Kuzindikira matenda a chithokomiro ndi njira yomwe ingaphatikizepo zinthu zambiri, kuphatikizapo kuchipatala, kuyesedwa kwa magazi, zojambula zamaganizo, biopsies, ndi mayesero ena. M'nkhaniyi, muphunzire zambiri zokhudza mayesero osiyanasiyana a magazi amene amagwiritsidwa ntchito monga gawo la matenda a chithokomiro , chithandizo, ndikutsata ndikutsata.
Mayeso a TSH
Kafukufuku wambiri wa chithokomiro ndiyeso la magazi lomwe limayeza kuchuluka kwa homoni (stimulating hormone) (TSH) m'magazi anu.
Nthawi zina mayesero amatchedwa test thythropin-stimulating test.
TSH yomwe ili pamwamba, kapena pamwambapa, imatengedwa ngati chizindikiro cha hypothyroidism. TSH yomwe "imachotsedwa" kapena yachibadwa, imatengedwa ngati umboni wa hyperthyroidism.
Pakali pano, zolemberazo zimayambira kuzungulira 0,5 mpaka 5.0. Mipata yomwe ili pamwambapa 3.0 ndi umboni wa hypothyroidism zomwe zingatheke, ndipo ndondomeko pansi pa 0,5 ndi umboni wa zotheka kuti hyperthyroidism ichitike. Tawonani kuti mafotokozedwewa ndi osiyana kwa amayi omwe ali ndi mimba .
Pezani zambiri za mayeso a TSH.
Free T4 / Free Thyroxine
Thyroxine, mahomoni opangidwa ndi chithokomiro, amadziwika kuti T4. T4 yaulere imayesa maulendo auufulu, osapangika a thyroxine m'magazi anu. T4 yaulere imakwera kwambiri mu hyperthyroidism, ndipo imatsitsa mu hypothyroidism.
MaseĊµera a T4 omwe samasuka kapena osayima amaimira mlingo wa hormone womwe umapezeka kuti ugwiritsidwe ndikugwiritsidwa ntchito ndi maselo. Manambala amodzi akuimira mahomoni omwe sangakhale nawo nthawi yomweyo, chifukwa amakhudzidwa ndi mankhwala ena, matenda, ndi kusintha kwa thupi monga kutenga mimba.
Chifukwa ma t4 a ufulu wa T4 amaimira kuchuluka kwa ma hormone omwe alipo, ufulu wa T4 umaganiziridwa bwino kuti ukuwonetsa mphamvu ya mthupi mwa wodwalayo kuposa chiwerengero cha T4 (pansipa).
Chiwerengero cha T4 / Total Thyroxine / Serum Thyroxine
Chiyesochi chimayeza kuchulukana kwa thyroxine m'magazi anu. Mtengo wapatali ukhoza kusonyeza hyperthyroidism, mtengo wotsika ukhoza kusonyeza hypothyroidism.
Mizere yonse ya T4 ikhoza kukwezedwa chifukwa cha mimba, ndi zina zapamwamba za estrogen, kuphatikizapo kugwiritsa ntchito mankhwala a estrogen kapena mankhwala oletsa kubadwa .
Free T3 / Free Triiodothyronine
Triiodothyronine ndi mankhwala otchedwa thyroid , ndipo amatchedwanso T3. T3 yaulere imayesa maulendo aulere, omwe sagwedezeka a triiodothyronine m'magazi anu. Free T3 imaonedwa kuti ndi yolondola kuposa Total T3. T3 yaulere imakwera kwambiri mu hyperthyroidism, ndipo imatsitsa mu hypothyroidism.
Chiwerengero cha T3 / Total Triiodothyronine
Chiwerengero cha T3 chimakhala chokwanira mu hyperthyroidism, ndi kutsika mu hypothyroidism.
T3 Resin Uptake (T3RU) / T7
Pamene kuyezetsa magazi kumachitika ndi T3 ndi T4, kuyesedwa kwa T3 (res3 (T3RU) nthawi zina kumatchedwa kuyesa T7. Chiyesochi chimayeza kuchuluka kwa malo osakanizidwa omwe amamanga mahomoni. Kukula kwa T3RU kumawonekera kwambiri ndi hyperthyroidism.
Thyroglobulin / Tg
Thyroglobulin (Tg) ndi mapuloteni opangidwa ndi chithokomiro. Matenda a Tg ali otsika kapena osadziwika ndi chithokomiro chodziwika bwino koma akhoza kukwera mu thyroiditis, matenda a Graves, kapena khansara ya chithokomiro. Kuwunika kwa magulu a Tg kumagwiritsidwa ntchito kawirikawiri poyesa momwe ntchito yathandizira khansara imayendera komanso kuyang'anira khansara yowonongeka.
