Njira Yothandiza kwa Amuna ndi Akazi omwe ali ndi HIV
Kulephera kwa Testosterone kumapezeka kawirikawiri mwa amuna ndi akazi omwe ali ndi HIV . Zovuta za endocrine, zomwe zingakhudze testosterone kupanga, zakhala zikudziwika kuti ndizovuta kwa HIV kuyambira masiku oyambirira a mliriwu (ngakhale kuti nthawi zambiri amagwirizana ndi matenda ochedwa).
Komabe, kafukufuku waposachedwapa wasonyeza kuti pafupifupi mmodzi mwa amuna asanu alionse omwe ali ndi kachilombo ka HIV adakayikira vuto la testosterone, mosasamala za kuchuluka kwa CD4, chiwerengero cha mavairasi , kapena chikhalidwe cha mankhwala.
Mofananamo, kuperewera kwa testosterone kumawoneka mwa amayi anayi omwe ali ndi kachilombo ka HIV, kawirikawiri pamakhala zovuta kwambiri, kutayika kwa HIV .
Udindo wa Testosterone
Testosterone ndi hormone ya steroid yomwe imayambira pa chitukuko cha ma testes (mapepala) ndi prostate mwa amuna komanso kupititsa patsogolo khalidwe lachiwerewere lachiwerewere (mwachitsanzo, kupweteka kwa minofu, fupa la fupa, kukula kwa tsitsi). Testosterone ndi yofunikanso kwa amai kusunga minofu ndi minofu yachibadwa, ngakhale kuti pamadera osachepera 10% kuposa amuna.
Amuna ndi akazi, testosterone ndi ofunikira kuti munthu akhale ndi thanzi labwino komanso wathanzi, zomwe zimapangitsa mphamvu ya munthu, mphamvu zake, ndi libido.
Mosiyana ndi zimenezi, testosterone imawonongedwa ndi:
- Kutaya kwa minofu yowonda
- Anemia
- Osteoporosis
- Insulin kukana
- Kuchulukitsa lipids (mafuta ndi / kapena kolesterolo) m'magazi
- Kuwonjezeka kwa mafuta ochepa mkati mwa mimba
Kulephera kwa Testosterone
Kulephera kwa Testosterone kwa amuna omwe ali ndi kachilombo ka HIV kumagwirizanitsidwa ndi zosavomerezeka zotchedwa endocrine zotchedwa amuna hypogonadism zomwe ntchito ya amuna gonads (testes) imakhala yovuta, zomwe zimapangitsa kuti mahomoni ogonana asachepe kwambiri kuposa momwe angaganizire pa msinkhu wa munthu.
Kwa anthu ambiri, hypogonadism imadziwika kuti imapezeka pakati pa amuna 25 pakati pa zaka zapakati pa 30 ndi 50, ikuwonjezeka kufika pa 14 pa zaka za pakati pa 50 ndi 79. Mosiyana ndi zimenezi, chiwerengero cha amuna omwe ali ndi kachilombo ka HIV ndi maulendo asanu.
Hypogonadism ikhoza kuyambitsidwa ndi vuto mu mayesero okha (choyambirira) kapena kutayika kumene kumachitika kunja kwa mayesero (apamwamba). Amuna akuluakulu omwe ali ndi HIV:
- Primary hypogonadism amawerengera 25% mwa milandu. Zingawonongeke ku ma testes chifukwa cha matenda (kuphatikizapo matenda ena opatsirana ), khansara ya testicular , kapena matenda opweteka kwa ma testes (ngakhale kuwonongeka kwa nyamakazi imodzi sikutanthauza kugwirizana ndi kuchepetsa kupanga testosterone).
- Thupi la hypogonadism limaphatikizapo 75 peresenti, ndipo nthawi zambiri limagwirizana ndi chisokonezo cha neuroendocrine chomwe chiyanjano pakati pa mitsempha ya mitsempha ndi dongosolo la endocrine ndi lovuta kwambiri. Ngakhale kuti palibe kachilombo ka HIV kamene kamayambitsa matendawa, HIV siyimayambitsa vutoli. M'malo mwake, hypogonadism imawonedwa pamaso pa matenda ambiri osatha, ndi kutupa kosalekeza ndi kuperewera kosawerengeka kumawonedwa kukhala zinthu zothandizira.
Hypogonadism ingathenso kuyambitsidwa ndi ubwana wachinyamata kapena kugwiritsa ntchito nkhanza za anabolic steroids. Mankhwala a HIV sanasonyezedwe kuti amapereka chithandizo ku hypogonadism.
Zizindikiro za Male Hypogonadism
Hypogonadism mwa amuna akuluakulu amadziwika ndi maselo a testosterone otsika (serum), komanso chimodzi kapena zingapo zotsatirazi:
- Kusokonezeka kwa minofu
- Kutaya mphamvu ndi mphamvu
- Kusokonezeka maganizo, kukhumudwa, kuvutika kwambiri
- Kukulitsa kwa minofu ya m'mawere (gynecomastia)
- Kuchetsa tsitsi ndi nkhope
- Kuwonjezeka m'matumbo a m'mimba
- Kutaya mafupa (osteoporosis)
- Testicular shrinkage
- Kulephera kugonana (mwachitsanzo, kupweteka kwa erectile, kuchepetsedwa kwa ejaculate, low libido, kuvutika kupeza mapulaneti)
Kuyesedwa ndi Kuzindikira
Kuzindikira kumapangidwa poyeza kuchuluka kwa testosterone m'magazi, omwe ali ndi subtypes atatu osiyana. Pamene mayesero amachitidwa, zotsatira zidzasonyeza onse testosterone ya munthu (onse ochepa) ndi chimodzi mwa zitatu zomwe zimatchedwa testosterone yaulere .
