Matenda a chithokomiro amateteza thanzi la wodwalayo poyamba, chifukwa mahomoni opangidwa ndi chithokomiro amatenga mbali yofunika kwambiri m'njira zambiri. Ngati mayeso a hypothyroidism akuwonetsa, ndiye kuti dokotala amakupatsani mankhwala apadera kuti abwezeretsenso chithokomiro cha chithokomiro. Koma zimatsimikiziridwa bwanji kuti mahomoni a chithokomiro sakwanira mthupi?

Kuperewera kwa mahomoni a chithokomiro

Chithokomiro cha chithokomiro chimagwira gawo lofunikira kwambiri machitidwe a thupi ngakhale panthawi yomwe khanda limakula. Ma mahomoni ake amakhudzidwa ndi metabolism, amathandizira kukula kwa mafupa. Mkhalidwe wabwinobwino wathanzi limatengera kuchuluka kwawo. Koma zonse ziyenera kukhala zopanda malire, zowonjezera kapena kuchepa kwa mahomoni a chithokomiro zimakhudza thanzi la anthu ndi thanzi lawo. Hypothyroidism ndi kuchepa kwa mahomoni a chithokomiro m'magazi a anthu.

Ndani ali pachiwopsezo

Matenda a chithokomiro, chotulukapo chake chomwe ndi kuchepa kwa mahomoni omwe amapangidwa kapena kuthekera kwa kuperewera kokwanira kwa zinthuzi ndi minyewa yamthupi, makamaka zimakhudza thanzi la wodwalayo, osamupatsa iye zomverera zowawa zilizonse. Matendawa amatha kupezeka pamtundu wa chibadwa, amatha kuchitika ngati mutamwa mankhwalawa kapena kuyamwa nthawi yayitali ndi mankhwala. Komanso, hypothyroidism nthawi zambiri imayamba ndi kusowa kwa ayodini mu chakudya. Kuperewera kwa kutulutsa kapena kupanga mahomoni a chithokomiro kumatha kuchitika chifukwa cha matenda ena omwe amafunika kupezeka. Pali funso lalikulu - lomwe limayesa amayi apakati omwe ali ndi hypothyroidism ayenera kutenga, chifukwa kukula kwa intrauterine kwa mwana wosabadwayo kumadalira thanzi la mayi. Ngati mayi wapezeka ndi hypothyroidism, kuyezetsa mahomoni nthawi yovomerezeka kumakhala kovomerezeka.

Zomwe zingakhale hypothyroidism

Mankhwala amagawa hypothyroidism m'magulu awiri:

chachikulu - monga chiwonetsero cha zovuta mu chithokomiro cha chithokomiro,
yachiwiri - imayamba chifukwa cha kusakhazikika kwa hyposis.

Kuti mupeze vuto lomwe lilipo mu endocrine system, muyenera kudziwa mayeso omwe amachitika pa hypothyroidism. Athandizire kuzindikira kuchepa kwa kuchuluka kwa mahomoni a chithokomiro m'magazi, kuti wodwalayo athe kukapimanso mayeso kuti adziwe zomwe zimayambitsa matenda a hypothyroidism.

Kuzindikira

Malaise, kusintha kwa khungu, kukhumudwa, kusamba kwa azimayi - kawirikawiri zotere zimachitika chifukwa cha hypothyroidism. Tsoka ilo, vuto lodziwitsa anthu matendawa ndi loopsa. Kupatula apo, zizindikirazo ndizopanda pake, madokotala amalankhula za masking kuchepa kwa chithokomiro, ndipo matenda ena ambiri amadziwika ndi mawonekedwe ofananawo. Kuti matendawa apangidwe moyenera, wodwala yemwe ali ndi vuto lokayikira ayenera kukayezetsa ena mosalephera.

Kuwerengera magazi kwathunthu

Kutumiza kuyesedwa kwa magazi ndi njira yovomerezeka mukakumana ndi achipatala. Kafukufukuyu amakupatsani mwayi wowunika momwe wodwalayo alili. Koma izi ndizofanana. Matenda ena, kuphatikizapo hypothyroidism, ndizosatheka kuzindikira komanso kupereka lingaliro la kuyezetsa magazi wamba. Chifukwa chake, kuti akhazikitse kafukufuku wowonjezereka, adotolo amatenga mbiri yachipatala ya wodwala, ndikukonza madandaulo, ndikuwunikira matenda ena. Gawo lotsatira la mayeso likhale yankho la funso: "Ngati hypothyroidism ikuyenera, mayeso otani?"

Mapazi amwazi

Kuyesedwa kwa magazi kumeneku kumakupatsani mwayi kuti muwone zodwala mu endocrine system, yomwe idzakhale uthenga wina wofufuza mahomoni. Phunziroli limathandizanso kuzindikira zovuta zina, osati kungokhala hypothyroidism. Ndi ziti zomwe zikuwonetsa kuti pali vuto ndi chithokomiro cha chithokomiro?

