Ukunyanga ama-Antibodies Xa i-TSH iqhelekile
Ukukhusela i-thyroid iyimfundiso engqubuzanayo. Ingaba kukho nto ongayenza ukukhusela imeko ye-thyroid, okanye ukuyigcina ingaba yimbi? Ukuba ucela, ezinye i-endocrinologists ziza kukugxotha, okanye zixelele ukuba unakho ukhetho lwezokwelapha. Iziphumo zophando, nangona kunjalo, zixhasa ukuqonda ukuba iHashimoto's thyroiditis-isifo esizimelayo esenza ukuba i-hypothyroidism-inokuthi ithinteke, inqande, okanye ime ngokupheleleyo phambi kokuba iqhubekele ekutshatyalaliseni i-thyroid gland kunye ne-hypothyroidism.
Kwintetho kwiNgqungquthela yase-Endocrine yoMbutho ka-Endo ka-2005, uDkt Ting Chang kunye noogxa bakhe babika ngokunika i-hormone ye-drug substitute levothyroxine (amagama aqhelekileyo aquka i-Synthroid, Levoxyl, neTirosint) kwizigulane zikaHashimoto's thyroiditis. Ezi zi gulane zineendlela eziqhelekileyo ze-thyroid ezikhuthaza i-hormone (TSH ), kwaye zikhethwe ngokuthi "i-euthyroid, nto leyo ithetha ukuba amazinga abo aseTSH aphakathi kwinqanaba eliqhelekileyo." Kodwa ke izi gulane nazo zaphakamisa i-thyroid peroxidase (TPO). ebonisa ukuba u-Hashimoto's thyroiditis uhamba ngokuzenzekelayo.
Isiqingatha sezigulane zanikwa i-levothyroxine ngeenyanga ezintandathu kwaye esinye isiqingatha asifumani unyango lweziyobisi. Iimvavanyo zomsebenzi we-thyroid kunye neziqu ze-autoantibody zilinganiswa ngaphambi nangemva kweenyanga-6. Iziphumo zibalulekileyo:
- Abo bafumana i-levothyroxine babencipha kakhulu amanqanaba omntu , kwaye amanqanaba e-antibody ayenyuka nakwezinye kwiqela elingajongwanga.
- Amanqanaba e-TSH ayancipha kwiqela eliphathweyo, ubuninzi be-0.5 vs 2.5 kwiqela elingajongwanga.
Abaphandi baphetha ngelithi unyango lokuqala lweprophylactic (ukuthintela) lwe-levothyroxine lunokuba luncedo ekuncediseni ukunciphisa ukuhamba kwe- Hashimoto's thyroiditis.
Oku akusiyo isifundo sokuqala sokubonisa ukuba unyango lokukhusela lunokunqanda ukuqhubela phambili kweHashimoto okanye uphuhliso lwe-hypothyroidism engaphezulu.
Ngomhla ka-Matshi 2001 kwiphephancwadi yeTyroid , abaphandi baseJamani babika ngokuhlola kwabo izigulane nge-euthyroid, iHashimoto, isiqingatha sazo esaphathwa ngayo i-levothyroxine unyaka, esinye isiqingatha singaphathwa. Emva konyaka ongu-1, amanqanaba okulwa nomntu kunye ne-lymphocytes, ebonisa ubungqina bokuvuvukala, wehla kakhulu kwiqela elifumana amayeza. Phakathi kweqela elingaphendulwanga, amanqanaba omntu onomzimba aphakanyisiwe okanye ahlala efana.
Abaphandi baphetha ukuba unyango lokuthintela izigulane ze-euthyroid zezigulane zikaHashimoto zanciphisa amanqaku ahlukeneyo e-thyroiditis . Baye bacacisa ukuba olo hlobo unyango luyakwazi ukunqanda inkqubela yesifo sikaHashimoto, okanye mhlawumbi ukuthintela uphuhliso lwe-hypothyroidism.
