TSH, T4, Free T4, T3, Free T3, Reverse T3, Antibodies, ndi Mavuto Ena
Mayeso a magazi a chithokomiro ndi mbali yofunika kwambiri yothetsera matenda a chithokomiro ndikuchiza matenda a chithokomiro. Pano pali chidule chomwe chimakuthandizani kumvetsetsa bwino mayesero a magazi a chithokomiro, zomwe akuyesa, zotsatira zake zikutanthauzanji, komanso zomwe zimakhudza matenda ndi chithandizo cha chithokomiro chanu. Mungathe kufotokoza momveka bwino ndikudziwa bwino zomwe zimatanthauza.
Mayeso a Chithokomiro | Chiwerengero cha Zolemba |
| TSH (Chithokomiro Chothandizira Kutulutsa Horoni) | 0,5-4.70 μIU / mL |
| Chiwerengero cha T4 (Thyroxine) | 4.5-12.5 μg / dL |
| Free T4 (Free Thyroxine) | 0,8-1.8 ng / dL |
| Chiwerengero cha T3 (Triiodothyronine) | 80 -200 ng / dL |
| Free T3 (Free Triiodothyronine) | 2.3- 4.2 pg / mL |
| RT3 (Zosintha T3 / Reverse Triiodothyronine) | 10-24 ng / dL |
| TPOAb (Matenda a Chithokomiro cha Peroxidase) | 0-35 IU / mL |
| TSI (Immunoglobulins ya Chithokomiro) | 0-1.3 |
| Tg (Thyroglobulin) | Palibe chithokomiro cha chithokomiro: 0-0.1 ng / ml. |
| TgAb (Matenda a Antigen) | 0-4.0 IU / mL |
TSH (Chithokomiro Chothandizira Kutulutsa Hormone)
Maina Ena: Seramu Thyrotropin
Zokhudza: Chithokomiro choyambitsa hormone (TSH) ndi hormone ya pituitary yomwe imatumiza uthenga ku chithokomiro cha chithokomiro. Ngati pituitary ikuzindikira kuti chiberekero chimatulutsa timadzi timene timatulutsa kachilombo, tizilomboti timapanga TSH zambiri, zomwe zimapangitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Pamene kachilomboka kamakhala ndi mahomoni ambiri otere, amachepetsa TSH, monga uthenga ku chikhomo kuti pang'onopang'ono kapena kusiya kutulutsa mahomoni a chithokomiro.
Zitsanzo : Mayeso a TSH amayesa kuchuluka kwa TSH m'magazi.
Mbali Yopezera : 0.5-4.70 μIU / mL. (Ma laboratories ena ndi 0.3 mpaka 4.5, kapena maulendo ena ofanana.)
Kutanthauzira kwachilendo: Pamtunda waukulu, ndipo pansi pa 10 μIU / mL ndi "subclinical" hypothyroidism , kuposa 10 μIU / mL ndi overt hypothyroidism. Pansi pa 0.1 mpaka 0,5 μIU / mL amawonedwa ngati umboni wa magulu a hyperthyroidism, osachepera 0.1 akhoza kukhala oposa hyperthyroidism.
"Maselo" a TSH amaonedwa kuti sapatula hypothyroidism kapena hyperthyroidism.
Kutanthauzira Mogwirizana : Mipata pamwamba pa 1.5 mpaka 2.0 μIU / mL ikhoza kukhala chisonyezero cha kutayika kwa chithokomiro. Mphamvu yabwino ndi yochokera ku 1.0 mpaka 1.5 μIU / mL.
Mikangano: Pali zotsutsana zambiri za mayeso a TSH ndi tanthauzo lake.
- Pakati pa abambo a endocrinologist, pali kutsutsana pankhani ya momwe TSH imafotokozera . Kawirikawiri, imayambira pafupifupi 0,4 / 0,5 mpaka 4.5 kapena kuposa. Koma ena otchedwa endocrinologists amakhulupirira kuti mapeto apamwamba a zolembera zofunikira ayenera kukhala 3.0.
- Pakati pa odwala matenda a endocrinologist, pali kusagwirizana podziwa ngati maola oposa 10.0 ayenera kuchiritsidwa. Madokotala ena amakhulupirira kuti magulu amenewa amachititsa kuti mankhwalawa asokonezeke. Ena amakhulupirira kuti "subclinical hypothyroidism" -ndipo mankhwalawa amafunika pokhapokha atakhala opitirira 10.0.
