Uhlobo lwee-TSH Reference: Isikhokelo sabathinteli be-Thyroid

Yonke Into Okufuneka Uyazi Ngayo i-Thyroid Yokukhuthaza iHormone Test

I-thyroid evuselela uvavanyo lwe-hormone-eyaziwa ngokuba nguvavanyo lwe-TSH-luvavanyo oluphambili olusetyenziswa ngabagqirha abaqhelekileyo ekuxilongweni nasekunyanga izifo ze-thyroid. Kubalulekile ukuba njengesigulane se-thyroid, uyayiqonda le mvavanyo, intsingiselo yeziphumo zakho, kunye neengxabano ezungeze uluhlu lweenkcukacha zeTSH.

Uvavanyo luni lweTSH?

Uvavanyo lwe-TSH luyinyathelo le-thyroid evuselela i-hormone okanye i-TSH.

I-TSH i-hormone ikhutshwa yi-pituitary gland ekuphenduleni kwimilinganiselo yehomoni ye-thyroid kwigazi lakho. Xa ama-hormone e-thyroid ephantsi afunyenwe, i-pituitary ikhupha i-TSH ngakumbi ukukhuthaza intsimbi yakho ye-thyroid ukuvelisa i-hormone engaphezulu. Xa kukho i-hormone ye -roid ephezulu, i-pituitary iyanciphisa umveliso we-TSH.

Uvavanyo lwe-TSH luvavanyo lokuqala lwegazi olusetyenziselwa ukuxilonga isifo se-thyroid nokulawula unyango lwe-thyroid. Kwinqanaba elisisiseko, amazinga aphakamileyo ye-TSH ayabonwa njengobungqina be-hypothyroidism, i-thyroid engasebenzi. Amanqanaba aphantsi ka-TSH aqwalaselwa ubungqina be-hyperthyroidism, i-thyroid engasebenzi.

IiRang Reang Ranges

Uluhlu lwesalathiso lufunyenwe ngokuthatha iqela elikhulu labantu kubemi, kuqhuba uvavanyo oluthile, ukubala ixabiso, nokudala uluhlu olumele lumele "amanqanaba" aqhelekileyo abantu abangenakho isifo okanye ukungavamile .

Uluhlu lwesithenjwa se-TSH lubonisa udidi lwee- TSH zamazinga abantu ababizwa ngokuba bakhululekile kwisifo se-thyroid kwaye banomsebenzi oqhelekileyo we-thyroid.

Okwangoku, kwiii-laboratories ezininzi e-US, i-reference reference ye-TSH iimvavanyo zi malunga ne-0.5 ukuya ku-5.0 mU / l. Kuxhomekeke kwibra, unokubonakala ufana nohlobo lwe-0.4 ukuya ku-5.5 mU / l, okanye u-0.6 ukuya ku-4.5 mU / l, njl., Kodwa ngokubanzi, u-0.5 ukuya ku-5.0 mU / l uthathwa njengama-lab.

Ngokuqhelekileyo, ugqirha wakho uya kutshintshwa kwinqanaba elingaphantsi kwe-0.5 mU / l njengombonakaliso we-hyperthyroidism (i-thyroid engasebenzi), kunye nezinga elingaphezu kwe-5.0 mU / l njengendlela ebonisa ngayo i-hypothyroidism ( i-thyroid engasebenzi .)

Ishati elandelayo ibonisa i-laboratory ye-laboratory TSH:

Inkcazo yoLungiso lweNkcazo

Uluhlu lwangempela lwe-TSH luye lwaphikisana ngaphezu kweyhumi. Emuva ngo-2003, emva kobungqina obubonise ukuba izigulane ezinezinga le-TSH kwisiphelo esiphezulu se-TSH yesithenjwa sesicatshulwa sasiqhubekile ukuhlakulela i-hypothyroidism ngokuphindaphindiweyo kunezo ezisezantsi kweloluhlu, i-American Association of Clinical Endocrinologists (AACE) Kunconywa ukuba oogqirha "baqwalasela unyango kwizigulana abavavanye ngaphandle kwemida yomda osecaleni ngokubhekiselele kwizinga elijoliswe kwi-TSH ye-0.3 ukuya kwi-3.0 mU / l. Ngelo xesha, i-AACE ikholelwa ukuba uluhlu olutsha " luya kubangela ukuxilongwa ngokufanelekileyo kwizigidi zabantu Abantu baseMelika abahluphekileyo ngenxa yeengxaki ze-thyroid, kodwa abazange baphathwe. "

