Matenda a chithokomiro nthawi zambiri amabweretsa mavuto a mtima. Ndipotu, chimodzi mwa zifukwa zofunika kwambiri kuti mudziwe ndi kuchiza matenda a chithokomiro ndikuteteza matenda a mtima omwe angatulukepo.
Mwachidule
Thanzi la chithokomiro ndi kachilombo kakang'ono kamene kali pamtambo pansi pa apulo ya Adam, ndipo imayang'anila ntchito zambiri zofunika za thupi.
Pakupatsa kuchuluka kwa mahomoni a chithokomiro, chithokomiro chimakuthandizani kuti thupi lanu lizikhala ndi thupi - makamaka chofunika, momwe thupi lanu limagwiritsira ntchito mpweya ndi mphamvu, komanso momwe mumagwirira ntchito, minofu, ndi khungu.
Kwenikweni, chithokomiro chimakhala ndi zotsatira zina pa lirilonse lirilonse la thupi, kuphatikizapo mtima.
Mwa munthu amene ali ndi matenda amtima, mtundu wa chithokomiro umatha kuwononga zizindikiro za mtima kapena kuyambitsa zatsopano, ndipo zikhoza kufulumizitsa vuto lalikulu la mtima. Matenda a chithokomiro akhoza ngakhale kutulutsa mavuto atsopano a mtima kwa anthu omwe ali ndi mitima yathanzi.
Matenda a chithokomiro amakhudza mtima mwa kupanga timadzi timene timatulutsa tizilombo toyambitsa matenda (matenda otchedwa hypothyroidism ) kapena hormone yambiri ya chithokomiro (yotchedwa hyperthyroidism ). Mitundu yonse ya matenda a chithokomiro ndi wamba ndipo zonsezi zingakhale ndi zotsatirapo pamtima.
Hypothyroidism
Hormone ya chithokomiro ndi yofunika kwambiri kuti thupi liziyenda bwino. Ngati palibe mavitamini a chithokomiro, mtima kapena mitsempha sizingathe kugwira bwino.
Mu hypothyroidism, mahomoni otere afupika amachititsa kuti minofu ya mtima ikhale yopanda mphamvu ndipo potsirizira pake ikhale yofooka.
Kuwonjezera apo, minofu ya mtima silingathe kumasuka pambuyo pa kumenya mtima kulikonse.
Kulephera kupumula kungapangitse kutaya kwa diastolic, vuto lomwe lingayambitse mtima kulephera . Hypothyroidism imayambitsanso mitsempha ya mitsempha, yomwe imayambitsa matenda oopsa .
Zizindikiro za mtima zikhoza kuchitika kwa aliyense amene ali ndi hypothyroidism, koma amakhala makamaka mwa anthu omwe ali kale ndi matenda a mtima.
Matenda a mtima wokhudzana ndi hypothyroidism ndi awa:
- Dyspnea- Kuthamanga kwambiri pochita khama ndi zosavuta kuchita zolimbitsa thupi mu hypothyroidism kawirikawiri zimakhala zofooka mu mitsempha ya mafupa. Kwa anthu omwe ali ndi matenda a mtima, angakhale chifukwa cha kuwonongeka kwa mtima.
- Kuchuluka kwa mtima wa mtima ( bradycardia ) -Kuima kwa mtima kumakhala ndi mahomoni a chithokomiro. Choncho, ndi hypothyroidism, kuthamanga kwa mtima kumagunda 10 mpaka 20 pamphindi pang'onopang'ono kusiyana ndi yachibadwa. Makamaka kwa odwala omwe ali ndi matenda a mtima, komabe hypothyroidism ingaipitse chizolowezi chogunda msanga (monga PVCs ) ndipo chingayambitse matenda oopsa.
- Diastolic hypertension -One angaganize kuti, chifukwa chosowa chithokomiro chimachepetsa kuchepetsa shuga, anthu omwe ali ndi hypothyroidism angadwale kwambiri magazi . Kawirikawiri, zosiyana ndizo-mitsempha ndi yovuta mu hypothyroidism, zomwe zimayambitsa matenda a magazi a diastolic.
