Nā hōʻailona maʻi i ka wā hou a me ka hypothyroidism congenital

Ma kēiaʻatikala e aʻo ai ʻoe:

Hoʻonui pinepine ʻia nā congenital hypothyroidism i ka wā kamaliʻi a ʻo kona kumu ke hoʻololi mau nei. Eia naʻe, kahi pāʻina o ka levothyroxine i koho pono ʻia no ka hoʻōla ʻana i hoʻopau i ka hopena o ka congenital hypothyroidism ma ke kino.

Nā kumu o ke kūkā Hypothyroidism

ʻO nā mea nui:

ʻO ka hala ʻana / i lalo o ka lōnao thyroid ma muli o nā genetics,
ʻO nā maʻi genetic ma ka biosynthesis o nā hormone thyroid,
ʻO ka nele a ʻole ka nui o ka iodine i loko o ka papa hānai wahine hiki ke alakaʻi i ka hypothyroidism i kahi keiki hou,
ʻO ka nui o thio a me isocyanates, a me ka cyanogenic glycosides, i ka meaʻai. He mea maʻamau ia e kāhea i kēia mau mea i ka strumogenic o ke olakino a ke kau ʻia nei lākou ma loko o ka maʻamau, Brussels sprout a cauliflower, canola, turnip, sweet potato ... Hiki ke hoʻomau ʻia ka papa inoa, akā ʻaʻole kēia ma ke ʻano o ka wā e hapai ai kēia mau huahana mai ka meaʻai. ʻAʻole lawa ia e hoʻopau iā lākou i loko o nā helu he nui loa,
Lawa lawa, ʻike ʻia ʻana i ka iodine hāpai ʻia e ka wahine hāpai. Mai ka piha o nā hebedoma 10-12, ua hōʻiliʻili nā kelepa waila nui i ka iodine, me ka radioactive,
ʻO ka hoʻomaʻamaʻa loa a me ka liʻiliʻi o ka hoʻomaʻamaʻa ʻana o ka congenital hypothyroidism ʻo ke ala o ka receptors hormone thyroid. I kēia hihia, nui nā TSH, a me T3, a me T4 i loko o ke koko, akā ʻike mau ka hypothyroidism. ʻElua wale mau ʻohana me kēia ʻano hoʻohālike o ka kongenital e wehewehe ʻia.

ʻO ka hypothyroidism congenital, ke hoʻopaʻa ʻia ma ke keiki, ua kapa ʻia ʻo ia ka cretinism. ʻOiaʻiʻo, ʻo ka nele o nā hormones thyroid e lohi i ka hoʻomohala a me ka noʻonoʻo o ke kanaka. Ua ʻōlelo ʻia ʻo Myxedema ma loko o ka hypothyroidism koʻikoʻi, me ka congenital, i ka wā ka ulu ʻana o ka hypothyroid a i ʻole ka myxedema edema.

Nā huapau

ʻO ke ʻano o ka pēpē ka ʻano o ke ʻano neonatologist i hōʻike ʻia i kahi maʻi maʻi ma ke kumu o ka hoʻokolokolo maʻalahi.

ʻOi aku ka nui o ka pēpē ma mua o kēlā me ke kaona o luna.
Ke kīwī nei i nā wāwae, nā lima, nānā ka maka. Uʻi ʻia ka ʻiliʻili o ke keiki a ke ʻano hoʻohālikelike ʻia me nā pēpē hou aʻe,
Ke paʻi ʻia, ʻaʻole i ʻike ʻia ke ʻano kiʻekiʻe o ke kino.
He lohi ke keiki a me ka hypothyroidism congenital, e piʻikaʻaka iki loa, nāwaliwali ka hūnā wai, nāwaliwali o kahi leʻaleʻa,
Eia naʻe, ʻoiai ke loaʻa nei ke keiki i ka paona ikaika. ʻAʻole ulu ka paona kino ma muli o nā momona, akā no ka hoʻonui ʻana i ka edema. Me ka hypothyroidism congenital i loko o ka pēpē, ke keiki, a me nā pākeke, nā mea ʻona a maikaʻi ʻole ke loaʻa ʻana akā he mea hiki ʻole ke hoʻopaʻa i ka wai o ka hōʻiliʻili i ka momona subcutaneous. Ma muli o kēia, ua maloʻo nui ka edema me kekahi hypothyroidism, a ʻānō hoʻi ka ʻili o ka ʻili.

Hiki ke loaʻa ka ʻike makana ʻoi aku ka ʻoi aku ma mua o 4-5 mau lā, no ka mea ma mua o ka wā, hiki ke ʻike ʻia nā homernal hormones i loko o ke koko o kahi pēpē. Aia nā kānana hoʻokolohua, kahi hoʻopili o kahi koko i hoʻopaʻa ʻia iā lākou, ka mea i lawe ʻia i loko o nā kuʻekuʻe hou mai nā kuʻekuʻe wāwae. Inā loaʻa ka nui o TSH i kēia ala, a laila ua hoʻokū ʻia ka maʻi.

ʻO ka hana hou e hoʻokumu ai i ke kumu o ka hypothyroidism congenital, ʻoiai ke hilinaʻi nei ka mālama ʻana iā ia ma nā ʻano like ʻole. ʻO ka hypothyroidism kongenital, inā “pili,” i hui pū ʻia me ka congenital adrenal insufficiency. ʻO kēia ke kumu, aia ka pilikia ma hypothalamus (hapa o ka lolo, ka pūnaehana koa ma waena o ke ʻano), kahi i loko o kēia maʻi ʻaʻole i hoʻoulu ʻia i nā aʻa adrenal a i ʻole nā kelepa thyroid. I kēia hihia, ʻoi aku ka maikaʻi o ke kuhikuhi ʻana i nā lāʻau thyroid, akā ʻo TSH, a hui pū ʻia me nā hormone adrenal, i kuhikuhi mua ʻia. ʻO ka mea pōmaikaʻi, he minamina ʻo ka maʻi neoneʻo hypothyroidism.

Hāpai congenital hypothyroidism

He mea maʻalahi ia nā mea āpau: ʻo ka hiʻohiʻona o ka pēpē, nānā a hiki ke mālama ʻia. Akā, ʻoi aku ka nui o nā hana subclinical o ka hypothyroidism congenital, ʻaʻole maʻalahi ke hoʻonohonoho pono. ʻO kēia mau ʻōuli i ka pēpē, heʻoiaʻiʻo nō naʻe, akā ua maloʻo naʻe, ʻaʻole e palupalu i ka maka, a hele pinepine ʻole ʻia ke keiki, ʻaʻole mālama ʻia ke keiki. ʻO ke kumu maʻamau o ka hypothyroidism congenital ʻoihana i lalo o ka hoʻopalepale thyroid, a ma kēia hihia, ulu nā subclinical, ngawari hypothyroidism.

Hoʻoulu ke keiki i ka lethargic a me ka phlegmatic, kino kiko, pinepine mau ia ma hope o ka hoʻolālā ʻana. Hoʻomaʻamaʻa ʻia kēia ma ka emi ʻana o ka hoʻolālā kino. Hōʻemi ʻia ke kūkulu kino ʻana: pihili ʻia nā fontanelles, nāʻi nā niho mua. ʻO ka maʻamau o ka constipation, ke ʻano kuʻuna maʻamau a he ʻano ʻano no ia mau keiki. Hoʻalaʻe ʻo Edema i ka nasopharynx, a hamani pinepine ke keiki i loko o ka waha. Hoʻokumu ʻia kahi ʻano adenoid i ka maka liʻiliʻi a me ka waha e hamama mau ana. Hoʻopilikia pū ʻia ke kōkua pepeiao, a i ʻole nā pepeiao.

Hoʻohālikelike nā ʻōkuhi o nā pākeke i ka wā maʻamau, akā ua hoʻohui ʻia nā pilikia o ka naʻau: atherosclerosis ʻike mua a me CHD ma hope. Holo ka lauoho, hemo nā kui, ʻikea ke kanaka i ka minamina, akā ʻaʻole kupapaʻu ka hoʻāʻo ʻana. ʻO ka maʻamau, hoʻohui ʻia ka anemia i kēia pahu maʻamau no ka hypothyroidism congenital. No laila, kahi pānaʻi o kahi kanaka o kahi ʻano pale melemele ʻonaʻeha ma muli o ka hui ʻana o ka anemia me ka ʻoli kuʻuna ākea.

ʻO nā hoʻokolohua wale nō ke hōʻike i ka maʻi kūpono. Hoʻonui nui ka TSH, a hoʻemi ʻia ka nui o nā hormone thyroid. Inā hana ʻoe i ka ultrasound, hiki iā ʻoe ke ʻike i kahi kaila, kahi hoʻololi i ke ʻano o ka nui o ka lolo thyroid.