- Kafukufuku wina amasonyeza kuti ngakhale pamene TSH imalowa m'matchulidwe, ngati wodwala ali ndi ma antibodies a Hashimoto, chithandizo chili choyenera .
- Madokotala ogwira mtima amakhulupirira kuti TSH ndi imodzi mwa zinthu zambiri zothandizira komanso zothandizira odwala chithokomiro. Amagwiritsa ntchito kuthamangira kwa TSH monga tyranny ya TSH.
- Madokotala ogwira mtima amakhulupirira kuti kuyeza kwa chithokomiro ndizowona, mahomoni a chithokomiro omwe amapezeka m'magazi a Free T4 ndi Free T3.
T4 / Thyroxine ndi Free T4 / Free Thyroxine
Pafupi: Thyroxine, yomwe imatchedwanso T4, ndi imodzi mwa mahomoni ofunikira kwambiri. Mahomoni ochulukitsidwa ndi chithokomiro ndi thyroxine . Thyroxine imatengedwa ngati "yosungirako" hormone-m'zimenezo sizingagwiritsidwe ntchito ndi thupi kutulutsa mphamvu ndikupereka mpweya ku maselo. Iyenera kutaya atomu ya ayodini, njira yotchedwa monodeiodination (kapena T4 mpaka T3 kutembenuka), ndipo ikhale triiodothyronine (T3) kuti igwiritsidwe ntchito ndi maselo.
Zotsatira: Chiwerengero cha T4 chiwerengero chonse cha thyroxine chikuyenda m'magazi. T4 yaulere imayesa kuchuluka kwa thyroxine m'magazi.
Thanzi la chithokomiro labwino limapanga kwambiri thyroxine, ndipo thyroxine iyenera kusandulika kukhala triiodothyronine (T3) pofuna kutulutsa mpweya ndi mphamvu ku maselo.
Chiwerengero cha Zolemba: Total T4: 4.5-12.5 μg / dL, Free T4: 0.8-1.8 ng / dL
Kutanthauzira Kwachizolowezi: Ambiri ambiri ochiritsira sayenera kuyesa Total T4 kapena Free T4. Komabe, nthawi zina, pamodzi ndi TSH yokwanira, Total T4 kapena Free T4 levels yomwe ili pansi pa zolembera zamtunduwu zimayesedwa umboni wa hypothyroidism. Pakati pa TSH, T4 kapena Free T4 levels yomwe ili pamwamba pa reference reference amalingalira umboni wa hyperthyroidism .
Kutanthauzira Mogwirizana : Kuti apeze chithandizo ndi chithandizo cha hypothyroidism, magawo omwe ali pamwamba pa hafu ya zolembera amawonedwa kuti ndi yabwino komanso umboni wa chithokomiro choyenera.
Zokangana: Ambiri ambiri omwe amagwiritsa ntchito mapuloteni amatha kugwiritsa ntchito mayeso a TSH pozindikira ndi kusamalira ma chithokomiro, ndipo chifukwa chake, musayesere kuti muyezo wa T4 uli wonse kapena wopanda.
T3 / Triiodothyronine ndi Free T3 / Free Triiodothyronine
Pafupi: Triiodothyronine (T3) ndi mankhwala otentha a chithokomiro. Chithokomiro chopatsa thanzi chimapanga triiodothyronine-mankhwala otentha a chithokomiro. Zonsezi ndi zotsatira za kutembenuka kwa thyroxine mu triiodothyronine.
Zitsanzo : Kuyeza kwathunthu kwa T3 kumayendera kuchuluka kwa triiodothyronine kumayenda m'magazi. T3 yaulere imayesa maulendo aulere, omwe alibe ma hormone triiodothyronine omwe amagwiritsidwa ntchito ndi thupi.
Mapulogalamu: Nambala T3: 80-200 ng / dL, Free T3: (Triiodothyronine): 2.3- 4.2 pg / mL
Kutanthauzira Kwachizolowezi: Ambiri ambiri ochiritsira sayenera kuyesa Total T3 kapena Free T3. Komabe, nthawi zina, pamodzi ndi TSH yowonjezereka, Total T3 kapena Free T3 maulendo pansi pa zolembera mndandanda amalingalira umboni wa hypothyroidism. Pakati pa ma TSH ochepa / ochepa, Total T3 kapena ma Free T3 omwe ali pamwamba pa zolembera zamtunduwu amawonedwa ngati umboni wa hyperthyroidism.
