I-TSH, i-T4, i-T4 yamahhala, i-T3, i-Free T3, i-Reverse T3, ii-Antibodies kunye nezinye izilingo
Ukuhlolwa kwegazi ngenxa yomsebenzi we-thyroid yinto ebalulekileyo kwinkqubo yokufumanisa isifo se-thyroid kunye nokuphathwa kweemeko ze-thyroid. Nantsi isishwankathelo ekuncedeni ukuba ufumane ukuqonda okungcono kwiimvavanyo zegazi ze-thyroid, ukuba zilinganisa ntoni, zeziphumo zithini, kunye nefuthe ekuxilongweni nasekulawuleni imeko yakho ye-thyroid. Unokwenza uhlalutye kwiinkcukacha ngamnye kwaye ufumane ukuqonda okungcono ukuba kuthetha ukuthini.
Test Test | Uhlobo lweNkcazelo |
| I-TSH (iHyroid stimulating Hormone) | 0.5-4.70 μIU / mL |
| Iyonke i-T4 (Thyroxine) | 4.5-12.5 μg / dL |
| I-T4 yamahhala (i-Thyroxine yamahhala) | 0.8-1.8 ng / dL |
| Iyonke i-T3 (i-Triiodothyronine) | 80 -200 ng / dL |
| I-T3 yamahhala (i-Free Triiodothyronine) | 2.3- 4.2 pg / mL |
| RT3 (Phindela iT3 / Reverse Triiodothyronine) | 10-24 ng / dL |
| I-TPOAb (i-Thyroid Peroxidase Antibodies) | 0-35 IU / mL |
| I-TSI (i-Immunoglobulins ye-Thyroid-stimulating) | 0-1.3 |
| Tg (Thyroglobulin) | Ayikho i-thyroid gland: 0-0.1 ng / ml. |
| TgAb (i-Thyroglobulin Antibodies) | 0-4.0 IU / mL |
I-TSH (iTyroid stimulating hormone) Uvavanyo
Amanye amagama: I- Serum Thyrotropin
Ngokuphathelele: I- thyroid evuselela i-hormone (TSH) yi-hormone ye-pituitary engumthunywa kwi-thyroid gland. Ukuba i-pituitary iyaphawula ukuba i-gland ikhiqiza i-hormone encinci ye-thyroid, i-pituitary ivelisa i-TSH engaphezulu, leyo ibangela ukuba i-gland ivelise enye i-hormone ye-thyroid. Xa i-pituitary ifumanisa i-hormone ephezulu ye-thyroid, ihlisa i-TSH, njengesigidimi kwi-gland ukunciphisa okanye ukuyeka ukuveliswa kwe-hormone ye-thyroid.
Amanyathelo: Uvavanyo lwe-TSH lulinganisa inani le-TSH egazini.
Ubungakanani benkalo : 0.5-4.70 μIU / mL. (Amanye ama-laboratories angama-0.3 ukuya ku-4.5, okanye ezinye iindidi ezifanayo.)
Ukuchazwa okuqhelekileyo: Ngaphezulu kweentlobo, kwaye ngaphantsi kwe-10 μIU / mL "yi-subclinical" hypothyroidism , ngaphezu kwe-10 μIU / mL iphezulu ye-hypothyroidism. Ngaphantsi kwe-0.1 ukuya ku-0.5 μIU / mL kuthathwa njengobungqina be-subclinical hyperthyroidism, ngaphantsi kwe-0.1 kunokuba ngaphezulu kwe-hyperthyroidism.
"Amanqanaba aqhelekileyo" Amanqanaba e-TSH acingelwa ukuba angabandakanyi i-hypothyroidism okanye i-hyperthyroidism.
Ukuchazwa okuhlangeneyo: Amanqanaba angaphezu kwe-1.5 ukuya kwi-2.0 μIU / mL inokuthi ibonakalise ukungasebenzi kwe-thyroid. Inqanaba elifanelekileyo liphuma kwi-1.0 ukuya ku-1.5 μIU / mL.
Iingxabano: Zininzi iingxabano malunga novavanyo lwe-TSH kwaye lithetha ntoni.
- Phakathi kwe-endocrinologists, kukho ukuphikisana malunga nokuba uluphi uhlobo lwe-TSH reference okufanele lube nalo. Ngokuqhelekileyo, ihamba ukusuka kwi-0.4 / 0.5 ukuya kwi-4.5 ukuya kwikho. Kodwa ezinye i-endocrinologists zikholelwa ukuba umgca wokugqibela webala lokubhekisa kufuneka ube ngu-3.0.