Serum cholesterol ili ndi zambiri kuposa zabwinobwino.
Myoglobin imakwera m'mitundu yonse ya hypothyroidism.
Creatine phosphokinase amapitilira muyeso wololedwa ndi nthawi 10-15. Enzyme iyi ndi chisonyezero cha kuwonongeka kwa minofu ya minofu, yomwe imagwira ntchito monga chofunikira pakuwunika kwa myocardial infarction, yomwe ikhoza kuthetsedwa ndi ECG.
Aspartate aminotransferase (AST) ndi apamwamba kuposa abwinobwino. Ili ndiye puloteni yamaproteni kagayidwe, chizindikiro chomwe, choposa chizolowezi, chimagwira monga chiwonetsero cha kuwonongeka kwa maselo.
Lactate dehydrogenase (LDH) imaposa muyeso wovomerezeka wa minofu necrosis.
Seramu calcium imaposa yachibadwa.
Mulingo wachepa wa hemoglobin.
Chitsulo cha Serum ndichoperetsetsa, osafikira milingo wamba.

Kukonzekera bwino kwamwazi kumakuthandizani kuti muwone zakusokonekera zambiri mthupi ndikupereka mayeso owonjezereka kutsimikizira kapena kutsimikizira kuyambitsidwa kwa matenda.

Kuyesa kwa magazi kwa mahomoni a chithokomiro

Kusanthula kolondola komwe kumakupatsani mwayi wodziwa kusowa kwa mahomoni a chithokomiro m'magazi, ndizowerengera magazi pazomwe zili ndi zinthuzo. Ma mahoni atatu akuluakulu, ofunikira kuti thupi lizigwira ntchito bwino, amapangidwa mwachindunji ndi chithokomiro cha chithokomiro ndipo amapangidwa ndi pituitary gland ya ubongo. Izi ndi mahomoni olimbikitsa kwambiri a chithokomiro (TSH) ndi mahomoni a T4. TSH imapangidwa ndi pituitary gland, ndi T3 ndi T4 ndi tezi ya chithokomiro. Gland ya chithokomiro imapanganso mtundu wina wa mahomoni - calcitonin, koma kuchuluka kwake kukufufuzidwa matenda ena. Chifukwa chake, kuyesa kwa magazi kwa mahomoni a chithokomiro kumakupatsani mwayi wodziwa kusalinganika komwe kulipo ndikusankha njira yowonjezerera ndikupanga chithandizo.

Kuchuluka kwa TSH komanso kuchuluka kwa T4 kumawonetsa gawo loyambirira la matendawa, lotchedwa subclinical hypothyroidism. Ngati mulingo wa TSH ndiwokwera, ndipo kupezeka kwa T4 kuli kochepa kuposa koyenera, ndiye kuti dokotala azindikire kuwonetsa kapena kuwonetsa hypothyroidism. Matendawa amafunika kugwiritsa ntchito mankhwalawa mwachangu, chifukwa gawo lotsatira la matenda omwe sanalandirepo ndi zovuta za hypothyroidism, zomwe zingayambitse myxedema, myxedema coma ndi kufa.

Gawo lofunikira kwambiri la kuyesedwa ndikuyesa mahomoni. Hypothyroidism imatha kukhazikitsidwa pokhapokha pochita kafukufuku. Iyi ndi njira yokhazikika, yosavuta, yotsika mtengo komanso yodziwika bwino.

Anti Assays

Chizindikiro china cha kugwira ntchito kwa chithokomiro cha chithokomiro komanso kukondoweza kwa mahomoni a chithokomiro ndikuwunika magazi kwa ma antibodies omwe ali ndi ayodini.

Ma antibodies a thyroperoxidase. Enzyme iyi imakhudzidwa mwachindunji ndi kapangidwe ka mahomoni a chithokomiro. Chowonetsera ichi sichosangalatsa, koma zochulukirapo m'magazi ziyenera kukumbukiridwa popanga matenda.
Ma antibodies a thyroglobulin - chizindikiro cha multivariate. Itha kukhala umboni wa kuphatikiza khansa ya poizoni kapena khansa ya chithokomiro, koma siyikhala ndi vuto linalake, ngati mulingo wa ma antibodies ku TG ukuwonjezeka, maphunziro owonjezera amafunikira omwe amachotsa kapena kutsimikizira DTZ kapena oncology.
Ma antibodies ku TSH receptor ndi chizindikiro cha chithandizo chabwino. Ngati kuchuluka kwa ma antibodies ku RTTG sikubwerera mwachizolowezi pakukonzekera mokwanira, ndiye kuti tiyenera kukambirana za zovuta zamatendawa komanso zomwe zingachitike opaleshoni.