Ngokomongameli we-AACE uHossein Gharib, MD,

Ukusabalalisa kwezifo ze-thyroid ezingakhange zifumaneke eUnited States ziphakamisa ngokukrakra ... Uluhlu olutsha lwe-TSH oluvela kwizikhokelo ze-AACE linika oogqirha ulwazi abanalo olufanelekileyo ukuze baxilonge izifo ezincinci ze-thyroid phambi kokuba zingabangela iziphumo ezinzulu kwimpilo yesigulane, i-cholesterol ephakamileyo, isifo senhliziyo, i-osteoporosis, ukungabikho komntwana, kunye nokudandatheka. "

Ngelo xesha, isimemezelo esivela kwi-AACE sabonwa ngabaninzi njengokuphuculwa kwexesha elide kunye nokufunwa kakhulu kwezigulane.

Ngelishwa, into ebonwa ngokuba yintlepheko yophuhliso lwezigulane ze-thyroid ayizange ibe negalelo elikhulu, ngezizathu ezininzi:

• Iibhonatories azizange zithathe uluhlu olutsha njengoluhlu lwesalathiso oluseburhulumenteni, oluthetha ukuba amanqanaba kuphela ngaphandle komdala, udidi olubanzi lubekwe uphawu olungavamile.
• Ukusekwa kwezonyango kwaqhubeka kungavumelani noluhlu lwesithenjwa se-TSH, njengoko kuboniswe ngamanqaku amabini ahloniphekileyo avela kwintetho ka-Septemba 2005 ye- Journal of Clinical Endocrinology kunye neMetabolism , ebonisa amacandelo amabini engxabano.

Odokotela baseMartin Surks, uGayotri Goswami kunye noGilbert Daniels baxela ukuba uluhlu lwesalathisi lufanele luhlale lufanayo kwinqaku yabo "Ukuphikisana kwi-Endocrinology Clinic: I-Thyrotropin Reference Reference kumele ihlale ingaguquki." Baxhomekeke kwimpikiswano yabo ekuthiwa "ngenxa yokuba unyango lwe-levothyroxine awunakucetyiswa nge-subclinical hypothyroidism, ngokuqinisekileyo akuqinisekanga kubantu abanomxholo ophezulu we-TSH" amanqanaba ama-2.5 ukuya ku-4.5 mU / l.

Oogqirha uLeonard Wartofsky noRichard Dickey baxelile kwinqaku yabo, "Ubu bungqina beNtsholongwane yeTrotrotin Reference Compliance," ukuba iindawo ezifunyenweyo zangaphambili azivumelekanga ngenxa yokuba abantu ababethatyathwa njengento eqhelekileyo "bahlambulukileyo" nabantu abanamazinga ahlukeneyo isifo se-thyroid. Bathi iingenelo zonyango zigqithise ngaphezu kwanoma yimuphi umngcipheko omncinci.

Oogqirha iWattofsky kunye noDickey balwela ukutshintshwa kwinqanaba elitsha, besithi:

Mhlawumbi asiyi kuba nexabiso eliqhelekileyo le-TSH ekwahlula ukuqhelekileyo kokungaqhelekanga, kodwa ukuqonda ukuba ithetha yexabiso eliqhelekileyo le-TSH liphakathi kwe-1.18 no-1.4 mU / l kwaye ngaphezulu kwama-95% abantu abaqhelekileyo baya kuba nezinga le-TSH ngaphantsi ngaphezu kwe-2.5 mU / l kubonisa ngokucacileyo ukuba nabani na abanexabiso eliphezulu kufuneka bahlolwe ngokucokisekileyo ukusilela kwe-thyroid yokuqala.

Ngo-2006, amaqela okuphela kwee-endocrinoloya awashiyile isincomo sokwandisa uluhlu lwesithenjwa se-TSH, kunjalo, impikiswano yangemva nangaphandle iqhubeke iminyaka engaphezu kweyishumi, kwaye ngo-2017, ukuphikisana kuyaqhubeka. Sekunjalo, uninzi lwabasebenzi bezempilo oluqhelekileyo luyalelwe ukuba lisebenzise uluhlu olubanzi lweenkcukacha zeTSH ekuxilongeni nasekuphatheni izigulane ze-thyroid.

