ʻO nā maʻi o ka glam thyroid e hoʻopilikia i ka mālama pono o ka mea maʻi ma ka mua, no ka mea ʻo nā mea hua a ka lāʻau thyroid i hana nui i nā hanana he nui. Inā hōʻike i nā hōʻike hypothyroidism, a laila ua kuhikuhi ke kauka i nā lāʻau lapaʻau kūikawā e hoʻihoʻi i ka hana thyroid. Akā pehea pehea e hoʻoholo ai ʻaʻole lawa ka nui o nā thyroid i ke kino?

I ke kakone ʻana o ka hormone thyroid

ʻO ka ʻōmaʻomaʻo thyroid ka mea nui i nā hana o ke kino a hiki i ka manawa o ke kūkulu ʻana i ka janal. Hoʻokomo ʻia kāna mau hana i ka metabolism, kōkua i ka ulu ʻana o ka iwi. ʻO ke kūlana aoao olakino e pili ana i ka nui. Akā maikaʻi nā mea āpau, ʻoi aku ka nui a nele paha i ka nui o ka hormone thyroid e pili pono i ka olakino a me ke olakino o ka poʻe. ʻO ka hypothyroidism kahi hemahema o nā hormones thyroid i ke koko kanaka.

ʻO wai ka hopena hopohopo

ʻO nā maʻi o ka maʻi thyroid, ka hopena o kahi hōʻemi i ka pae o nā hormones i hana ai a i ʻole ka hoʻopiʻi ʻana ʻana o nā ʻāpono o kēia mau mea i nā ʻili o ke kino, pili nui ka pōmaikaʻi o ka mea maʻi, me ka hāʻawi ʻole iā ia i kekahi ʻano hōʻeha ʻeha. Hiki i kēia ʻano ke hōʻeha i ka genetically, hiki ke hōʻeha ia i ka lawe ʻana i nā lāʻau lapaʻau a i ʻole ka lōʻihi i ka ʻike me nā mea kanu. No laila, ulu pinepine ka hypothyroidism i ka nele o ka iodine i ka meaʻai. ʻO ka nele o ka assimilation a i ʻole hana ʻana i nā hormone thyroid e hiki ke hoʻopiʻi ʻia e nā maʻi ʻē aʻe e pono ai ke nānā i ka maʻi. Aia kekahi nīnau koʻikoʻi - e hoʻomaʻamaʻa i nā wahine hāpai i ka hypothyroidism e lawe, no ka mea, ʻo ka ulu ʻana o ka intrauterine o ka pūpū pololei e hilinaʻi nui ʻia i ke olakino o ka makuahine. Inā loaʻa kahi wahine ma ka hypothyroidism, ʻo ka hoʻokolohua ʻana i ka hormone ma ka wā hāpai a he hana maʻamau.

He aha paha o ka hypothyroidism

Hoʻokaʻawale ka lāʻau lapaʻau i ka hypothyroidism i ʻelua mau ʻano:

ka mua - e like me kahi hōʻike o nā pilikia i nā kelena thyroid.
kekua - ulu ia ma muli o ka lawehala o ka maʻi o ka maʻi.

I mea e hoʻomaopopo ai i kahi pilikia i loko o ka pūnaehana endocrine, pono ʻoe e ʻike i nā ʻike e hana ai no ka hypothyroidism. Pono lākou e kōkua i ka ʻike ʻana i ka emi ʻana o ka nui o nā hormones thyroid i ke koko, i hiki i ka mea maʻi ke hōʻeha hou i nā hoʻokolohua hou e hoʻokumu ai i ke kumu o ka hypothyroidism.

Diagnosis

ʻO Malaise, ka hopena o ka ʻili, ke kaumaha, nā kuhihewa o nā kāne ma loko o nā kāne - pinepine loa kēlā mau ʻōuli i ka hopena o ka hypothyroidism. Eia naʻe, ʻo ka pilikia o ka hana ʻana i ka maʻi pololei, he ʻeha. Ma hope o nā mea āpau, hoʻopili ʻia nā hōʻailona, kamaʻilio nā kauka e pili ana i ka hoʻomaʻemaʻe i ka hemahema o ka nui o ka maʻi thyroid, a me nā maʻi ʻē aʻe he nui nā hōʻailona like ʻole. I mea e loaʻa pono ai ka hoʻomanawanui ʻana, ʻo ka mea maʻi me ka haʻiʻi ʻana i ka hypothyroidism pono e hoʻomaʻemaʻe i kekahi o nā hoʻokolohua ʻole me ka lanakila ʻole.

ʻO ka helu koko piha

ʻO ka hoʻouna ʻana i kahi hōʻike koko nui he kaʻina kauoha ia i ka wā e hoʻopili ai i kahi ʻoihana olakino. Ma ia palapala hōʻike hiki iā ʻoe ke loiloi i ke ʻano olakino o ka mea maʻi. Akāʻo kēia ka ʻike laulā. I kekahi mau maʻi, me ka hypothyroidism, ʻaʻole hiki ke ʻike a akomi ʻia e ka hōʻike koko ʻano ākea. No laila, e hoʻohui i nā noiʻi hou aku, e hōʻiliʻili ke kauka i ka moʻolelo olakino o ka mea maʻi, hoʻomaʻamaʻa i nā hoʻopiʻi, e hōʻike ana i kahi maʻi āpau. ʻO ka pae aʻe o ka hoʻokolohua e pane i ka nīnau: "Inā i manaʻo ʻia ka hypothyroidism, he aha nā hōʻike e lawe ai?"