Hoʻomaka maikaʻi nā hōʻailona o ka hypothyroidism congenital e ke koho ʻana i nā hormone thyroid, a hoʻomaka ʻia ka hoʻomaʻamaʻa ʻana ma mua o 5-17 mau lā ma hope o ka hānau ʻana o kahi kanaka.

E like me nā keiki me ka hypothyroidism subclinical paʻa i ke kūlana, pane koke ko lākou kūlana i ka mālama kūpono. Ua kapaʻia nā pediatricians i kēia hanana "catastrophic recovery." Hōʻalo koke ka pīhoihoi, hoʻōla ka keiki, ulu ka pākeke, hoʻomau ka holomua ma kahi o ka maʻamau maʻamau. Loaʻa kēia mau mea i kahi lā, ʻoiai ʻaʻole mau ka maʻamau o nā hormones i loko o nā hoʻāʻo koko.

I ka paʻakikī o ka mālama ʻana i nā keiki me nā hormone thyroid ʻo ia e ulu ana, pono ka loli no lākou a loli ke ʻano, e like me ke koho hou ʻia. E like me ka poʻe pākeke, ke ʻano like ko ka mālama ʻana, ʻaʻole loli nā lula (ʻo ka wā hapai, ke kaumaha nui, ka menopause, etc.), a ʻoi aku ka hopena o ka hopena. I nā mau makahiki, ua hui pū kekahi pathology concomitant, pono ke kauka ke koho i nā lāʻau lapaʻau i hui pū ʻia me nā hormone thyroid i kauoha mau ʻia, he mea nui ia no ke kanaka a ʻaʻole hoʻi e hōʻole ʻia.

I kēia lā, ʻo ka sodium levothyroxine ka mea i makemake nui ʻia, akā ua hui pū ʻia (T3 + T4 a i T3 + T4 + iodine) i ʻōlelo mau ʻia. Hoʻololi mau ʻia ka pā mua ma mua (50-150 gg / lā no kahi pākeke, 5-15 gg / kg no kahi keiki hou a ma kahi o 2 gg / kg no kahi keiki), e hoʻonui lohi nei i kahi mea ponoʻī. E pili ana ka endocrinologist i ke kiʻekiʻe o ka TSH: inā inā hoʻonui ʻia, a laila e hoʻonui ʻia ka lāʻau, a inā e hōʻemi ʻia, a laila he kau overdose. Inā ʻoi aku kahi kanaka ma mua o 55, a laila kāohi ikaika lākou i ka kolamu a me ka hana puʻuwai, aia nā hiʻohiʻona o ke koho lāʻau (ʻike i ka papaʻaina).

I ka pākeke, ʻike ʻia ʻo TSH no 1-1, 3-1 a me 6 mau mahina ma hope o kona ʻano maʻamau, a laila ma loko o nā makahiki mua, e hoʻokau ʻia ana nā hōʻike i kēlā me kēia mau mahina, a laila ma ka liʻiliʻi loa i hoʻokahi makahiki. Kūleʻa nā keiki i ka mālama ʻana me ka hana maʻamau o TSH - ʻoi aku i 2-3 mau pule. Inā ʻaʻole maʻamau ʻo TSH ma ka liʻiliʻi e hoʻokahi, a laila hoʻomaka ke koho wīwī.

Pono pinepine ka hypothyroidism e koi pinepine i ka lāʻau lapaʻau lōʻihi. Eia naʻe, ʻo ka hewa kūpono o nā hormone thyroid i kuhikuhi ʻia e ke kauka ma ka ʻāpana kūpono e pili wale ana i ka lōʻihi a me ka loaʻa o ke ola.

Hoʻohana pinepine i ka nui o ka hormone thyroid ma ka hopena kūpono e hiki ai ke keiki ke mālama i ka like o ka hoʻomohala ʻana e like me kāna mau hoa.

Hoike ʻike

ʻO ka hypothyroidism i loko o nā keiki he ʻano pathological i hōʻike ʻia e ka hapa piha ʻole a me ka ʻāpana hapa o nā hormone thyroid: thyroxine (T4), triiodothyronine (T3) a me thyrocalcitonin. I nā pule mua o ka hoʻoulu ʻana i ka maʻi fetal, e hana ana nā hormone thyroid ma ka embryo, akā ma ka wiki he 10-12 e hoʻomaka ai ka ʻōmaʻomaʻo thyroid i ka hana ma ka ʻōpio. ʻO ka hana ʻana o nā hormones thyroid i loko o nā pūpuna o ka kelapa - nā selula thyroid, hiki iā ia ke hopu a hōʻiliʻili iodine kūwaho mai ka plasma koko. ʻO ke ʻano nui o ka hormone thyroid no ka hoʻomohala maʻamau o ka ulu ʻana o ke keiki, ka mea ma mua o nā antenatal a me nā hebedoma mua o ka wā postnatal. Ka hoʻonāukiuki i nā ʻōhua o ka thyroid i ke kaʻina o ka embryogenesis: ka hoʻokaʻawale ʻana o nā kiko o ka iwi, ka hoʻokumu ʻana a me ka hana ʻana o nā hematopoietic, nā māhina a me ka pale ʻana i ka ʻōnaehana o ka hana o ka lolo, me ka cebec cerebral.

ʻO ka hemahema o nā hormone thyroid i nā keiki e hōʻeha i nā hopena koʻikoʻi ma mua o nā pākeke, a me ka ʻōpio ke keiki, ʻo ka hypothyroidism ʻoi aku ka pilikia no kona olakino a me ke ola. Hypothyroidism i nā keiki e alakaʻi i ka lohi i ka ulu kino a me ka noʻonoʻo (ka ulu ʻana, ka ʻōpio, ka naʻauao), ka hōʻino ʻole ʻana i nā ʻano āpau āpau (protein, nā momona, kākaʻaka, kalima) a me nā ʻōnaehana thermoregulation.

Ka helu ʻana o ka hypothyroidism i nā keiki

Hiki i ka hypothyroidism i nā keiki ke congenital a loaʻa paha. Me ka hypothyroidism congenital, hānau ʻia nā keiki me ka nele o ka thyroid. ʻO ke kiko o ka hypothyroidism congenital, e like me ka endocrinology o kaedi, kahi mea e pili ana i ka 1 pākēkē o 4-5 mau keiki hou (ʻo nā kaikamahine he 2 mau manawa i ʻoi aku i nā keiki kāne).

E like me ka paʻakikī o nā hōʻike, hypothyroidism i loko o nā keiki hiki ke lilo (transient), subclinical, manifest. Hoʻololi i ka pae o ka haunaele i ka hana o nā hormone thyroid, ka mua (thyrogenic), ka lua (pituitary) a me ka papa kiʻekiʻe (hypothalamic) hypothyroidism i loko o nā keiki.

Nā kumu o ka hypothyroidism i nā keiki

Hoʻokumu ka hypothyroidism i nā keiki me nā maʻi ʻē aʻe i ka hana o ke ʻano hypothalamic-pituitary-thyroid. I ka 10-20% o nā hihia, ʻo nā kumu o ka hypothyroidism congenital i loko o nā keiki ka mea hiki ke hoʻonaninani a genetic inā hoʻoili ʻia ka huaʻāina mutant e ke keiki mai ko lākou mau mākua, akā i nā hapa nui he maʻi ka maʻi.

Basically, loaʻa nā keiki me ka hypothyroidism pili i ka pathology o ke kelekoʻo thyroid ponoʻī. ʻO ke kumu maʻamau o ka hypothyroidism i loko o nā keiki ka maʻi o ka maʻi thyroid e hōʻike ʻia ana e ka aplasia (ʻaʻole hoʻi), hypoplasia (underdevelopment), a i ʻole dystopia (neʻe) ka huelo. ʻO nā mea pili i ke kaiāulu (radiation, nele i ka iodine i ka meaʻai), pākia intrauterine, ka lawe ʻana i kekahi mau lāʻau lapaʻau (thyreostatics, tranquilizer, bromides, lithium salts), ka heleʻana o ka thyroiditis autoimmune, a me ka goiter endemika e hoʻonāukiuki i ka hōʻeha o ka thyroid. In 10-15% o nā hihia, ua pili nā hypothyroidism i nā keiki me ka synthesis o ka hoʻopalehu o nā hormone thyroid, kā lākou metabolism a hōʻino paha paha i nā ʻāpana ʻāwelana i kuleana no ka hoʻoweliweli ʻana o nā kiko i kā lākou hana.