Testosterone yaulere ndi mtundu wa testosterone umene mulibe mapuloteni, umalowetsa maselo ndikugwiritsira ntchito mapulogalamu ena omwe sangathe. Zimayesedwa kuti ndizoyeso zenizeni za testosterone, ngakhale kuti zikuimira 2-3 peresenti ya anthu onse. Payekha, testosterone yonse imadziwika kuti ndi yolondola kwambiri chifukwa zotsatira zingawoneke ngati zachilendo zina zopanda malire zikukwera.
Kuyezetsa kuyenera kuchitidwa m'mawa chifukwa chiwerengero chikhoza kusinthasintha ndi 20% patsiku. Zomwe "Zachizoloŵezi" zimangokhala zomwe zili muzokambirana za labu. Mipukutuyi ikhonza kusiyana, koma, pofuna kulingalira, ili pakati
- 250-800 ng / dL kwa testosterone wathunthu, ndi
- 50-200 pg / mL kwa testosterone yaulere.
Komabe, kafukufuku wa "wamba" sangathe kupangidwa ndi manambala okha. Maseŵera a testosterone amatha kugwa pafupi ndi 1-2% chaka chilichonse atakwanitsa zaka 40. Choncho, zomwe zingakhale zachilendo kwa mwana wazaka 60 sizidzakhala zofanana kwa mwana wazaka 30. Kuyezetsa kumafunika kupangidwa payekha ndi dokotala wanu wothandizira.
Kupatsidwa Chithandizo
Ngati matenda a hypogonadism atsimikiziridwa, testosterone mankhwala othandizira mankhwalawa angasonyezedwe. Zilonda za testosterone zamtunduwu zimalimbikitsidwa, zomwe zimapereka zotsatira zochepa ngati mankhwala akugwiritsidwa ntchito ndi kusintha kwa dokotala. Njira zotsogoleredwa ndi FDA ndi Depo-testosterone (testosterone cypionate) ndi Delatestryl (testosterone enanthate).
Pafupifupi, jekeseni amaperekedwa milungu iwiri kapena inayi iliyonse. Kupewa zotsatira za kusinthasintha magulu a testosterone-zomwe zingachititse nthawi zina kusinthasintha kwamaganizo, mphamvu, ndi ntchito yogonana-kuchepa kwa mlingo ndi kuchepa kwafupipafupi nthawi zambiri zimagwiritsidwa ntchito.
Zotsatira za mankhwala zingaphatikizepo:
- Zikodzo ndi / kapena khungu lamoto
- Kutaya tsitsi kapena kupukuta tsitsi
- Kutupa kwa mapazi, zibowo kapena thupi
- Kugonana ndi mpweya
- Kukula kwa minofu ya m'mawere (gynecomastia)
- Magazi amatha
- Kuwonjezera kwa prostate
Thandizo la Testosterone m'malo mwake lingayambitsenso kupititsa patsogolo kansa ya prostate yomwe inalipo kale. Chifukwa cha ichi, ma prostate-specific antigen (PSA) odwala adzayesedwa ndi kuyang'aniridwa pa nthawi ya mankhwala.
Zonsezi, jekeseni wamatenda amapereka njira yodalirika yokhala ndi hypogonadism, ndi kuwonjezereka kwa ophatikizana mu kukhala tcheru, ubwino, libido, minofu yotsitsimutsa, ndi luso lokonza. Zowonongeka zikuphatikiza maulendo odwala nthawi zonse ndi maulendo otsogolera.
Mankhwala ovomerezeka, odzola, ndi othandizira opanga mavitamini aliponso, ndipo angagwiritsidwe ntchito nthawi zina. Kambiranani izi ndi dokotala wanu.
Hypogonadism pa Akazi Okhala ndi HIV
Kwa akazi, testosterone imapangidwa m'mimba mwa mazira ndi adrenal glands. Mofanana ndi amuna, ndi hormone yofunika kwambiri yokhala ndi minofu ndi mafupa, komanso mphamvu, mphamvu, ndi libido.
Ngakhale hypogonadism ndi yochepa kwambiri kwa amayi omwe ali ndi kachilombo ka HIV, ikhoza kuchitika ndipo kawirikawiri imakhala yokhudzana ndi kachilombo ka HIV ndi matenda opatsirana. Kukhazikitsidwa kwa ART kungasinthe kusokoneza komanso nthawi ya hypogonadal.
Panopa palibe njira zothetsera mankhwala a hypogonadism achikazi, ndipo zosankha za mankhwala ndizochepa. Mankhwala opatsirana am'madzi (HRT) angakhale oyenera kwa ena, pamene ntchito yaifupi ya testosterone ingayambe kuyendetsa galimoto, minofu yowonda, ndi magetsi.
Komabe, chidziwitso sichinakwaniritsidwe pa ntchito ya testosterone kuti apeze hypogonadism m'mayi omwe ali ndi amayi omwe ali ndi HIV. Lankhulani ndi wothandizira zaumoyo wanu za zotsatira zoyenera. Testosterone sivomerezeka kwa amayi omwe ali ndi mimba kapena akufuna kukhala ndi pakati.
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