Ukuba unempawu okanye iimpawu ze-hyperthyroidism, kubalulekile ukuba uhlalutye olunzulu ukuze ufumane unyango ngokufanelekileyo kwaye ukhawuleze, ukuba kuyimfuneko. Ugqirha wakho uya kwenza uvavanyo olusisigxina, uhlaziye imbali yakho yezobugqirha, kwaye usebenzise iimvavanyo zegazi ezinzulu (ezifana ne-TSH, T3, T4) ukuze ufumane ukuxilongwa; Iimvavanyo zokucinga, ezifana ne-thyroid ultrasound okanye i-CT scan nazo ziyalelwe.
I-Hyperthyroidism inokulawulwa kodwa ingabangela iingxaki xa zingashiywanga zingakhange ziphendulwe, ngoko ukuxilongwa kwangaphambili kuhlale kukuhle.
Uviwo
Emva kokuphonononga iimpawu zakho kunye nemingcipheko yesifo se-thyroid, ukuba ugqirha wakho ugxeka ukuba unokuxilongwa kwe-hyperthyroidism, uya kwenza uviwo olunzulu olujolise kwi-thyroid yakho, kodwa nakwezinye iindawo zomzimba wakho.
Uvavanyo lweTyroid
Ngethuba loviwo lwe-thyroid , ugqirha uya kugcina (palpate) entanyeni yakho, efuna ukwandiswa kwe-thyroid kunye neendununu.
Uya kukhangela into eyaziwa ngokuba "yinto evuyisayo," echaza ukunyuka kwegazi kwi-thyroid ekwazi ukuvakalelwa. Ugqirha wakho uya kuphulaphula "ingxolo" kunye ne-stethoscope yakhe, isandi sokwanda kwegazi kwi-thyroid.
Ubukho be-thyroid bumnandi kunye / okanye izandi zibonisa izifo zesifo se- Graves .
Uvavanyo lweMvelo
Ngaphandle kokuhlolwa kwe-thyroid, ugqirha uya kuhlola lonke umzimba wakho ngemiqondiso ye-thyroid engasebenzi.
Ngokomzekelo, uya kuhlola iimpawu zakho zokucinga, ngokukhawuleza okanye ukuphendula ngokuthe ngqo kwintetho kungabonakalisa i-hyperthyroidism. Uya kuphinda ahlole izinga lentliziyo yakho, isigqi, kunye negazi. Oku kungenxa yokuba iipilpitations , i-fibrillation ye-atrial , ukushaya kwentliziyo, okanye uxinzelelo lwegazi lunokuba luncedo kwi-hyperthyroidism.
Ezinye iindawo zeemviwo zenyama ziquka:
- Uvavanyo lwekhanda lakho, ekubeni ulusu oluqhenqelekileyo nolushushu, lunokuba ngumqondiso we-hyperthyroidism. Ipesenti encinci yabantu abanesifo se-Graves nabo bahlakulela ukugqithisa kwiimpawu zabo (i-myxedema ye-pretibial).
- Ukuqwalasela ubungakanani obuninzi kunye nobungqina beenwele zakho, njengokunciphisa, ukucoceka, okanye ukunyuka kweenwele kunokubonakalisa imeko ye-thyroid
- Ukuqwalaselwa naluphi na ukuthuthumela, ukuzulazula kwezandla, okanye ukunyuka kweengxubevange ezifana nokugubungqa kwetafile, ukuhamba kweenyawo, okanye ukunyakaza okunyamekayo (kaninzi kunzima kakhulu kubantwana)
- Ukuhlolwa kwamehlo akho, njengokubomvu, ukugubha, ukuma, ukuvuvukala, ukukhukhumala, kunye namanzi amanzi kunokubonakalisa ingxaki ye-thyroid. Ukongezelela, "i-lid lag" (xa inkophelo ephezulu ingalandeli ngokunyanzela ukunyuka kwemehlo xa ukhangela phantsi) ibonakala kwi-hyperthyroidism.
IiLabs kunye novavanyo
Iimvavanyo zegazi ziquka uvavanyo lwe-hormone ye-thyroid (TSH), kunye ne-thyroxine (T4) kunye novavanyo lwe-triiodothyronine (T3). Ugqirha wakho unokuvavanya amanqanaba e-antibody we-thyroid ukuqinisekisa ukuxilongwa kwesifo se-Graves.