Hiki i ke hypomyroidism lua a me ke kula nui i nā keiki ma muli o ka anominal congenital o ka pituitary a me / a hypothalamus a i ʻole ke ʻano genetic i ka synthesis o TSH a me thyroliberin, nāna e hoʻoponopono i ka huna ʻia o nā hormone thyroid. Ka loaʻa i ka hypothyroidism i nā keiki hiki ke hōʻeha me ka hōʻeha ʻana i ka pituitary a i ʻole ka lolo thyroid ma muli o ke kaʻi a me ka hoʻōla ʻana, trauma a i ʻole ka hōʻemi, a me ka hemahema o ka iodine.

Nā hōʻailona o ka hypothyroidism i nā keiki

ʻO ka hypothyroidism i loko o nā keiki hou he mau hōʻike maʻi liʻiliʻi, ka mea e loaʻa ai ka hopena o ka lawe ʻana (40-42 mau pule), ka nui o ke kaumaha o ke keiki (ma luna o 3.5-4 kg), ka āmahu o ka maka, nā pūlima, ka alelo (macroglossia), nā manamana lima a me nā manamana wāwae. loloa a me ka hanu kaumaha, haʻahaʻa nui, uwe nui. I nā pēpē hou me ka hypothyroidism, lōʻihi jaundice, hoʻōla hou o ka hōʻulu umbilical, umbilical hernia, nāwaliwali hānai momona hiki ke hoʻomaopopo ʻia.

Hoʻonui mālie nā hōʻailona o ka hypothyroidism a ʻike ākea i ka ulu ʻana o ke pēpē, ʻokoʻa lākou i ka nānā ʻana i ka wā o ka hoʻoulu ʻana ma muli o ka uku e nā hormone thyroid. Aia i ka wā kamaliʻi ma nā keiki me ka hypothyroidism, ʻike ʻia nā hōʻailona o ka lohi i ka hoʻomohala ʻana i ka somatic a me ka psychomotor: i ka nui lethargy, ke hiamoe nei, nā ʻōpū o ka naʻau, ka lethargy a me ka hana kūlohelohe, ulu nui a me ke kaumaha, hoʻonui nui a me ka wā e pani ʻana i ka fontanel, lohi ka mea, hemahema nā mākaukau (mālama i kou poʻo, huli , noho, kū).

Me ka hypothyroidism i loko o nā keiki, ulu ke bradypsychia - hoʻowahāwahā ʻole i ka honua o waho me ka ʻike a me ka piʻo scanty: ʻaʻole hele ke keiki, ʻaʻole ia e haʻi i nā syllables pilikino, ʻaʻole pāʻani ma ke kūʻokoʻa, e hana ʻole i ka hoʻopili maikaʻi ʻana. Aia nā hōʻailona e hōʻino i ka ʻōpū o ka naʻau, hoʻemi i ka pale ʻana i nā pale, pallor a me ka ʻili maloʻo, ʻokiʻoki, haʻahaʻa haʻahaʻa o ke kino, anemia, constipation.

ʻO ka hōʻeha nui o nā hōʻailona o ka hypothyroidism congenital i loko o nā keiki e hilinaʻi nei i ka etiology a me ka paʻakikī o ka maʻi. ʻO ka pōʻino o ka hemahema o ka nui o ka nui o ka hormone thyroid i ka wā mua o ka ulu ʻana o ka holomua o ka intrauterine he hōʻeha ʻole i ka hoʻomohala ʻana o ka ʻōnaehana waena o ke keiki, e alakaʻi ana i ka dementia a me ka cretinism me ka hōʻeha o ka noʻonoʻo nui, deformity skeletal, dwarfism, pilikia noʻonoʻo, ka hoʻolohe a me ka ʻōlelo (a hiki i ke kuli), a me ka luʻu o ka moʻo ʻana.

Me kahi pākaha mālie, hiki ke hoʻopau ʻia a hōʻailona ʻia nā hōʻailona o ka hypothyroidism i nā keiki i ka manawa neonatal a puka aʻe ma hope, i ke makahiki o 2-6 mau makahiki, i kekahi manawa ma ka wā ʻōpiopio. Inā hele mai ka hypothyroidism i nā keiki ma luna o nā makahiki he 2, ʻaʻole ia e hoʻokō i ka maʻi noʻonoʻo. I nā keiki kahiko a me nā ʻōpio, hiki ke hoʻopili ʻia ka hypothyroidism e ka loaʻa ʻana o ka paona nui, ka momona, ka ulu nui ʻana a me ka wā ʻōpiopio, ka ʻilihune maikaʻi ʻole, ka noʻonoʻo lohi ʻana, a maikaʻi ʻole nā hana kula.

Ke mālama nei i ka hypothyroidism i nā keiki

Pono e hoʻomaka ʻia ka mālama ʻana i ka hypothyroidism congenital i nā keiki ma ka lā mua ma hope o ka maʻi (aʻaʻohe ma mua o 1-2 mau pule ma hope o ka hānau ʻana) i mea e pale ai i nā pōʻino nui o ka hoʻomohala ʻana o ka psychosomatic keiki.

I ka hapa nui o ka congenital a loaʻa i ka hypothyroidism i loko o nā kamaliʻi, ʻo nā lāliʻi kaulike o ke ola me kahi synthetic hormon tiro thyme, ʻo ka sodium levothyroxine, pono. Hoʻomaopopo ʻia ka lāʻau lapaʻau i kahi inika mua o 10-15 μg / kg momona kino i kēlā me kēia lā ma lalo o ka nānā mau ʻana i ke ʻano o ke keiki a me nā ʻōhua biochemical e koho ai i ka hopena kūpono o ka lāʻau. Hoʻohui hou ʻia nā huaora (A, B12), nā lāʻau nootropic (hopantenic acid, piracetam), meaʻai maikaʻi, kaʻai, hoʻomaʻamaʻa hana.

Me kahi ʻano subclinical o ka hypothyroidism i nā keiki, ʻaʻole pono ke koi ʻia o ka mālama ʻana, ma kēia hihia ke hōʻike ʻia nei ka mālama kānāwai. Me ka hoʻomohala ʻana o ka cretinism, kahi hiki ʻole ke hoʻōla maikaʻi ʻia, lawe ka sodiumroxine sodium i hoʻomaikaʻi maikaʻi i ke ala o ka maʻi.

Puhi a me ka pale ʻana i ka hypothyroidism i nā keiki

ʻO ka hoʻohuihui o ka hypothyroidism i loko o nā keiki e hilinaʻi ana i ke ʻano o ka maʻi, ʻo ka makahiki o ke keiki, ka manawa i hoʻomaka ai ke ʻano o ka mālama ʻana, a me ka kūpono kūpono o ka levothyroxine. Ma ke kānāwai, me ka mālama pono ʻana o ka hypothyroidism i nā keiki, ʻike koke ʻia ke ʻano, a laila ʻike ʻia nā mākau maʻamau e pili ana i ka ulu kino a me ka noʻonoʻo.

ʻO ka haʻalele ʻole a i ka hoʻomaka mua ʻana o ka mālama ʻana no ka hypothyroidism e alakaʻi i ka loli hohonu a hikiʻole i ke kino a me ka hemahema o nā keiki.

Pono nā keiki me ka hypothyroidism e nānā mau ʻia e ka lolo, pediatric endocrinologist, pediatric neurologist me ka mālama pinepine ʻana i ke kūlana thyroid.

ʻO ka paleʻana o ka hypothyroidism i nā keiki i loko o ka hoʻokomo nui o ka iodine e kahi wahine hāpai i ka meaʻai a i ʻole i ke ʻano o nā lāʻau lapaʻau, ʻokoʻa i nā wahi iʻai ʻole iodine, ʻike mua i ka hemahema o ka nui o ka hormone thyroid i nā māmā hāpai a me nā keiki hou.

He aha ka maʻi?

ʻO ka gland thyroid ka mea nui e lilo ai i ke kanaka endocrine system. Hana ia i nā hana he nui pono no ke kūkulu ʻana o ke keiki. Loaʻa i ka lākona ka ʻike ʻike āpau mai ka ʻaoʻao ma o ka ʻike ʻana o nā leo, ʻā, ʻā. Ke hana nei ke kino o ke kanaka me ke kōkua o nā hormone - nā meaola biochemical. Hoʻohana ka ʻōnaehana neuroendocrine ma waena o ka lolo a me ke kino.

ʻO nā kino nui e hoʻomaʻamaʻa i ka ʻike a pau ka pituitary a me ka hypothalamus. Hāʻawi lākou i ka hana thyroid gland i kahi "kauoha" e pili ana i ke ʻano o ka hormone e pono ai ke kino.

He mea paʻakikī ʻoi paha ka nui o nā hana e hāʻawi ana i kahi hao hao. ʻO nā mea nui ka mea like:

ka pale aku o ka ea ma ke kō, a me ka metabolism,
ka hoʻohuihā ʻana o ka vitamina A i ka puʻuwai,
komo i ka ulu ʻana o ka naʻauao,
hoʻohaʻahaʻa i ka cholesterol
ka ulu ʻana o ka ulu i loko o nā keiki,
hoʻoponopono o nā kalima metabolism, a me nā momona, nā huapalapala a me nā ʻōmole.