- Phakathi kwama-endocrinologists, kukho ukungavumelani malunga nokuba amanqanaba angaphantsi kwe-10.0 aya kuphathwa. Abanye oogqirha bakholelwa ukuba ezi nqanaba ziqinisekisa ukuba unyango lwe -hormone ye-thyroid lusetyenziswe-kanti abanye bacinga ukuba "i-hypclinical hypothyroidism" -eyo unyango luyimfuneko kuphela emva kokuba amanqanaba angaphezu kwe-10.0.
- Olunye uphando lubonisa ukuba nangona i-TSH ingena kwibala lesibheno, ukuba isigulane sinama -antibodies kaHashimoto, unyango luyafaneleka .
- Amagqirha ahlangeneyo akholelwa ukuba i-TSH yodwa kwizinto ezininzi zokuxilonga nokulawula izigulane ze-thyroid. Bhekisela ekunyanzeliseni kwi-TSH njengeTrranny ye-TSH.
- Amagqirha ahlangeneyo akholelwa ukuba umlinganiselo okwenene we-thyroid umsebenzi yinto ekhoyo, ekhoyo i-hormone ye-thyroid ejikelezayo kwigazi-i-Free T4 kunye ne-Free T3.
I-T4 / Thyroxine ne-Free T4 / Free Thyroxine
Ngokuphathelele: I- Thyroxine, eyaziwa nangokuthi yi-T4, yenye yee-hormone eziphambili ze-thyroid. Uninzi lwama-hormone oluveliswa yi-thyroid gland yi- thyroxine . I-Thyroxine ithathwa ngokuba yi-"storage" hormone-kuloo yedwa ayinakunyulwa ngumzimba ukuvelisa amandla nokuhambisa i-oxygen kwiiseli. Kufuneka ilahle i-athomu ye-iodine, inkqubo ebizwa ngokuthi i- monodeiodination (okanye i-T4 kuya ku-T3 ukuguqulwa), ibe yi-triiodothyronine (T3) ukuze isetyenziswe ngamaseli.
Iimilinganiselo: Ixabiso le-T4 lilinganisa inani le-thyroxine elijikelezayo kwigazi. I-T4 yamahhala inokulinganisela inani elingafumanekiyo, elingenakubalwa kwe-thyroxine egazini.
I-thyroxine ephilileyo ivelisa i-thyroxine, kwaye i-thyroxine kufuneka iguqulwe ibe yi-triiodothyronine (T3) ukwenzela ukuhambisa i-oksijini namandla kumaseli.
Ubungakanani bemiqathango : I-T4 iyonke: 4.5-12.5 μg / dL, i-T4 yamahhala: 0.8-1.8 ng / dL
Ukutolika okuqhelekileyo : Amaninzi amaninzi aqhelekileyo awalinga i-Total T4 okanye i-Free T4. Nangona kunjalo, kwezinye iimeko, kunye ne-TSH ephakamileyo, i-Total T4 okanye ii-Free T4 kumanqanaba angaphantsi kwereyholo lokubhekiselelwa kubonwa ubungqina be-hypothyroidism. Ngaphandle kwamazinga aphantsi / athatywayo we-TSH, i-Total T4 okanye ii-Free T4 kumanqanaba angaphezulu kwereyholo lokubhekiselelwa zibonwa ubungqina be- hyperthyroidism .
Ukuchazwa okuhlangeneyo: Ukuxilongwa kunye nokunyangwa kwe-hypothyroidism, amanqanaba kwisiqingatha esiphezulu soluhlu lwesibhengezo lubonwa ngokufanelekileyo kunye nobungqina bento efanelekileyo ye-thyroid.
Iingxabano: Uninzi lwe-endocrinologists oluqhelekileyo lisebenzisa kuphela iimvavanyo ze-TSH ekuxilongeni nasekulawuleni izimo ze-thyroid, kwaye ngenxa yoko, ungavavanyi amazinga angama-T4 apheleleyo okanye akhululekileyo.
T3 / Triiodothyronine kunye ne-Free T3 / Free Triiodothyronine
Ngokuphathelele: I- Triiodothyronine (T3) yi-hormone esebenzayo ye-thyroid. I-thyroid yegciwane ephilileyo ivelisa i-triiodothyronine-i-hormone esebenzayo ye-thyroid. Eminye imiphumo yokuguqulwa kwe-thyroxine ibe yi-triiodothyronine.
Iimvavanyo : Iimvavanyo ezipheleleyo zeT3 zilinganisa inani lilonke le-triiodothyronine elijikelezayo kwigazi. I-T3 yamahhala inokulinganisa amanqanaba akhululekileyo, angabonakaliyo e-hormone triiodothyronine ekhoyo ukuze isetyenziswe ngumzimba.
