Hyperprolactinemia

I-Hyperprolactinemia ithinta umuntu oyedwa kwabangu-10, okwenza kube esinye sezifo ezivame kakhulu ze-hormone ye-pituitary gland. Amazinga aphezulu e-prolactin angaholela ezinkingeni zokuzala, ezingavamile imijikelezo yokuya esikhathini, ukwehla kwesifiso socansi, nokunye okukhathazayo ngempilo yokuzala. Izindaba ezinhle ukuthi ngokuxilongwa nokuphathwa okufanele, abantu abaningi abane-hyperprolactinemia bangakwazi ukuphatha izimpawu zabo ngokuphumelelayo futhi babuyisele impilo yabo yokuzala. 

Iyini i-Hyperprolactinemia? 

I-Hyperprolactinemia yisimo sezokwelapha esibonakala ngamazinga aphezulu kunejwayelekile e-prolactin egazini. Le hormone ikhiqizwa kuphela i-anterior pituitary gland, isitho esilingana nephizi esingaphansi kobuchopho. 

Lesi simo sitholwa lapho amazinga eprolactin edlula ububanzi obujwayelekile. Amalabhorethri ezokwelapha ngokuvamile abheka amanani alandelayo njengokujwayelekile: 

• Kwabesilisa: Ngaphansi kuka-20 ng/mL 
• Okungeyonaabesifazane abakhulelwe: Ngaphansi kuka-25 ng/mL 
• Okhulelwe noma abesifazane abancelisayo: 80 kuya ku-400 ng/mL 

Umzimba womuntu ugcina ibhalansi ngokucophelela ye-prolactin, i-metabolising i-hormone ngokuyinhloko ngesibindi (75%) nezinso (25%). Ngaphansi kwezimo ezijwayelekile, i-prolactin ine-half-life ye-25 kumaminithi we-50 egazini, enezinga lokukhishwa kwe-200 kuya ku-536 mcg ngosuku ngemitha yesikwele somzimba. 

Iyini iProlactin? 

I-Prolactin iyi-hormone ebalulekile ekhiqizwa ngokuyinhloko yi-anterior pituitary gland, ngokukhiqizwa okwengeziwe okwenzeka ezicutshini ezihlukahlukene zomzimba, kuhlanganise nesimiso sezinzwa esiyinhloko, isimiso somzimba sokuzivikela, isibeletho, nezindlala zebele. Le hormone eyinkimbinkimbi ingeyomndeni ofanayo ne-hormone yokukhula kanye ne-placental lactogen, ukwabelana ngesakhiwo samakhemikhali esifanayo. 

I-hormone yenza imisebenzi eminingi ebalulekile yezinto eziphilayo emzimbeni: 

• Iqala futhi igcine ukuncelisa 
• Isekela ukukhula kwezicubu zebele 
• Ingculazi ekufakweni kokukhulelwa 
• Ikhuthaza ukukhula kwamaseli e-mammary gland 
• Inomthelela ekulawuleni amasosha omzimba 
• Isiza ekwakhekeni kwemithambo yegazi 

Ukukhiqizwa nokukhululwa kwe-prolactin kulawulwa ngokucophelela yizici ezimbili eziyinhloko: i-dopamine, evimbela ukukhululwa kwayo, ne-estrogen, eyivuselelayo. Izisusa ezihlukahlukene zingabangela ukukhiqizwa kwe-prolactin, okuhlanganisa ukugqugquzela ingono, ukucindezeleka, kanye nemithi ethile efana ne-antipsychotics. 

I-Prolactin isebenza ngokubophezela kuma-receptors athile atholakala kuwo wonke umzimba, kufaka phakathi ama-ovari, isibeletho, amabele, isibindi, nobuchopho. Lawa ma-receptors, aziwa ngokuthi ama-prolactin receptors (PRL-Rs), ahumusha amasignali e-hormone enze izenzo zebhayoloji ngokusebenzisa izindlela ezihlukahlukene zamaselula. 