Pēlā, ua hāʻawi kēia mea ola i ka hoʻomōhala piha o ke kino o ke pēpē. Eia kekahi, i ka hoʻomohala ʻana o ke ʻano piʻina a me ke kala, hoʻokani ʻo ia i kekahi o nā kuleana nui. Hoʻokomo ʻia ka hao olakino i ʻelua mau ʻano o ka hormone:

tiriko (T4),
triiodothyronine (T3).

E noʻonoʻo wale i nā mea e tupu ana i ke kino inā he pilikia ka glid thyroid. ʻOiai, me ka loaʻa ʻana o ka maʻi hypothyroidism congenital i loko o nā pēpē, hoʻēmi ka hana o nā hormones i luna. ʻO kā lākou hemahema e hoʻopilikia nui i ka hana o ke kino holoʻokoʻa. Ma kahi o nā hormones e hiki ke alakaʻi i ka pale ʻana o ka noʻonoʻo a me ka hoʻomohala ʻana o ke keiki, ua lohi ka ulu. Ke loaʻa nei ka pēpē i ka momona o ke kaumaha, ua loaʻa iā ia ka maʻi palehaʻeha lohi, ke hoʻemi ʻia ka ikaika, pilikia ka puʻuwai o kona naʻau a me ke koko. Eia kekahi, e hana pono nā ʻaleka i ka hana hewa, hōʻeha ʻia ka iwi.

Nā kumu nui

No ke aha i hōʻea ai ka hypothyroidism congenital i loko o nā keiki? Aia nā kumu he nui e hoʻonāukiuki i ka nānā ʻana o ka maʻi. I waena o lākou, hoʻokaʻawale nā kauka i nā mea nui:

Mea moʻomeheu ʻano. ʻO ka maʻi e nīnau nei e pili pono ana i nā genetics. I ka nui o nā manawa, kū mai ka maʻi thyroid ma mua o ka hānau ʻana o ka pēpē - i ka wā o ka hoʻomohala ʻana i ka wahine hāpai. Pili ke ʻano me kēia ʻano hanana genations.
Hoʻopilikia i ka hoʻokumuʻana o nā hormones. Hana kēia ma muli o ka emi ʻana o ka hoʻoweliweli ʻana o ka lolo thyroid i ka iodine. I kekahi manawa ke hele wale ka halihali o nā mea pono e pono ai no ka synthesis o nā hormone. A i kekahi manawa ke waiho nei ke kumu ma ka waiho hewa ʻana o ka iodine metabolism ma ke kino.
ʻO ka hāʻule ʻana o ka hypothalamus. ʻO kēia kahi o ka pūnaehana ʻōwili. Hoʻopili ia i ka hana o ke kelā thyroid, a me nā kelepona endocrine ʻē aʻe. Hoʻokomo nā mīhini o ka hypothalamus i nā maʻi endocrine koʻikoʻi.
Hoʻemi ka hoʻohaʻahaʻa i nā hormone thyroid. Hiki i kēia hanana ke ʻano ma muli o ka manaʻo o ka wahine, ʻo ka ʻōpū lā, ua lawe i nā lāʻau antithyroid.
Nā maʻi Autoimmune.
ʻO kou mauʻu thyroid.
Hoʻemi i ka lawaiʻa.
ʻO ka overdose me kekahi mau lāʻau lapaʻau (hoʻomākaukau o ka lithium, corticosteroids, ka vitamina A, nā beta-blockers).
Hōʻikeʻike i ka maʻi.
ʻO nā maʻi maʻi.
ʻO ka hemaʻo Iodine.
Parestiestest infestations.
Hoʻolālā me ka iodine radioactive.

Nui nā kumu kumu e alakaʻi ai i ka maʻi hoʻomehana. Eia nō naʻe, i ka hapa nui, ʻo ke kumu o ka maʻi i ke keiki, ʻaʻole i maopopo.

ʻO nā ʻano nui

Hōʻikeʻia kēia maʻi e ka emi ʻana o ka hana ʻana i nā hormones thyroid, nona ke kuleana no ka metabolism i ke kino. I kēia mau lā, he maʻi maʻamau ka hypothyroidism. Hoʻokoʻa i nā ʻano like ʻole, nā pae kahi e hoʻomohala ai.

ʻO ka pilikia nui loa ka hiki o ka papa lōʻihi o ka maʻi asymptomatic o ka maʻi. A ua alakaʻi kēia i nā hōʻeha he nui, ma muli o ka hopena i ʻoi aku ka paʻakikī o ka hoʻomaʻamaʻa.

Hiki ke maʻi ʻia ka maʻi hypothyroidism e nā ʻano like ʻole. Wahi a nā poʻe loea, hilinaʻi nā kumu i ke ʻano o ka maʻi. I kēia lā, hoʻokaʻawale ʻia lākou e ʻelua:

Hoʻokomo pinepine ʻia ka congenital hypothyroidism i ka wā hāpai. ʻO ka luku thyroid ka mea. Ma hope o ka hānau ʻana o kahi pēpē, hiki i ke ʻano pēpē ke hoʻonāukiuki i ka liʻiliʻi o ka ʻōnaehana o ka pīpī o ke pēpē, kahi lawa i ka hoʻomohala ʻana i ka noʻonoʻo, a me ka hana kūpono ʻole.

Hiki i nā hypothyroidism hiki ke hoʻopau ʻia me ka nele o ka hoʻokomo iodine, ma hope o kahi hana e hoʻoneʻe ai (mahele ʻokoʻa a ʻokoʻa paha) ka nui o ka pala thyroid. ʻO kekahi mau mea hoʻonāukiuki i kou ʻano palekana ponoʻi paha, ka mea e hōʻino ai i kahi kelepona koʻikoʻi.

Ka hoʻokaʻawale ʻana i nā loli pathological e kū mai ana i ka lāʻau thyroid.

hypothyroidism kumu
kekona
kaiaulu.

Loaʻa kēlā me kēia me kāna mau kumu kikoʻī. ʻO ka hypothyroidism primus kahi maʻi maʻi i hoʻowalewale ʻia e nā mea e pili pololei ana me ka thyroid gland. Eia ka mea penei:

nā kuʻuna genetic,
mau ala helehelena o ka hoʻonohonoho ʻana o ke kino,
a me nā hana hoʻopihapiha kūlike e pili pololei ana i ka nui o ka thyroid gland,
ka nele iodine i ke kino.

ʻO ka ulu ʻana o kahi ʻano lua kahi maʻi e pili ana i ka pōʻino o ka gland pituitary, i mea e pani ai ka hana o ka hormone TSH. ʻO nā mea nui i ka loaʻa o ka maʻi i kēia hihia.

ka hooulu mana o ka huina,
kaumaha nui a me ka uha pinepine ʻana,
hana ʻino a me ke kino,
ʻili i loko o ka kelopona pituitary.

Ke hoʻōla nui ka pae kula ma ka hana i ka hypothalamus.

ʻO nā hōʻailona a me nā hōʻailona o ka maʻi

ʻO nā manawa pinepine i nā lā mua o ke ola o kahi keiki, ʻaʻole kū ʻia ka hypothyroidism. Ke kūpaʻa nei nā hōʻailona o ka maʻi ma hope o hoʻokahi mau mahina. I kēia manawa, ʻike nā mākua a me nā kauka i ka neʻe o ka hoʻonui ʻana i ka pēpē. Eia naʻe, i kekahi mau pēpē, hiki i nā hōʻailona o ka hypothyroidism congenital ke hele i loko o nā hebedoma mua o ke ola.

Aia nā hōʻailona maʻamau:

ʻO ka nui o ka hānau hānau (ʻoi aku ka paona pēpē ma luna o 3.5 kg).
ʻO kahi pēpē i hoʻololi ʻia me nā mea hopena āpau (kino a ʻiliʻoki ʻia, ʻili lōʻihi, nā hemahema o ka lubrication).
ʻO ka maka o Edematous, nā lehelehe, nā maka.
Nā paleʻai hoʻomalu.
Ua huehue ka nui o ka fossae supraclavicular i ke ʻano o nā papa ʻalā.
He waha e hamama ana, he alelo.
ʻO ka heleʻana o nā hōʻailona o ka moekolohe.
Hoʻolaha kahe nui o nā feces mua.
ʻO ka leo paʻakikī o kahi pēpē, haʻahaʻa haʻahaʻa (i ka uwe ʻana).
ʻO ka hoʻōla kaumaha o ka navel (pinepine ka hernia).
The triangle of the nasolabial region nagiging cyanotic.

