Mu hypothyroidism, kutentha kwa chithokomiro sikulephera kutulutsa mahomoni otchedwa thyroxine (omwe amatchedwanso T4). Chifukwa T4 ndi yofunika kwambiri pakulamulira thupi, kuchepa kwa thupi, minofu, ndi mtima , hypothyroidism nthawi zonse ndi vuto lalikulu.
Chithokomiro chokhacho chimayendetsedwa ndi hormone TSH (chithokomiro chopangitsa hormone).
Ngati nthenda ya chithokomiro sichikupatsa T4 yokwanira, miyeso ya TSH ikuwonjezeka kuti athandize chithokomiro kugwira ntchito mwamphamvu. Mu hypothyroidism-imene chithokomiro sichitha kupanga T4 mokwanira-mazinga a TSH amakhala pafupi kwambiri.
Tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda timene timakhalapo m'magulu a T4 omwe amatha kukhala osiyana siyana (kutanthauza kuti hypothyroidism sakhalapo), koma TSH imawonjezereka. Choncho matenda a chithokomiro amatanthauza kuti chithokomiro chokha sichigwira ntchito bwinobwino. Ndi "kukwapula" chithokomiro (ndi mazinga akulu a TSH) kuti ma t4 okwanira angathe kusungidwa.
Pali zotsutsana lero lero ponena za tanthauzo lenileni la subclinical hypothyroidism. Chifukwa chakuti magulu a T4 alidi achilendo pamkhalidwe umenewu, mwachidziwitso, hypothyroidism siziyenera kukhala vuto lalikulu.
Koma umboni umasonyeza kuti subclinical hypothyroidism imabweretsa mavuto odwala nthawi zina-ndipo nthawi zina, ayenera kuchiritsidwa.
Mwina chodetsa nkhaŵa kwambiri ndi subclinical hypothyroidism ndi chakuti zingakhudze mtima.
Momwe Magulu Amatsenga Amadzimadzi Amadziwira
Matendawa amapezeka ndi mayeso a magazi, makamaka, poyeza mazinga a T4 ndi ma TSH.
Tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda timakhalapo ngati ma t4 ali m'kati mwake (0,8 mpaka 1.8 ng / L), ndipo ma TSH ali pamwamba pamtunda (0.3 mpaka 3.04 mU / L). Komabe, akatswiri ambiri amaganiza kuti subclinical hypothyroidism kukhala "yofunika" pokhapokha ngati ma TSH ali pamwamba kwambiri: pamwamba pa 10 mU / L.
Zimayambitsa
Zimakhulupirira kuti subclinical hypothyroidism ndi yochepa chabe, kapena mawonekedwe oyambirira, a matenda omwe amawulutsa frank hypothyroidism-omwe amadziwika kuti autoimmune thyroiditis ( Hashimoto's thyroiditis ). Inde, m'kupita kwa nthaŵi, pafupifupi theka la anthu omwe ali ndi subclinical hypothyroidism adzapitiriza kukhala ndi hypothyroidism, omwe ali otsika kwambiri T4 ndi zizindikiro zonse zomwe zimayendera limodzi . Choncho, chifukwa chimodzi madokotala amachiza subclinical hypothyroidism ndikuteteza kuti chitukukochi chikhale choopsa kwambiri.
Zizindikiro Zotheka?
Ngakhale kuti chikhalidwechi sichisonyeza zizindikiro mwa anthu ambiri, ena amavomereza zizindikiro zofatsa zomwe zimaganizira hypothyroidism, monga kudzimbidwa, kutopa, kapena kulemera kosawerengeka. Zanenedwa kuti anthu omwe ali ndi subclinical hypothyroidism angathe kukhala ndi nkhawa, nkhawa, kapena matenda osokonezeka.
Mmene Zimakhudzira Mtima
Kuwonjezera pa chiopsezo chotsiriza kukhala ndi hyky hypothyroidism, nkhawa yaikulu ndi subclinical hypothyroidism ndikuti imakhudzidwa ndi kuwonjezeka kwa matenda a mtima.
Kafukufuku wambiri wasonyeza kuti pali mgwirizano pakati pa miyeso yapamwamba ya TSH (yaikulu kuposa 10 mU / L) komanso chitukuko cha matenda a mchere (CAD) . Kufufuza kozengereza kwa maphunziro angapo ochipatala omwe anali odwala oposa 25,000, subclinical hypothyroidism anali kugwirizana ndi kuwonjezeka kwa chifuwa cha mtima, matenda a CAD, ndi imfa ya mtima. Powonjezera ena anapeza kuti chinawonjezeka kwambiri chifukwa cha mtima kulephera kwa odwala ndi subclinical hypothyroidism.