ʻŌkuhi koko

Ma kēia hōʻike koko hiki iā ʻoe ke hōʻike i nā ʻano abnormalities i loko o ka ʻoihana endocrine, e lawelawe ʻia he ʻelele ʻē aʻe no ka nānā ʻana e pili ana i ka hormonal. Kōkua nō kēia noiʻi pū ʻana i nā pilikia ʻē aʻe, ʻaʻole wale nō ka hypothyroidism. He aha nā hōʻailona e hōʻike ana i kahi pilikia me ka gland thyroid?

ʻO ka kolamu Serum kahi iʻoi aku ma mua o ka maʻamau.
Kū ʻia Myoglobin i nā ʻano āpau o ka hypothyroidism.
Lāpau i ka phosphokinase ka palena ʻae ʻia ma ka manawa 10-15. ʻO kēia enzyme kahi hōʻailona o ka luku ʻana i nā uaua o nā uaua, e lawelawe nei i kahi mea no ka hoʻoholo ʻana i ka infococote myocardial, hiki ke hoʻopau ʻia e ECG.
ʻOi aku ka kiʻekiʻe o ka aspartate aminotransferase (AST) ma mua o ka maʻamau. ʻO kēia kahi kinakē o ka protein metabolism, kahi hōʻailona e, mahele i ka pākaukau, e lawelawe nei me ka hōʻailona o ka luku cell.
ʻO ka dehydrogenase Lactate (LDH) nui i kahi pae ʻokoʻa no ka necrosis kiko.
ʻOi aku ka paʻū Serum ma mua o ka maʻamau.
Hoʻopau ka pae hemoglobin.
ʻO ka hao Serum ma kahi liʻiliʻi, ʻaʻole i hiki i nā pae maʻamau.

ʻO kahi biochemistry koko holoʻokoʻa e hiki ai iā ʻoe ke hōʻike i nā hewa he nui i loko o ke kino a kuhikuhi i nā hoʻokolokolo hou e hōʻoia ai a hōʻoia paha i ka maʻi hoʻomaka.

Hōʻike koko ke koko o ka thyroid hormones

ʻO kahi palapala noiʻi e hiki ai iā ʻoe ke hoʻomaopopo i ka nele o nā hormone thyroid i loko o ke koko, ʻoiaʻiʻo, he ʻano maʻi no ke kaona o ka ʻike o nā ʻāpana like. ʻEkolu mauʻano nui, pono no ka hana maikaʻi o ke kino, e hana pololei ʻia e ka kelepa thyroid a hana ʻia e ka pituitary gland o ka lolo. ʻO kēia ke ʻano thyroid-stimulating hormone (TSH) a me ka hormone T4. Hoʻokumu ʻia ka TSH e ka kelima pituitary, a me T3 a me T4 e ke kelepaʻo thyroid. Hoʻopau kekahi i ka momona thyroid kekahi i kekahi ʻano o ka hormone - calcitonin, akā ke noiʻi ʻia ana kona nui no nā maʻi ʻē aʻe. No laila, he hoʻokaʻina koko no nā hormone thyroid e hiki ai iā ʻoe ke hoʻomaopopo i ka nānā ʻana i ka wā i koho ai a koho i ke ʻano no ka noiʻi hou ʻana a me ka mālama ʻana.

ʻO kahi hoʻonui hoʻonui TSH a me kahi maʻamau maʻamau o T4 e hōʻike i ka hoʻomaka mua o ka maʻi, ka mea i kapa ʻia ʻo subclinical hypothyroidism. Inā kiʻekiʻe paha ke kiʻekiʻe o ka TSH, a ma mua o ka T4 ka haʻahaʻa o ka maʻamau, a laila e ʻike ke kauka i ka hōʻike a loaʻa i ka hypothyroidism. Ma kēia ʻano maʻi e pono ai ka hoʻohana koke ʻana i ka lāʻau lapaʻau, ʻoiai ka hana hou i ka maʻi hapai, ʻo ka hypothyroidism paʻakikī, ka mea hiki ke alakaʻi i ka myxedema, myxedema coma a me ka make.

ʻO ka pae kūikawā o ka hoʻokolohua ʻo ka hoʻomaʻamaʻa hormon. Hiki ke hoʻokumu ʻia ka hypothyroidism ma o ke alakaʻi ʻana i ia ʻano aʻo ʻana. He hana kūlana maʻamau kēia, maʻalahi, maʻalahi a kūpono hoʻi.

Nā Mākeke Antibody

ʻO kahi hōʻailona hou o ka hana o ke kinikula thyroid a me ka assimilation o ka nui o ka thyroid he hōʻike koko no nā antibodies i nā lāʻau iodine e loaʻa ai.

Nā antibodies i kāu thyroperoxidase. Hoʻokomo pololei kēia enzyme i ke kāpili o nā hormone thyroid. ʻAʻole ʻike kēia ʻano i ka ʻike ʻole ʻia, akā ʻo ka hoʻonui ʻia ʻana o nā ʻike i loko o ke koko e pono ai e noʻonoʻo i ka wā e hana ai i kahi maʻi maʻi.
Nā antibodies i kāu thyllasobob - he hōʻailona multivariate. Hiki iā ia ke lilo i mau hōʻike no ka diffuse goiter a i ʻole nā maʻi thyroid, akā ʻaʻole ia e mau i kekahi mau kikoʻī, inā he nui ka pae o nā antibodies iā TG, e pono nā haʻawina hou e kāpae a hōʻoia paha i ka DTZ a i ka oncology.
ʻO nā Antibodies i ka mea hoʻokipa TSH kahi hōʻailona o ka mālama maikaʻi. Inā hoʻi ʻole ka pae o nā antibodies e hele i ka rTTG i ka wā kūpono o ka mālama ʻana, a laila e kamaʻilio mākou e pili ana i ka hewa o ka maʻi a me ka hiki ke hōʻiliʻili ʻoi.