Inā ʻaʻole hoʻomaka ʻia ka mālama ʻana i ka malama mua o ke ola, ʻo ia ke ʻano e hōʻike ana ke keiki i ka noʻonoʻo, ke kino, ka haʻi ʻana a me ka naʻau o ka mana ʻana. I ka lāʻau lapaʻau, kēia kūlana i kapa ʻia he cretinism.

Me ka mālama pohō ʻana i nā makahiki he 3-4 mau mahina, ʻike ʻia nā hōʻailona ʻē aʻe. Hōʻike lākou i ka holomua. ʻO nā hōʻailona o ka maʻi like i kēia:

Hoʻemi i ka momona.
Haki i ke kaʻina hana.
Hoʻopili i ka ʻili.
Constipation maʻi mānoanoa.
He haʻahaʻa kiʻekiʻe.
Pūʻai hypotension.
ʻO ka maloʻo a me ka palu o ka ʻili.
Lauoho lauoho.

I nā makahiki he ʻelemakule, ua loaʻa ka maʻi i kēia mau hōʻailona:

Lag ma loko o ke ʻano noʻonoʻo, hoʻomohala kino.
Ka hoʻololi o ka helehelena helehelena.
ʻO ka huli ʻana o nā niho.
He haʻahaʻa haʻahaʻa.
He pulse luhi.
Hoʻonui ka naʻau.

Hoʻokomo ʻia nā mea nui i ka Hypothyroidism Congenital

Ma kahi o 85% o nā hanana o ka hypothyroidism congenital he sporadic. ʻO ke kumu o ka hapa nui o lākou he dysgenesis o ka nui o ka lāʻau thyroid.

Ma kahi o 15% o nā manawa o ka hypothyroidism congenital ma muli o nā hopena o nā antibodies o ka makuahine i ka aʻu thyroid a i ʻole ka hoʻoilina o nā pathologies o T4 synthesis.

Eia kekahi mau ʻano congenital hypothyroidism i kēia lā ua loaʻa ka genetic mutations e alakaʻi ana i ka hoʻomohala ʻana o ka maʻi.

ʻO nā kumu nui o ka hypothyroidism congenital

Nā maʻi thygenesis (underdevelopment):

Nā alahele iʻike ʻia o ka T4 synthesis:

ʻĀina Syndrome.
Kālala o nā thyroid peroxidase.
Ke helehelena o ka sodium iodide symporter.
Ke kuʻuna o ka thyroglobulin.
ʻO ke ala nui o ka deiodinase hormone thyroid.

ʻO ka hypnotalamic central hypothalamic-pituitary hypothyroidism.

Hoʻokomo ʻia ka congenital hypothyroidism e nā antibodies māmā.

He aha ka mea e hana ai me ka hypothyroidism?

ʻO ka hoʻomohala o ka prenatal o ka pūpū, no kekahi kumu ke hala o ka pancreas a ʻaʻole hana, ua hele ʻia ma muli o nā hormone thyroid o ka makuahine, e komo ana i ka pleka.

Ke hānau kahi pēpē, hāʻule nui ka pae o kēia mau hormones i loko o kona koko. I ka loaʻaʻana o ka pūpū, ma mua o kona wā mua, pono maoli ka nui o nā hormone thyroid no ka hoʻolālā kūpono ʻana o ka pūnaehana pīpī koʻikoʻi o ka pēpē.

He mea koʻikoʻi kēia no nā hana o ka meelination o nā lolo neurons.

Me ka nele o nā hormone thyroid i kēia manawa, ʻano hana o kahi cortex cerebral o ke keiki, ka mea hiki ʻole ke huli ʻia. Hōʻike ia iā ia iho i nā pae like ʻole o ka retardation noʻonoʻo o ka pēpē a hiki i ka cretinism.

Inā hoʻomaka ka hoʻololi ʻia ʻana o ka huli ʻana ma kahi manawa kūpono (ʻo ka pule mua o ke ola) e pili ana i ka hanana ʻana o ka hanana nūnū o ke kikowaena olakino. Me ka manawa like me ka hoʻokumu ʻana o kahi pōʻino i ka ʻoihana sentral, me ka congenital hypothyroidism ʻaʻole i uku ʻia i ka manawa kūpono, hoʻomohala ʻia ke kāʻei a me nā ʻuhane kino kūwaho a me nā ʻōnaehana.

I ka nui o nā hihia, ʻaʻole pono ka ʻona maʻi o ka hypothyroidism hopena. Hiki i ke hypenitisism kongenital ma loko o kahi wahine hou ke kau nei ma muli o nā hōʻailona o ke kiʻi olakino ma nā manawa 5% wale nō.

Nā hōʻailona mua o ka hypothyroidism congenital:

ka ʻōpū ʻōpū
lōʻihi (ʻoi aku ma mua o 7 mau lā) hyperbilirubinemia,
leo haʻahaʻa
umbilical hernia
hoʻonui ʻia posterior fontanel,
hypotension
hoʻonui ʻia thyroid,
macroglossia.

Inā ʻaʻole i lawe ʻia nā hana therapeutic i ka manawa, ma hope o 3-4 mau mahina i ʻike ʻia ai kēia mau hōʻailona aʻe:

pilikia paʻakikī
mea momona maikaʻi ʻole
he ʻano hūnā
loaʻa kālā maikaʻi maikaʻi
ka maloʻo ʻana a me ka pono o ka ʻili,
hypothermia
hōʻai naʻau.

Ma hope o ʻeono mau malama o ke ola, e hōʻike ke keiki i nā hōʻailona o ka lohi i ka hoʻomohala ʻana i ka olakino, hoʻomohala ʻana a me ka ulu hoʻomaikaʻi ʻana mai ka ulu ʻana: hypertelorism, ākea ākea ākea, ka pani hope o nā fontanels (e nānā i ke kiʻi).

E maikaʻi nā ʻike, he aha nā hōʻailona a me ka mālama ʻana o ka hypothyroidism i nā wahine, no ka mea ke noho mau nei ka maʻi congenital me ka mea maʻi no ke ola.

ʻO ka maʻi maʻi

Pono e kuhikuhi pono i ka hana hoʻohālikelike me ka wikiwiki o ka hoʻohana ʻana i ka T4 i ke koko, a laila lilo ke koho ʻana i kahi momona o L-T4 e ukali ana, ʻo ia ka mea e hōʻoia ai i ka hoʻomau mau o ka ʻike paʻa ʻana o ka T4 a me TSH.

ʻO ka paipai mua o L-T4 o ka 10-15 mcg / kg ke kino kino i kēlā me kēia lā. E hana hou ʻia ka nānā ʻana a me ka nānā ʻana i kahi kūpono ponoʻī o L-T4.

ʻO ka hoʻomaikaʻiʻana no ka hypothyroidism congenital

Ka hilinaʻi nui ʻana o ka maʻi i ka timeliness o ka hoʻomaka ʻana o ka hoʻōla hoʻololi L-T4. Inā ʻoe e hoʻomaka i nā ʻelua pule o ka ola hou o ka male hou ʻana, nalowale loa nā hewa ʻana o ka hoʻomohala kino a me ka psychomotor.

Inā hoʻomaka ʻia ka manawa hoʻomaka o ka hānō o ka hili ʻana, a hoʻomaka ka hopena, piʻi ka hopena o ka hoʻomohala ʻana o ka maʻi, a hiki i ka oligophrenia a me nā ʻano koʻikoʻi.

He maikaʻi loa ka nānā ʻana o ka hypothyroidism me ka hoʻomākaukau ʻana i ka hoʻokaumaha hormone thyroid. ʻO ka lāʻau lapaʻau ʻoiaʻiʻo loa no ka hypothyroidism i manaʻo ʻia ʻo ka hormone thyroid i loaʻa synthetically (artificially).

ʻO ke ʻano wale o ke kauʻana i ke ʻano me kēia lāʻau lapaʻau ke kipa maʻamau i ke kauka, nāna e koho i ke ʻano kūpono o ka lāʻau a hoʻoponopono iā ia i ka wā mālama.

Hoʻomaka nā hōʻailona o ka hypothyroidism e nalowale, nui loa i ka wiki mua o ka lāʻau. ʻO kā lākou pau loa i hoʻopau ʻia i loko o kekahi mau mahina. Loaʻa nā keiki i ka makahiki mua o ke ola a ma kahi ʻelemakule ponoʻole ka mālama ʻana. ʻO nā kānaka a me nā nāwaliwali nāwaliwali e pane mālie e lawe i ka lāʻau.

