saqarTvelos samedicino Jurnali Medical Journal of Georgia
saqarTvelos samedicino Jurnali Medical Journal of Georgia
saqarTvelos samedicino Jurnali Medical Journal of Georgia
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11endokrinologiahiperprolaqtinemia mamakacebSiS.janjRava, q.asaTiani, l.uCava, a.xmeliZe,m.janjRava, e.xmeliZe, n.baramiZe m.daneliaiv.javaxiSvilis saxelobis Tbilisis saxelmwifouniversitetis medicinis fakultetis endokrinologiisdepartamenti(recenzia - med. mecn. kand. m. korinTeli)Sesavali: prolaqtini warmoadgens polipeptidurjaWvs, romelic Sedgeba 199aminomJavis naSTisagan. misi molekulurimasa 23kda, prolaqtinis sinTezze pasuxismgebeligeni moTavsebulia me-6 qromosomaze.prolaqtini gamomuSavdebahip<strong>of</strong>izis wina wilis laqtotr<strong>of</strong>ebismier, romelic Seadgens adenohip<strong>of</strong>izisujredebis10-29%-s. maTi fiziologiurihiperplazia da hipertr<strong>of</strong>ia aRiniSneba:orsulobisas, laqtaciisas da axalSobilebSi.hiperprolaqtinemiis sindromisaTvis,damaxasiaTebelia prolaqtinis hipersekrecia.daavadeba ufro xSirad gvxvdebaqalebSi, vidre mamakacebSi, boloperiodSi aRiniSneba misi matebis tendeciamamakacebSi (1,2,3).daavadebis etiologiuri faqtorebiSeiZleba iyos: 1) hip<strong>of</strong>izis sxvadasxvagvaridazianeba: a) hip<strong>of</strong>izis mTlianobisdarRveva, b) mikro an makro prolaqtinoma,g) ‘carieli” Turquli kexis sindromi,d) Sereuli forma (somatotropul-laqtotropuliadenoma),e) simsivneebi _ somatotropinoma,kortikotropinoma, Tireotropinoma,gonadotropinoma, v)krani<strong>of</strong>aringioma, z) Serwymuli hipopituitarizmTanhip<strong>of</strong>izis adenoma, T) idiopaTiuriforma,2) hipiTalamur-hip<strong>of</strong>izuri funqciisdarRveva, kerZod: a) infeqciebi (meningiti,encefaliti), b) granulomatozuri dainfiltraciuli procesebi(sarkoidozi,histiocitozi, tuberkulozi da sxv.),g) simsivneebi(glioma, meningioma da sxva),d) metaboluri darRvevebi (RviZlis cirozi,Tirkmlis qronikuli ukmarisoba),e) travmebi (hip<strong>of</strong>izis fexis dazianeba,sisxlCaqceva da sxva), v) limfociturihip<strong>of</strong>iziti.3) simptomuri hiperprolaqtinemia:a) pirveladi hipoTireozi, b) sakvercxeebispolikistozi, g) estrogenmaproducirebelisimsivneebi, d) TandayoliliTirkmelzeda jirkvlis hiperplazia,e) hiperprolaqtinemia sportsmenebSi.4) farmakologiuri preparatebiTgamowveuli hiperprolaqtinemia: a) tricikluriantidepresantebi (imipramini, amitriptilini,haloperidoli), b) estrogenebi(Casaxvis sawinaaRmdegod ansamkurnalod), g) d<strong>of</strong>aminis blokatorebi(metiklopramidi, domperidoli, feno-Tiazidi), d) kalciumis arxebis blokatorebi(verapamili), e) H 2receptorebisblokatorebi (cimetidini, ranitidini), v)narkotikuli saSualebebi, z) adrenergulisistemis inhibitorebi (rezerpini, a-meTild<strong>of</strong>a, karbid<strong>of</strong>a) (4,5).klinikuri maxasiaTeblebi: hiperprolaqtinemiamamakacebSi gvxvdeba 40-59wlis asakSi, pacientebi eqims Semdegi ZiriTadiCiviliT mimarTaven: ereqciulifunqciis darRveva, uSviloba, libidosdaqveiTeba, iSviaTad ginekomastiiTa daufro iSviaTad galaqtoreiT. mamakcebSihiperprolaqtinemia ZiriTadad gamovlindebamakroadenomis saxiT, romeliciwvevs irgvlivmdebare qsovilebis rRvevasda gamovlindeba tropuli hormonebisdeficitiT. xSirad dasmuli diagnozi_“fsiqologiuriimpotencia” arasworia.avadmy<strong>of</strong>ebi uCivian Tavis tkivils,mxedvelobis simaxvilis darRvevas, rac,ZiriTadad, mamakacebSi gamowveuli makroadenomisarsebobiT, testosteronisestrogenad gardaqmnis darRvevis gamo,
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