Kubalulekile ukuphonononga iziphumo zakho zovavanyo kunye nogqirha wakho. Ungesabi ukubuza imibuzo. Le yimpilo yakho, ngoko kubalulekile ukuba uqonde oko kwenzekayo.
Iziphumo zeTSH
Uluhlu oluqhelekileyo lovavanyo lwe-TSH lu malunga nama-0.5 kuya kuma-5.0 iiyunithi zamazwe ngamazwe ngeli litre (mIU / L). Bonke abantu abane-hyperthyroidism ephambili baneTSH ephantsi; Nangona kunjalo, izinga le-TSH yedwa alikwazi ukufumana umlinganiselo we-hyperthyroidism. Yingakho ugqirha wakho uza kuphinda ahlole amanqanaba akho eT4 neT3.
I-Free Free T4 kunye ne-T3 Iziphumo
Ukuxilongwa kwe-primary hyperthyroidism kuyahambisana ne-TSH ephantsi, kunye ne-T4 ephezulu kunye / okanye ukuhlolwa kwegazi lwe-T3.
Njengengcambu, ukuba i-TSH yakho iyinto eqhelekileyo okanye iphakanyisiwe, kwaye i-T4 yakho kunye ne-T3 yakho ekhululekile iphezulu, uya kufuna iMRI ye-pituitary gland ukuvavanya kwimeko ebizwa ngokuba yi-central or TSH-induced hyperthyroidism.
I-T3 ephakamileyo kunye neziphumo eziqhelekileyo ze-T4 ziphumo
Ukuba i-TSH yakho iphantsi kwaye i-T3 yakho iphakamileyo (kodwa i-T4 yakho ekhululekile iyinto eqhelekileyo), mhlawumbi ukuba ukuxilongwa kwakho kusekhona isifo se-Graves okanye isigulane se-thyroid esivelisa i-hormone kakhulu. Uvavanyo lokucinga, olubizwa ngokuba yi-iodine efundwayo, luyakwazi ukwahlula phakathi kwezi zifo zimbini.
Ukuthatha kakhulu i-T3 (ebizwa ngokuba yongxowankulu ye-T3) enye inokwenzeka.
I-T3 eqhelekileyo kunye neziphumo eziphezulu zeT4 ze-Free
Ukuba i-TSH yakho iphantsi, i-T4 yakho ekhululekile iphakamileyo, kodwa i-T3 yakho iyinto eqhelekileyo, unokufumana i-hyperthyroidism ekubeni ungathathi kakhulu iT4 (levothyroxine). Esinye isifo sokuxilongwa sisifo sengxaki ye-thyroid.
Le nhlanganisela yebhabhaneki ingabonakala kubantu abane-hyperthyroidism abanesifo esingafaniyo nesifo se-thyroidal (umzekelo, ukusuleleka kakubi) okunciphisa ukuguqulwa kweT4 ukuya kwi-T3.
Ngokuqhelekileyo i-Free T4 kunye ne-T3 Iziphumo
Ukuba i-TSH yakho iphantsi, kodwa amazinga akho e-T3 kunye ne-T4 aqhelekileyo, unokuba ne-subclinical hyperthyroidism. Oku kuya kubonakala nangokukhulelwa.
I-Antibody Results
Ukuvavanya igazi lakho kwiintsholongwane, ezifana ne-thyroid-stimulating immunoglobulin okanye i-TSH receptor autoantibodies, kubalulekile. Uvavanyo oluchanekileyo luqinisekisa ukuxilongwa kwezifo ze-Graves, nangona abanye abantu abanesifo banalo vavanyo lolwabiwo olubi. Kule meko, uvavanyo lwe-iodine (i-RAIU) luya kuqinisekisa ukuxilongwa.
Ukucinga
Kwiimeko ezininzi, iimvavanyo zokucinga , ezifana ne-ultrasound, i-iodine i-iodine (RAI-U), i-CT scan okanye i-MRI iya kwenziwa ukwenzela ukuxilongwa ngokuchanekileyo nangokuchanekileyo.
Scan Scan Iodine
Kuvavanyo lwe-iodine (RAI-U) lwe-iodine (RAI-U), i-dose encinci ye-iodine ye-i-radioactive 123 ilawulwa kwipilisi okanye ifom ye-liquid.
Kwiiyure ezimbalwa kamva, inani le-iodine kwisistimu yakho lilinganiswa, lihamba ne-X-ray. I-thyroid engapheliyo iya kuphakamisa iziphumo ze-RAI-U (i-gland eyingozi kakhulu ithatha ixabiso eliphezulu lee-iodine kunokuqhelekileyo, kwaye ukufunyanwa kubonakala kwi-X-ray).