Bweretsani T3
Pamene thupi liri pampanipani, mmalo mwa kusintha T4 mu T3 - mawonekedwe otentha a hormone - thupi limateteza mphamvu pochita zomwe zimadziwika kuti Reverse T3 (RT3), mawonekedwe osachitidwa a hormone T3. Phindu la ma test RT3 ndilopikisana, monga akatswiri ena amakhulupirira kuti thupi limapanga RT3 mmalo mochita masewera olimbitsa thupi T3, zomwe zimapangitsa kuti mukhale ndi vuto lalikulu mu timadzi timatenda a T3.
Matenda a Chithokomiro Peroxidase (TPO) (TPOAb) / Antithyroid Peroxidase Antibodies
Matenda a chithokomiro a Peroxidase (TPO), amadziwika kuti Antithyroid Peroxidase Antibodies.
(Kale, ma antibodieswa ankatchedwanso Antithyroid Microsomal Antibodies kapena Antimicrosomal Antibodies).
Mankhwalawa amatsutsana ndi chithokomiro cha peroxidase, yomwe imakhala ndi gawo la kusintha kwa T4-to-T3. Matenda a TPO angakhale owonongeka, monga matenda a Hashimoto, komanso kawirikawiri, m'magulu ena a chithokomiro monga post-partum thyroiditis.
Zikuoneka kuti ma antibodies a TPO amapezeka 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.
Matenda a Thyroglobulin / Antithyroglobulin Mankhwala
Kuyesera kwa majeremusi a thyroglobulin (omwe amatchedwanso antithyroglobulin antibodies) amagwiritsidwa ntchito kufufuza zifukwa zomwe zimayambitsa matenda a chithokomiro. Ngati mwapezeka kale ndi Matenda a Graves, kukhala ndi ma antibodies apamwamba amatanthauza kuti mwinamwake mumakhala ndi hypothyroid. Ma antibodies a Thyroglobulin amakhala abwino pa pafupifupi 60 peresenti ya odwala a Hashimoto ndi 30 peresenti ya odwala a Graves.
Matenda a Immunoglobulins (TSI) / TSH Othandiza Kukhazikitsa Matenda (TSAb)
Matenda opatsirana a TSH (TRAb) amawoneka kwa odwala ambiri omwe ali ndi mbiri ya, kapena omwe ali nawo, Matenda a Graves. Kuyesera kawirikawiri kumachitidwa kwa mtundu wina wokhazikika wa TRAb umene umapita ndi mayina osiyanasiyana, kuphatikizapo:
- Matenda a Immunoglobulins (TSI)
- Matenda amphamvu a TSH (TSAb)
Magulu a immunoglobulins (stimulating thyroid) (TSI) amatha kupezeka mwa anthu ambiri omwe ali ndi matenda a Graves, ndipo chiwerengero chawo chimawapeza odwala 75 mpaka 90 peresenti ya odwala a Graves. Pamwamba pamagulu, matenda a Graves 'amagwira ntchito kwambiri. (Kupezeka kwa ma antibodies sikumatulutsa matenda a Graves).
Kawirikawiri, anthu ena omwe ali ndi matenda a Hashimoto amakhalanso ndi ma antibodieswa, ndipo izi zingayambitse nthawi zochepa zazing'ono za hyperthyroidism.
Pamene kuyang'anira TSI, miyezo yapamwamba ingathandize kuthandizira kubwereza kwa matenda a Graves, ndipo kuchepetsa mphamvu za TSI zingasonyeze kuti mankhwala a Graves akugwira ntchito.
Kuwunika kwa TSI ndikofunika kwambiri panthawi ya mimba, chifukwa miyezo yapamwamba, makamaka pa mimba yoyamwitsa komanso m'zaka zitatu, ndizoopsa kwa feteleza kapena feteleza. Mankhwala a TSI amayi amatha kubwerera kwa mwana wosabadwa kudzera pamtunda, kupanga mwana hyperthyroid mu utero, kapena pakubereka. Kafukufuku wasonyeza kuti pafupifupi 10 peresenti ya amayi apakati omwe ali ndi TSI yokwera amapereka ana omwe ali ndi hyperthyroidism yochepa.
Zotsatira:
Braverman, MD, Lewis E., ndi Robert D. Utiger, MD. Werner ndi Ingbar's The Thyroid: Mawu Ofunika ndi Otsogolera. 9th ed. , Philadelphia: Lippincott Williams & Wilkins (LWW), 2012.
Roti, Elio, ndi. al. "TSH Receptor Antiling Measurement mu Kufufuza ndi Kusamalira Matenda a Manda Ndilofunika Kwambiri," Journal of Clinical Endocrinology & Metabolism, Vol. 83, No. 3737-3784 http://jcem.endojournals.org/cgi/content/full/83/11/3781
Spencer, Carol. "Kufufuza kwa mahomoni a chithokomiro ndi zinthu zina zogwiritsira ntchito," Chithokomiro cha Chithokomiro . February 6, 2004. http://www.thyroidmanager.org/chapter/assay-of-thyroid-hormones-and-related-substances/