Ndipo kafukufuku wambiri wagwirizanitsa kugonana kwa hypothyroidism ndi kuchuluka kwa mafuta m'thupi.
Ngakhale kuti kusonkhana sikutsimikiza-ndi-zotsatira, ndizodabwitsa kuti kupitirira tizilombo toyambitsa matenda kumatulutsa matenda akuluakulu a mtima. Izi zimapereka umboni wakuti lingaliro la subclinical hypothyroidism lingasokoneze mtima. Kuwonjezeka kwa chiopsezo cha mtima kumayang'aniridwa ndi subclinical hypothyroidism ndithudi ndi chinthu chovuta kwambiri cha chikhalidwe ichi.
Kodi Tizilombo Tomwe Timagwiritsa Ntchito Tizilomboti Tiyenera Kuziona?
Tizilombo toyambitsa matenda tizilombo toyambitsa matenda tingachiritsidwe popereka chithandizo chamatenda a chithokomiro. Chithandizo chimayang'aniridwa ndi kuyang'anitsitsa bwino magulu a magazi a TSH; mavitamini a kodzosiyo okwanira amaperekedwa kuti achepetse miyeso ya TSH kubwerera kumtundu wambiri.
Pali umboni wochepa chabe wochokera ku maphunziro azachipatala omwe amachititsa kuti matenda a hypothyroidism azikhala bwino. Phunziro lomwe limasonyeza kuti limachepetsa zizindikiro, phindu loyezera limakhala lochepa kwa odwala omwe ali ndi chiwerengero choyamba cha TSH (kutanthauza kuposa 10 mU / L).
Mofananamo, umboni wosonyeza kuti matendawa amatha kuchepetsa chiopsezo cha matenda a mtima. Pa kafukufuku wopangidwa ku Great Britain, pakati pa odwala aang'ono (osakwana zaka 70) ndi subclinical hypothyroidism, odwala omwe adalandira chithandizo chamatenda a chithokomiro anali otsika kwambiri. Palibe odwala omwe amadwala matenda opatsirana pogonana.
Kuwonjezera apo, kuchiza subclinical hypothyroidism kwambiri kumapangitsa ziwalo zingapo zoopsa zapakati, kuphatikizapo mitsempha ya kolesterolini, ma CRP , ndi mphamvu zogwira ntchito.
Mfundo Yofunika Kwambiri
Akatswiri ambiri amalimbikitsa chithandizo chamagulu a hypothyroidism pamene ma TSH amakhala aakulu kuposa 10 mU / L, kaya pali zizindikiro kapena ayi.
Kaya maselo a hypothylinist amayenera kuchitidwa pamene ma tsh ali osachepera 10 mU / L amakhalabe mfundo yotsutsana. Madokotala ambiri amalimbikitsa chithandizo ngakhale m'munsimu ngati odwala ali ndi zizindikiro zoganiza za hypothyroidism, kapena ngati ali ndi mitsempha ya mafuta m'thupi kapena zoopsa zina za matenda a mtima.
Kodi Mukuyesedwa?
M'masiku akale (zaka khumi kapena ziwiri zapitazo), kuyezetsa ntchito ya chithokomiro kunali gawo lachidziwitso cha mankhwala. Koma mwa chidwi cha ndalama zopezera ndalama, nthawi zambiri sichizolowezi.
Ndizomveka kufunsa dokotala kuti apeze mayesero a magazi ngati muli ndi zizindikiro zosonyeza kuti hypothyroidism (onani pamwambapa), ngati muli ndi cholesterol, kapena mukufuna kungotsimikiza kuti mukuchita zonse zomwe mungathe kuti muchepetse mtima wanu .
Zotsatira:
Rodondi N, Elzen WP, Bauer DC, et al. Tizilombo toyambitsa matenda timene timakhala ndi matenda a mtima komanso imfa. JAMA 2010; 304: 1365.
Gencer B, Collet TH, Virgini V, et al. Kusokonezeka kwa chithokomiro cha matenda a chithokomiro komanso kuopsa kwa mtima kusokonekera. Kuthamanga kwa 2012; 126: 1040.
Razvi S, Weaver JU, Butler TJ, Pearce SH. Levothyroxine Kuchiza kwa Magulu Opatsirana a Hypothyroidism, Zochitika Zowopsa ndi Zosasokoneza Maganizo, ndi Kufa. Arch Intern Med 2012.