Inā maʻa ʻia ka hypothyroidism ma muli o ka nele o kāu gland thyroid, kahi maʻi o Hashimoto, a i ʻole ka maʻi radiation, i ʻole ke ʻano o kona mālama ʻana. ʻO kaʻoiaʻiʻo, aia kekahi mau hihia, me ka thyroiditis Hashimoto, hoʻihoʻi hou ʻia ka hana pancreatic me ka wikiwiki.
Inā ʻo nā ala āpau ke kumu o ka hypothyroidism, ma hope o ka pauʻana o nā maʻi lalo, nalowale nā hōʻailona o ka hypothyroidism.
ʻO ke kumu o ka hypothyroidism kekahi mau lāʻau lapaʻau, ma hope o ke hoʻopau ʻia ʻana o ka ʻōmaʻomaʻo o ka thyroid.
ʻAʻole pono ia ʻo Hypothyroidism i nā ʻano latin o nā lawelawe. Eia nō naʻe, i ʻole e pau i ka holomua o ka maʻi, pono ka mea maʻi e nānā mau loa.

Loaʻa nā ʻikepili e pili ana i nā pōmaikaʻi o ka hapanui o ke ʻano maʻi no ka hypothyroidism latent i loaʻa i kēia lā, a i ʻole nā ʻepekema ʻokoʻa i kēia mau manaʻo. I kēlā mau hihia, i ka wā e hoʻoholo ai i ka mea kūpono o ka mālama ʻana, kūkākūkā pū me ka mea kauka me ka hōʻaʻikepili ʻana i ka pono o ke kumukūʻai kālā o ka mālama ʻana a me nā pōʻalo kūpono iā ia me nā pono i manaʻo ʻia.

E makaʻala! ʻO ka poʻe maʻi e hōʻeha nei i nā maʻi o ka pūnaehana cardiovascular a me ka maʻi mellitus, pono pono i ka nui o ka lāʻau kūpono o nā lāʻau lapaʻau, ʻoiai he nui ka nui o ka holomua o ka hormone pectoris a i ʻole ka atrial fibrillation (hana i ka uha o ka naʻau).

Kukola

Me ka hōʻike ʻana i ka hypothyroidism congenital, ua kau ke kauka i nā lāʻau lapaʻau e pili ana i ka sodium levothyroxine, ka mea e ola ai ka nui.

Pono e lawe ʻia nā lāʻau lapaʻau e like me nā kuhikuhi a me ke koho ʻana i ka endocrinologist. Ma hope o 1.5-2 mau mahina o ka mālama ʻana, pono ia e kipa i ke kauka i mea e hōʻoia i ke kūpono o ka ʻona i ʻōlelo ʻia. Inā hoʻohuli ʻo ia ka liʻiliʻi loa o ka nui, loaʻa nā maʻi i ka hōʻailona o ka hypothyroidism:

Inā nui aʻe ke ʻano, ua ʻokoʻa nā hōʻailona:

I ka poʻe maʻi me ka puʻuwai puʻuwai, i ka hoʻomaka ʻana o ka mālama ʻana, e hoʻolaʻa pinepine ʻia kahi liʻiliʻi o ka levothyroxine, e hoʻonui iki ʻia e pono. Inā paʻakikī ka hypothyroidism i ka manawa o ka hopena o ka maʻi, ʻaʻole hiki ke ʻae ʻia ke hoʻopiʻi.

Nui! I ka hiki ʻole o ka hoʻomaʻamaʻa kūpono ʻana, ʻo ka hypothyroidism congenital i loko o nā keiki hiki ke alakaʻi i kahi ʻano liʻiliʻi, akā nui ka ola - ka hypothyroid coma (myxedema coma). Ke mālama ʻia nei ka mālama ʻia ʻana o kēia maʻi ma kahi haukapila, i loko o ka waihona mālama mālama me ka hoʻokele intravenous o ka hoʻomākaukau ʻana i ka lāʻau thyroid.

Inā hele ʻole ka hana i ka hanu, ua hana ʻia kahi ʻano hana hoʻowalewale kūloko. Ke hoʻomanawanui nei ka mea maʻi i ka hoʻokolohua olakino holoʻokoʻa no ka hele ʻana o nā pathologies concomitant o ka puʻuwai. Inā loaʻa iā lākou, e kuhikuhi ʻia ka hana kūpono.

Ke kāohi nei i ka hypothyroidism i kahi keiki

Pono ke ʻano o ka hypothyroidism i ka wā hapai me ka mālama kūikawā, no ka mea e hiki ke hoʻopilikia i ka hoʻomohala ʻana o ka wahine a me nā mea nui nā hopena congenital.

Me ka hypothyroidism i kahi wahine hāpai, pono e hoʻomaka koke ka hoʻomaʻamaʻa.Inā hōʻike ka maʻi i mua o ka hapai ʻana, pono mau ka wahine e kiaʻi pono i ka pae o ka hormone thyroid a hoʻokau i ka hoʻoponopono kūpono ʻana i ka hopena i ʻōlelo ʻia i ka lāʻau. Ke lawe nei i kahi keiki, pono ka hoʻonui ʻana i ka hāmeʻe ma 25-50%.
Hiki ke ola no ka mālama ʻana me ka hypothyroidism postpartum. Me ka hoʻomaka ʻana o kēlā me kēia hāpai ʻana hou, pono nā wahine e hoʻomaʻamaʻa piha i ka hypothyroidism. ʻO kekahi manawa hele ka maʻi postpartum ma hope iho, a ma nā hihia ʻē aʻe, e hoʻomau ka maʻi ma ke ola o ka wahine.

Hoʻoponopono mālama

ʻO ka manawa pinepine loa, ʻo ka mālama ʻana o ka hypothyroidism ke ola lōʻihi, no laila e lawe pono ʻia ka lāʻau lapaʻau e ʻae e like me ke kumu. I ka manawa e holomua ana ka hypothyroidism congenital, no laila ke ʻano nui o ka nui o ka hormone mai ka manawa i ka manawa, e like me ka nui o ka attenuation o ka hana thyroid.

I loko o nā hapa he nui e lawe ana i ka hoʻomākaukau ʻana i ka hormone thyroid, ma hope o kā lākou haʻalele ʻana, e hoʻomohala ʻia nā hōʻailona o ka hypothyroidism me ka ikaika hou. I kēlā kūlana, pono e hoʻomau ʻia ka lāʻau lapaʻau.

Hiki i nā kongenital hypothyroidism ke kūkulu i ka hoʻopiʻi ʻana o kekahi maʻi maʻi. I kēia hihia, ma hope o ka ho'ōla ʻana o ka maʻi lalo, hoʻihoʻi hou ka hana thyroid. I mea e hoʻāʻo ai i kāna hana, kahi hana hoʻōki o kahi manawa o ka hoʻohana ʻana i nā mākau hoʻoliʻi thyroid.

ʻO ka hapa nui o nā poʻe maʻi me kēia huki ʻana e nānā i kahi hoʻihoʻi pōkole o nā hōʻailona nui o ka hypothyroidism. ʻO kēia no ka mea, me ke ʻano o ka lohi ʻana, e hoʻouna i nā hōʻailona i ka gland thyroid e pili ana i ka pono e hoʻomau i ka hana.

Inā hiki i ka gland ke hoʻokō kūʻokoʻa me ka wā e hiki mai ana, hiki ke hoʻopau ʻia ka mālama ʻana. ʻĀ, inā haʻahaʻa ka hana ʻana o ka hormone, pono ʻoe e hoʻomau i ka lawe ʻana i ka lāʻau.

ʻO ka lawe ʻana i ka hoʻomākaukau ʻana i ka hormone thyroid e koi i ka mea maʻi e kipa i kahi keʻena olakino 2 mau manawa i kēlā makahiki (no ka hōʻoia hōʻoia). Ua hoʻāʻo ʻia ka poʻe maʻi no ka hoʻoulu ʻana i ka hormone thyroid (TSH). Hōʻike ka hopena o ke aʻo ʻana i ka hoʻokō ʻana o ka neʻe o ka hormone me nā kūleʻa.

Congenital

Ua hana ʻia ka hōʻike ʻana o ka hypothyroidism congenital inā he pēpē hou ma hope o ka hānau ʻana, ua loaʻa ka maʻi o ka thyroid. Hōʻike ʻia i ka hoʻomohala prenatal a hiki ke lilo i waena, waena (kūloko, tertiary) a me peripheral i nā ʻōlelo o ka hōʻino o ka pili. ʻO nā hōʻailona o ka maʻi he mau loa, mau loa ia, a me ke ʻano o ka hypothyroidism subclinical a i ʻole hōʻike, paʻakikī.

Ua kapa ʻia kēlā hypothyroidism ʻoiaʻiʻo a he thyrogenic. ʻO ke ʻano o ka haʻahaʻa haʻahaʻa o nā hormones t4 a T4 a me T3 i pili pū me ke kiʻoniʻoni o ka gland thyroid ponoʻī iho.