- Kupweteka kwa mtima kusagwedezeka kapena kusintha kwa mtima kwatsopano -Hyroidroidism imatha kuchepetsa mtima kufooka kwambiri ndipo ikhoza kusokoneza mtima kwa nthawi yoyamba kwa odwala omwe ali ndi matenda a mtima ochepa.
- Edema (kutupa) -Edema ikhoza kuchitika chifukwa cha kuwonongeka kwa mtima. Kuwonjezera apo, hypothyroidism yokha ikhoza kupanga mtundu wa edema wotchedwa myxedema, womwe umayambitsidwa ndi kuwonjezeka kwa mapuloteni osadziwika ndi ma molekyulu ena mumkati mwa madzi (maselo kunja kwa maselo a thupi).
- Kuwopsa kwa matenda a mitsempha (CAD) - Ngati kuchepetsa mahomoni a chithokomiro kungapangitse angina (kupweteka kwa chifuwa ndi CAD) kawirikawiri kwa odwala omwe ali ndi angina, kuwonjezeka kwa LDL cholesterol (cholesterol choipa) ndi puloteni ya C-yowonongeka ndi hypothyroidism ikhoza kuthamangira kwambiri CAD yodalirika.
Matenda a hyphyothyism nthawi zambiri amakhala osokonezeka kwambiri . Kawirikawiri amayamba pang'ono pang'ono, kotero zizindikiro zake zimatha "kukuwombera". Komanso, makamaka kwa okalamba, hypothyroidism kawirikawiri imapezeka popanda kuphatikiza kwa zizindikiro za "buku" zomwe madokotala amayembekezera.
Ndiponso, hypothyroidism imakonda kwambiri kuposa momwe madokotala ambiri amadziwira. Kotero ngati muli ndi zizindikiro zilizonse zosonyeza hypothyroidism ndipo dokotala alibe chidziwitso chodziwika bwino kwa iwo (makamaka ngati muli ndi matenda a mtima amtundu uliwonse), muyenera kufunsa adokotala kuti awonetse mahomoni a chithokomiro.
Hypothyroidism imachiritsidwa ndi mankhwala a chithokomiro . Matenda oyenera a hypothyroidism ndi ovuta komanso ovuta.
Hyperthyroidism
Hyperthyroidism imayamba chifukwa cha kuchuluka kwa mahomoni a chithokomiro. Pakakhala mahomoni ambiri a chithokomiro, minofu ya mtima "ikukwapulidwa" ngati kavalo ndipo, munthu amene ali ndi matenda a mtima ali ngati kukwapula kavalo wotopa.
Kuchulukitsa mavitamini a chithokomiro kumawonjezera mphamvu ya kupachika kwa minofu ya mtima ndi kuwonjezera kuchuluka kwa mpweya umene mtima umafuna. Zimapangitsanso kuchuluka kwa mtima. Chotsatira chake, ntchito ya mtima yawonjezeka kwambiri.
Zizindikiro za mtima zikhoza kuchitika kwa aliyense amene ali ndi hyperthyroidism, koma zingakhale zoopsa makamaka kwa anthu omwe ali ndi matenda a mtima. Zizindikiro zofala zimaphatikizapo:
- Kuthamanga kwa mtima kwambiri ( tachycardia ) ndi mapiritsi - Mphuno (ndiko kuti, yosavomerezeka) hyperthyroidism ndi chifukwa chofala cha kuchuluka kwa mtima kwa mpumulo ndi kupuma mofatsa. Hyperthyroidism nthawi zonse iyenera kuyendetsedwa ndi mayeso a magazi musanayambe kudziwa kuti sinus tachycardia sinasayenera . Makamaka odwala omwe ali ndi matenda a mtima, hyperthyroidism angathenso kupanga mitundu yambiri ya mankhwala, monga PVCs, ventricular tachycardia, komanso makamaka kupha tizilombo toyambitsa matenda . Inde, ndikofunikira kutulutsa hyperthyroidism kwa aliyense amene ali ndi matenda a atrial popanda chifukwa chomveka.
