwm lo lus, txhawm rau xam seb koj tus dev puas muaj polyuria, koj yuav tsum muab nws qhov hnyav hauv kg los ntawm 50. Qhov tshwm sim yuav yog qhov ntau tshaj plaws ntawm milliliters ntawm cov zis nws yuav tsum tau tsim ib hnub. Yog tias qhov ntau lawm, koj yuav muaj polyuria.
Diuresis yog tswj los ntawm antidiuretic hormone los yog ADH, uas txhawb nqa cov reabsorption ntawm dej hauv ob lub raum (tshwj xeeb los ntawm qib ntawm lub raum tubules.). Yog li ntawd, nyob rau hauv pathologies nyob rau hauv uas synthesis los yog kev ua ntawm cov tshuaj no yog hloov, polyuria tshwm sim.
polydipsia hauv dev yog dab tsi?
Polydipsia muaj ib qho nce hauv dej kom tsawg Hauv dev, polydipsia yog suav tias yog thaum dej ntau tshaj100 ml ib kg ntawm qhov hnyav hauv ib hnub (100ml / kg / hnub). Hauv lwm lo lus, txhawm rau xam seb koj tus dev muaj polydipsia, koj yuav tsum muab nws qhov hnyav hauv kg los ntawm 100. Qhov tshwm sim yuav yog qhov ntau tshaj plaws ntawm milliliters dej uas nws yuav tsum tau haus ib hnub. Yog tias noj ntau dua, nws yuav nthuav tawm polydipsia.
Nws yuav tsum nco ntsoov tias kev haus dej yog tswj hwm los ntawm Lub Chaw Thib Ob , nyob ntawm qib hypothalamic. Yog li ntawd, nyob rau hauv cov pathologies uas lub Thirst Center yog stimulated, peb yuav soj ntsuam polydipsia.
polyuria-polydipsia syndrome
Thaum ib tug neeg tso zis ntau dua thiab haus dej ntau, peb hais tias lawv muaj polyuria-polydipsia syndrome (PU/PD syndrome). Tiag tiag, ib qho kos npe ua rau lwm tus, thiab vice versa. Qhov ntawd yog, yog tias ib tus neeg tso zis ntau dua, lawv yuav tsum tau nce lawv cov dej kom tsis txhob muaj dej. Hauv lwm txoj kev, yog tias ib tus neeg haus dej ntau dua, lawv yuav tso zis ntau ntxiv kom tsis txhob muaj dej ntau dhau.
feem ntau yog tias polyuria (nce diuresis) tshwm sim feem ntau thiab qhov no yog qhov ua rau cov polydipsia thib ob (nce dej haus). Txawm li cas los xij, txawm hais tias nws tsis tshua muaj ntau, qhov kev tawm tsam kuj tuaj yeem tshwm sim nyob rau hauv uas tus thawj polydipsia ua rau ib tug thib ob polyuria.
Lub sijhawm no nws yog ib qho tseem ceeb uas yuav tsum tau taw qhia tias ob qho tib si polyuria thiab polydipsia yog cov tsos mob tshwm sim, lawv tsis yog kab mob hauv lawv tus kheej. Thaum tus dev nthuav tawm cov tsos mob no, nws yuav tsum kuaj xyuas cov kab mob uas ua rau muaj cov tsos mob zoo li no txhawm rau kho lawv.
Vim li cas thiaj li polyuria thiab polydipsia tshwm sim hauv dev?
Ua rau thawj polyuria hauv dev
Peb yuav tsum sib txawv ntawm ob hom polyuria raws li osmolarity ntawm cov zis, vim cov ua yuav txawv.
1. Watery polyuria. Cov laj thawj tuaj yeem yog:
- Txo hauv ADH synthesis thiab secretion: Raws li peb tau hais lawm, cov tshuaj no txhawb nqa dej rov qab los rau hauv lub raum. Yog hais tias nws cov synthesis thiab secretion txo, cov dej tsawg yuav reabsorbed nyob rau hauv lub raum tubules thiab cov zis ntim yuav nce.