I-TSH evamile kunye ne-Hypothyroidism

Kubalulekile ukuba izigulane ze-thyroid zikwazi ukuba uphando lubonise ukuba:

• Kwi-iodine-eyaneleyo yabemi, i-TSH ithetha yi-1.5 mU / l
• Kuphando lwamacandelo oluntu aneziganeko eziphantsi zeHashimoto's thyroiditis, i-TSH ithetha ngu-1.18 mU / l
• Xa abantu abane-antibodies anti-antithyroid okanye imbali yentsapho ye-auto-immune disease ye-thyroid ayibandakanyi kwibala lokubaluleka kwebala, isalathisi yesiganeko esiqhelekileyo isuka kwi-0.4 ukuya kwi-2.5 mU / l
• Ngethuba lokukhulelwa, izikhokelo zithetha ukuba ama-TSH amanqanaba awafanele aphakamise ngaphezu kwama-3.0, ukwenzela ukukhusela impilo yomama nomntwana.
• Amanqanaba e-TSH ekupheleni okuphezulu kwoluhlu lwendawo yokubhekisa adibaniswa nemingcipheko eyongeziweyo yomdlavuza we-thyroid, i-cholesterol ephakamileyo, ukungabikho kwengqondo, isifo senhliziyo, uhlobo lwesifo sikashukela, kunye neminye imiba yempilo.
• Amanqanaba e-TSH athambekele ekuphakanyeni ngaphambili kwimini. Uvavanyo lwe-TSH olwenziwe kamva ngosuku luyakubonisa amanqanaba akho njengoluhlu lwereferensi, ngelixa uvavanyo lwentsasa lwangaphambili lungabonisa i-hypothyroidism.

Ukuba umphumo wakho wokuvavanya kwe-TSH ungaphakathi kwinqanaba lokubhekisa kwaye uxelelwa ukuba "i-TSH yakho iyinto eqhelekileyo," ngaba usenokuba yi-hypothyroid? Amagqirha amaninzi aqhelekileyo athi ayikho, kwaye abaninzi ababandakanyekayo kunye nabasebenzi behlabathi bathi Ingaba unokwenza i-hypothyroid kunye nezinga eliqhelekileyo le-TSH ekugqibeleni lihlala liyingxabano.

ILizwi

Njengoko ufundile, inkcazo yezinga "eliqhelekileyo" le-TSH lixhomekeke kugqirha othetha naye kunye neengcinga zakhe malunga nesifo se-thyroid. Ngexesha elifanayo, uvavanyo lwe-TSH kunye nohla lwe-TSH lubonisa ukubaluleka kwimpilo yakho ye-thyroid kunye nonyango. Ngenxa yoko, kukho izinto ezibalulekileyo zokugcina engqondweni.