Momwe mungayesedwe

Odwala onse omwe akuwaganizira kuti ali ndi vuto la kukhudzana kwa khungu, funso limabuka momwe angapangire kusanthula kwa hypothyroidism. Iyi ndi njira yosavuta yokonzekera. Kuyesa konse kwa magazi kumachitika m'mawa, pamimba yopanda kanthu kapena ayi - sizitengera mbali, popeza izi zimachitika popanda kudya. Kafukufuku amatengedwa kuchokera mu mtsempha, womwe umawalola kuti azichita molondola.

Ndi mayeso ati oti atenge ndi hypothyroidism?

Mndandanda woyeserera womwe uyenera kutsatidwa kuti mudziwe matendawa ndi:

kuyezetsa magazi kopanda magazi popanda leukocyte formula ndi ESR,
kusanthula kwa zamankhwala.

Kuyesa komwe kumatsimikizira kuchuluka kwa mahomoni a chithokomiro:

TTG - mahomoni olimbikitsa chithokomiro,
T3 - triiodothyronine General and free,
T4 - thyroxine yaulere komanso yonse,
autoantiever assay.

Kusanthula kwapadera ndikofunikira kuti muzindikire kuchuluka kwa maselo amagazi osiyanasiyana, magawo awo.

Kusanthula kwamayikidwe am'madzi kumawonetsa kusokonezeka kwamchere wamchere ndi mafuta. Kutsika kwa kuchuluka kwa sodium, kuwonjezeka kwa ma enzymes a chiwindi kapena chiwindi kumawonetsa molondola hypothyroidism.

TTG ndiyofunikira kwambiri pazisonyezo. Homoni yolimbikitsa chithokomiro imapangidwa ndi gitu. Kuwonjezeka kwa misempha ya TSH kukuwonetsa kuchepa kwa ntchito ya chithokomiro ndipo kungayambitse kuwonjezeka kwake. Masewera a pituitary amachititsa kuti gland ikwaniritse mahomoni ambiri a chithokomiro.

Mukadutsa mayeso a TSH, muyenera kudziwa kuti m'mawa mwake muli pakati pa masambawo, amachepetsa masana, ndipo amawuka madzulo.

Gland ya chithokomiro imatulutsa 7% T3 triiodothyronine ndi 93% T4 thyroxine.

T4 ndi mtundu wosagwira ntchito wa mahomoni, womwe pambuyo pake umasinthidwa kukhala T3. Mitundu yonse ya thyroxine imazunguliridwa ndi mapuloteni amtundu wa globulin omangidwa. T4 yaulere (0,1%) ndiyomwe imagwira ntchito kwambiri, imakhala ndi zochita zolimbitsa thupi. Amayang'anira kuwongolera kwa pulasitiki ndi mphamvu ya metabolism m'thupi.

Kuchulukitsa kwa T4 yaulere kumapangitsa kuti pakhale mphamvu zowonjezereka zama cell, maselo ochulukirapo, komanso mawonekedwe a hypothyroidism.

Zachilengedwe za T3 kapena triiodothyronine zimaposa T4 3-5 nthawi. Zambiri zimagwirizananso ndi mapuloteni a plasma ndipo ndi 0.3% yokha yomwe ili mwaulere, wopanda malire. Triiodothyronine amawonekera atatha 1 atomu ya ayodini chifukwa cha thyroxine kunja kwa chithokomiro cha chithokomiro (chiwindi, impso).

Kafukufuku wa T3 kuti adziwe hypothyroidism amalembedwa zotere:

ndi kuchepa kwa mulingo wa TSH komanso mtundu wa T4 yaulere,
pamaso pa zizindikiro za nthendayi ndi mulingo wabwinobwino wa thyroxine waulere,
ndi Zizindikiro za TTG ndi T4 zomwe ndi zapamwamba kapena zotsika kuposa zabwinobwino.

Chochulukitsa chomwe chimayambitsa kuperewera kwa mahomoni a chithokomiro ndi chotupa cha autoimmune, chomwe ndikupanga autoantibodies kulimbana ndi minofu yanu. Zimapweteketsa wodwala pomenya ma cell a gland ndikusokoneza magwiridwe antchito ake.

Kuyesedwa kwa antiapy ndi njira yabwino kwambiri yopezera matenda monga azida matenda kapena Hashimoto's chithokomiro.

Kuzindikira mtundu uliwonse wa hypothyroidism

Chifukwa chake, ndimayeso ati omwe amayenera kuchitidwa kuti hypothyroidism idziwe? Zomwe zili mu T3 ndi T4, komanso TSH, zimayankha funso loyamba. Hypothyroidism ndi mkhalidwe momwe chithokomiro cha chithokomiro sichipanga mahomoni okwanira kapena sichimatulutsa konse.. Ndizosangalatsa kuti zochita za T3 ndizochulukirapo kuposa T4, koma ayodini amafunikira kuti apangidwe pang'ono. Izi ndi zomwe thupi limagwiritsa ntchito ngati mulibe iodini wokwanira - T4 imakhala yocheperako, koma T3 imawonjezeka.