Kutanthauzira Mogwirizana : Kuti apeze chithandizo ndi chithandizo cha hypothyroidism, magawo a hafu yapamwamba ya zolembera zazing'ono amawonedwa ngati umboni wokhudzana ndi chithokomiro chokwanira, ndipo miyezo yomwe ili pamwamba pa 25th percentile ya zolembera zamtunduwu imayesedwa bwino. Mu malingaliro ophatikizana, magulu ochepa kwambiri angapangitse mankhwala ndi mankhwala a chithokomiro m'malo mwake, kapena mankhwala omwe akuphatikizapo T3 .
Zokangana: Kuyesera T3 ndi Free T3 ndizovuta kwambiri kuposa kuyezetsa T4 . Izi ndizo chifukwa ambiri ochita kafukufuku samakhulupirira kuti chiwerengero cha T3 chimakhudza zizindikiro, komanso kuti palibe malo ochiritsira ndi T3 hormone .
Chifukwa chakuti ma T3 amaimira nthawi yomweyo mahomoni omwe amapezeka, ufulu wa T3 umaganiziridwa ndi othandizira ena kuti azitha kuwonetsa mthupi mwa odwala, poyerekezera ndi TSH ndi / kapena T3.
RT3 / Zosintha T3 / Zotsutsana ndi Triiodothyronine
Pafupi: Kubwereza T3 ndi mawonekedwe a T3 omwe sagwira ntchito ndipo amapangidwa mowonjezereka panthawi yamavuto.
Zitsanzo: T3 yopanda ntchito, yopanda phindu yomwe imapangidwa pamene thupi liri m'mavuto.
Mtundu Wotsalira : Kawirikawiri 10-24 ng / dL
Kutanthauzira Kwachizolowezi: Seweroli silikuchitidwa kawirikawiri ndi madokotala wamba, omwe amawona kuti alibe phindu muyeso iyi.
Kutanthauzira Mogwirizana: Madokotala ophatikizana ndi omwe madokotala ena omwe amaganizira kwambiri kuchuluka kwa ma hormone kulingalira kuti ali ndi RT3 kapena RT3 / T3 kusiyana kwa chiŵerengero kuti akhale chizindikiro chachikulu cha chithokomiro chosagwira ntchito kapena chosagwira ntchito. Iwo amakhulupirira kuti kutsogolo kwa T3 kuyenera kugwera mu theka lache lachiyero.
Mikangano: Kusintha T3 ndi mayesero otsutsana . Ambiri mwa madokotala amatsutsa phindu la RT3 pakupeza, kuchiza ndi kuyang'anira hypothyroidism. Madokotala okhudzidwa ndi omwe amaganizira za kuchuluka kwa ma hormone balance, komabe, taganizirani kuti RT3 ndipamwamba ndi chizindikiro chachikulu cha chithokomiro chosagwira ntchito kapena chosagwira ntchito.
Matenda a TPOAb / Matenda a Peroxidase
Maina Ena: Matenda a Antithyroid Peroxidase
Pafupi: Matenda a chithokomiro a peroxidase (TPO), omwe amamasuliridwa monga TPOAb, ndi ma antibodies omwe amayamba chifukwa cha chiopsezo chodzidzimutsa pa chithokomiro cha chithokomiro. Amagwiritsira ntchito mankhwalawa, ndipo nthawi zambiri amatha kuwonongeka kwa nthawi. Tizilombo toyambitsa matenda a TPOAb timayambitsa chithokomiro peroxidase, yomwe imathandiza kuti T4 ifike ku T3. Mitengo ya TPOAb yowonjezereka ikhoza kukhala umboni wa kutupa kwa chifuwa, kapena chiwonongeko chamtundu monga matenda a Hashimoto. Kawirikawiri, TPO imapezeka mu mitundu ina ya chithokomiro monga post-partum thyroiditis .
Zitsanzo: Mayesowa amayesa mlingo wa ma antibodies a TPO.