Pehea e hoʻoponopono ai

I ka maʻi āpau me ka hypothyroidism kānalua, kū mai ka nīnau pehea e hana ai i kahi ʻano loiloi no ka hypothyroidism. He papa hana maʻalahi kēia. Pau nā hōʻike koko āpau i ke kakahiaka, ma ka ʻōpū ʻole ʻole a i ʻole - ʻaʻole kahi mea pāʻani, no ka mea he kūʻokoʻa kēia mau māhele ʻana i ka ʻano kai. Lawe ʻia nā ʻōkuhi mai kahi vein, e ʻae iā lākou e hana pololei.

He aha nā hōʻike e lawe ai me ka hypothyroidism?

ʻO ka papa inoa maʻamau o nā hoʻokolokolo e pono ai e lawe e hoʻoholo i ka maʻi:

ka nānā koko ākea ʻole me ka ʻōmole leukocyte a me ESR,
loiloi hoʻomākina.

ʻO nā hoʻāʻo e hōʻoia i ka pae haʻahaʻa o ka hormone thyroid:

TTG - e hoʻōla ana i ka hormone thyroid.
T3 - triiodothyronine nui a me ka manuahi,
T4 - ouroxine a me nā maʻamau,
assantibody assay.

Pono ka loiloi laulā e hoʻoholo ai i ka helu o nā nui koko, ko lākou mau ʻāpana.

Hōʻike ka loiloi biochemical i nā haʻalulu wai-paʻakai a me nā momona. ʻO ka hōʻemi i nā pae o ka sodium, he hoʻonui i ka creatinine a i ʻole nā enzyme e hōʻike me ka hypothyroidism pololei.

ʻO TTG ka mea nui o ka hōʻailona. Hoʻoulu ʻia ka thyroid-stimulate hormone e ka pituitary gland. Hoʻonui ka hoʻonui i nā pae TSH i ka hoʻohaʻahaʻa o ka hana thyroid a hoʻomaka paha i kona hoʻonui. Hoʻokumu ka hapanui hipocary i ka hana i ka lua e hoʻopili i kahi nui o nā hormones thyroid.

Ke lawe nei ʻoe i ka hōʻike no TSH, pono ʻoe e ʻike i ke pae ʻana i ke kakahiaka ma waena o ka rima, hōʻemi i ka wā o ke ao, a ala ʻia i ke ahiahi.

ʻO ka gland thyroid i hana i ka 7% T3 triiodothyronine a me 93% T4 thyroxine.

ʻO T4 kahi ʻano hormonal hāleau, hope loa i huli ʻia i T3. Ka huina o ka thyroxine a me ka protein globulin i kahi moku i hoʻopaʻa ʻia. ʻO ka T4 manuahi (0.1%) ka mea ikaika, he hopena pili kino. Na ia e kuleana no ka hoʻoponopono ʻana i ka palaka a me ka metabolism i loko o ke kino.

I ka hoʻonui ʻia ʻana o ka pae manuahi free T4 alakaʻi i ka hoʻonui ʻia ʻana o ka ikehu i loko o nā mea i hoʻonui ʻia, hoʻonui i ka hana metabolism, a me nā hiʻohiʻona o ka hypothyroidism.

ʻO ka hana ola olakino o T3 a i ʻole triiodothyronine ma mua o T4 3-5 mau manawa. Hoʻopili ka hapa nui loa ia i nā protein protein a ʻo 0.3% wale nō ka mea i kahi kūlana kūʻokoʻa ʻole, i ʻole ka palena. ʻIke ʻia ka Triiodothyronine ma hope o ka nalowale o ka atom iodine e ka thyroxine ma waho o ka lolo thyroid (ma loko o ke ake, nā ʻōpū).

Ua hōʻike ʻia kahi hōʻike T3 e hoʻoholo i ka hypothyroidism i kēlā mau hihia:

me ka hoʻemi ʻana o ke kiʻekiʻe o ka TSH a me ke ʻano o T4 noa,
i ke alo o nā hōʻailona o ka maʻi a me kahi pae maʻamau o ka thyroxine free,
me nā hōʻailona TTG a me T4 ʻoi aku ke kiʻekiʻe a haʻahaʻa paha ma mua o ka maʻamau.

ʻO ke kumu maʻamau o ka nānāʻole ʻana i nā hormone thyroid he lesima autoimmune o ka pauku, ʻo ia ka mea e hana ai i nā autoantibodies e hakakā i kāu pilikino. Hana ʻino lākou i ka mea maʻi ma ka hoʻouka ʻana i nā wahī o ka kelepona a hoʻopili ʻana me kāna hana maʻamau.

ʻO ka hoʻokolohua lāʻau paena ka ala maikaʻi loa e ʻike ai i nā maʻi e like me ka maʻi bazeda a i ʻole thymitisitis Hashimoto.