- Systolic hypertension - Kupangika kwamphamvu kwa mtima kumawonjezera sysilic blood pressure (kupanikizika m'mitsempha ya mitsempha pamutu wa mtima).
- Dyspnea ndi kuyesayesa pang'ono - Kuthamanga kwambiri kungakhale chifukwa cha kufooka kwa minofu kamene kakugwirizana ndi hyperthyroidism kapena kuwonjezeka kwa mtima kulephera.
- Kulephera kwa mtima -Hyperthyroidism yokha ikhoza kubweretsa mtima kulephera, koma kawirikawiri. Komabe, ngati matenda a mtima alipo kale, kupweteka kwa mtima ndi hyperthyroidism n'kofala ndipo kungakhale kovuta kwambiri kuchiza.
- Angina oopsa - Odwala omwe ali ndi CAD amavutika kwambiri ndi matenda a hyperthyroidism. Izi zingaphatikizepo kuchuluka kwa angina kapena ngakhale matenda a mtima.
Mofanana ndi hypothyroidism, hyperthyroidism ikhoza kupezeka popanda kupanga zizindikiro zamakono zolemba. Choncho aliyense amene ali ndi zizindikiro za mtimazi zomwe sangazifotokozere mosavuta ayenera kukhala ndi chithokomiro choyenera.
Njira yabwino kwambiri yothetsera hyperthyroidism ndi yotsutsana. Ku US, madokotala ambiri nthawi yomweyo amatha kuthetseratu chithokomiro chopitirira muyeso ndi ayodini ya radioactive . Kenako amapereka mapiritsi a hormone ya chithokomiro chifukwa chithokomiro sichigwira ntchito. Komabe, izi nthawi zina zingakhale zolakwitsa chifukwa nthawi zina chithokomiro chopitirira muyeso ndi matenda a Hashimoto omwe amatha nthawi yayitali, choncho vuto lochotsa chithokomiro sichifunikira.
Pogwiritsira ntchito mankhwala osokoneza bongo pofuna kuteteza khungu la chithokomiro (monga Tapazole kapena PTU ku US) kumapangitsa kuti madokotala azitenga nthawi yaitali, akatswiri ambiri amakhulupirira kuti izi zingachititse kuti atha kukhala osangalala.
Mawu Ochokera
Matenda a chithokomiro akhoza kusokoneza kayendedwe kake ka ziwalo za thupi. Zina mwa mavuto akuluakulu omwe angayambitse matenda a chithokomiro ndi mavuto omwe amakhudza mtima. Ndipotu, matenda a chithokomiro amachititsa kuti mtima ukhale wochiritsika. Aliyense amene ali ndi zizindikiro za mtima wa mtundu uliwonse ayenera kutsimikiza kuti adokotala amayesa mayeso awo a chithokomiro, ndipo kuti chikhalidwe chilichonse cha chithokomiro chomwe chingapezeke n'chokwanira.
> Zosowa
> Klein I, Ojamaa K. Kutentha kwa Hormone ndi Matenda a Mtima. N Engl J Med 2001 Feb 15; 344 (7): 501-9.
> Jonklaas J, Bianco AC, Bauer AJ, et al. Malangizo a Chithandizo cha Hyperothyroidism: Yokonzedwa ndi American Thyroid Association Task Force On Thyroid Hormone Replacement. Chithokomiro 2014; 24: 1670.
> Ross DS, Burch HB, Cooper DS, et al. 2016 Makomiti a Chithokomiro cha America a ku America Otsogolera Kuzindikira ndi Kusamalira Hyperthyroidism ndi Zina Zimayambitsa Thyrotoxicosis. Chithokomiro 2016; 26: 1343.