- Lub raum tsis ua hauj lwm los teb rau ADH: Txawm hais tias ADH yog synthesized, lub raum tubules tsis rhiab rau nws, yog li nws tsis tsim nws. effect.
Osmotic polyuria:yog tshwm sim los ntawm kev txo qis reabsorption ntawm dej vim muaj osmotically active solutes nyob rau hauv lub raum tubules, uas tsis reabsorbed thiab luag dej.
Ua rau thawj polydipsia hauv dev
- Txoj kev coj cwj pwm uas ua rau tsiaj txhu haus tau yuam kev
- Pathologies uas txhawb lub Thirst Center ntawm theem ntawm Central Nervous System
Kab mob ua rau polyuria thiab polydipsia hauv dev
1. Cov dej polyuria
- Central diabetes insipidus: tshwm sim hauv cov tsiaj me vim qhov tsis paub txog qhov ua rau (idiopathic) lossis lwm qhov mob hauv Central Nervous System uas ua rau tsawg synthesis thiab/los yog secretion ntawm ADH.
- Nephrogenic diabetes insipidus: vim tsis muaj lus teb rau ADH. Nws tuaj yeem yog thawj (vim lub raum tsis zoo hauv lub raum) lossis lwm yam pathologies.
Cov kab mob uas tuaj yeem ua rau mob ntshav qab zib hom 2 nephrogenic insipidus yog:
- Pyometra: yog ib tug kab mob purulent nyob rau theem ntawm lub tsev menyuam. Cov tshuaj lom uas tsim los ntawm cov kab mob uas ua rau tus kab mob cuam tshuam rau kev ua ntawm ADH.
- Pyelonephritis: yog ib qho kab mob thiab kis kab mob ntawm lub raum pelvis uas cov ntshav ntws mus rau lub raum medulla nce, txo nws. osmolarity thiab tiv thaiv cov reabsorption ntawm dej nyob rau hauv lub raum tubules. Tsis tas li ntawd, cov kab mob co toxins tuaj yeem cuam tshuam nrog kev ua ntawm ADH.
- Hyperadrenocorticism lossis Cushing's Syndrome: ntau dhau glucocorticoids txo ADH synthesis, cuam tshuam nrog ADH kev ua thiab txo qis permeability ntawm lub raum tubules.
- Hypoadrenocorticism los yog Addison's Syndrome: Mineralocorticoid deficiency txo qis osmolarity ntawm lub raum medulla, uas tiv thaiv cov reabsorption ntawm dej thiab nce ntim ntawm tso zis.
- Pheochromocytoma: yog ib qho qog ntawm cov qog adrenal uas ntau dhau ntawm catecholamines ua rau cov hlab ntsha kub siab thiab nce rau hauv lub raum, ua rau polyuria..
- Hypercalcemia: Kev nce hauv calcium hauv cov ntshav cuam tshuam nrog kev ua ntawm ADH. Hypercalcemia tuaj yeem pom hauv neoplasms, hyperparathyroidism, kab mob raum ntev, vitamin D intoxication, thiab kab mob granulomatous.
- Hypokalaemia: qhov tsis muaj cov poov tshuaj hauv cov ntshav txo qis kev tso tawm ntawm ADH, txo cov osmolarity ntawm lub raum medulla thiab cuam tshuam nrog kev ua haujlwm. ntawm ADH. Hypokalemia tuaj yeem pom hauv cov neeg mob ntuav / raws plab, kab mob raum thiab ntshav qab zib.
ob. Osmotic polyuria
- Diabetes Mellitus: Kev muaj cov piam thaj hauv lub raum tubules tiv thaiv cov dej reabsorption, uas ua rau cov zis ntau ntxiv.
