Ngati muli ndi zizindikiro za hyperthyroidism, nkofunika kuti muyambe kufufuza bwino kuti mutha kuchipatala mwamsanga komanso mwamsanga, ngati kuli kotheka. Dokotala wanu adzafufuza bwinobwino, ayang'anenso mbiri yanu yachipatala, ndi kuyesa mwatsatanetsatane mayeso a magazi (monga TSH, T3, T4) kuti adziwe matenda; Mayesero ojambula, monga chithokomiro ultrasound kapena CT scan akhoza kulamulidwa.
Hyperthyroidism ikhoza kuyang'aniridwa koma ingayambitse vuto ngati silingathenso, kotero kuti matenda oyamba amayamba nthawi zonse.
Kufufuza
Pambuyo poyang'ana zizindikiro zanu ndi zifukwa zoopsa za matenda a chithokomiro, ngati dokotala akudandaula kuti akhoza kudwala matenda a hyperthyroidism, adzachita kafukufuku wozama pogwiritsa ntchito chithokomiro chanu, komanso mbali zina za thupi lanu.
Kukonzekera kwa Chithokomiro
Pakati pa mayeso a chithokomiro , dokotala wanu adzakhudza (palpate) khosi lanu, akuyang'ana kukulitsa chithokomiro ndi mitsempha.
Adzalumikizanso zomwe zimadziwika kuti "zokondweretsa," zomwe zimafotokozera kuwonjezeka kwa magazi mu chithokomiro chomwe chingamveke. Dokotala wanu adzamvetsera ndi "mawu" ndi stethoscope yake, yomwe ndikumveka kwa kuchuluka kwa magazi kupita ku chithokomiro.
Kukhalapo kwa chithokomiro kumakondweretsa ndi / kapena mboni ndizolimbikitsa kwambiri za Matenda a Manda .
Kusanthula thupi
Kuwonjezera pa mayeso a chithokomiro, dokotala wanu azifufuza thupi lanu lonse kuti azisonyeza zizindikiro za chithokomiro chowonjezera.
Mwachitsanzo, adzayesa malingaliro anu, monga kuganizira mofulumira kapena kosavuta kumakhala chizindikiro cha hyperthyroidism. Adzasuzanso kuchuluka kwa mtima, nyimbo, ndi kuthamanga kwa magazi. Izi zili choncho chifukwa chakuti mapulitations , matenda opatsirana pogwiritsa ntchito mankhwala , kupweteka kwa mtima, kapenanso kuthamanga kwa magazi kungapangitse kuti munthu azikhala ndi matenda a hyperthyroidism.
Mbali zina za kufufuza zakuthupi ndizo:
- Kufufuza khungu lanu, chifukwa khungu losalala ndi lofunda, lingakhale chizindikiro cha hyperthyroidism. Ochepa peresenti ya anthu omwe ali ndi matenda a Graves amakhalanso ndi ziphuphu (pretibial myxedema).
- Kuwona tsitsi lanu lonse ndi ubwino wake, monga kupatulira, bwino, kapena tsitsi lokhalira kungasonyeze kuti ndi chithokomiro
- Kuwonekera kwa kuthamanga kulikonse, kugwedeza kwa manja, kapena kuyenda kwa hyperkinetic monga kusewera kwa tebulo, kugwedeza mapazi, kapena kusuntha kwapopera (nthawi zambiri kuopsa kwa ana)
- Kupenda maso anu, monga ofiira, kupukuta, owuma, kutupa, kudzikweza, ndi maso akutha kungakhale zizindikiro za vuto la chithokomiro. Kuonjezera apo, "chivindikiro" (pamene chikopa chapamwamba sichikutsatirani kuyenda kwa maso pamene mukuyang'ana pansi) mukhoza kuwona mu hyperthyroidism.
Mapulogalamu ndi Mayesero
Kuyezetsa magazi kumaphatikizapo kuyesayesa kowonongeka ka hormone (TSH), pamodzi ndi thyroxine (T4) ndi triiodothyronine (T3). Dokotala wanu nayenso angayesetse nthendayi ya mankhwala a chithokomiro kutsimikizira kuti matenda a Graves akupezeka.
Ndikofunika kubwereza zotsatira zanu zoyesera ndi dokotala wanu. Musaope kufunsa mafunso. Uwu ndiwo thanzi lanu, choncho ndifunikira kuti mumvetse zomwe zikuchitika.