Izimpawu ze-Hyperprolactinemia 

Lokhu okulandelayo yizimpawu ezijwayelekile zamazinga aphezulu eprolactin: 

• ukungazali 
• Ukuncipha kwe-libido (isifiso socansi) 
• Ukuncipha kwamathambo 
• Ukuphuma kobisi ezingonweni (galactorrhea) 

Abesifazane abane-hyperprolactinemia bavame ukubhekana nokungahambi kahle kokuya esikhathini, kuhlanganise nezikhathi ezingavamile noma ukungabikho ngokuphelele kokuya esikhathini (amenorrhea). Bangase futhi babone ukoma kwesitho sangasese sowesifazane, okungaholela ekuphatheni kabi ngesikhathi sobudlelwane obuseduze. 

Abesilisa abanamazinga e-prolactin aphakeme ngokuvamile baba nezimpawu ezihlukene. Lokhu kufaka phakathi ukungasebenzi kahle kwe-erectile, ukwehla kwamazinga e-hormone e-testosterone, nokuthuthukiswa kwezicubu zebele ezikhulisiwe, isimo esaziwa ngokuthi i-gynecomastia. 

Izimbangela Nezingozi Ze-Hyperprolactinemia 

Odokotela bahlukanisa lezi zimbangela zibe izinhlobo ezintathu eziyinhloko: ezomzimba, ze-pathological, nezihlobene nemithi. 

• Izimbangela ze-Physiological ze-hyperprolactinemia: Izimo ezihlukahlukene zempilo zingabangela amazinga e-prolactin aphakeme: 
  • I-Prolactinoma (Imbangela evame kakhulu) iyithumba elibi elikhula ku-pituitary gland. Lezi zimila zenzeka kaningi kwabesifazane kunabesilisa. 
  • Isifo sezinso ezingapheli 
  • I-thyroid engasebenzi kahle (hypothyroidism) 
  • Izikhwama ezithinta indawo yesifuba 
  • I-Polycystic ovary syndrome 
  • Ukulimala odongeni lwesifuba 
  • Ezinye izimila ze-pituitary gland 
• Izimbangela ezihlobene nemithi ye-hyperprolactinemia: Imithi ethile ethinta amazinga e-dopamine emzimbeni ingabangela amazinga aphezulu e-prolactin: 
  • Imithi ye-Antipsychotic (ikakhulukazi i-risperidone) 
  • Imithi yokulwa nesicanucanu 
  • Amaphilisi okulawula ukuzala 
  • Imithi yomfutho wegazi ophezulu 
  • Imithi ye-heartburn kanye nesifo se-reflux yamathumbu (GERD) 
  • Imithi yobuhlungu equkethe ama-opioid  
  • Amanye ama-antidepressants 
• Izimbangela Zengqondo ze-Hyperprolactinemia: Izici ezingokomzimba nezingokwengqondo ezingase zibangele ukwanda kwesikhashana kumazinga eprolactin yilezi: 
  • Ukucindezeleka 
  • Ukuzivocavoca 
  • Ukuvuselela udonga lwesifuba 
  • Ukukhulelwa (amazinga e-prolactin akhuphuka ngokwemvelo, ne-pituitary gland ikhula ngosayizi kanye namazinga e-prolactin afinyelela isiqongo ekubelethweni) 

Izinkinga ze-Hyperprolactinemia 

Lesi simo sithinta ngokuyinhloko impilo yokuzala ngezindlela eziningana: 

• Ukungazali okuphikelelayo ngenxa yokuphazamiseka kwe-ovulation kwabesifazane 
• Ukuncipha kwamathambo okuholela ku-osteoporosis 
• Ukuncipha kokukhiqizwa kwe-testosterone emadodeni 
• Ukungasebenzi kahle kwezocansi kubo bobabili ubulili 
• Ukuphazamiseka komjikelezo wokuya esikhathini ovamile 
• Ukuvimbela ukufakwa kwe-embryo ngempumelelo 

