GADUDHOI BOLOI GURDA

GADUDHOI BOLOI GURDA (Glandula suprarenalis), gadudhoi jufti tarashshuhi dokhili, ki dar sari gurdaho joy giriftaand. G. dar odam dar sathi muhrai XI sina – muhrai I kamar, dar pasi sifoq voqe meboshand. Gadudi rost shakli sekunja doshta, gadudi chap hilolshakl ast. G. hamrohi gurdaho andaruni gilofi charbi (capsula adiposa) joy girifta, bo niyom (mushakparda)-i gurda (fascia renalis) pushida shudaand. Darozii G. dar odami kalon az 30 to 70 mm, barash az 20 to 35 mm, gafsiash az 3 to 10 mm ast; vazni hardui G. 10 – 14 g meboshad. G. az moddahoi qishrii beruni va magzii dokhili iboratand. Dar kudakoni navzod vazni G. ba hisobi miyona 3,5 g meboshad.
G. az hisobi se guruhi arteriyahoi favqigurdavi (boloi, mobayni va poyoni) bo khun tamin megardand; onho dar shakli muraghoi sershumor ba parenkhima vorid shuda, dar moddai magzi sinusoidho hosil mekunand. Az G. khun ba tavassuti venai markazi va venahoi sershumori sathi, ki ba silsilai venavii uzvu boftahoi atrof mepayvandand, jori meshavad. Muraghoi limfavi bo muraghoi khungard mutavozi joy giriftaand. G.-ro torhoi asabi simpatiki va parasimpatikii asabhoi batni, gumroh va diafragmavi bo asab tamin mekunand.
Moddai qishrii G. ba qitahoi tupchagi, bandchagi va shabakavi judo meshavad. Qitai tupchagi az hujayrahoi shaklan nodurust iborat ast. Dar qitai bandchagi (mobayni) hujayrahoi gadud gird omadaand. Hujayrahoi qitai shabakavi (daruni) shakli turi nodurustro dorand. Moddai qishrii G. doroi lipidhoi ziyod buda, ba on rangi zard mebakhshand. Gormonhoi moddai qishri – kortikosteroidho (glyuko- va mineralokortikoidho) dar mitokhondriyai hujayrahoi tarashshuhi az kholesterin hosil meshavand. Kortikosteroidho ba hama guna namudi mubodilai moddaho, tonusi ragho, immunitet va g. tasir merasonand. Az in lihoz moddai qishrii G. qitai muhimtarini tamini hayoti odam dar sharoiti muqarrari va hangomi mutobiqat ba stresshoi gunogun mahsub meshavad. Dar qitai tupchagii moddai qishri aldosteron hosil meshavad. On mineralokortikoidi asosi buda, dar tanzimi mubodilai obu namakho shirkat mevarzad. Dar qitai bandchavi beshtar kortizol hosil meshavad. Kortizol glyukokortikoid buda, ba mubodilai safedaho, ravgan, karbogidratho, kislotahoi nukleat va kortikosteron (khosiyati glyukokortikoid va mineralokortikoidro dorad) tasir merasonad. Dar qitai shabakavi gormonhoi jinsi, asosan androgenho ba vujud meoyand. Sintezi kortikosteroidho, khususan sintezi glyukokortikoidhoro gormonhoi adrenokortikotropi tanzim menamoyand. Dar umqi G. moddai magzi joy giriftaast. Hujayrahoi gadudii on hujayrahoi khromaffini yo feokhromi nom giriftaand, zero ba onho namakhoi khrom rangi zardi burtob mebakhshand. Dar moddai magzi gayr az hujayrahoi gadudi, torho va hujayrahoi sershumori asab niz vujud dorand. Hujayrahoi khromoffini se navi gormon (adrenalin, noradrenalin va dofamin) hosil mekunand, ki zeri yak nomi umumi – katekholaminho muttahid gashtaand. Adrenalin faqat dar G. sintez meshavad; noradrenalin va dofaminro hamchunin paragangliyaho va neyronhoi sershumori silsilai asabhoi simpatiki hosil menamoyand. Hamai on boftahoe, ki katekholaminhoro hosil mekunand, sistemai adrenaliniro ba vujud meorad. Faoliyati hujayrahoi khromaffiniro tasiroti gunoguni muhiti beruni va dokhili ba angezish meorand (mas., ehsosot, gipotenziyai arteriyavi, gipoglikemiya, kori jismoni, khunuk khurdan va g.).
Faoliyati G.-ro az rui konsentratsiyai gormonho va mahsuli onho dar khunu peshob muqarrar mekunand. Faoliyati glyukokortikoidii G. az rui miqdori 17-oksikortikosteroidho (17-OKS) dar khun, hamchunin dar miqdori shaboruzii peshob muayyan karda meshavad. Faoliyati androgeni va qisman glyukokortikoidii G.-ro vobasta ba ikhroji shaboruzii 17-ketosteroidho tavassuti peshob (meyori muqarrarii on baroi zanho 22 – 60 mkmol/shaboruz yo 6,4 – 18 mg/shaboruz, baroi mardon 23 – 80 mkmol/shaboruz yo 6,6 – 23,4 mg/shaboruz ast) muqarrar mekunand. Baroi oshkor sokhtani illathoi G. az usulhoi tashkhisi radioimmunologi, rentgenologi – pnevmoretroperitoneum, tomografiya, angiografiya, UZI, tomografiyai kompyuteri va g. istifoda karda meshavad.
Alomathoi bolinii amrozi G. nisbat ba meyori muqarrari kam shudan (gipokortisizm) yo afzudan (giperkortisizm)-i sintezi gormonho mahsub meshavand. Bemorihoe, ki sababi onho illati faoliyati G. ast: bemorii addison, bemorii Itsenko-Kushing, sindromi adrenogenitali, virilizm, khromaffinoma, giperaldosteronizm va g.
Ad.: Klinicheskaya nefrologiya, M., 1983; Slavina L.S., Zabolevaniya endokrinnikh jelez, L., 1984; Gruzina E.A., Lakiza V.V., Ukhod za bolnimi s endokrinnimi zabolevaniyami, Kiev, 1987.
KL
Rasmi 1. Gadudhoi boloi gurda va munosibati tarafayni onho bo gurda (namud az pesh): 1 – gadudhoi rost va chapi boloi gurdaho; 2 – gurdahoi rost va chap.

Rasmi 2. Sokhtori mikroskopii gadudhoi boloi gurda: 1 – gilofaki gadudi boloi gurda; 2 – qitai tupchagi; 3 – qitai bandchagi; 4 – qitai shabakavi; 5 – moddai magzi; 6 – muragi sinusoidi.
A. S. Osimov.