Zotsatira za TSH
Kuyimira kwachiyeso kwa mayeso a TSH ndi pafupifupi maola 0,5 mpaka 5.0 milli-maiko awiri pa lita imodzi (mIU / L). Anthu onse okhala ndi hyperthyroidism oyambirira ali ndi TSH yochepa; Komabe, mlingo wa TSH wokha sungathe kudziwa kuchuluka kwa hyperthyroidism. Ichi ndi chifukwa chake dokotala wanu adzawonanso ma T4 anu ndi ma T3.
Free Free T4 ndi T3 Zotsatira
Kudziwa kwa hyperthyroidism yoyamba ikugwirizana ndi TSH yochepa, ndi T4 yapamwamba komanso / kapena T3 magazi.
Monga mbali, ngati TSH yanu ndi yachilendo kapena yapamwamba, ndipo T4 yanu ndi T3 yanu ndi yapamwamba, mudzafunika MRI ya chifuwa chanu kuti muyese matenda omwe ali pakati kapena TSH-omwe amachititsa hyperthyroidism.
Pamwamba T3 ndi Zotsatira Zowoneka T4 Zotsatira
Ngati TSH yanu ili yochepa ndipo T3 yanu ili pamwamba (koma T4 yanu yaulere ndi yachibadwa), mwinamwake kuti matenda anu akadali a Graves 'matenda kapena nthongo ya chithokomiro yomwe imatulutsa mahomoni ambiri. Chiyeso chojambula, chomwe chimatchedwa radioactive iodine scan scan, chingathe kusiyanitsa pakati pa zizindikiro ziwirizi.
Kutenga kwambiri T3 (kutchedwa kuyezeka kwa T3 kumeza) ndi mwayi wina.
Zowoneka T3 ndi Zotsatira Zapamwamba T4 Zotsatira
Ngati TSH yanu ili yochepa, T4 yanu yaulere ili pamwamba, koma T3 yanu ndi yachibadwa, mwina mumakhala ndi hyperthyroidism musanatenge T4 (levothyroxine) yochuluka kwambiri. Chidziwitso china chotheka ndi vuto la chithokomiro la amiodarone.
Kuphatikizidwa kwa labukukuku kungawonetsedwe kwa anthu omwe ali ndi hyperthyroidism omwe ali ndi matenda osakanizidwa (omwe ndi matenda aakulu) omwe amachepetsa kutembenuka kwa T4 mpaka T3.
Zachibadwa Zosatha T4 ndi T3 Zotsatira
Ngati TSH yanu ili yochepa, koma ma t3 anu ndi T4 ndizomwe zili zachilendo, mukhoza kukhala ndi hyperthyroidism. Izi zikhoza kuwonanso mu mimba.
Zotsatira za Antibody
Kuyesera magazi anu kwa ma antibodies, monga immunoglobulin kapena kutentha kwa TSH receptor autoantibodies, ndikofunika. Chiyeso chotsimikizirika chimatsimikizira kuti matenda a Graves ndi omwe amapezeka, ngakhale kuti anthu ena omwe ali ndi matendawa ali ndi mayeso oletsa kutsutsa. Pachifukwa ichi, mayeso omwe amawotchedwa iodine (RAIU) angayesetse.
Kujambula
Nthaŵi zambiri, mayesero ojambula , monga ultrasound, opaleshoni ya iodin (RAI-U), CT scan, kapena MRI adzachitidwa kuti apeze bwinobwino.
Kusintha kwa Iodine Yowopsa
Mu kuyesa kwa iodine kukwera (RAI-U), mlingo wawung'ono wa ayodini wothamanga kwambiri 123 umaperekedwa piritsi kapena mawonekedwe a madzi.
Patapita maola angapo, kuchuluka kwa ayodini mu kachitidwe kanu kumayesedwa, limodzi ndi X-ray. Chithokomiro chopitirira muyeso nthawi zambiri chimakweza zotsatira za RAI-U (mankhwala opitirira muyeso amatha kutenga ayodini apamwamba kusiyana ndi achizolowezi, ndipo amawoneka pa X-ray).
