Kwi-hypothyroidism, isifo se-thyroid siyakwazi ukuvelisa okwaneleyo i-thyroid hormone thyroxine (ebizwa ngokuba yi-T4). Ngenxa yokuba i-T4 ibaluleke ngokubalulekileyo ekulawuleni umthambo womzimba, umsebenzi wokugaya inyama, umsebenzi we-muscle, kunye nomsebenzi wenyama , i-hypothyroidism isoloko ingxaki enkulu.
I-thyroid gland yona ilawulwa yi-hormone TSH (i-thyroid evuselela i-hormone).
Ukuba i-thyroid gland ayivelisi ngokwaneleyo i-T4, amazinga e-TSH ayanda ukwenzela ukukhuthaza i-thyroid ukuba isebenze nzima. Kwi-hypothyroidism-apho i-thyroid ayikwazi ukwenza ngokwaneleyo i-T4-amazinga e-TSH ahlala ephakamileyo kakhulu.
I-subclinical hypothyroidism yimeko apho ama-T4 amanqanaba ahlala kwinqanaba eliqhelekileyo (oko kukuthi, i-frank hypothyroidism ayifumanekanga), kodwa amazinga e-TSH aphakanyisiwe: amanqanaba aphezulu e-TSH ayadingeka ukuze agcine le nqanaba le-T4 eliqhelekileyo. Ngoko i-subclinical hypothyroidism ibonisa ukuba i-thyroid gland ngokwayo ayisebenzi ngokuqhelekileyo. Kuphela "ngokubetha" i-thyroid (ngezinga eliphezulu ze-TSH) ezaneleyo zamanqanaba e-T4 zingagcinwa.
Kukho ukuphikisana namhlanje malunga nokubaluleka kwe-hyplinroidism. Ngenxa yokuba ama-T4 amanqanaba akwimeko eqhelekileyo kule meko, kwiingcamango, i-subclinical hypothyroidism ayifanele ibe yingxaki enkulu.
Kodwa ubungqina bubonisa ukuba i-subclinical hypothyroidism ivelisa iingxaki zekliniki ubuncinci ngamanye amaxesha-kwaye ngoko, ngamanye amaxesha, kufuneka iphathwe.
Mhlawumbi inkxalabo enkulu kwi-subclinical hypothyroidism kukuba inokuchaphazela intliziyo.
Indlela i-Subclinical Hypothyroidism ifunyaniswa ngayo
Le meko ifunyaniswa neengxaki zegazi, ngokukodwa, ngokulinganisa amazinga eT4 kunye namazinga e-TSH.
I-hyplinicism i-hypothyroidism ikhona ukuba amazinga angama-T4 aqhelekileyo (0.8 ukuya ku-1.8 ng / L), kwaye amazinga e-TSH angaphezu kwebala eliqhelekileyo (0.3 ukuya ku-3.04 mU / L). Nangona kunjalo, iingcali ezininzi zicinga ukuba i-hyplinicism e-subclinical "ibe yinto ebalulekileyo" kuphela xa amazinga e-TSH aphakanyisiwe kakhulu: ngaphezulu kwe-10 mU / L.
Izizathu
Kukholelwa ukuba i-hypclinical hypothyroidism yindlela epholileyo, okanye ifom yokuqala, yeengxaki ezivame ukuvelisa i-hypankroidism-frank-mostly autoimmune thyroiditis ( iHashimoto's thyroiditis ). Enyanisweni, ekuhambeni kwexesha, isiqingatha sabantu abane-subclinical hypothyroidism kuya kuqhubeka ukuphuhlisa i-frank hypothyroidism, kunye namazinga aphantsi e-T4 kunye nazo zonke iimpawu ezihamba nazo . Ngoko, esinye sezizathu abanye oogqirha baphatha i-subclinical hypothyroidism kukuthintela ukuphuhliswa kokugqibela kwesimo esibi kakhulu se-hypothyroidism.
Iimpawu Zenzekayo?
Nangona le nkalo ibonakala ingabonakalisi iimpawu kubantu abaninzi, abanye bayakuvuma ukuba iimpawu ezinobuncwane zibonisa ukuba i-hypothyroidism, njengokuqhawulwa, ukukhathala, okanye ukufumana ubunzima obungachazi kakuhle. Kuye kwacetyiswa ukuba abantu abane-subclinical hypothyroidism banokuba neemeko eziphezulu zokuxhalaba, ukuxinezeleka, okanye ukuphazamiseka kwengqondo.
Indlela Echaphazela Intliziyo ngayo
Ngaphandle kwengozi ekugqibeleni ukuphuhlisa i-frank hypothyroidism, ukukhathazeka ngokuyinhloko nge-subclinical hypothyroidism kukuba kudibaniswa nesiganeko sokwanda kweesifo senhliziyo.
