Chirwere cheshuga insipidus chinoratidzwa nekunyanya kugadzirwa weti ine chekuita nenyota yakanyanya. Zvinokwanisika kusiyanisa marudzi akawanda, anonyanya kuzivikanwa ayo aneurogenic diabetes insipidus uye nephrogenic diabetes insipidus. Idzi hadzina hunhu hwakafanana asi ese ari maviri anoratidza dambudziko rekutonga muitsvo. Muviri hauchengete mvura yakakwana kuti uvhare zvaunoda.

Tsanangudzo yechirwere cheshuga insipidus

Chirwere cheshuga insipidus mhedzisiro yekushomeka kana kusanzwa kune antidiuretic hormone: vasopressin. Sechikamu chekushanda zvakanaka kwemuviri, hormone iyi inogadzirwa muhypothalamus yozochengetwa mupituitary gland. Mushure mematanho maviri aya muuropi, vasopressin inoburitswa mumuviri kugadzirisa huwandu hwemvura mumuviri. Ichaita paitsvo kuti idzoke zvakare mvura yakasvibiswa, uye nokudaro kudzivirira kubviswa kwayo muweti. Nenzira iyi, inobatsira kuvhara zvinodiwa nemvura yemuviri.

Muchirwere cheshuga insipidus, vasopressin haigoni kutamba basa rayo se antidiuretic agent. Mvura inobudiswa yakawandisa, izvo zvinoguma nekugadzirwa kweweti yakawandisa inobatanidza nenyota yakasimba.

Mhando dzechirwere cheshuga insipidus

Nzira dzinobatanidzwa muchirwere cheshuga insipidus haisi nguva dzose dzakafanana. Ndicho chikonzero nei zvichikwanisika kusiyanisa akawanda mafomu:

• neurogenic, kana central diabetes insipidus, iyo inokonzerwa nekusakwana kusunungurwa kwe antidiuretic hormone kubva ku hypothalamus;
• nephrogenic, kana peripheral, chirwere cheshuga insipidus, chinokonzerwa netsvo kusanzwa kune antidiuretic hormone;
• gestational chirwere cheshuga insipidus, chimiro chisingawanzoitiki chinoitika panguva yekuzvitakura iyo inowanzova chikonzero chekuparara kwevasopressin muropa;
• dipsogenic diabetes insipidus iyo inoratidzirwa nekusagadzikana kwenyota nzira mu hypothalamus.

Zvikonzero zvechirwere cheshuga insipidus

Panguva ino, zvinofanirwa kucherechedzwa kuti chirwere cheshuga insipidus chinogona kunge chiri chekuzvarwa (chiripo kubva pakuzvarwa), chakawanikwa (chinotevera kunze parameters) kana idiopathic (nechikonzero chisingazivikanwe).

Zvimwe zvezvikonzero zvakazivikanwa kusvika nhasi zvinosanganisira:

• kukuvadzwa kwemusoro kana kukuvara kwehuropi;
• kuvhiyiwa kweuropi;
• kukuvara kwevascular senge aneurysms (kuwedzeredzwa kwenzvimbo yemadziro e arteri) uye thrombosis (kuumbwa kwekuvhara ropa);
• mamwe marudzi egomarara kusanganisira mamota muuropi;
• autoimmune hosha;
• zvirwere zvehutano hwemagetsi zvakadai se encephalitis uye meningitis;
• tibhii;
• sarcoidosis;
• polycystic itsvo chirwere (kuvapo kwe cysts muitsvo);
• sickle cell anemia;
• chipanje medullary itsvo (congenital itsvo chirwere);
• pyelonephritis yakaoma;
• l'amylose;
• chirwere cheSjögren;
• etc.

Kuongororwa kwechirwere cheshuga insipidus

Diabetes insipidus inofungidzirwa pakubuda kweweti yakawanda yakabatana nenyota yakanyanyisa. Zvino kusimbiswa kwechirwere ichi kunogona kubva pane:

• bvunzo yekudzivirira mvura inoyera kubuda kweweti, kugadzika kwe electrolyte yeropa uye uremu nguva nenguva;
• weti miedzo yekutarisa weti yehuga (hunhu hwechirwere cheshuga mellitus);
• kuongororwa ropa kuona yakanyanya sodium concentration kunyanya.

Zvichienderana nenyaya, mamwe maedzo ekuwedzera anogona kuzotariswa kuti aone chikonzero chechirwere cheshuga insipidus.

Zviitiko zvakawanda zvechirwere cheshuga insipidus zvakagarwa nhaka. Nhoroondo yemhuri yechirwere cheshuga insipidus chinhu chikuru chengozi.

• Polyuria: Chimwe chezviratidzo zvechirwere cheshuga insipidus is polyuria. Uku ndiko kugadzirwa kweweti yakawandisa inodarika marita matatu pazuva uye inogona kusvika kusvika pamakumi matatu emarita mumatambudziko akaomarara.
• Polydispsia: Chiratidzo chechipiri chechiratidzo ndeye polydipsia. Ndiwo maonero enyota yakanyanya pakati pe3 ne30 litres pazuva.
• Possible nocturia: Zvinowanzoitika kuti polyuria uye polydipsia iendeswe ne nocturia, inoda kuita weti usiku.
• Dehydration: Mukushaikwa kwekutonga kwakakodzera, chirwere cheshuga insipidus chinogona kukonzera kupera simba uye kusashanda zvakanaka kwemuviri. Hypotension uye kuvhunduka kunogona kuonekwa.

Kutarisira kunoenderana nezvakawanda zvimiro zvinosanganisira rudzi rwechirwere cheshuga insipidus. Inogona kunyanya kusanganisira:

• hydration yakakwana;
• kuderedza kushandiswa kwekudya kwemunyu uye mapuroteni;
• kutungamirirwa kwevasopressin kana mafomu akafanana akadai se desmopressin;
• kutonga kwemamorekuru anokurudzira kugadzirwa kwevasopressin senge thiazide diuretics, chlorpropamide, carbamazepine, kana kunyange clofibrate;
• kurapwa kwakananga kwakanangana nechikonzero chakaonekwa.

Kusvika iye zvino, hapana mushonga wekudzivirira wakagadzirwa. Muzviitiko zvakawanda, chirwere cheshuga insipidus chinowanikwa nhaka.