Mu matenda a Graves, RAI-U ndi okwera ndipo mukhoza kuona kuti paliponse m'matumbo onse. Ngati muli hyperthyroid chifukwa cha nthendayi yowonjezera mahomoni a chithokomiro, zotsatirazi zidzawonekera m'mimbayi. Ngati muli ndi thyroiditis ngati chifukwa cha chithokomiro chanu choyambitsa, chiwombankhanga chidzakhala chotsika m'mimba yonse.
Ngakhale kuti ayodini 123 yosokoneza mavitamini sichivulaza chithokomiro chanu, sayenera kupatsidwa kwa amayi omwe ali ndi mimba kapena akuyamwitsa.
Chithokomiro Chokhazikika
Chithokomiro chotchedwa ultrasound chimatha kudziwika, komanso mitsempha yomwe imayambitsa hyperthyroidism. Kwa amayi omwe ali ndi mimba kapena akuyamwitsa, chithokomiro cha ultrasound nthawi zambiri chimagwiritsidwa ntchito ngati njira yowonjezereka yododometsa iode.
CT Scan
Mankhwala a CT, omwe amadziwika kuti computed tomography kapena kansalu, ndi mtundu wina wa X-ray umene ungathandize kuti muzindikire khunyu, komanso mitsempha yambiri ya chithokomiro.
Maginito Resonance Imaging (MRI)
Mofanana ndi CT scan kapena ultrasound, MRI sungauze dokotala mmene chithokomiro chikugwirira ntchito, koma chingathandize kupeza mchere wambiri wa goitis ndi chithokomiro.
Nthawi zina MRI ndi yabwino kwambiri kuti ikhale ndi kansa ya CT chifukwa sichifuna jekeseni wina uliwonse, umene uli ndi ayodini ndipo imatha kusokoneza kuyeza kwa iodine.
Kusanthula Kusiyanasiyana
Ngakhale zizindikiro za hyperthyroidism zikhoza kulakwitsa chifukwa cha mantha aakulu kapena kupanikizika, angathenso kutsanzira zazochitika zina zamankhwala.
Mwachitsanzo, kutayika kosawerengeka kungakhale chizindikiro cha matenda onse (mwachitsanzo, matenda, matenda osatulutsa chithokomiro, kapena khansara). Kungakhalenso chizindikiro choyamba cha matenda a maganizo, monga kuvutika maganizo kapena kuvutika maganizo, makamaka ngati munthu akukumana ndi kusinthasintha maganizo, kukwiya, kapena kusasamala-chizindikiro chofala kwambiri kwa anthu achikulire omwe ali ndi hyperthyroidism.
Kuthamanga mtima kwa mtima mwamsanga kapena nyimbo zosasinthasintha za mtima kungakhale chizindikiro choyamba cha vuto lalikulu la mtima kapena mapapo kapena kuchepa kwa magazi.
Zitsanzozi ndizomwe zili pamphepete mwa madzi, chifukwa nthawi zambiri zimapezeka. Nkhani yabwino ndikuti dokotala akhoza kuwonetsa kapena kuthetsa vuto la hyperthyroidism mosavuta ndi mofulumira ndi mbiri yachipatala, kuunika kwa thupi, ndi mayeso ena a magazi.
Pomaliza, ngati dokotala akukudziwani kuti ali ndi hyperthyroidism, ndiye kuti akufuna kudziwa chomwe chimayambitsa hyperthyroidism (mwachitsanzo, Graves 'matenda motsutsana ndi thyroiditis). Izi zingathetsedwe ndi mayeso ambiri a magazi komanso mayeso ojambula zithunzi omwe amachititsa kuti ayambe kuwunika.
> Zotsatira:
> American Thyroid Association. (2018). Matenda a Manda a FAQ.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Zakulupa I. Hyperthyroidism: Kuzindikira ndi Chithandizo. Am Phys Physician. 2016 Mar 1; 93 (5): 363-70.
> Ross DS. (2017). Kuzindikira kwa hyperthyroidism. Cooper DS, ed. Zaposachedwa. Waltham, MA: UpToDate Inc.
> Ross DS et al. Maphunziro a Chithokomiro cha American Thyroid Guidelines for Discover and Management of Hyperthyroidism ndi Zina Zimayambitsa Thyrotoxicosis. Chithokomiro . 2016 Oct; 26 (10): 1343-1421.