Izinkinga ezengeziwe zingase zenzeke lapho i-hyperprolactinemia ivela ngenxa yesimila se-pituitary (prolactinoma). Lokhu kufaka phakathi izinkinga zomphumela omkhulu njenge: 

• Ukushoda okubonakalayo 
• Izinkinga ze-cranial nerve 
• I-pituitary apoplexy (ukopha kungazelelwe ku-tumor) 
• I-Psychosis, ikakhulukazi lapho amazinga e-prolactin ehlala ephakeme isikhathi eside 

Sifo 

Ukuhlolwa kwegazi kokuqala kusebenza njengesiqalo, kodwa lokhu kuhlolwa akukwazi ukukhomba imbangela eyinhloko yamazinga aphezulu e-prolactin. Odokotela bacabangela izici ezimbalwa lapho betolika imiphumela yokuhlolwa: 

• Ukuhlolwa kokusebenza kwegilo 
• Ukuhlolwa kokusebenza kwezinso 
• Izilinganiso zezinga lama-hormone 
• Ukuhlolwa kokukhulelwa (kwabesifazane abaneminyaka yobudala) 
• Ukuhlaziywa kwesici sokukhula 

Uma ukuhlolwa kwegazi kuqinisekisa i-hyperprolactinemia, odokotela bavame ukutusa i-magnetic resonance imaging (MRI) yobuchopho. Lokhu kuskena okuningiliziwe kusiza ukukhomba izimila ezingase zibe khona ku-pituitary gland, ikakhulukazi i-prolactinomas, engabangela amazinga aphezulu e-prolactin. 

Ukwelashwa 

Odokotela ngokuvamile batusa izindlela zokwelapha ezilandelayo: 

• Ama-Dopamine Agonists: Le mithi yokwelapha yomugqa wokuqala. Basebenza ngokulingisa ikhono lemvelo le-dopamine lokunciphisa ukukhiqizwa kwe-prolactin. 
• Ukushintshwa KweHormone: Ezinye iziguli zingase zithole ukwelashwa kwe-estrogen noma kwe-testosterone ukubhekana nezimpawu ezithile 
• Ukuhlinzwa: Igcinelwe izimo lapho imithi ibonakala ingasebenzi, noma izimila zisongela ukubona 
• Ukwelashwa Kwemisebe: Inketho engavamile esetshenziswa lapho kokubili imithi nokuhlinzwa kunganikezanga imiphumela eyanele 
• Ukuphathwa Kwemithi: Odokotela bangase banikeze olunye uhlobo lomuthi olufanayo ukuvimbela i-hyperprolactinemia uma imithi kadokotela ibangela lokho. 

Uzoyibona Nini Udokotela 

Isiqondiso sezokwelapha esisheshayo siyadingeka kulezi zimo: 

• Ukuthuthukiswa okusha noma okubi kakhulu izinhlungu zekhanda 
• Izinguquko ekuboneni noma ekulimaleni kwenkundla yokubuka 
• Ukukhiqizwa kobisi lwebele okungalindelekile 
• Izinguquko ezibalulekile zokuya esikhathini Izinkinga zokuzala ezintsha noma eziya ziba zimbi 

Prevention 

Ukuguqulwa okuningana kwendlela yokuphila kungasiza ukugcina amazinga e-prolactin enempilo: 

• Prakthiza ukulawula ingcindezi ngokuzindla nokuphefumula okujulile 
• Gcina amaphethini okulala angashintshi kanye nenhlanzeko yokulala enhle 
• Yidla ukudla okulinganiselayo okunothe ngovithamini B6, zinc, ne-magnesium 
• Zivocavoce okuvamile ngaphandle kokuzikhandla ngokweqile 
• Gcina isisindo esinempilo ngokudla okufanele 
• Nciphisa ukusetshenziswa kotshwala ne-caffeine 
• Gwema ukugqoka izingubo ezivimbelayo endaweni yesifuba 
• Ukuhlolwa kofuzo: Lokhu kungasiza ekutholeni i-prolactinoma kusenesikhathi uma unesihlobo sezinga lokuqala (ingane yakini noma umzali) onalesi simo. 