Kuhi ʻia o kekahi ʻano o ka hypothyroidism

No laila, he aha nā hōʻike e pono ai e lawe i ka hypothyroidism e ʻike? ʻO ka ʻike o T3 a me T4, a me TSH hoʻi, e pane i ka nīnau mua. ʻO ka hypothyroidism kahi kūlana ma kahi o ka gland thyroid e hana i ka nui o ka hormone a ʻaʻole ia e hoʻoulu i ka nui.. ^ E Ha yM. He mea kūleʻa ia ʻoi aku ka nui o nā hana ola o T3 i kahi o T4, akā e pono ai no ka iodine no ka hana ʻana i ka haʻahaʻa. ʻO kēia ka mea hoʻohana ke kino inā ʻaʻole lawa ka iodine - lilo ka T4 i liʻiliʻi, akā hoʻonui ka T3.

Hiki i ke kanaka ke noho i kēia moku no kahi manawa lōʻihi, ʻaʻole ia e pili i kēia olakino. Hiki i nā hōʻailona kikoʻī loa: hoʻemi i ka hana, ʻohi lauoho, kui, lethargy ... hypovitaminosis maʻamau a ʻeha ʻole, ʻaʻole? ʻAʻole kuhi nei kēia ʻano hypothyroidism i ke ola o kahi kanaka, no laila ʻaʻole ia e hele i ke kauka a no laila ʻaʻole ia e loaʻa ka lapaʻau.

Inā hoʻēmi ʻia ka T3 a me T4, ke hele nei kēia a piha i ka hypothyroidism. Hiki ke hoʻoholo i kāna hōʻemi ma o ka uha o nā hōʻailona a me ka pae o nā hormones i ka loiloi.

Hohele ka papa helu ʻano i ka hypothyroidism i:

Latent - subclinical, huna ʻia, ʻoluʻolu.
Hoʻohui - pili i ke kāʻei haʻahaʻa.
Hoʻopau - nā mea paʻakikī loa, ʻoiai paha he koma. Kuhi i kēia ʻano nā myxedema, myxedema coma (myxedema + coma i hoʻokumu ʻia e ka hypothyroidism) a me nā pēpē pēpē.

He aha nā mea e kamaʻilio nei ka TTG a me TRG?

Akā i nā pae maʻamau o ka nui o ka hormone thyroid i nā helu āpau, ʻaʻole i hōʻoia i ka mea i ʻole ka hypothyroidism! No ka hoʻomakaʻana a i ʻole ka nānā ʻana o ka hypothyroidism subclinical, pono ia e lawe i kahi loiloi no TSH. ʻO kēia hāmeʻa, ka mea i kapa ʻia ʻo ka thyroid-stimelling, e hoʻoulu i ka gland pituitary e hoʻoulu i ka hana o ka hormonal i ke kūlohelohe o ka thyroid. Inā hoʻonui ʻia ʻo TSH, a laila ʻaʻole lawa ka nui o ka nui o ka hormone thyroid. I kēia hihia, ʻo ka ʻike maʻamau o ka T3 a me T4 e like me nā mau loiloi ʻaʻole i ʻoluʻolu i nā pono o ke kino. Ua kapa ʻia kēlā ʻano hypothyroidism huna ʻia.

No kahi subclinical, latent form of hypothyroidism, TSH i ka hoʻokolokolo ʻana pono ka pilina ma ka hono mai ka 4.5 a 10 mIU / L. Inā nui ka TSH, a laila he hypothyroidism kēia, akā uaʻoi aʻe ka paʻakikī. Ma ke ala, he kahiko a hiki i ka 4 mIU / L ka mea kahiko, a i loko o nā noiʻi hou no ka hypothyroidism no nā kauka ua hōʻemi ia i 2 mIU / L.

Hoʻopau ʻo TSH i ka kelaki pituitary. No ka hana i kēia, hoʻoneʻe ka hypothalamus ma o TRH. Ke hoʻohana nei nā kauka i kēia mea i mea e hōʻoia / alakaʻi i ka maʻi pituitary e lilo i kumu o ka hypothyroidism. Hāʻawi ʻia kahi kanaka me ka TSH haʻahaʻa i ka TRH i ka lāʻau lapaʻau a ʻike ʻia nā loli i nā mea hōʻoiaʻiʻo. Inā pane ka gland pituitary i ke kauoha o TRH e hoʻonui i ka luhi o ka hormone thyroid-hoʻoulu ʻia a hana ia i ka manawa, a laila ʻaʻole ke kumu o ka hypothyroidism. Inā ʻaʻohe mea e hōʻike i ka input o TRG e like me ka helu ʻana ʻana, a laila pono ʻoe e ʻimi no ke kumu o ka ʻōpū o ka pituitary - ʻokoʻa pinepine ka MRI.

Hōʻike pinepine ʻia ka maʻi maʻamau o ka maʻi pituitary e ka lawa ʻole o ka nui o nā ʻenemi ʻē aʻe, nā hoʻokolohua e hiki ai ke hoʻolilo ʻia.

ʻO ke pae o TRH, a i ʻole thyroliberin e hōʻike i ka hana a nā hypothalamus.

Nā antibodies i ka thyroid peroxidase a me nā mea ʻē aʻe

Thyroperoxidase, thyroperoxidase, thyroid peroxidase, TPO nā inoa inoa like ʻole no ka enzyme like. Pono e pono ke kohoʻana o T3 a me T4. E luku aku nā antibodies i ka peroxidase o ka enzyme, kēlā me kēia, inā ʻoe e hāʻawi i ke koko i ka nui o ka thyroid hormones, e kipa aʻe ko lākou hemahema. Inā loaʻa kēia mau mea maʻamau i ke koko, a laila hoʻonā kēia i kahi kaʻina autoimmune i loko o ke kino, kumu a hypothyroidism e ka auto-agresi o ke ʻano like.