Gawo la Malire : The reference range ndi 0-35 IU / mL
Kutanthauzira Kwachizolowezi : Ngati ma TPOAb akulowa m'ndandanda wa zolembera, iwo amawoneka ngati oyenera. Izi sizikutulutsa matenda a Hashimoto koma zimakhala zochepa kwambiri. Mitundu ya TPOAb yowonjezera imatulutsa kutupa kwa mankhwala, makamaka chifukwa cha Hashimoto's thyroiditis kapena mitundu ina ya thyroiditis .
Zikuoneka kuti TPOAb imapezeka pafupifupi 95 peresenti ya odwala a Hashimoto's thyroiditis, ndipo 50 mpaka 85 peresenti ya odwala a Graves. Kuika kwa ma antibodies omwe amapezeka kwa odwala omwe ali ndi matenda a Graves nthawi zambiri amakhala ochepa kuposa odwala omwe ali ndi matenda a Hashimoto. Komabe, m'maganizo ochiritsira, TPOAb yakwezeka sichifuna kupatsidwa chithandizo pokhapokha ataperekedwa ndi overt hypothyroidism kapena hyperthyroidism.
Kutanthauzira Mogwirizana : Odwala ena akweza TPOAb, koma ali ndi "euthyroid," omwe ali ndi tini, T3, ndi TSH maulendo. Kafukufuku wina wasonyeza kuti chithandizo choperewera ndi levothyroxine chiyenera kukhala choyenera kwa odwalawo, , ndikuthandizani kupewa kupititsa patsogolo kutentha kwa hypothyroidism.
Zokangana: Ambiri okhulupirira zachipatala sakhulupirira kuti TPOAb imayesedwa, koma amasankha kukhazikitsa chithandizo cha chithokomiro ndi chithandizo cha mankhwala pazotsatira za TSH zokha.
TSI / Immunoglobulins (stimulating Thyroid-stimulating)
Pafupi: Chithokomiro chomwe chimayambitsa immunoglobulin-TSI-ndi ma antibodies omwe amachititsa kuti chithokomiro chikulitse ndi kutulutsa hormoni yowonjezereka, zomwe zimachititsa hyperthyroidism. Mayesowa nthawi zina amatchedwanso kuti TSH yolandira antibody.
Zotsatira: Kuyezetsa kwa TSI kumayendera mlingo woyenda wa maselo ena m'magazi.
Chiwerengero cha Zolemba: Zosakwana kapena zofanana ndi 1.3
Kutanthauzira kwachidziwikire : Maseŵera a TSI akukwera pakati pa 75 mpaka 90 peresenti ya odwala a Graves. Pamwamba pamagulu, matenda a Graves 'amagwira ntchito kwambiri. (Kulephera kwa ma antibodies sikumatulutsa matenda a Graves). Dziwani kuti anthu ena omwe ali ndi matenda a Hashimoto ali ndi ma antibodieswa, ndipo izi zingayambitse nthawi yayitali ya hyperthyroidism.
Mayeso a TSI amachitikira kuti azindikire matenda a Graves ndikuyesa matenda oopsa a goiter . Amagwiranso ntchito m'mayi amene ali ndi pakati ndi matenda a Graves , m'miyezi itatu yapitayi ya mimba, kuti aone ngati mwanayo ali ndi chiopsezo chobadwa ndi hyperthyroidism kapena matenda a Graves.
Tg / Thyroglobulin
Pafupi: Thyroglobulin (Tg) ndi mapuloteni omwe amachititsa khungu la chithokomiro, ndipo kukhalapo m'magazi ndi chizindikiro chakuti wodwala ali ndi vuto la chithokomiro-kaya mtundu wonse kapena otsalira atasiya opaleshoni kapena opatsirana pogwiritsa ntchito radioactive (RAI) .
Zitsanzo : Mayeso a Tg amayesa mlingo wa Tg m'magazi. Tizilombo toyambitsa matenda timayesedwa makamaka pa odwala khansa ya chithokomiro, kuti tidziwe ngati tizilombo ta khansa timayambitsa thyroglobulin musanapange chithandizo, kuti mudziwe ngati mankhwala akugwira ntchito, komanso kuti athandizidwe kuti apeze kachilomboka. Popeza ambiri a khansa ya khansa -ya, papillary ndi follicular-amapanga thyroglobulin, ndipo kuchulukana kwa thyroglobulin kungakhale chizindikiro cha khansa kubwerera.