Munthu akhoza kukhala mdziko lino kwa nthawi yayitali, izi sizingawononge thanzi lake. Zizindikiro zosadziwika kwambiri ndizotheka: kuchepa kwa magwiridwe antchito, tsitsi la brittle, misomali, ulesi ... Ordinary hypovitaminosis kapena kutopa, sichoncho? Hypothyroidism yamtunduwu sikusokoneza moyo wa munthu, chifukwa chake samapita kwa dokotala chifukwa chake samalandira chithandizo.

Ngati onse T3 ndi T4 atachepetsedwa, izi ndizokhazokha kale. Kuopsa kwake kungatsimikizidwe ndi kuuma kwa zizindikiro komanso kuchuluka kwa mahomoni pakuwunika.

Gulu la gulu limagawa hypothyroidism mu:

Zochulukitsa - zochepa, zobisika, zofatsa).
Kuwonekera - kufanana ndi kusasamala kwenikweni.
Zovuta - zovuta kwambiri, mwinanso ngakhale kupweteka. Fomuyi imaphatikizapo myxedema, myxedema coma (myxedema + chikomokere chifukwa cha hypothyroidism) ndi mwana wakhanda wakhanda.

Kodi TTG ndi TRG zikukambirana ndi ziti?

Koma ngakhale magwiritsidwe abwinobwino a mahomoni a chithokomiro pakuwunikira konse sikutsimikizira kuti munthu alibe hypothyroidism! Kuti mupeze matenda oyamba kapena kupezeka kwa subclinical hypothyroidism, ndikofunikira kuti muwonenso za TSH. Hormon iyi, yomwe imatchedwanso kuti chithokomiro cha chithokomiro, imatulutsa tinthu tambiri kuti tithandizitse timadzi tambiri ta chithokomiro. Ngati TSH imakwezedwa, ndiye kuti thupi lilibe mahomoni okwanira a chithokomiro. Potere, ngakhale ndende wamba ya T3 ndi T4 malinga ndi kusanthula sikukwaniritsa zosowa za thupi. Hypothyroidism yotereyi imatchedwanso chobisika.

Kwa subclinical, mtundu waposachedwa wa hypothyroidism, TSH pakuwunikira kuyenera kukhala pamtunda kuchokera ku 4.5 mpaka 10 mIU / L. Ngati TSH ikulu, ndiye kuti iyi ndi hypothyroidism, koma yayamba kale. Mwa njira, zikhalidwe mpaka 4 mIU / L ndi zachikale, ndipo pazosinthidwa zatsopano za hypothyroidism kwa madokotala zidachepetsedwa kukhala 2 mIU / L.

TSH imatulutsa England. Kuti muchite izi, hypothalamus imalimbikitsa kudzera pa TRH. Madokotala amagwiritsa ntchito mfundoyi kutsimikizira / kutsimikizira kuti ndi matenda achilengedwe chifukwa cha hypothyroidism. Munthu yemwe ali ndi TSH yotsika amapatsidwa mankhwala TRH ndipo kusintha kosinthika kumawonedwa. Ngati pituitary gland ikulabadira lamulo la TRH kuti liwonjezere kuchuluka kwa mahomoni opatsirana a chithokomiro ndikuchita panthawi, ndiye kuti vuto la hypothyroidism mulibe. Ngati palibe chochita ndi kulowetsa kwa TRG malinga ndi kusanthula, ndiye kuti muyenera kuyang'ana zomwe zimayambitsa vuto la pituitary - MRI nthawi zambiri imayikidwa.

Kuphatikizika kwadongosolo la pituitary kumasonyezedwa ndi kuperewera kwa mahomoni ake ena, mayeso omwe amatha kudutsanso.

Mlingo wa TRH, kapena thyroliberin, umawonetsa zochitika za hypothalamus.

Ma antibodies ku chithokomiro cha chithokomiro ndi zina

Thyroperoxidase, thyroperoxidase, chithokomiro cha chithokomiro, TPO onse ndi mayina osiyanasiyana a enzyme yomweyo. Ndikofunikira pakupanga kwa T3 ndi T4. Ma antibodies amawononga enzyme peroxidase, motere, ngati mumapereka magazi kumahomoni a chithokomiro, zimasowa kusowa kwawo. Ngati ma antibodies amenewa alipo m'magazi, ndiye kuti izi zikutanthauza njira ya autoimmune mthupi, hypothyroidism imayamba chifukwa cha kuzunza kwamphamvu kwa chitetezo chathupi.