ʻO kahi kaʻina autoimmune kekahi mea maʻi, no laila e hoʻākāka pinepine ʻia e nā maʻi pena i loko o ke koko. Hōʻike ka helu koko maʻamau i ka liʻiliʻi o ka hoʻonui ʻana i ka ESR, hiki nō, akā ʻaʻole pono nā leukocytosis. Aia ia i ka ʻano o ke kaʻina o ka autoimmune.

ʻO ka pae kiʻekiʻe nui o ka anti-TPO he 100 U / ml a ʻoi aku.

ʻO ka hypothyroidism kahi kūlana o ke kao holoʻokoʻa, ʻo ka asymptomatic hypothyroidism e hōʻino no ka olakino.

No laila, ʻoi aku ka hoʻonui ʻana o ka kolamu a me nā triglycerides - e hōʻeha kēia i ka atherosclerosis, e hoʻopōʻino i nā moku a hoʻoweliweli i ke kahe koko.
ʻO ka hypothyroidism nā kumu like ʻole o ka anemia. ʻO ka anemia hypypromromic me ka nele o ka hemoglobin, ka normochromic me ka nui o ka nui o nā kōwela koko ʻulaʻula.
Kū ʻia ʻo Creatinine.
ʻO ka hana no ka hoʻonui ʻana i nā enzymes AST a me ALT a me ka hypothyroidism ʻaʻole i kū maoli ʻia, akā pili kēia mea i loko o ka poʻe āpau me kahi maʻi maʻi.
Hopu ka Hypothyroidism i nā ʻāpana ʻē aʻe o ka ʻoihana endocrine, e hōʻeha ana i nā pilikia o ke kāne ma nā kāne ʻelua, ʻoi aku ka nui o nā wāhine. Hoʻonui ka nui o ka prolactin, e hōʻemi ana i ka hopena o nā gonadotropins.

Peripheral, a i ʻole receptor hypothyroidism

Hōʻailona ʻoi aku. Ma muli o nā loli i ka pae o ka hua a i ka wā i hānau ai ke kanaka, he haʻahaʻa loa ka hopena o ka lāʻau thyroid. I kēia hihia, hoʻāʻo ka endocrine maikaʻi ma ka hilinaʻi maikaʻi e hoʻolako i ke kino me nā hormones, akā ʻaʻole hiki i nā hua ke ʻike. Ke kū nei ka manaʻo o nā hormones ma kahi ho'āʻo e "hōʻea" i nā ʻenemi, akā, ʻoiaʻiʻo, ʻaʻole loaʻa.

Ma kēia hihia, hoʻāla ʻia ka nui o ka thyroid, ka nui o ka hormone thyroid i loko o ke koko, hoʻāʻo ke kaapuni pituitary e hoʻoulu i kahi nui thyroid gland, akā ʻaʻole mau i nā hōʻailona o ka hypothyroidism. Inā he haʻahaʻa nā mea āpau no nā hormone tiroid, a laila hiki ʻole kēia i ke ola. Loaʻa kekahi mau hihia i hoʻololi wale ʻia kekahi hapa o nā receptors. Ma kēia hihia, ke kamaʻilio nei mākou e pili ana i ka mosaicism genetic, i ka manawa o nā papa o ke koena i ke kino me nā mea maʻamau a me nā genotype maʻamau, a ʻāpana me kahi genotype haʻahaʻa a hoʻololi i kekahi genotype.

He hoʻohiwahiwa nei kēia ʻano leʻaleʻa a ʻaʻole i neʻe ka mālama ʻana i kēia lā, pono nā kauka e pili i ka terapi maʻi.

Nā hōʻike hoʻokolohua Hypothyroidism

ʻO ka hypothyroidism kahi maʻi thyroid, ʻo ia kekahi o nā laʻi o ka hoʻoulu ʻana o ka ʻōnaehana o ka pale ke kino o ke kino. I kekahi manawa e hoʻomaka ana ka maʻi ma ka monophase, me ka ʻole e hele i nā ala ʻē aʻe. ʻO kekahi o nā ala no ka hoʻokauʻana i ka hypothyroidism ʻo ka hoʻokaʻina koko koko no ka ʻike ʻana o ka hormone i loko.

Hōʻike ʻole aku ʻo Hypothyroidism i ka manawa lōʻihi a ma kahi hihia wale ʻole i hōʻike ʻia e hōʻike ai i ke kiʻi hauoli i ʻoi. ʻO ka mana nui loa i ka hopena hope loa he hōʻike i nā hōʻike no ka hypothyroidism.

Ma waena o nā kiʻi haukapila i hoʻolaha ʻia o ka hypothyroidism, pono e hoʻomanaʻo ʻia:

Wehewehe, lethargy,
Hōʻike i nā mea āpau e hana
ʻO ka wikiwiki wikiwiki, hoʻemi i ka hana,
ʻEhaʻeha
ʻO ke puʻupuʻu, hoʻomanaʻo hoʻomanaʻo ʻole,
Ke kūwaha ʻana i nā lima, nā wāwae
ʻIli maloʻo, kuku nā lauoho, lauoho.

ʻO kēia nā hopena āpau o ka hapa ʻole o nā hormones thyroid i loko o ka lolo thyroid ma ke kino. I ka hoʻohui ʻana i nā diagnostics laboratorium, ua nānā ʻia kahi loiloi ultrasound o ka gland, hiki i kahi mālo hiki ke kuhikuhi pū ʻia i kahi hihia o nā nodules hewa. E noʻonoʻo pono i kā mākou mea e ʻike ai nā hōʻike a me ka hypothyroidism.