Izifundo eziliqela sele zibonise umbutho phakathi kwamazinga aphezulu aseTSH (ngaphezulu kwe-10 mU / L) kunye nophuhliso lwe- coronary disease (CAD) . Uhlalutyo oluhlanganisiweyo lwezifundo eziliqela zeekliniki ezibandakanya izigulane ezingama-25,000, i-hyplinroidism esecandelism yayixhomekeke kwimeko yokunyuka kwentliziyo, i-CAD yesifo kunye nokufa komzimba. Olunye uhlalutyo oluhlanganisiweyo lufumene umngcipheko ophezulu wokwehluleka kwentliziyo kwizigulane ezine-subclinical hypothyroidism.
Kwaye uphando oluthile lunxulumene ne-subclinical hypothyroidism kunye namazinga okwanda kwe-cholesterol.
Ngelixa umbutho ungabonakali imbangela-kunye-nentsingiselo, kubonakala ukuba i-hypothyroidism eyona nto ivelisa izifo ezinzima zesifo. Le nyaniso inika ingqalelo kwiingcamango zokuthi i-hyplinroidism ye-subclinical inokuchaphazela intliziyo. Ukwanda kwengozi yomzimba kubonwe nge-subclinical hypothyroidism yinto ebaluleke kakhulu yimeko.
Ngaba kufuneka i-Hypothyroidism ilandelwe?
I-hyplinroidism ye-subclinical ingaphathwa ngokunika i-hormone ye-hormone yonyango. Unyango lukhokelwa ngokunyamekela ngenyameko amanqanaba egazi le-TSH; i-hormone ye-thyroid eyaneleyo inikwe ukunciphisa amanqanaba e-TSH kwakhona kwibala eliqhelekileyo.
Kukho ubungqina obunqununu ukusuka kwizifundo zeklinikhi ezonyango lwe-hypothyroidism elungileyo. Kwiingcaphephe ezibonisa ukuba kunciphisa iimpawu, inzuzo enokulinganisa ibonakala iphela kulawo gulane amazinga okuqala eTSH aphakanyisiwe kakhulu (oko kukuthi, ngaphezu kwe-10 mU / L).
Ngokufanayo, ubungqina bokuba unyango lwe-hyplinroidism luyanciphisa umngcipheko wesifo senhliziyo. Kwisifundo esenziwa kwi-Great Britain, phakathi kwezigulane ezincinci (ezingaphantsi kweminyaka engama-70 ubudala) kunye ne-subclinical hypothyroidism, ingozi yesifo senhliziyo esilandelayo yayingaphantsi kakhulu kwizigulane ezithobele unyango lwe-hormone ye-thyroid. Akukho nzuzo yonyango yabonwa kwizigulane ezithembekileyo nge-subclinical hypothyroidism.
Ukongezelela, unyango lwe-hypothyroidism lugqithisa kakhulu izinto ezinobungozi bomzimba, kuquka amazinga e-cholesterol, amanqanaba e- CRP kunye nomsebenzi we-vascular.
Ngaphantsi
Uninzi lweengcaphephe zincoma ukuphathwa kwe-hyplinroidism xa i-TSH iphezulu kune-10 mU / L, nokuba ingekho impawu.
Ingaba i-hyplinroidism ye-subclinical ifanele iphathwe xa amazinga e-TSH angaphantsi kwe-10 mU / L ahlala ingongoma. Oogqirha abaninzi bancomela unyango ngolu hlobo oluphantsi ukuba izigulane zinempawu ezibonisa ukunyuka kwe-hypothyroidism, okanye ukuba ziye zaphakamisa amanqanaba e-cholesterol okanye ezinye izifo zengqondo yesifo.
Ngaba Ufanele Uvivinywe?
Kwimihla endala (iminyaka elishumi okanye amabini edlulileyo), ukuhlolwa komsebenzi we-thyroid kwakuyinxalenye yesigqibo sokuhlolwa kwezonyango. Kodwa kwintlalo yolondolozo lweendleko, ngokuqhelekileyo ayisoloko isenza njalo.
Kunengqondo ukucela ugqirha wakho ukuba ahlole i-thyroid yegazi xa unempawu zokubonisa i-hypothyroidism (jonga ngasentla), ukuba uphakamise amazinga e-cholesterol, okanye ukuba ufuna ukuqiniseka ukuba wenza konke onokukwenza ukunciphisa ingozi yakho yomzimba .
Imithombo:
Rodondi N, den Elzen WP, Bauer DC, et al. I-hyplinicism kunye neengozi ze-coronary disease and mortality. JAMA 2010; 304: 1365.
Gencer B, Collet TH, Virgini V, et al. I-subclinical thyroid neyingozi yentlekele yokukhubazeka kwentliziyo: uhlalutyo lomntu ngamnye othabatha inxaxheba kwi-6 cohorts. Ukuhamba ngo-2012; 126: 1040.
Razvi S, Weaver JU, Butler TJ, Pearce SH. Levothyroxine unyango lwe-Subclinical Hypothyroidism, Iziganeko zeMvakalelo ye-Cardiovascular and Fatalities. Arch Intern Med 2012.