Njira ya autoimmune imakhalanso yotupa, chifukwa chake nthawi zambiri imadziwika ndi zotupa m'magazi. Kuwerengera kwamasiku onse kumawonetsa kuchuluka kwa ESR, ndizotheka, koma leukocytosis siyofunikira. Zimatengera momwe machitidwe a autoimmune alili.

Mlingo wofunikira kwambiri wa anti-TPO ndi 100 U / ml ndi zina zambiri.

Hypothyroidism ndi chikhalidwe cha chamoyo chonse, ngakhale asymptomatic hypothyroidism imadzetsa thanzi.

Chifukwa chake, cholesterol ndi triglycerides zimawonjezeka - izi zimayambitsa atherosulinosis, yomwe imachepetsa mitsempha ya m'magazi ndikusokoneza magazi.
Hypothyroidism imayambitsa mitundu yosiyanasiyana ya magazi m'thupi. Hypochromic anemia yolephera kukhala ndi hemoglobin, Normochromic yokhala ndi maselo ofiira a magazi.
Creatinine amadzuka.
Makina owonjezera michere AST ndi ALT mu hypothyroidism sanakhazikike modalirika, koma izi zimachitika pafupifupi kwa munthu aliyense yemwe ali ndi vuto lotere.
Hypothyroidism imagwiranso zigawo zina za endocrine dongosolo, zomwe zimayambitsa kusokonezeka mu gawo la kumaliseche mu azimayi onse, nthawi zambiri mwa akazi. Kuchuluka kwa prolactin kumawonjezera, komwe kumachepetsa mphamvu ya gonadotropins.

Peripheral, kapena receptor hypothyroidism

Fomu yochepera. Chifukwa cha kusintha pamlingo wa majini kuyambira pakubadwa mwa anthu, ma receptor a chithokomiro ndi otsika. Pankhaniyi, dongosolo la endocrine lokhazikika limayesa kupereka thupi ndi mahomoni, koma maselo sangathe kuzizindikira. Masautso a mahomoni amatuluka poyesa "kufikira" kwa olandila, koma, sizinaphule kanthu.

Pankhaniyi, mahomoni a chithokomiro m'magazi amawonjezereka, tinthu tambiri timene timayesa kukopa gland yodwala, koma zizindikiro za hypothyroidism sizimatha. Ngati ma receptor onse a mahomoni a chithokomiro ndi otsika, ndiye kuti izi sizikugwirizana ndi moyo. Pali zochitika zochepa pomwe gawo lokha la zolandirira limasinthidwa. Poterepa, tikulankhula za genetic mosaicism, pomwe gawo la maselo mthupi lili ndi ma receptor abwinobwino komanso genotype yabwinobwino, ndikugawana ndi genotype yotsika komanso yosinthika.

Kusintha kwodabwitsaku ndikosachita bwino ndipo chithandizo chake sichinapangidwe lero, madokotala akuyenera kutsatira chidziwitso chamankhwala.

Mayeso a Hypothyroidism

Hypothyroidism ndi matenda a chithokomiro, omwe ndi amodzi mwa magawo a kuukira kwamphamvu kwa chitetezo chathupi mthupi. Nthawi zina matendawa amapezeka mu monophase, osapita ku matenda ena. Njira imodzi yodziwira matenda a hypothyroidism ndiyo kuyesa kwa magazi ma laboratori chifukwa cha kuchuluka kwa mahomoni momwemo.

Hypothyroidism sitha kudziwonetsa kwa nthawi yayitali ndipo pokhapokha ngati itanyalanyazidwa imawonetsa chithunzi chowoneka bwino chachipatala. Choyambitsa chachikulu pakuwonetsa kotsiriza ndichimodzimodzi mayeso a hypothyroidism.

Mwa chithunzi chotchulidwa cha hypothyroidism, ziyenera kudziwika:

Zofooka, ulesi,
Kusayang'anira chilichonse chomwe chimachitika
Kutopa msanga, ntchito yachepa,
Kugona
Zosokoneza, kukumbukira zosavomerezeka,
Kutupa kwa mikono, miyendo,
Khungu lowuma, misomali ya brittle, tsitsi.

Zonsezi ndi zotsatira za kusowa kwa mahomoni a chithokomiro mu chithokomiro cha chithokomiro. Kuphatikiza pa ma diagnostics a labotale, kuyezetsa kwa gland ndikutchulidwa, kuphatikizanso kwa biopsy kungatchulidwenso ngati maboma akuwoneka kuti ali ndi vuto. Tiyeni tikambirane mwatsatanetsatane zomwe mayesowa amawonetsa ndi hypothyroidism.