Hoʻoulu i ka hormone thyroid

ʻO ka hapa nui o nā poʻe endocrinologists e hilinaʻi i ke kiʻekiʻe o ka hormone thyroid-hoʻoikaika i ke koko o ka mea maʻi, a i ʻole TSH. ʻO kēia hormon e hoʻāla ʻia e ka gand pituitary a hana ʻia e hoʻōla i ka momona thyroid.

Me ke kiʻekiʻe o ka hormone like i ke koko, hiki iā mākou ke manaʻo e hana ka nui o nā kelepona pituitary i ka hoʻowalewale o ka ʻaila, a ma muli, ʻaʻole lawa ka nui o nā kūmole kelepona.

Hoʻololi nā ʻano o nā maʻi heʻena o ka thyroid-stimulate i ʻāina ʻē aʻe. Penei:

No Lūkini, ka loli maʻamau o TSH i ke koko o ka mea maʻi ma waena o 0.4-4.0 mIU / L.
Ua hoʻokaʻawale ka poʻe endocrinologists ʻAmelika i kahi ala hou, e like me nā hopena o kā lākou noiʻi, i kūpono i kekahi kiʻi ʻokoʻa maoli - 0.3-3.0 mIU / L.

Ma mua, ua maʻamau ka laulima o TSH ma ka 0.5-5.0 mIU / L - ua hoʻololi ʻia kēia hōʻailona ma kahi o 15 mau makahiki i hala aku nei, ka mea i alakaʻi ʻia ai ka nui o ka maʻi o ka maʻi thyroid.

I kā mākou ʻāina, he mea kūpono ia e noʻonoʻo i ka kuhikuhi mua. ʻO TSH ma luna o ʻehā mIU / L e hōʻike ana i ka hypothyroidism, a ma lalo e hōʻike ana i ka hyperthyroidism.

Ma kēlāʻaoʻao ʻē aʻe, ua hilinaʻi pū ka waihona TSH ma nā ʻano ʻē aʻe. No ka laʻana, haʻahaʻa ka mālama ʻana o ka hormone thyroid-stimulate i ka maʻi oncological o nā kumulāʻau pituitary, no ka mea hiki ʻole iā ia ke hoʻopuka i ka hormone. Hoʻomaopopo kahi ʻano like ma hope o ke kaʻi a i ʻole ka trauma e hoʻopili ana i ka hypothalamus.

Nui ka mana i ka hopena o ka noi ʻana i kahi manawa pili koko. I ke kakahiaka, ke kiʻekiʻe o ke kiʻekiʻe o ka TSH i ke koko, hoʻoneʻe i ka lā awakea, a ala hou ia i luna o ka awelika i ke ahiahi.

Hiki ke hoʻopaʻa ʻia ka hormone T4 i loko o kēia ʻano:

Uwau T4 - ʻo ka paʻa ʻana o ka paʻa a me nā ʻano manuahi o ka hormone T4,
Hoʻolaha - kahi hāmeʻe ʻole i pili ʻole i ka mololi protein, a loaʻa i ka hoʻohana ʻana i ke kino,
Hoʻohui - ka ʻaina o ka hormone T4, kahi paʻa i hoʻopaʻa ʻia e ka mololi protein a ʻaʻole hiki ke hoʻohana ʻia e ke kino. ʻO ka hapa nui o T4 i loko o ke kino i kahi kūlana.

ʻAʻole hiki ke hoʻopaʻa ʻia kahi hulina kikowaena ākea o ka hypothyroidism ma ke aʻo ʻana o ka ʻike ʻana, no ka mea e hoʻomālamalama i ka pilikia ma hoʻokahi wale nō - pehea ka ulu ʻana o ka lolo i ka lolo thyroid. No kahi noi holoʻokoʻa, hōʻike ʻia nā hōʻike no nā ʻano manuahi o nā hormones T3 a me T4.

Ka pili pololei o ka T4 i ka T4 pili. Akā ʻo kēia mau mea ʻoi loa ka nānā ʻana i ia mea, ʻo ka hoʻopaʻa ʻana o ka T4 a i ka molekine protein e hilinaʻi pū me ia ka nui o ka protein i loko o ke koko. A no ka hiki ʻana o ka hoʻōla ʻana me ka protein me ka maʻi a me nā maʻi hepatic, i ka wā o ka hapai a me ka lactation, ʻo ke ana ʻana ka nui T4 ʻaʻole maikaʻi loa ia.

ʻOi aku ka nānā ʻana i ka T4 manuahi - kēia ke ʻano o ka hormone pono e komo i loko o nā pūpuna a hoʻololi i T3. ʻO ka mea hope loa he ʻano ikaika o ka hormone thyroid.

Inā i hoʻowalewale ʻo T4 - ʻo ka thyroxine ma lalo o ka maʻamau, ʻoiai ʻo TSH i hoʻokiʻekiʻe ʻia, hoʻihoʻi maoli ke kiʻi i ka endocrinologist i hypothyroidism. Hoʻomaopopo pinepine kēia mau ʻōkuhi.

E like me ka mea i ʻōlelo ʻia ma luna, i hoʻokumu ʻia ʻo T3 i nā pūpuna o ke kino mai T4. Ua kapa ʻia kēia hiona he triothyronine a he ʻano hana ikaika o ka lāʻau thyroid.

E like me T4, ka laulā maʻamau, manuahi, a me nā mea i hoʻopili ʻia ʻana o ka triiodothyronine ua ʻike ʻia. ʻAʻole hōʻike pololei ʻo T3 i kahi hōʻailona kūpono o ka hypothyroidism, akā hiki ke hoʻokō i ke kiʻi maʻi.