Kwesinye isifundo, abaphandi baseJapan bafumene ukuba unyango nge-levothyroxine lunokunciphisa iziganeko zeHashimoto's thyroiditis, kunye nokunciphisa iimpawu zesifo.
Kuhlolisiso lwezigulane ezineesifo se-Hutumoto se-euthyroid, elinye iqela lezigulane lafumana unyango lwe-levothyroxine, kwaye elinye iqela lingafumani unyango. Emva kweenyanga ezili-15, iqela eliphathwe ngayo liye lakhula ngokukhululeka kwamanqanaba e-T4, iyanciphisa kakhulu amanqanaba e-TSH kunye nokunciphisa i-anti-thyroglobulin antibody (Tg-Ab) kunye ne-anti-thyroid peroxidase.
Ubungakanani beengqungquthela ze-thyroid nazo zancipha kwiqela eliphathwayo, ngelixa abo bangenakufumana unyango banokunyuka kwindwangu ye-thyroid , uphawu lokuvuvukala.
Abaphandi babika ukuba nangona unyango lwe-levothyroxine "lunyanzelekile kwi- patient ye-hypothyroid autoimmune thyroiditis , unyango olubonakaliswa ukuba luvimbele inkqubo yezilwanyana kwiimodeli zezilwanyana kusekhona ingxabano kwizigulane zezifo zikaHashimoto apho eso sifo asizange sichithe i- thyroid iglofu ngokwaneleyo ukuba ibangele i-hypothyroidism. "U
Noko ke, bafumanisa ukuba unyango lwe-levothyroxine kwizilingo ezigcina i- TSH kumazinga aphantsi aqhelekileyo zibonakala zingasebenzi nje kuphela ekunciphiseni amanqanaba omntu kodwa kunye nobukhulu be-goiter, ekugqibeleni ekuthintela ukuqhubela phambili kwi-autoimmune hypothyroidism.
ILizwi
Njengokuba ubona, kukho uphando olubalulekileyo olubonisa ukuba unyango lokukhusela nge-levothyroxine lunokuqinisekiswa kubantu abane-euthyroid yesifo sikaHashimoto, abanamazinga aqhelekileyo e-TSH kodwa amanqanaba abo olwachasayo abonisa ubungqina bokugula kwesifo sikaHashimoto . Unjalo unyango lunokuthi lunciphise iimpawu ze-hypothyroidism, zinciphisa ukuphakama kwamanqindi e-thyroid , ukunceda ukukhusela ukuguqulwa kwesifo esisodwa , nokukhusela ukuphuhliswa kwe-hypothyroidism.
Ukuba unempawu ze-thyroid , i-"TC" evamile , kodwa awuzange uhlolwe i-antibodies ye-thyroid, ugxininise ukuba uvavanyo lwe-TPO lwenziwe ngudokotela wakho.
Ukuba unempawu ze-thyroid, i-TSH yesimo "esingaqhelekanga" kunye neengxaki ze-thyroid eziphakamileyo, cinga ukucela unyango, kwaye ukuba ugqirha wakho akafuni, cinga ukufumana ugqirha owaziyo okanye ovulekileyo .
Imithombo
En-Ting Chang, Du-An Wu, Dee Pei, Shi-Wen Kuo, Ming-Chen Hsieh. [P2-552] Impembelelo yoLawulo lwe-L-Thyroxine kwizigulane nge-Euthyroid Hashimoto's Thyroiditis. I-Endocrine Society Endo ka 2005
I-Thyroid, ngo-2001 uMar; 11 (3): 249-55, "unyango lwe-One prophylactic ye-euthyroid I-Hashimoto's thyroiditis izigulane ezine-levothyroxine: ingaba inzuzo?"
Duygu Yazgan Aksoy, kunye. al. "Iimpembelelo zeProphylactic Thyroid Hormone Ukutshintshwa kwi-Euthyroid yeHroidmoto's Thyroiditis" Endocr J (Japan) Vol. 52: 337-343, (2005).