Chithokomiro chotulutsa chithokomiro

Ambiri endocrinologists amadalira mulingo wa mahomoni opatsa chithokomiro m'magazi a wodwala, kapena TSH. Hormone iyi imapangidwa ndi gitini ndipo imapangidwa kuti ilimbikitse chithokomiro cha chithokomiro.

Ndi kuchuluka kwambiri kwa timadzi timeneti m'magazi, titha kunena kuti chithokomiro cha pituitary chimagwira ntchito pakuyambitsa gland, ndipo motero, mahomoni a chithokomiro ndi osakwanira.

Mitundu ya zofunikira za mahomoni opatsa chithokomiro imasiyana m'maiko osiyanasiyana. Zosiyanasiyana ndizotsatirazi:

Kwa Russia, mulingo wabwinobwino wa TSH m'magazi a wodwalayo umasiyanasiyana pamlingo wa 0.4-4.0 mIU / L.
American endocrinologists atenga mtundu watsopano, malinga ndi zotsatira za kafukufuku wawo, mogwirizana ndi chithunzi chenicheni - 0,3-3.0 mIU / L.

M'mbuyomu, mtundu wa TSH nthawi zambiri unkakhala wa 0.5-5.0 mIU / L - chizindikiro ichi chinasinthidwa kukhala zaka 15 zapitazo, zomwe zidapangitsa kuti pakuwonekera kuwonekera kwa zachiwopsezo cha chithokomiro.

M'dera lathu, ndikofunikira kuyang'ana pa chizindikiro choyamba. A TSH pamwambapa kanayi mIU / L akuwonetsa hypothyroidism, ndipo pansipa pake pamusonyeza hyperthyroidism.

Kumbali ina, ndende ya TSH imadaliranso pazinthu zina zambiri. Mwachitsanzo, kutsika kocheperako kwa timadzi tonunkhira ya chithokomiro kumawonedwa m'matenda a oncological a pituitary gland, chifukwa samatha kupanga mahomoni. Njira yofananayo imawonedwa pambuyo pa sitiroko kapena zoopsa zomwe zakhudza hypothalamus.

Mphamvu yayikulu pa zotsatira za phunziroli imakhala ndi nthawi yopereka magazi. M'mawa kwambiri, mulingo wa TSH m'magazi umawonjezeredwa, umachepera masana, ndipo umadzuka pamlingo wapakati pamadzulo.

T4 timadzi titha kuphunziridwa mu mitundu iyi:

Chuma T4 - kuchuluka kwa mitundu yayikulu ya ma T4,
Kwaulere - mahomoni omwe samalumikizidwa ndi molekyulu ya protein, ndipo amapezeka kuti agwiritsidwe ntchito m'thupi,
Zophatikizidwa - kuchuluka kwa mahomoni a T4, omwe amamangidwa kale ndi molekyulu wa protein ndipo sangagwiritsidwe ntchito ndi thupi. Ambiri a T4 mthupi amakhala omangika.

Kufufuza kwathunthu kwa matenda a hypothyroidism sikungangokhala kokha pazowerengera zamisala, popeza zimawunikira vutoli pokhapokha - kuchuluka kwa ubongo komwe kumalimbikitsa chithokomiro cha chithokomiro. Phunziro lokhazikika, mayeso amitundu yaulere ya mahomoni T3 ndi T4 ndi omwe amapatsidwa.

T4 yathunthu imatengera T4 yomwe ikugwirizana. Koma posachedwa, chisamaliro chochepa chidaperekedwa kwa icho, popeza kumangika kwa T4 ku molekyulu ya mapuloteni kumadaliranso kuchuluka kwa mapuloteni omwewo m'magazi. Ndipo popeza kuchuluka kwa mapuloteni kumatha kuwonjezeka ndimatenda aimpso komanso kwa chiwindi, nthawi yokhala ndi pakati komanso kuyamwa, kuyeza T4 yonse sikugwira ntchito nthawi zonse.

Chisamaliro chochulukirapo chimaperekedwa kwaulere kwa T4 - uwu ndi mtundu wa mahomoni, omwe mtsogolomo ayenera kulowa m'maselo ndikusintha kukhala T3. Chotsirizachi ndi mtundu wogwira wa mahomoni a chithokomiro.

Ngati T4 yaulere - thyroxine ili pansipa, pomwe TSH imakwezedwa, chithunzicho chimakankhira endocrinologist ku hypothyroidism. Zizindikiro izi nthawi zambiri zimawonedwa molumikizana.

Monga tafotokozera pamwambapa, T3 imapangidwa m'maselo a thupi kuchokera ku T4. Hormone iyi imatchedwa triothyronine ndipo ndi mtundu wogwira wa mahomoni a chithokomiro.

Monga T4, mitundu yonse yaulere, yomasuka, komanso yomangidwa imafufuzidwa. T3 yonse sichizindikiro cholondola cha hypothyroidism, koma imatha kutsimikizira chithunzi chazidziwitso.

