АДДИСОН КАСАЛЛИГИ: ЭРТА АНИҚЛАШ ВА ДАВОЛАШ ЖИҲАТЛАРИ
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бирламчи адренал етишмовчилик, Aддисон касаллиги, АКТГ, кортизол, ренин, глюкокортикоидлар, минералокортикоидлар, адреналит##article.abstract##
Бирламчи буйрак усти етишмовчилиги ёки Аддисон касаллиги полиэтологик касаллик бўлиб, уларнинг энг кенг тарқалган сабаби аутоиммун адреналит ҳисобланади. Аутоиммун адреналит буйрак усти безининг зарарланиши натижасида юзага келади, бу ўз навбатида глюкокортикоидлар, минералокортикоидлар ва андрогенларнинг етишмаслигига олиб келади. Қўшма Штатлар ва Ғарбий Европада Аддисон касаллигининг тахминий тарқалиши 20 000 кишига битта ҳолат; Ҳаёт учун хавфли бўлган клиник ҳолатларда буйрак усти етишмовчилигини тўғри ташҳис қўйиш керак ва бундай белгиларга (масалан, шок, артериал гипотензия ва қон ҳажмининг пасайиши). Буйрак усти кризидан олдинги клиник кўринишлар нозик бўлиб, гиперпигментация, холсизлик, анорексия, ортостаз, кўнгил айниши, мушак ва бўғимларда оғриқ ва тузга бўлган талабни ошишини ўз ичига олиши мумкин. Кортизол даражаси пасаяди ва адренокортикотропик гормон миқдори ошиши кузатилади. Агар клиник жиҳатдан шубҳа қилинган бўлса, беморлар ташхисни тасдиқлаш учун кортикотропин стимуляцияси тестини ўтказиш керак. Бирламчи буйрак усти етишмовчилигини даволаш глюкокортикоидлар ва минералокортикоидларни қабул қилиш талаб этилади. Стресс ҳолатида (масалан, инвазив жарроҳлик амалиётида) глюкокортикоидларнинг миқдорини кўпайтириш зарур. Бирламчи буйрак усти бези етишмовчилиги ёки аутоиммун адреналитни даволашда йўндош аутоиммун касалликларни инобатга олиш талаб этилади; 50% беморларнинг ҳаёт анамнезида бошқа аутоиммун касаллик ривожланиши мумкин.
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