Isiphetho 

Inhlanganisela yokwelashwa, ukuguqulwa kwendlela yokuphila, nokuqapha okuvamile kusiza iziguli ukuba zithole imiphumela emihle. Ukuhlolwa okuvamile, ukulawula ukucindezeleka okufanele, nokukhetha indlela yokuphila enempilo kudlala indima ebalulekile ekulawuleni amazinga e-prolactin ngempumelelo. Lawa masu, kanye nokuqwashisa okwandayo ngalesi simo, aqhubeka nokuthuthukisa izinga lempilo yabantu abathintekayo ngenxa ye-hyperprolactinemia. 

FAQs 

1. I-hyperprolactinemia ithinta bani? 

I-Hyperprolactinemia ithinta ngokuyinhloko abantu abangaphansi kweminyaka engama-40, kanti abesifazane babhekana nayo kaningi kunamadoda. Lesi simo asivamile ukwenzeka ezinganeni, nakuba singathinta abantu banoma iyiphi iminyaka noma ubulili. 

2. I-hyperprolactinemia ivame kangakanani? 

Lesi simo sithinta ngaphansi kuka-1% wabantu jikelele. Kwabesifazane abanezinkinga zokuzala, ukuvama kukhuphuka kufike ku-5-14% wamacala, ikakhulukazi kulabo abanemijikelezo yokuya esikhathini engavamile. 

3. Uyini umehluko phakathi kwe-hyperprolactinemia ne-prolactinoma? 

Nakuba i-hyperprolactinemia ibhekisela emazingeni aphezulu e-prolactin kunoma iyiphi imbangela, i-prolactinoma iyi-tumor enobungozi ekhiqiza i-prolactin eyengeziwe. I-prolactinomas yenza cishe ama-40% azo zonke izimila ze-pituitary ezixilongwayo. 

4. Yini ebangela amazinga aphezulu eprolactin kwabesifazane? 

Kunezici eziningana ezingakhuphula amazinga e-prolactin kwabesifazane: 

• Ukukhulelwa nokuncelisa 
• Imithi ethile 
• Ukucindezeleka nokuzikhandla ngokomzimba 
• Izinkinga ze-thyroid 
• Ukulimala kwezindonga zesifuba noma ukuvuselela 

5. Yini okufanele ngiyigweme uma iprolactin yami iphezulu? 

Abantu abane-prolactin ephezulu kufanele bagweme: 

• Ukujima okunamandla aphezulu 
• Izingubo ezimpintshayo esifubeni 
• Ukuphuza utshwala ngokweqile 
• Ukudla okunoshukela omningi 
• Imikhiqizo equkethe i-Gluten 

6. Ingabe i-prolactin ephezulu ingaba yingozi? 

Yebo, amazinga aphezulu e-prolactin angalashwa angaholela ezinkingeni ezinkulu, kuhlanganise nokungazali, ukulahlekelwa amathambo, nezinkinga zombono uma kubangelwa isimila esikhulu. Ukuqapha njalo kanye nokwelashwa okufanele kusiza ukuvimbela le miphumela emibi. 

7. Yikuphi ukudla okwehlisa iprolactin? 

Nakuba kungekho ukudla okukhethekile okuyehlisa ngokuqondile i-prolactin, a Ukudla okunazo zonke ukusekela impilo yonke ye-hormonal kunenzuzo. Faka ukudla okunothiswe kuvithamini B6 no-vitamin E, okungasiza ukugcina amazinga e-prolactin enempilo. 

8. Ihlolwa kanjani i-hyperprolactinemia?

Ukuhlola kuhilela ukuhlolwa kwegazi okulula kokulinganisa ukugcwala kweprolactin, ngokuvamile okwenziwa ekuseni. Ukuhlolwa okwengeziwe kungase kuhlanganise ukuhlolwa komsebenzi wegilo kanye nokuskena kwe-MRI uma kusolwa isimila.

UDkt. Neha V Bhargava

MS, DNB (obgyn), MNAMS, Fellow (Gynae Oncology)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529