ʻOi aku ka mea nui o ka hoʻokūkū me ka T3 manuahi, ʻoiai me ka hypothyroidism, ʻike pinepine ʻia ia i ka pae maʻamau. ʻO kēia ke kumu o ka nele o ka thyroxine deficiency, hoʻopiʻi ke kino i nā enzyme e hoʻololi i ka T4 i T3, a no laila ua hoʻohuli ʻia nā koina thyroxine residual i ka triiodothyronine, mālama i ka pae T3 maʻamau.

ʻO kēlā me kēia maʻi i loko o ke kino i hoʻoulu ʻia e ka maʻi, ka maʻi bacterium a i ʻole ka hopena i ka pane koke ʻana o ke ʻano pale i ke ʻano o ka hoʻokuʻu ʻana o nā antibodies e luku iā ke kanaka ʻē - ke kumu o ka maʻi.

I ka hihia o ka hypothyroidism autoimmune, hoʻoholo ka mea pale i ka pathogen me ke hewa, e hoʻopiʻi ʻia ana i ka ʻōmaʻa o ke kanaka me nā antibodies.

Ma ke kaʻina hana o ka lele ʻana i ka autoimmune ma ka lula, ua hoʻohālikelike a me nā ʻano ākea ʻole. Kūlana - nā antibodies i ka peroxidase thyroid, ʻo lākou pū kekahi AT-TPO.

Hoʻokomo ʻia kēlā mau antibodies i nā kelepa kelepona, luku aku iā lākou. Ma muli o ka pili ʻana o nā hua i ka pānaʻi follicle, ma hope o ko lākou luku ʻana, komo nā membrane i ke kahe koko. Kuhi ka ʻōnaehana pale i nā kino o nā ʻāina ʻē i loko o ke koko - nā membranes - hoʻoholo i ko lākou kumu a hoʻomaka i ka hoʻouka hou ʻana - no laila, hōʻemi ʻia ka pae ʻana o AT-TPO.

ʻO ka koho ʻana i kēia mau antibodies i ke koko he mea maʻalahi loa, a lilo lākou i māka gula no ka hoʻomaʻamaʻa i ka thyimitis autoimmune. Inā hōʻike nā hopena o nā hōʻike i ka nui o ka nui o ka AT-TPO i loko o ke koko, ʻo hypothyroidism paha kekahi o ke ʻano o ka maʻi thyroiditis, a hiki i kēia hana ke mau makahiki.

Nā hōʻailona ʻē aʻe

He paʻakikī kēia mau ʻōuli a ʻike pinepine ʻia, a i nā manawa e hoʻokaʻawale ʻia ai, pili pū kekahi me lāua. Eia kekahi, hiki i ke kauka ke kuhikuhi i kahi immunogram, kahi biopsy o ka pani i ka wai a me ka hōʻike maʻamau i ka urine.

Ke hoʻomau nei ka nānā ʻana o ka mimi me ka ʻole o ka haʻalele ʻana mai ka pākaukau.
Hōʻike ka immunogram i kahi emi o ka T-lymphocytes ma lalo o nā palena maʻamau, ka hoʻonui ʻana o ka neʻe o ka immunoglobulins, kiʻi like me ka biopsy - he nui nā antibodies i nā pūlima kelima.
ʻO ka hōʻike koko ākea - e hōʻike ana i ka nui o ka pākaha sedimentation erythrocyte, lymphocytosis pili - he hōʻemi i ka nui o nā lymphocytes.
Hōʻike i kahi hōʻike e pili ana i ka biochemistry ka hapa o ka hapa i ka albumin o ka huna, ka nui o ka neʻe ʻana o ka triglycerides a me ka cholesterol, globulins a me nā lipoproteins haʻahaʻa haʻahaʻa.

Ke lawe nei ka decoding o nā hualoaʻa o ka diagnostics laboratorium e kahi endocrinologist e alakaʻi ana i kēia noi. ʻAʻole ʻona e hana kekahi koʻikoʻi no ka mālama ponoʻana i nā maʻi o ka poʻe maʻi, ʻoiai nā hopena o nā hōʻike no ka hypothyroidism, ʻoiai inā i hoʻopili ʻia ke kiʻi i hōʻike ʻia me ka mea i loaʻa, ʻaʻole ia he maʻi kulupa, akā e kōkua wale nō iā ia.

He aha nā hōʻike e pono ai e hoʻoholo i ka hypothyroidism?

ʻO ka mea kūpono e hōʻike ai i nā hoʻokolohua no ka hypothyroidism, e ʻōlelo ka endocrinologist ma ka ʻike. Ma ke ʻano he kānāwai, ua kuhikuhi ʻia ka mea maʻi i nā haʻawina a me nā haʻawina kōkua. Akā, ʻo ke kumu nui o ka nānā ʻana i nā maʻi thyroid e noʻonoʻo ʻia ka hoʻohālikelike koko.

No ka hoʻoholo ʻana i ka hypothyroidism, ua kau ʻia nā ʻano hōʻike like ʻole:

Kūʻai koko nui.
Kuhi i nā pae o ka hormone.
Nui a me free T3 a me T4.
Hoāʻo koko no nā antibodies.
Ka hana maʻi o ke ʻano o ka hypothyroidism.

Nā hōʻike Hormone

ʻO ka hoʻāʻo ʻana no ka hypothyroidism no nā hormone kekahi o nā ala nui e ʻike ai i kahi maʻi. ʻIke ka poʻe āpau he integral a a me nā mea nui biologically ikaika i pili i nā hana koʻikoʻi, me ka hoʻoholo ʻana i nā hana o nā kuhi thyroid.