1. Kufuneka ucele ukuba i- TSH iqwalasela ugqirha wakho ekujolise kuwe, kwaye kutheni. Unokuba nogqirha okholelwa ukuba ukugcina wena phezulu kwoluhlu kukuphela kwenjongo okanye umntu ojolise kwi-TSH ephantsi kunye nokuphulukiswa kweempawu zakho. (Kananjalo, oogqirha bajolise kumgangatho ophantsi okanye okhuselayo we-TSH kumaninzi omdlavuza we-thyroid, njengendlela yokuthintela ukuphindaphinda komhlaza.) Uninzi lwabagqirha, kunjalo, kusetyenziswa i-TSH yesalathisi ye-0.5 ukuya ku-5.0 ukuxilongwa nokuphathwa sakho sifo.
2. Akufanele ukwamkele iimpendulo "eziqhelekileyo," "phezulu," okanye "ezantsi" njengengxelo kwiimvavanyo zegazi lakho. Endaweni yoko, cela amanani okwenene uze ucele uluhlu lwee-laboratory. Kulungile nangoko, cela ikhophi yemiphumo yokuhlolwa kwegazi.
3. Ukuba iinqanaba lakho lokuvavanya kwe-TSH zingaphakathi kwinqanaba lokubhekisa, kwaye unempawu ezihambelanayo ne-hypothyroidism, unokufuna ukucela iimvavanyo ezongezelelweyo ukunceda ekuxilongeni ngakumbi. Nangona oogqirha abaqhelekileyo bahlala bexhomekeke kuvavanyo lwe-TSH kuphela, abanye oogqirha banokulinganisa i-hormone ye-thyroid (iT4) kunye ne- triiodothyronine (T3) -kwakunye namazinga okuchithwa kwe-thyroid kunye ne-T3. La oogqirha bafuna iindlela ezongezelelweyo zokuxilonga. Ngokomzekelo, xa ama-hormone akho e-T4 ne-T3 ephantsi, i-hypothyroidism iyaxelwa, kwaye xa iphakamileyo, i-hyperthyroidism iyaxelwa. Ama-antibodies-ngakumbi i-thyroid peroxidase (TPO) ezinokuthi zifumane isifo seHashimoto-ngamanye amaxesha zilinganiswa. I-subset of practitioners believe that a thyroid gland ekhoyo kwinkqubo yokungafezeki ngokuzenzekelayo-njengokuba kuboniswe ngamanqanaba e-TPO aphakanyisiwe-angabangela iimpawu ze-hypothyroidism ngaphambi kokuba i-hypothyroidism ibonakaliswe kwi-TSH, okanye i-Free T4 kunye ne-Free T3. Baye bakholelwa ukuba unyango olwenziwe nge-thyroid i-hormone ye-drug substitution lusetyenzise ukukhupha iimpawu zakho, ukunciphisa amanqanaba akho omzimba, kwaye kukuthinte ukuba ube yi-hypothyroid.
4. Ukuba amazinga akho okuhlola eTsh awela kumgangatho ophezulu kwoluhlu lwesithenjwa, kwaye unempawu ehambelana ne-hypothyroidism, cinga ngokuxoxa ngesilingo sokunyanga kwe-thyroid hormone esikhundleni sakho.
5. Ukuba ugqirha wakho wenqaba ukuqhuba iimvavanyo ezongezelelweyo okanye wenqaba ukukuphatha, cinga ukufumana ugqirha omtsha kwinkonzo yakho ye-thyroid. Amagqirha ahlangeneyo kunye namaxesha amaninzi aquka iimvavanyo ezininzi ngaphezu kovavanyo lwe-TSH, kwaye uthathe ingqalelo yakho imbali kunye neempawu zezobugqirha, ngenjongo yokufumana i- TSH ekhuselekileyo kunye neyona nto iyakusindisa ngokukhuselekileyo iimpawu zakho.

> Imithombo:

> Anderson et. al., "Ukuguquka komntu ngamnye kwiSerum T4 kunye ne-T3 kwiZifundo eziqhelekileyo: I-Clue kwi-Understanding of Substlinical Thyroid Disease," I-Journal ye-Clinical Endocrinology kunye neMetabolism, 87 (3): 1068-1072.

> Garber J, uCobin R, Gharib H, et al. Izikhokelo zengonyango ze-hypothyroidism kubantu abadala: I-Cosponsored by association yaseMelika ye-endocrinologist clinic kunye ne-American cootic association. I-Endocrine Practice. 2012; 18 (6): 988-1028. i-doi: 10.4158 / ep12280.gl.

> Guber HA, Farag AF. Ukuvavanywa komsebenzi we-endocrine. Ku: McPherson RA, Pincus MR, eds. I-Henry's Clinical Diagnosis kunye noLawulo lweeLebhu zeeLebhu. Wama-22. Philadelphia, PA: Elsevier Saunders; 2011: isahluko 24.

> Surks, et.al. "Ukuphikisana kwi-Endocrinology yezonyango: I-Thyrotropin Reference Reference kumele ihlale ingaguquki," I-Journal ye-Clinical Endocrinology kunye neMetabolism 90 (9) / 5489-5496.

> I-Wartofsky & Dickey, "Ukuphikisana kwi-Endocrinology yezonyango: Ubu bungqina beNtsholongwane yeTrothropin Inkqubo yokuChobisa," I-Journal ye-Clinical endocrinology kunye ne-Metabolism.