Kikiki

ʻO nā sela secretory e hana ana i ka thyroxin a me ka triiodothyronine e hoʻoponopono ʻia e ka gland pituitary me ke kōkua o ka hormone thyroid-hoʻouluulu - TSH. Me kona lawa ʻole o ka synthe, hoʻoemi ʻia ka hana o T3 a me T4. Ua kapa ʻia kēia ʻano maʻi me ka pituitary a i ʻole kekahi. Ma luna o ka kelepona pituitary i ka "hierarchy" hormonal ʻo ia ka hypothalamus. Ke hoʻohana nei i kāu thyroliberin, e hoʻolōʻihi i ka hoʻokumuʻana o TSH. Hypothalamic insufficiency i kapa ʻia ma ka papahele.

Kelepona

Nā kumu e ka antibodies o ka makuahine, ka mea i kūkulu ʻia i ka thyroid-stimulus hormone o ka puʻu pituitary o ke keiki. ʻO ka lōʻihi ka manawa o nā hebedoma 1-3. ʻO ke koho hoʻoiho lua e ka neʻe ʻana i kahi kūlana paʻa. I kēia hihia, nā manawa o ka hoʻomaikaʻi i ʻokoʻa me ke hoʻonui ʻana i nā hōʻailona, e koi ai i ke kaola ʻana i nā ola o nā hormone i nā papa.

Manaipo

Ua'ōlelo ʻia ka nele o nā hormones. ʻO ka hormone thyroid-stimulating ma mua o ka maʻamau, a ʻo ka glid thyroid e hua i kāu thyroxine liʻiliʻi. E hoʻoulu ana i kahi kiʻi kikoʻī piha o ka hypothyroidism, a me kahi koi o ka T 4 - nā hoʻopiʻi. E pili paha i kēia o ka hāʻule ʻana o ke kaila, ka hoʻokuʻu ʻana o ka noʻonoʻo, ka coma hypothyroid.

A eia kahi ʻē aʻe e pili ana i ka goiter nodular o ka papa thyroid.

Nā kumu kumu o ka hypothyroidism a hiki i hoʻokahi makahiki

ʻO ka hapa nui o nā pēpē (a hiki i ka 90% o nā maʻi āpau) e loaʻa i kahi kumu mua. Hiki ke kumu ma:

nā ʻōpū i ka hoʻomohala ʻana o ke kino - e kahe ana ma hope o ka sternum, ma lalo o ka alalʻana, ʻaʻole i lawa ka hoʻomohala (hypoplasia), ʻokoʻa ka emi ʻole o ka hoʻopuni thyroid.
infauterine maʻi,
huilima,
ka hoʻohana ʻana i nā lāʻau hāpai wahine e hōʻino i ka hoʻomohala ʻana (cytostatics, lithium salts, bromine, tranquilizer),
ka ʻike ʻana i nā mea hoʻonaninani
ʻike maka
Iodine nele i ka ʻai a ka makuahine, thyroiditis, enditer goiter,
ka hui ʻana o nā ʻano genes (maʻamau i hui pū ʻia me nā pale o ka naʻau, nā hana hōʻihi).
ka kuhi ʻana i ka hoʻokumu ʻana o nā hormones ma muli o kahi hema i ka hoʻopili ʻana o ka iodine e ka aʻai thyroid.
hoʻoilina hanana holomua - pendred syndrome (kamaʻilio a me ka hoʻonui ʻana o ka nui thyroid gland).

Hōʻike ʻia nā ʻano kumu nui o ka hypothyroidism (ka lua a me ka papa haʻahaʻa) i ke ʻano o ke lolo - cysts, defect developmental, benign a malignant neoplasms, trauma i ka wā hānau, hōʻeha ʻia no ka hoʻopiʻi ʻana o ke kaula umbilical.

Hōʻike ka puka peripheral i ka pau ʻole o ka protein o ka receptor, kahi i loaʻa ma nā membranes o nā pona a hui pū me nā hormone thyroid.. ^ E Ha yM. ʻO ke kumu no kēia kaohiʻana o nā ʻano genetic i lawe ʻia e ka hoʻoilina, a ʻo ka hopena he mea i poina ai ke kū'ē i nā hormones (resistenation). I kēia hihia, heʻano maʻamau a hoʻonui iki paha ka hormonal background i loko o ke koko, akā ʻaʻole pane nā cell i ka T3 a me T4.

ʻO nā kumu o ka loaʻa o ka hypothyroidism i nā keiki hiki:

nā lolo ʻōpū
hōʻeha pōʻino, hana,
ka nele o ka iodine i ka meaʻai a me ka wai (pau i ke aniani iodine).

ʻO nā hōʻailona mua i nā keiki

Ka hoʻomaopopo ʻana i ka hypothyroidism i loko o kahi pēpē pēpē a paʻakikī loa. ʻAʻole ʻokoʻa nā hōʻailona maʻamau ma ke ʻano he nui a ʻike ʻia i nā ala o nā kino o nā kino, nā mea kūlohelohe ʻē aʻe. Hiki ke loaʻa i nā hōʻailona kūlohelohe:

wā hāpai wahine (40-42 mau pule),
hua nui (mai 3.5 kg),
ʻōlelo ʻohui
ka ʻā ʻana o ka maka, ʻoiai ʻo ia hoʻi ma nā maka.
ka humuhumu o nā lima ma nā lima, a me nā wāwae.
ʻaʻano pōkole
leo kūhea haʻahaʻa (leo ʻekemu),
umbilical hernia, lohi hoʻolōʻihi i ka ʻōpū o ka umbilical,
hoʻomaumau iā Jaundice o ka hānau keiki hou,
wikiwiki wikiwiki a hānai
ke ʻano o cyanosis a me ka hana ʻana i ka hanu ma ka huki ʻana.

Inā umauma ka pēpē, a laila nāwaliwali o nā lāʻau lapaʻau. Akā paʻa kēlā mau keiki ma hope o ka loaʻa ʻana o ke kaumaha o ke kino, pilikia lākou i ka hoʻokaʻina ʻana o ka meaʻai - bloating, constipation, ʻona maikaʻi ʻole. ʻIke lākou i ka fohou e hoʻonui nui ʻia, ʻaʻole lawa o ka iwi o ka ʻupena, paʻa i ke ʻano o nā ʻōpū hip.

ʻO ka hoʻomohala ʻana o ka psychomotor o nā keiki

ʻO nā hopena koʻikoʻi nui loa e pili ana i ka hypothyroidism i ka hoʻopili pili. Mai ka manawa neonatal, aia nā hōʻailona o ka lag i ka hoʻomohala ʻana i ka psychomotor:

nāwaliwali ākea, lethargy,
hoʻowahāwahā i ke kaiāulu - ʻaʻole ke keiki e hoʻāʻo e hoʻokalakupua, e hele, ʻaʻole hoʻi e pane i ka ʻōlelo i haʻi ʻia mai iā ia.
i ka wā pōloli a i ʻole nā māka ʻūlū, ke hoʻomau nei ʻole ia i nā hola
ʻaʻole palupalu nā neʻe, ʻike ʻia ka lethargy a me ka nāwaliwali o ka naʻau,
lohi ke hoʻomaka e hoʻopaʻa i kona poʻo, ʻōwili ma luna o kahi moena, ʻaʻole noho.

Inā holomua ka hypothyroidism congenital, a laila hoʻomohala ka dementia (cretinism), ʻehā ka lohe, lohe a me ka ʻōlelo. Hiki ke ʻike ʻia kēlā mau hōʻailona i ka hapa lua o ka makahiki me kahi hemahema o ka nui o nā hormones. ʻO nā hihia koʻikoʻi ʻoi paha ka mea i hūnā ʻia a ʻike ʻia ma ka 5 mau makahiki wale nō a i ʻole i ka wā ʻōpiopio.

ʻO nā ʻano o nā maʻi, ka hopena ma hope o 2 mau makahiki o nā makahiki he ʻona. ʻAʻole paʻa ka hoʻolālā noʻonoʻo me lākou. Loaʻa paha ka momona a me ka ulu ʻana o ka ulu ʻana, nā wā a me ka lohi o ka noʻonoʻo e nā hana haʻahaʻa haʻahaʻa.

ʻO ka pale ʻana i ka maʻi

Ke hana ʻia nei ka pale ʻana o ka hypothyroidism congenital me ka pale ʻana o ka pilikia iodine i loko o nā wahi o ka hopena (me ka haʻalulu iodine haʻahaʻa i ka wai), me ka ʻike pū kekahi o nā mea kūlike i ka wā e hoʻolālā ana i ka hapai. Ke kono ʻia nei ka ʻōlelo makuahine

e hoʻololi i ka paʻakai ʻai me ka paʻakai iodized (hoʻohui wale i ka ʻai mākaukau),
hoʻonui i ka māhele i ka ʻai o nā huahana nā iodine - ka iʻa kai, ke kai kūloko, algae, cod ate, aila ʻaʻa, ʻōpū moana, feijoa, kiwi, nā ʻĀpana,
hana ia i kahi hōʻike koko no ka ʻike o nā hormone thyroid a me ka hoʻokolohua me ka endocrinologist.
lawe i nā lāʻau lapaʻau a i ʻole nā mea paʻakikī i ka iodine (Vitrum Prenatal Forte, Multi Tabs Intensive, Multimax no Pregnant Women, Pono, Pregnakea) e like me ka ʻōlelo a ke kauka.