Umlinganiselo wesalathiso : Ixabiso le-T3: 80-200 ng / dL, i-T3 yamahhala: I-Triiodothyronine): 2.3- 4.2 pg / mL
Ukuchazwa ngokuqhelekileyo : Amaninzi amaninzi aqhelekileyo awalinga i-Total T3 okanye i-Free T3. Nangona kunjalo, kwezinye iimeko, kunye ne-TSH ephakamileyo, i-Total T3 okanye ii-Free T3 kumanqanaba angaphantsi kwoluhlu lweenkcukacha lubonwa ubungqina be-hypothyroidism. Ngaphandle kwezinga eliphantsi / elixinzelelweyo le-TSH, i-Total T3 okanye ii-Free T3 kumanqanaba angaphezulu kwereyholo lokubhekiselelwa zibonwa ubungqina be-hyperthyroidism.
Ukuchazwa okuhlangeneyo: Ukuxilongwa kunye nokunyangwa kwe-hypothyroidism, amanqanaba kwisiqingatha esiphezulu soluhlu lwesalathisi luboniswa ubungqina bokuba umsebenzi we-thyroid okwaneleyo, kwaye amanqanaba kwi-25 ye-percentile ephezulu yoluhlu lwesibhengezo lubonwa ngokufanelekileyo. Ngombono odibeneyo, amanqanaba angaphantsi-mali angagunyazisa unyango ngeyeza le-hormone ye-substitute medication, okanye amayeza aquka ngokuthe ngqo iT3 .
Iingxabano: Ukuvavanya i-T3 kunye ne-T3 yamahhala yinkxalabo ngakumbi kunokuhlolwa kwe-T4 . Oku kubangelwa kukuba oogqirha abaninzi abakholelwa ukuba inqanaba le-T3 linempembelelo kwiimpawu, kwaye akukho ndawo yokunyanga nge-T3 hormone .
Ngenxa yokuba amazinga angamahhala e-T3 amelela i-hormone efumanekayo ngokukhawuleza, i-T3 yamahhala icatshulwa ngabasebenzi abathile abadibeneyo ukubonisa kakuhle isimo se-hormonal yesigulane, xa kuthelekiswa ne-TSH kunye / okanye i-T3 iyonke.
I-RT3 / i-Reverse T3 / i-Reverse Triiodothyronine
Ngokumalunga: Ukubuyela kwi-T3 yindlela ye-T3 engasebenzi kwaye iveliswa ngamanani aphezulu ngexesha loxinzelelo.
Iimvavanyo: Ifomu engasebenziyo, engenamsebenzi yeT3 eveliswayo xa umzimba uphantsi kwengcinezelo.
Uhlobo loNxibelelwano : Ngokuqhelekileyo 10-24 ng / dL
Ukuchazwa okuqhelekileyo: Olu vavanyo alunakwenziwa ngokuqhelekileyo ngamagqirha aqhelekileyo, angaboni nantoni na kule milinganiselo.
Ukuchazwa ngokudibeneyo: Amagqirha ahlangeneyo kunye nalawo oogqirha abagxile kwi-balance hormone balance balinganisela i- RT3 ephakamileyo okanye ukungalingani kwemilinganiselo ye-RT3 / T3 kuba yinto ebalulekileyo ye-thyroid engasebenzi okanye engasebenzi. Bakholelwa ukuba i-T3 efunekayo kufuneka iwele kwisiqingatha esingaphantsi kwebala eliqhelekileyo.
Iingxabano: Ukutshintsha i-T3 kukuvavanya . Amagqirha aqhelekileyo kwinxalenye enkulu axoshe ixabiso le-RT3 ekuxilongweni, ekuphatheni nasekulawuleni i-hypothyroidism. Amagqirha ahlangeneyo kunye nalabo abajolise kwi-balance hormone balance, nangona kunjalo, qwalasela i-RT3 ephakamileyo ukuba ibonakaliso oluphambili lwe-thyroid engasebenzi okanye engasebenzi.
I-TPOAb / i-Thyroid Peroxidase Antibodies
Amanye amagama: I- Antithyroid Peroxidase Antibodies
Ngokumalunga: I- thyroid peroxidase (TPO) yamanqindi, kunye nesigqityiweyo njenge-TPOAb, ziyi-antibodies eziphuhliswayo ngenxa yokuhlaselwa ngokuzenzekelayo kwi-thyroid gland. Bajolise kwi-gland, kwaye ngokuqhelekileyo kubangele ukutshabalalisa i-gland ngokuhamba kwesikhathi. Ama-antibodies we-TPOAb ahlasela i-thyroid peroxidase, i-enzyme eyenza indima ekuguquleni kwe-T4 ukuya kwi-T3. Amanqanaba e-TPOAb aphakanyisiwe angabungqina bokuvuvukala kwintsimbi, okanye ukutshabalalisa izicubu ezifana nesifo sikaHashimoto. Ngokuqhelekanga, i-TPO ibonakala kwezinye iindlela ze-thyroiditis ezifana ne- post-partum thyroiditis .
