Kuteteza Antibodies Pamene TSH ndi Yachibadwa
Kuteteza chithokomiro choletsa ndi nkhani yotsutsana. Kodi pali chilichonse chimene mungachite kuti muteteze chithokomiro, kapena kuti chikhale choipa kwambiri? Ngati mufunsapo, akatswiri ena amatha kukuchotsani, kapena kukuuzani kuti mulibe njira zothandizira. Komabe, kafukufuku wa kafukufuku amathandizira kumvetsetsa kuti Hashimoto's thyroiditis-matenda omwe amachititsa kuti munthu azidwala hypothyroidism-akhoza kutetezedwa, kuchepetseratu, kapenanso kuleka kwathunthu asanalowetsedwe m'thupi lanu komanso kutentha thupi.
Pokamba nkhani pa msonkhano wa Endocrine Society wa Endo 2005, Dr. Ting Chang ndi anzake adanenapo za kupereka mankhwala otchedwa lavothyroxine omwe amadziwika kuti Synthroid, Levoxyl, ndi Tirosint ndi odwala a Hashimoto's thyroiditis. Odwalawa anali ndi mahomoni ambiri omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda (TSH ), ndipo tinkatchedwa "euthyroid," kutanthauza kuti maselo awo a TSH anali osiyana kwambiri. Chizindikiro cha Hashimoto's thyroiditis.
Theka la odwala anapatsidwa levothyroxine kwa miyezi isanu ndi umodzi ndipo theka lina silinalandire mankhwala osokoneza bongo. Matenda a chithokomiro ndi ma autoantibody titers anali kuyesedwa isanafike ndi pambuyo pa miyezi 6. Zomwe anapeza zinali zofunika:
- Amene analandira levothyroxine anali ndi kuchepa kwakukulu kwa magulu a antiantibody , ndipo magulu a antibody omwe anawonjezeka kwambiri mwa ena mwa gulu losatulutsidwa.
- MaseĊµera a TSH adatsika m'magulu otetezedwa, oposa 0,5 ndi 2.5 mu gulu losatulutsidwa.
Ofufuzawa anapeza kuti mankhwala oyamba a antivphylactic (preventionative) a levothyroxine angakhale othandiza kuchepetsa kupititsa patsogolo kwa chitetezo cha Hashimoto's thyroiditis.
Uku sikuli koyamba kuti asonyeze kuti chithandizo chopewa chithandizo chingalepheretse kupita patsogolo kwa Hashimoto kapena chitukuko cha overtothyroidism.
M'nkhani ya March 2001 ya magazini ya Throroid , ofufuza a ku Germany adanena za kufufuza kwawo kwa odwala omwe ali ndi Hashimoto wa euthyroid, theka la omwe anadwala levothyroxine kwa chaka, theka lina losatengedwera. Pambuyo pa chaka chimodzi, magulu a antibody ndi ma lymphocytes, omwe ali umboni wa kutupa, adachepa kwambiri pokhapokha mu gulu lolandira mankhwala. Pakati pa gulu losatulutsidwa, magulu a antibody ananyamuka kapena anakhalabe ofanana.
Akatswiriwa anapeza kuti odwala a Hashimoto amatha kuchepetsa matenda osiyanasiyana a chithokomiro . Anaganiziranso kuti chithandizochi chingathe kulepheretsa kuti matenda a Hashimoto apitirire, kapena kuteteza chitukuko cha hypothyroidism.
Mufukufuku wina, ofufuza a ku Japan adapeza kuti mankhwala a levothyroxine amachepetsa matenda a Hashimoto's thyroiditis, komanso kuthandizira kuchepetsa zizindikiro za matendawa.
Phunziro la odwala omwe ali ndi matenda a Eshyroid a Hashimoto, gulu limodzi la odwala analandira mankhwala a levothyroxine, ndipo gulu lina silinalandire chithandizo. Pambuyo pa miyezi 15, gulu lochiritsidwa lidawonjezeka kwambiri ma T4, kuchepa kwa TSH ndi kuchepa kwa anti-thyroglobulin antibody (Tg-Ab) komanso anti-thyroid peroxidase antibody levels.
Kukula kwa magulu a chithokomiro kunachepetsanso m'magulu ochiritsidwa, pamene osalandira chithandizo anali ndi kuchuluka kwa kukula kwa chithokomiro , chizindikiro cha kutupa kwa gland.
Ofufuzawa anafotokoza kuti ngakhale mankhwala a levothyroxine "ali ovomerezeka mu hypothyroid autoimmune thyroiditis odwala , mankhwala omwe amasonyeza kuti amachititsa kuti pakhale njira zowonongeka zogwiritsira ntchito zinyama zimatsutsanabe ndi odwala a Hashimoto odwala omwe matendawa sanawononge chithokomiro chothetsera hypothyroidism. "
Komabe, anapeza kuti mankhwala a levothyroxine omwe amachititsa kuti TSH ikhale yochepa kwambiri amawoneka kuti ndi othandiza osati kungochepetsera mayendedwe a autoantibody komanso kukula kwa goiter, zomwe zingathetseretu kupititsa patsogolo kuthamanga kwa hypothyroidism.
Mawu ochokera
Monga momwe mukuonera, pali kafukufuku wochititsa chidwi omwe amasonyeza kuti mankhwala oteteza levothyroxine angakhale oyenera kwa anthu omwe ali ndi matenda a Eshhyroid a Hashimoto omwe ali ndi mazinga oyenera a TSH koma omwe ma antibody awo amasonyeza umboni wa matenda a Hashimoto omwe sagwira ntchito . Chithandizo choterocho nthawi zina chingathetsere matenda a hypothyroidism, kuchepetsa kukwera kwa mankhwala a chithokomiro , kuthandizira kupewa kuwonjezereka kwa matenda omwe amachititsa kuti thupi likhale lokha , komanso kuteteza chitukuko cha hypothyroidism.
Ngati muli ndi zizindikiro za chithokomiro, tSH ya "yachibadwa", koma simunayesedwe ndi mankhwala a chithokomiro, tsatirani kuti mayeso a TPO achite ndi dokotala wanu.
Ngati muli ndi zizindikiro za chithokomiro, tSH ya "yachibadwa", komanso tizilombo toyambitsa chithokomiro, tikambirane kupempha chithandizo, ndipo ngati dokotala sakufuna, ganizirani kupeza dokotala wodalirika kapena wodalirika .
Zotsatira
En-Ting Chang, Du-An Wu, Dee Pei, Shi-Wen Kuo, Ming-Chen Hsieh. [P2-552] Mphamvu ya L-Thyroxine Administration kwa Odwala ndi Euthyroid Hashimoto's Thyroiditis. Endocrine Society Endo 2005 Zotsalira
Chithokomiro, 2001 Mar, 11 (3): 249-55, "Kuchiza mankhwala kwa chaka chimodzi kwa odwala Hashimoto's thyroiditis odwala levothyroxine: kodi pali phindu?"
Duygu Yazgan Aksoy, et. al. "Zotsatira za Prophylactic Throsy Hormone m'malo mwa Euthyroid Hashimoto's Thyroiditis" Endocr J (Japan) Vol. 52: 337-343, (2005).