Kwi-Graves 'isifo, i-RAI-U iphakamileyo kwaye uyabona ukuba kukho i-gland. Ukuba u-hyperthyroid ngenxa ye-hormone ye-thyroid ephezulu, i-hormone ye-thyroid iyakuthi ibonakale kuloo ndawo. Ukuba unayo i-thyroiditis njengesizathu sogonyamelo lwakho lwe-thyroid oluyingozi, i-uproke iya kuba yinto ephantsi kuyo yonke into.
Nangona iodine ye-i-radioactive 123 ingabonakali kwi-thyroid gland, akufanele inikwe abafazi abakhulelweyo okanye abancelisayo.
I-Thyroid Ultrasound
I-thyroid ultrasound iyakwazi ukubona i-goiter, kwakunye neengqungquthela ezinokubangela i-hyperthyroidism. Kuyabasetyhini abakhulelweyo okanye abancancisayo, i-thyroid ultrasound isetyenziswa rhoqo njengendlela yokukhangela iodod i-radioactive.
CT Scan
I-CT scan, ebizwa ngokuba yi-tomography okanye i-scan scan, iyona hlobo olukhethekileyo lwe-X-ray enganceda ukufumana i-goiter, kunye neendununu ezinkulu ze-thyroid.
Ukujonga umfanekiso weMagnetic Resonance (MRI)
Njenga-CT scan okanye i-ultrasound, i-MRI ayikwazi ukuxelela ugqirha indlela i-thyroid isebenza ngayo, kodwa inokukunceda ukufumanisa i-goiter ne-nodules ye-thyroid.
I-MRI ngamanye amaxesha inokukhetha kwi-CT scan ngoba ayifuni nayiphi na injection yokuchaseneyo, ene-iodine kwaye inokuphazamisa ukukhangela kwe-iodine.
Ukuxilongwa okuhlukeneyo
Nangona iimpawu ze-hyperthyroidism ziphosakele ngenxa yokwesaba okanye ukuxinezeleka, ziyakulinganisa ezinye zeemeko zonyango eziqhelekileyo.
Ngokomzekelo, ukulahleka kwesisindo esingachazwanga singabonakalisa isigulo senyama yonke (umzekelo, isifo, isifo esingenayo i-thyroid, okanye umhlaza). Kungaba ngumqondiso wokuqala wokugula ngengqondo, njengokudandatheka okanye ukugula ngengqondo, ngakumbi xa umntu ehlaselwa yimvakalelo, ukucaphuka, okanye ukunganakwa-uphawu oluqhelekileyo kubantu asebekhulile abane-hyperthyroidism.
Isantya senhliziyo esheshayo okanye isantya esingenasiphelo isingeniso sokuqala senhliziyo yokuqala okanye ingxaki yemiphunga okanye i-anemia.
Le mizekelo ingumxholo we-iceberg, njengoko kudla ngokuphindaphindiweyo. Iindaba ezilungileyo kukuba ugqirha unokukwazi ukuqinisekisa okanye ukunciphisa ukuxilongwa kwe-hyperthyroidism ngokukhawuleza kunye nangoko kwimbali yonyango, ukuhlolwa kweemvelo kunye nokuhlolwa kwegazi.
Ekugqibeleni, ukuba ugqirha wakho uxilonga nge hyperthyroidism, uya kufuna ukufumana isizathu sokuba u-hyperthyroidism wakho (umzekelo, isifo se-Graves ne-thyroiditis). Oku kunokulungiswa kunye nokuhlolwa kwegazi ngaphezulu kunye nokuhlolwa kweemifanekiso ezibizwa ngokuba yi-radioactive scan scan.
> Imithombo:
> I-American Thyroid Association. (2018). Izifo zeMangcwaba FAQ.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10 Edition. WLL / Wolters Kluwer; 2012.
> IiKravets I. I-Hyperthyroidism: Ukuxilongwa kunye noTyango. I-Phys Physician. 2016 uMar 1; 93 (5): 363-70.
> Ross DS. (2017). Ukuxilongwa kwe-hyperthyroidism. Cooper DS, ed. Isemgangathweno. Waltham, MA: UpToDate Inc.
> Ross DS et al. Izikhokelo ze-American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism kunye nezinye izizathu ze Thyrotoxicosis. Thyroid . 2016 Oct; 26 (10): 1343-1421.