- Cov kab mob raum mob: Tus naj npawb ntawm kev ua haujlwm nephrons txo qis thiab, raws li kev them nyiaj rov qab, cov nephrons tseem muaj sia nyob nce lawv qhov pom. Yog li ntawd, osmotically active solutes accumulates nyob rau hauv lub raum tubules, tiv thaiv dej reabsorption thiab nce zis tso zis.
Peb yuav tsum nco ntsoov tias ob qho tib si aqueous thiab osmotic polyuria yuav ua rau polydipsia thib ob kom tsis txhob muaj dej.
3. Polydipsia
- Psychogenic polydipsia: qhov no yog ib qho kev coj cwj pwm tsis zoo uas tus tsiaj pib haus cawv. Nws tuaj yeem tshwm sim hauv cov xwm txheej ntxhov siab lossis hauv cov dev uas yuav tsum tau ua haujlwm ntau lub cev.
- Brain hlav, mob taub hau los yog mob cerebrovascular: cov no yog pathologies uas tuaj yeem txhawb nqa lub Thirst Center ntawm theem nrab.
- Hepatic encephalopathy: cov tshuaj uas yuav tsum tau metabolized los ntawm daim siab nyob rau hauv cov ntshav, uas txhawb lub Thirst Center.
tib yam, peb yuav tsum nco ntsoov tias thawj polydipsia yuav ua rau cov polyuria thib ob kom tsis txhob muaj dej ntau dhau.
Tshuaj rau polyuria thiab polydipsia hauv dev
Raws li peb tau hais, polyuria thiab polydipsia yog cov tsos mob tshwm sim uas muaj qee yam kab mob. Yog li, txhawm rau kho cov tsos mob no nws yuav tsum tau kho cov kab mob tshwj xeeb uas ua rau lawv:
- Central diabetes insipidus: Kho nrog desmopressin, ib qho hluavtaws analog ntawm ADH.
- Nephrogenic diabetes insipidus: kho nrog thiazide diuretics uas txo sodium reabsorption, uas ua rau plasma sodium txo, txo cov dej haus thiab, yog li ntawd., qhov ntim ntawm cov zis. Tsis tas li ntawd, nyob rau hauv cov ntaub ntawv ntawm cov ntshav qab zib theem nrab nephrogenic, nws yuav tsum tsim kom muaj kev kho mob tshwj xeeb raws li thawj kab mob. Cov kab mob xws li pyometra lossis pyelonephritis yuav raug kho nrog tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob. Cushing's Syndrome yuav raug kho nrog trilostane (yog tias nws yog pituitary) lossis los ntawm adrenalectomy (yog tias nws yog adrenal). Addison's Syndrome yuav raug kho nrog glucocorticoids (hydrocortisone lossis prednisone) thiab mineralocorticoids (fludrocortisone lossis deoxycorticosterone privalate). Pheochromocytoma yuav kho nrog toceranil phosphate lossis adrenalectomy. Cov kab mob electrolyte xws li hypercalcemia lossis hypokalemia yuav raug kho los ntawm kev kho thawj cov kab mob uas ua rau lawv.
- Diabetes Mellitus: Kev kho mob yog ua raws li kev tswj hwm insulin, kev tawm dag zog tsis tu ncua, thiab noj cov rog tsawg, muaj fiber ntau.
- : tsis muaj kev kho mob, yog li peb yuav tsum txwv peb tus kheej rau kev tswj cov tsos mob thiab kev kho mob nephroprotective. Nws yog ib txwm ua raws li kev tswj hwm ntawm ACEI vasodilators thiab lub raum noj zaub mov (tsawg hauv cov protein, sodium thiab potassium, thiab nplua nuj nyob rau hauv omega 3 fatty acids, soluble fiber thiab antioxidants).
- Psychogenic polydipsia: tsis txhob muaj kev ntxhov siab uas ua rau muaj kev haus dej ntau.
- Hepatic encephalopathy: Feem ntau tshwm sim los ntawm cov pob txha pob txha uas raug phais kaw.