ʻO ka hypothyroidism i loko o nā keiki he mau mea congenital. Hoʻololi ia e ka genetic mutations, kahi nele o ka iodine i loko o kaʻai a ka makuahine, a me nā kaʻina maʻi infectious a autoimmune. I ka wā hānau, ʻike ʻia nā hōʻike honspecific; i ka wā e ulu ai lākou, ke ʻano ke ʻano o nā maʻi i alakaʻi i ka dementia, deformation of the bone of the skeleton.

A eia kekahi mau mea e pili ana i ka pale ʻana o ka goiter endema.

E ʻike i ka hypothyroidism, ua nānā ʻia kahi pēpē hou no ka hoʻāla ʻana i ka hormone thyroid. Hoʻomaka ma mua o ka maʻi. Ua kuhikuhi ʻia nā keiki i ke ola ʻana o ke koina a pau me ka levothyroxine.

Hoʻokumu ʻia ka gland thyroid i nā keiki i ka hoʻomohala ʻana i ka maʻi fetal. ʻO ka maʻamau, ʻaʻohe ia o nā loli i ka contours, nodes. ʻO nā mea ʻokoʻa (hoʻonui, hoʻemi), a me nā hōʻailona ʻē aʻe e hōʻike i ka hiki ʻana o nā maʻi (hypofunction, hyperfunction) a me ka pono e hoʻomaka i ka mālama ʻana.

I ka hoʻomaka mua ʻana, hiki i ka thyroiditis i nā keiki ke like asymptomatic. Hōʻike ʻia ka maʻi carimmune Hashimoto e ka huhū, nā waimaka. Hoʻomaopopo nā hōʻailona o kahi kūlana maʻi. E hoʻokō paʻa wale nō nā maʻi ma ka maʻi maʻi. Koho ʻia ka hana maʻi ma ke kahua o ka papa.

Mai nā lā mua, ua hoʻoholo ʻia nā ʻenekini i nā keiki. ʻO ka ulu, ke akamai, a me nā hana a nā keiki i ke keiki e pili ana i ke ʻano o ko lākou pae. He aha kāu e lawe ai? He aha ka mea e haʻi ai ka decryption (ma ke ʻano, no ke aha e hoʻokiʻekiʻe ʻia ai, hoʻohaʻahaʻa ʻia)?

Inā he thyiditis thyne latent latent maʻamau, a ua loaʻa ka hapai, hiki ke mālama koke ʻia ka maʻi lapaʻau e hoʻopakele i ka wahine hāpai. Hoʻokomo ka hoʻolālā i ka ʻano o ka hoʻopaʻa ʻana, no ka mea, ʻo nā hopena o ka wahine a me ke keiki e hiki ke kaumaha loa.

ʻO ka hapanui o nā pono pituitary e kū nei i nā ʻelemakule, akā he mea lahilahi a loaʻa paha i loko o nā keiki, postpartum. Hoʻohana ʻia ka huina, ʻāpana, ʻāpana a me ke kula kiʻekiʻe. Hoʻopilikia i ka hopena o ka maʻi hypopituitaritis no ke kūloko ʻana no nā hormones, MRI, CT, X-ray a me nā mea ʻē aʻe. Hoʻolālā - hoʻihoʻi hou o ka hana e nā hormone.

Nā ʻano o ka maʻi

Ua hoʻokaʻawale ʻia ka Hypothyroidism ma ka kongenital a loaʻa. ʻO ka hypothyroidism kongenital i nā keiki ke nānā me ka pinepine o 1 hihia ma kahi 5,000 pā hou. ʻO ka uluʻana o nā keikikāne he 2 mau manawa haʻahaʻa ma mua o nā kaikamahine.

E like me ka paʻakikī o nā hōʻailona o nā kauka maʻi o ka hapa ʻole o nā hormone thyroid, hōʻike, transient (transient) a me subclinical hypothyroidism i loko o nā keiki ka hoʻohanohano ʻia.

Hoʻokumu i ka pae ma ka haunaele o ka hana ʻana o ka hormone thyroid, hōʻike ʻia nā ʻano ma lalo o ka hypothyroidism:

mua (thyrogenic) - ma muli o ka hōʻino pololei o ka iwi thyroid, hōʻikeʻia e ka hoʻonui nui ʻana o ka pae TSH (thyroid stimulus hormone),
kekona (hypothalamic-pituitary) - Ua pili pū ia me ka poino i ka hypothalamus a me / a i ʻole ka pituitary gland, ka mea i hoʻopili ʻia e ka lawa ʻole o ka huna ʻana i ka hormone thyroid-stimulate a me kāuroliberin, i ukali ʻia e ka hoʻolemi ʻana o ka hana thyroid.

Nā kumu kumu a me nā hopena paʻakikī

ʻO nā kumu o ka hypothyroidism i loko o nā keiki he mau ʻāpana o nā hana o ka ʻōnaehana hypothalamic-pituitary-thyroid. Ma kahi o 20% o nā hihia, loaʻa ke ʻano o ka hypothyroidism i nā keiki me ka anomalies genetic i hoʻoilina a i loaʻa maoli i ke ʻano. Ma waena o nā ʻano genetically hoʻoholo o ka maʻi, ua loaʻa ka congenital myxedema (cretinism) e loaʻa pinepine.

ʻO kekahi kumu nui o ka hypothyroidism kongenital i loko o nā keiki, ʻo ka malformations o ka gland thyroid (hypoplasia, aplasia, dystopia), kahi e hoʻonāukiuki ai i nā maʻi o ka intrauterine, a me ka nui o nā hopena maikaʻiʻole e pili ana i ka kino o ka wahine hāpai.

ʻO nā ʻano lua o ka hypothyroidism congenital i loko o nā keiki e pili pū me nā mea pono ʻole i ka hoʻomohala ʻana o ka hypothalamus a me / a nā pituitary gland.

Loaʻa ka hypothyroidism i nā kamaliʻi e nānā pinepine ʻia. ʻO nā kumu no kona kū ʻana.

lahilahi iodine
hana ʻino i ka momona thyroid a i ʻole ka pituitary gland i hana ʻia e kahi ʻoki a i ʻole ke ʻano aʻeha ʻana, trauma, a i ʻole ka hōʻola.

No ka ʻike mua ʻana i ka hypothyroidism congenital i loko o nā keiki, ke mālama ʻia nei kahi hōʻike ʻana o nā pēpē āpau.

Nā hopena hiki paha ke hoʻopiʻi

I ka haʻalele ʻole o ka mālama ʻana, hiki i nā hypothyroidism i nā keiki ke alakaʻi i nā hoʻopiʻi penei:

hoʻohaʻahaʻa noʻonoʻo ʻana i ka ʻano paʻakikī,
hoʻokū i ke ola kino,
ʻopi momona
koma hx
mahuahua i hiki mai i nā maʻi o ka maʻi,
megacolon:
Iaomi
normocytic normalochromic anemia,
hypoparathyroidism.

Me ka hoʻomaʻamaʻa mua, mahalo nui ʻia ka prognosis. Hoʻopau ka hopena hoʻoliʻi Honeone i ka uku wikiwiki i ke kūlana o kahi keiki maʻi a i ka wā e hiki mai ana, hiki i kāna hoʻomohala ʻona psychomotor e like me nā hiʻohiʻona pili i ka makahiki.

Inā ʻōkuhi ʻia nā mea hoʻohuli ma hope o ke ʻano o nā hōʻailona o ka cretinism i kahi keiki, a laila hiki ke pale ʻia i kā lākou holomua. I nā kūlana like, ʻaʻohe hoʻololi o ke keiki a loli i ke kīnā.

ʻO nā keiki e loaʻa ana i ka hypothyroidism ma lalo o ka mālama mau o kahi endocrinologist, pediatrician, neuropathologist. Ma kahi o hoʻokahi hapa hapaha, pono lākou e hoʻoholo i ka pae o ka hormone thyroid-stimulating i ke koko.

ʻO ka hypothyroidism i nā keiki ka hopena i ka hopena koʻikoʻi ma mua o nā pākeke. ʻO ka ʻōpio ke keiki, ʻo ka nui aʻe ka pilikia o ka loaʻa ʻana o nā hormone thyroid no kona olakino.