Chizoloŵezi chimodzi chochizira odwala ndi khansa ya chithokomiro ndi-pambuyo pochotsa opaleshoni ya chithokomiro, ndipo nthawi zina amadzimadzi a iodin (RAI) amatha kuika mankhwala osokoneza bongo omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tiziyambitsa . Chofunika kwambiri, odwala amapatsidwa mlingo waukulu wa mankhwala (omwe amadziwika kuti supra-physiologic) kuti apange mazinga, omwe sungapezeke.
Kusunga odwala m'magulu omwe amawoneka kuti ali mu hyperthyroid akhoza kuteteza khansa yowonongeka.
Kafukufuku amene adafotokozedwa pa msonkhano wa 2017 Wopereka Chithandizo cha Khansara, akutsutsa mwambo umenewu povomereza umboni wakuti pali zowopsa za mtima zomwe zikugwirizana ndi chizolowezi chimenechi.
Hyperthyroidism yomwe siidali chifukwa cha mankhwala kale ndi yodziŵika bwino ya chiopsezo cha atrial fibrillation ndi stroke ya ischemic. Amagwirizananso ndi ululu wa angina ndi matenda a mtima kwa odwala omwe ali kale ndi ziwalo za mtima.
Phunziroli, ofufuza anayeza mtima wa hyperthyroidism chifukwa cha kuchuluka kwa mankhwala a levothyroxine , mawonekedwe a thyroxine (T4) hormone, mwa oposa 182,000 odwala khansa ya chithokomiro. Iwo apeza kuti kuchuluka kwa mankhwala a levothyroxine kumawonjezera chiopsezo cha matenda a mtima ndi kupwetekedwa kwa sitirojekiti mu opulumuka khansara ya chithokomiro.
Mwachindunji, iwo apeza:
- Pambuyo pa khansa ya chithokomiro, kuwonjezeka kwa matenda a mtima ndi kupwetekedwa mtima
- Chiopsezo chinali chachikulu kwa odwala omwe analandira chithokomiro chonse
- Kuopsa kwake kunali kwakukulu kwa iwo omwe ali ndi mlingo waukulu wa levothyroxine (ndipo omwe anali ndi mlingo wochepa wa TSH)
- Panali chiopsezo chachikulu cha matenda opatsirana pogonana, omwe ankagwirizanitsidwa ndi mlingo waukulu wa levothyroxine
Malingana ndi ochita kafukufuku, kagawo kakang'ono kokha kameneka kanakhala chifukwa cha kuchulukitsitsa kwa mavitamini oopsa. M'malo mwake, mphamvu ya hyperthyroidism yowonjezera kuthamanga kwambiri kwa magazi ndi kusintha kwa mtima kumagwira ntchito-mwazifukwa zina-zinali zolakwa.
Phunziro lina la 2013 linayang'ana matenda oopsa a mtima kwa odwala omwe anasiyanitsa khansara. Kafukufukuyu anapeza kuti 19 peresenti ya odwala anafa chifukwa cha mavuto a mtima-kuphatikizapo matenda a mtima, kupweteka kwa m'mimba, m'mimba m'mimba, ndi m'mimba-poyerekeza ndi 7,4 peresenti omwe anafa ndi khansara yokha. Kuopsa kwa imfa kuchokera ku matenda a mtima kunagwirizanitsidwa ndi miyeso ya TSH: Kutsika kwa TSH, kumakhala koopsa.
Zotsatira za odwala khansa ya chithokomiro
Zotsatirazi ndizofunikira kwa odwala khansa ya chithokomiro , makamaka pamene muli ndi chithokomiro chonse , kapena muli-kapena dokotala wanu akuyamikira-mankhwala opatsirana a levothyroxine pambuyo pa opaleshoni.
Choyamba, popeza kafukufukuyu akuwonetsa chiopsezo chachikulu chokhudzana ndi chithokomiro chokwanira, muyenera kukambirana ngati chithokomiro chonse chikufunikira monga chithandizo cha khansa yanu ya chithokomiro. Kafukufuku waposachedwapa wasonyeza kuti opaleshoni ya lobectomy imachotsa khungu imodzi yokha ya chithokomiro - ndiyo mankhwala opaleshoni opangidwa ndi khansa ya chithokomiro , yomwe imakhala ndi khansa ya chithokomiro.
Chachiwiri, akatswiri ambiri amakhulupirira kuti kulibe phindu loletsa kuthetsa TSH. Mfundo zatsopano za American Thyroid Association ndi European Thyroid Association zimalimbikitsa TSH kudandaula pokhapokha ngati wodwalayo "ali ndi zilonda zam'mimba kapena ali ndi chifuwa choopsa kwambiri chomwe chachitidwa opaleshoni ndi ayodini ya radioactive." Malingana ndi magulu awiriwa:
Pafupifupi 85 peresenti ya odwala angasonyezedwe kukhala opanda matenda pambuyo poyambitsa matenda otupa poyesera wodwalayo 'serum thyroglobulin level ndi kuchita neck necksonography. Pamene wodwalayo amva kuti alibe chifuwa pazifukwa izi, malangizo a ATA ndi ETA amasonyeza kusunga magazi TSH m'munsi mwawo.
Onani kuti ngakhale kuti malangizo ndi ndondomeko zimakhalapo, madokotala ambiri amakhala ndi kachilombo koyambitsa matenda a chithokomiro, ndipo amapereka mankhwala osokoneza bongo kwa odwala onse a khansa ya chithokomiro.
Chachitatu, tikuwonanso kuwonjezeka kwakukulu kwa chiwerengero cha matenda a kansa ya kansa. Ngakhale akatswiri ena amakhulupirira kuti kuwonjezereka kwenikweni kwa chiŵerengero cha khansa ya chithokomiro, izi ndizovuta kwambiri, monga ena amakhulupirira kuti kuchuluka kwa chiŵerengerochi ndiko makamaka chifukwa cha kuchulukitsidwa kwa "matenda" a khansa ya kanseri. Chifukwa cha kuchuluka kwa kugwiritsira ntchito zojambula, ambirimbiri ang'onoang'ono, khansa, koma akudzidzidzika kwambiri "zovuta" zomwe zimatulutsa chithokomiro. Pali kutsutsana pazomwe ma tholombowa amavomereza, koma osati mankhwala opweteka a kansa omwe ife tikudziŵa tsopano angawonjezere mavuto a mtima.
Pomaliza, ngati muli ndi mbiri ya khansa ya chithokomiro, muyenera kutsimikiza kuti dokotala wanu nthawi zonse amayesa ndikuyang'anira thanzi la mtima wanu.
> Zotsatira:
> Klein Hesselink EN, Klein Hesselink MS, de Bock GH, et al. Kufa kwa mtima kwa nthawi yaitali kwa odwala omwe amasiyana ndi chithokomiro cha kadosiyumu: phunziro lofufuza. J Clin Oncol. 2013; 31 (32): 4046-4053. do: 10.1200 / JCO.2013.49.1043.
> Shin DW, Suh B, Yoon JM, et al. Kuopsa kwa matenda a mtima wodwala komanso kupweteka kwa khunyu ku khansa ya chithokomiro kutenga levothyroxine. J Clin Oncol. 2017; 35 (suppl 5S; abstr 105).
> "Chithokomiro Chothandizira Kutulutsa Hormoni (TSH). http://thyca.org/pap-fol/more/tsh-suppression/