Chofunika kwambiri pakuwonetsa matendawa ndi T3 yaulere, ngakhale ndi hypothyroidism, nthawi zambiri imawonedwa kuti imakhalabe yofanana. Izi ndichifukwa choti ngakhale kuchepa kwa thyroxine, thupi limapanga ma enzymes ochulukirapo omwe amasintha T4 kukhala T3, chifukwa chake zotsalira za thyroxine zimasinthidwa kukhala triiodothyronine, kusunga mulingo wabwinobwino wa T3.

Matenda aliwonse mthupi oyambitsidwa ndi kachilombo, bakiteriya kapena kachilombo kamayambitsa kuyankha kwamphamvu kwa chitetezo chathupi mwanjira yotulutsa ma antibodies omwe amayenera kuwononga thupi lachilendo - chomwe chimayambitsa matendawa.

Pankhani ya autoimmune hypothyroidism, chitetezo cha mthupi chimazindikira kuti pathogen yolakwika mwanjira inayake, ikukhudza chithokomiro cha chithokomiro cha munthu.

Mukakhala pakuwukira kwa autoimmune ku gland, ma antibodies enieni komanso osatchulidwa amapangidwa. Zapadera - ma antibodies opita ku chithokomiro peroxidase, alinso AT-TPO.

Ma antibodies amenewo amatsutsana ndi maselo a gland, amawawononga. Popeza ma cell ali ndi mawonekedwe a follicle, atatha kuwonongeka, nembanemba imalowa m'magazi. Chitetezo cha mthupi chimazindikira matupi achilendo m'magazi - zimagwira - zimazindikira komwe zimayambira ndikuyambanso kuukira - mwakutero, kupanga kwa AT-TPO kumachitika mozungulira.

Kudziwa ma antibodies m'magazi ndikosavuta, ndipo amakhala golide wodziwika bwino wa autoimmune chithokomiro. Ngati zotsatira za mayesowa zikuwonetsa kuchuluka kwa AT-TPO m'magazi, hypothyroidism mwina ndi gawo limodzi la chithokomiro, ndipo gawo ili limatha zaka.

Zizindikiro zina

Zizindikirozi ndizovuta ndipo zimayang'aniridwa limodzi, ndipo zikapukutidwa, zimalumikizana. Kuphatikiza apo, adotolo amatha kukupatsani mankhwala a immunogram, a biopsy a gland komanso mayeso a mkodzo wamba.

Kusanthula kwamkodzo kwamkodzo sikungopatuka kuchoka pazomwe zimachitika.
The immunogram akuwonetsa kuchepa kwa kuchuluka kwa T-lymphocyte pansipa yokhazikika, kuwonjezeka kwa kuchuluka kwa ma immunoglobulins, chithunzi chofanana ndi biopsy - pali ma antibodies ambiri m'maselo a gland.
Kuyesa kwa magazi - kukuwonetsa kuchuluka kwa maselo a erythrocyte sedimentation, lymphocytosis - kuchepa kwa kuchuluka kwa ma lymphocyte.
Kafukufuku wokhudzana ndi zamankhwala osokoneza bongo akuwonetsa kuchepa kwa gawo la mapuloteni, kuwonjezeka kwa kuchuluka kwa mapuloteni ndi cholesterol, ma globulins ndi lipoproteins yotsika.

Kuwunika kwa zotsatira za kufufuza kwa labotale kumachitika ndi endocrinologist yemwe akuwongolera phunziroli. Laborator iliyonse simatenga udindo wodzipatsa wodwala, chifukwa zotsatira za mayeso a hypothyroidism, ngakhale chithunzicho chikugwirizana ndi amene walandiridwacho, sikuti ndi matenda azachipatala, koma chithandizo chokha kwa iye.

Ndi mayeso ati omwe akuyenera kuchitika kuti mudziwe hypothyroidism?

Zomwe zimafunikira kuti mupereke mayeso a hypothyroidism, endocrinologist anena pamayeso. Monga lamulo, wodwalayo amapatsidwa maphunziro a labotale komanso othandizira. Koma njira yayikulu yodziwira matenda a chithokomiro imawerengedwa kuti ndi magazi.

Kuti mudziwe hypothyroidism, mitundu yotsatira ya mayeso imayikidwa:

Kuyesedwa kwa magazi konse.
Kuzindikira kuchuluka kwa mahomoni.
Zambiri komanso zaulere T3 ndi T4.
Kuyesedwa kwa magazi kwa ma antibodies.
Kupeza zida za hypothyroidism.