ʻO ia ke kumu e kuhikuhi ʻia ai nā maʻi maʻi i nā hoʻokolohua hormonal. Inā, e like me nā hopena o nā loiloi, ʻaʻole i ʻoluʻolu ke kaona o kekahi mau mekala i ʻōlelo ʻia, e ʻōlelo lākou i kahi hana hōʻemi a hoʻonui ʻia o ka nui o ka thyroid e hilinaʻi nei i nā mākaukau, a e kau ʻia kekahi hana lapaʻau.

Pōhoihoi, hana ʻia nā hoʻokolohua e ʻike ai i kēia mauʻano:

Hoʻokomo ʻoe i ka hormone thyroid - like i ka pituitary a, ʻaʻole like me kekahi mea ʻoi aku ka maikaʻi, e hōʻike i kahi maʻi o ka gland thyroid. Hōʻike nā kuhikuhi o ttg i ka mau 0.4-4 mU / l. Inā ulu ka lolo thyid gland function i loko o ke kino a i ka hopena o nā mea pono ʻole, e piʻi ka nui o TSH i ka manawa hypothyroidism e alakaʻi i kona helehelena.
He mea koʻikoʻi hoʻi nā hormone thyroxine no ka hōʻoia ʻana i kahi maʻi maʻi. Inā nele lākou, nā hana abnormalities i ka glandula thyroid. Hiki ke hoʻomaopopo ʻia ka nele o kēia mau hormones e ka goiter hoʻonui nui ʻia.
ʻO ka wehewehe ʻana o triiodothyronine - ke ʻano like o ka hormone like i ke kino i loko o kahi ākea ākea a me kahi kūʻokoʻa. I ka hihia mua, i ka wā o ka nānā ʻana, e hoʻoholo ʻia ke kumukūʻai o ka waiwai biologically i loko o ke koko. Kēia maʻalahi, loli ka pae o ka triiodothyronine manuahi, me ka hoʻomohala ʻana o ka hypofunction o ka kele thyroid, he hana maʻamau kēia hormon. Hoʻoholo wale ʻia kāna helu helu helu inā pono ia e ʻike i kekahi mau loli i ka ʻōmaʻaʻai o ka thyroid a hoʻoholo i nā ʻano lāʻau.

ʻO ka hoʻomākaukau no nā hoʻokolohua hypothyroidism

No ka hilinaʻi ʻana o nā hopena o ka laboratorium a me ka hōʻike hoʻokō pono, pono ia e hoʻomākaukau no lākou ma mua. No ka hana ʻana i kēia, ua lawa ia e nānā ai i kēia mau ʻōlelo hāpai:

ʻO ka lā ma mua o nā hoʻokolohua e kali ʻia ana, pono e haʻalele i ka huaʻī mai ka meaʻai a me nā mea inu a me ka ulaula e hoʻoneʻe.
He mea nui ia e hoʻoponopono i ke kūlana psycho-emotional. I ka manawa e hala ai i nā hoʻokolohua, ʻaʻole ʻoe e ʻalupalu, ʻehaʻeha a i ʻole ke kaumaha.
No kahi lā, haʻalele ʻia nā hana kino kaumaha a pau, pono e hoʻomaha holo ke kino.
Hoʻomaopopo ʻia e hāʻawi i ke koko ma ka ʻōpū ʻole, no laila ua ʻōlelo ʻia nā mea maʻi ʻaʻole e ʻai i nā hola 12 i mua o ke kaʻina hana.
Hoʻopili i ka hoʻohana ʻana i nā lāʻau lapaʻau a hōʻemi paha i ko lākou dosis i hōʻike ʻia e ke kauka.
Ke hōʻike ʻia nei i nā hana e hoʻopiʻi i ka hana o ka gland thyroid no ka nānā ʻana i kā lākou hana kūʻokoʻa.
ʻAʻole kuhi ʻia nā wahine e lawe i nā hoʻokolohua i ka wā ʻo menstruation. ʻO nā lā maikaʻi loa no ke kaʻina hana he 4-7 mau hāloʻe.

Nā palapala noiʻi hou no ka hypothyroidism

Inā he kūpono nā hōʻoia o ka ʻoihana laboratorium no ka hypothyroidism, ua kuhikuhi ʻia nā hana hoʻokolohua instrumental no ka mea maʻi e hōʻoia i ka ʻoi aku ka hōʻoia maʻalahi:

ʻO ka nānā ʻana i ka ultrasound - e hiki ai iā ʻoe ke hoʻomaopopo i nā sila i loko o ke kino, a me kā lākou kūloko ʻana, ʻano, ʻano, a me nā contours. Mahalo i ka ultrasound, ua hiki ke ʻike i nā puka mai 1 mm ka lōʻihi.
ʻO ka maʻi thyint scintigraphy kahi hana diagnostic e hoʻohana ai i ka radioisotopes. Ma mua o ka hoʻopunipuniʻana, koi ʻia ka hoʻomākaukau e hoʻonui i ka hilinaʻi o ka hoʻokolokolo.
Nā Biopsy i ukali ʻia e ka hoʻokolohua moʻolelo.

Inā hāʻawi ʻia nā ʻano like i ka hopena maikaʻi, ma kēia hihia, ke hoʻoholo nei ke kauka i ka mālama ʻana a kuhikuhi i nā lāʻau lapaʻau a me nā ʻano hana ʻē aʻe o ka lāʻau i ka mea maʻi, ma muli o nā hopena o ka hoʻokau.