Gawo Loyenera: Ngati mulibe chithokomiro, muyenera kukhala osachepera 0.1 ng / ml. Ngati muli ndi gland, iyenera kukhala yochepera kapena yofanana ndi 33 ng / mL
Kutanthauzira Kwachizolowezi: Vuto lochepa la thyroglobulin ndilochibadwa kwa anthu omwe alibe matenda a chithokomiro. Zotsatira zapamwamba kwa munthu amene ali ndi chithokomiro zimatanthauza kuti ma thyroglobulin amatha kuyang'aniridwa mtsogolo kuti athandizidwe kuti azindikire kubwereza. Matenda a Thyroglobulin ayenera kukhala 0 kapena otsika kwambiri pambuyo pa opaleshoni ya chithokomiro kapena pambuyo pa mankhwala opatsirana a iodine (RAI) . Ngati akadakalipo, chithandizo choonjezera chingayesedwe. Ngati miyambe ikuyamba kuwuka pambuyo pa chithandizo cha khansa ya chithokomiro, izi zikhoza kukhala chizindikiro kuti khansara yatha.
Zinthu zomwe zimayambitsa kutentha kwa chithokomiro-ie, goiter, thyroiditis , kapena hyperthyroidism-zingayambitsenso mitsempha yapamwamba ya thyroglobulin. Chiyeso sichimalamulidwa nthawi ya chithandizo cha izi, komabe.
Tizilombo toyambitsa matenda TgAb / Thyroglobulin
About: Matenda a Thyroglobulin odziwika ngati TgAb-ali ndi ma antibodies against thyroglobulin.
Zitsanzo : Mayeso a TgAb amayesa kuchuluka kwa ma antibodies omwe amazungulira m'magazi.
Mapulogalamu ofotokozera : The reference range ndi zosakwana 4.0 IU / mL
Kutanthauzira kwachidziwikire : Maseŵera okwera a TgAb amapezeka pafupifupi 10 peresenti ya anthu omwe ali ndi chithokomiro choyenera, ndipo ambiri mwa anthu 15 mpaka 20 mwa anthu 100 ali ndi khansa ya chithokomiro. Miyezo ya TgAb imakula kwambiri pa 60 peresenti ya odwala a Hashimoto ndi 30 peresenti ya odwala a Graves. Ngati mwapezeka kale ndi matenda a Graves, pokhala ndi Matenda a TgAb okwezeka kumatanthauzanso kuti mumatha kukhala hypothyroid.
TgAb ingasokoneze zotsatira za thyroglobulin (Tg), choncho ndizofunika kuti omwe ali ndi kansa ya chithokomiro akhale ndi ma TgAb omwe amayang'aniridwa ndi Tg nthawi zonse.
Mawu Ochokera
Mndandanda wa mapepala ndi mayunitsi a muyeso wagwiritsidwa ntchito akhoza kusiyana ndi labu ku lab. Nthawi zonse dziwani zenizeni zazomwe mumayesero ndi mayeso oyesera pa labotale komwe mayesero anu akuchitidwa.
Madokotala ena kapena ogwira ntchito kuofesi amaitana kuti akuuzeni zotsatira za mayeso. Mutha kumva "zotsatira zanu zinali zabwino," kapena "mayesero anu anali achilendo" ngati zotsatira za mayesero. Izi sizikukwanira zambiri. Nthawi zonse funsani kope lenileni la zotsatira za mankhwala, kuphatikizapo mayesero a chithokomiro. Makamaka ndi mayesero a magazi a chithokomiro, muyenera kudziwa momwe mumagwirira ntchito, komanso momwe mungagwiritsire ntchito, kuti muteteze chithandizo chabwino cha chithokomiro.
> Zotsatira:
> Bahn, R., Burch, H, Cooper, D, et al. Hyperthyroidism ndi Zina Zimayambitsa Thyrotoxicosis: Malangizo Otsogolera a American Thyroid Association ndi American Association of Clinical Endocrinologists. Chitetezo cha Endocrine. Vol 17 No. 3 May / June 2011.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Garber, J, Cobin, R, Gharib, H, et. al. Malangizo Okhudza Zipatala za Hypothyroidism M'zochitika Zakale: Ambiri amathandizidwa ndi American Association of Clinical Endocrinologists ndi American Thyroid Association. " Chitetezo cha Endocrine. Mph. 18 No. 6 Novemba / December 2012.