Mayeso a mahormone

Kuyesa kwa hypothyroidism yamahomoni ndi imodzi mwanjira zazikulu zodziwira matenda. Aliyense amadziwa kuti mahomoni ndi othandizira komanso ofunikira pazamoyo zomwe zimathandizira m'njira zambiri zofunika, kuphatikizapo kudziwa ntchito ya chithokomiro cha chithokomiro.

Ichi ndichifukwa chake odwala amapatsidwa mayeso a mahomoni. Ngati, malinga ndi zotsatira za kusanthula, kuchuluka kwa mahomoni ena sikukwaniritsa zikhalidwe zovomerezeka, amalankhula za kuchepetsedwa kapena kuwonjezeka kwa ntchito ya chithokomiro kutengera zomwe zikuwonetsa, ndipo chithandizo chamankhwala chimayikidwa.

Kwenikweni, kuyezetsa kumachitika kuti muwone mahomoni otsatirawa:

Mahomoni opatsa chithokomiro - ali a pituitary ndipo, monga palibe abwinoko, amawonetsa kusokonezeka kwa chithokomiro cha chithokomiro. Zizindikiro za ttg nthawi zambiri zimakhala 0.4-5 mU / l. Ngati chithokomiro cha chithokomiro chikukula m'thupi ndipo chisonkhezero cha zinthu zosafunikira chikuchitika, mulingo wa TSH panthawi ya hypothyroidism umachepa kwambiri ndipo umatsogolera mawonekedwe ake.
Mahoroni a Thyroxine ndiwofunikanso kutsimikizira kuti ali ndi matenda. Ngati akusowa, zodwala zamtundu wa chithokomiro zimayamba. Kuperewera kwa mahomoni amenewa kumatha kutsimikiziridwa ndi tsekwe lokwera.
Tanthauzo la triiodothyronine - mahomoni otero amakhala m'thupi mokhazikika komanso momasuka. Poyambirira, pakuwunikira, kuchuluka kwazinthu zonse zokhudzana ndi zamankhwala zimatsimikizika m'magazi. Osati kawirikawiri, kuchuluka kwa kusintha kwa triiodothyronine kwaulere, ndikupanga kwa hypofunction ya tezi ya chithokomiro, mahomoni awa amatha kukhala abwinobwino. Kuchulukitsa kwake kumatsimikiziridwa pokhapokha ngati pakufunika kuzindikira kusintha kwina kwa chithokomiro ndikuzindikira njira zamankhwala.

Kukonzekera kwa mayeso a hypothyroidism

Pa kudalirika kwa zotsatira za mayeso a labotale ndi zida, ndikofunikira kukonzekera pasadakhale. Kuti tichite izi, ndikokwanira kuwona zotsatirazi:

Tsiku lisanafike mayeso omwe amayembekezeredwa, tiyi wa khofi ayenera kuyikidwa pambali pazakudya ndi mowa ndipo kusuta kuyenera kutayidwa.
Ndikofunikira kutulutsa mtundu wamalingaliro. Panthawi yopereka mayeso, simuyenera kukhala amantha, okhumudwa kapena opsinjika.
Kwa tsiku, zolimbitsa thupi zonse zimasiyidwa, thupi liyenera kupumula kwathunthu.
Ndikulimbikitsidwa kupereka magazi pamimba yopanda kanthu, chifukwa chake odwala amalangizidwa kuti asadye maola 12 asanachitike.
Chepetsani kugwiritsa ntchito mankhwalawa kapena muchepetse mlingo wawo monga adokotala adanenera.
Mankhwala osokoneza bongo omwe amakhudza kugwira ntchito kwa chithokomiro cha chithokomiro nawonso sawerengedwa kuti awunikire kudzipanga kwawo.
Amayi samalimbikitsidwa kuti azichita mayeso pa nthawi ya kusamba. Masiku oyenera a njirayi ndi mizere 4-7.

Njira zowonjezera zowunika za hypothyroidism

Ngati mayeso a labotale a hypothyroidism ndi abwino, njira zoyeserera zofunikira zimaperekedwa kuti wodwalayo atsimikizire bwino matendawa:

Kufufuza kwa Ultrasound - kumakupatsani mwayi wosindikiza zisindikizo m'thupi, komanso momwe zimapangidwira, mawonekedwe, kapangidwe kake ndi ma contour. Chifukwa cha ultrasound, ndizotheka kudziwa mawonekedwe kuchokera pa 1mm mulifupi.
Chithokomiro chithokomiro ndi njira yodziwira pogwiritsa ntchito ma radioisotopes. Asanachitike, kukonzekera kumafunika kuwonjezera kudalirika kwa mayeso.
Biopsy yotsatiridwa ndikuwunika kwa mbiriyakale.

Ngati njira zoterezi zimaperekanso zotsatira zabwino, pankhaniyi, adotolo amasankha mankhwalawo ndikupereka mankhwala ndi njira zina zochizira kwa wodwala, kutengera zotsatira za mayeso.