Amanyathelo: Olu vavanyo lusetyenziswa kumgangatho we-antibodies ze-TPO.
Umlinganiselo wesalathiso: Uluhlu lwesithenjwa luvela ku-0-35 IU / mL
Ukuchazwa ngokuqhelekileyo : Ukuba ama-TPOAb awela phantsi kwoluhlu lweenkcukacha, zijongwa njengesiqhelo. Oku akuyikulawula ngokupheleleyo isifo sikaHashimoto kodwa kwenza kube lula kakhulu. Amanqanaba e-TPOAb aphakanyisiweyo aphakamisa ukuvuvukala kwe-gland, ngokuqhelekileyo ngenxa ye-Hashimoto's thyroiditis okanye ezinye i- thyroiditis .
Kulinganiselwa ukuba i-TPOAb iyabonakala malunga nama-95 eepesenti zezigulane ezineHroidmoto's thyroiditis, kunye nama-50 ukuya kuma-85 ekhulwini kwizigulane zezifo ze-Graves. Ukugxilwa kwamagciwane okufumaneka kwizigulane ezinezifo ze-Graves zihlala ziphantsi kunezigulane ezineesifo sikaHashimoto. Nangona kunjalo, kwi-TPOAb ephakamileyo ayifunanga unyango ngaphandle kokuba ihamba ne-hypothyroidism okanye i-hyperthyroidism.
Ukuguqulelwa okuhlangeneyo : Ezinye izigulane ziye zaphakamisa i-TPOAb, kodwa zenye "i-euthyroid," ngezinga eliqhelekileyo le-T4, T3, kunye ne-TSH.Eminye uphando ibonise ukuba unyango lokuthintela i-levothyroxine lunokuqinisekiswa kwezi gulane, njengoko kunokunciphisa ukuphakama kwamagciwane , kwaye uncede ukukhusela ukuqhubela phambili kwi-hypothyroidism.
Iingxabano: Abaninzi be-endocrinologists abakholelwa ekuhlolweni kwe-TPOAb, bakhetha ukuxilonga i-thyroid kunye nokuphathwa kweyeza kwiingxaki ze-TSH zodwa.
I-ISI / i-Immunoglobulins evuselela i-Thyroid
Ngokuphathelele: I- thyroid eyenza i-immunoglobulin-i-TSI-i-antibodies ekhuthaza umdlalo we-thyroid ukunyusa nokukhulula i-hormone ye-thyroid, okubangelwa yi-hyperthyroidism. Olu vavanyo ngamanye amaxesha luthiwa ngokuba yi-TSH yamkela i-antibody.
Amanyathelo: Uvavanyo lwe-TSI lusetyenziswa kwinqanaba le-antibodies egazini.
Ubungakanani boLungiso: ngaphantsi okanye lulingana no-1.3
Ukuchazwa okuqhelekileyo : Amazinga e-TSI aphakanyisiwe kwi-75 ukuya kwi-90 ekhulwini yezigulane zezifo ze-Graves. Ukuphakama kwamanqanaba, xa kusebenza kakhulu isifo seMangcwaba. (Ukungabikho kwala maqhekeza angagqithanga izifo ze-Graves.) Qaphela: abanye abantu abanesifo seHashimoto nabo banezikhuhlane ezinje, kwaye oku kunokubangela iziganeko zexesha elifutshane ze-hyperthyroidism.
Uvavanyo lwe-TSI lwenziwa ngokuqhelekileyo ukuze lubone izifo ze-Graves kwaye zihlolisise i-goiter ye-toxicular goiter . Kwakhona ngokuqhelekileyo kwenziwa kwindoda ekhulelwe eneSifo se-Graves , kwiinyanga ezintathu zokugqibela zokukhulelwa, ukuvavanya ingozi yokuzalwa kwintsana yokuzalwa ne-hyperthyroidism okanye isifo se-Graves.
Tg / Thyroglobulin
Ngokuphathelele: I- Thyroglobulin (Tg) yiprotheni eveliswa yi-thyroid gland, kunye nokuba khona kwayo egazini kukubonakalisa ukuba isigulane sinesifo se-thyroid-ingaba ingqungquthela okanye intsalela ishiye emva kokuhlinzwa okanye i- RAI) .
Amanyathelo: Uvavanyo lwe-Tg lulinganisa izinga le-Tg kwigazi. I- hyroglobulin ihlolwe kakhulu kwizigulane zomdlavuza we-thyroid, ukuchonga ukuba izicubu zomhlaza zivelisa i-thyroglobulin ngaphambi kokuba unyango, ukuchonga ukuba unyango lusebenza, kwaye kukunceda ukufumana ukuphindaphinda emva kokonyango. Ekubeni uninzi lwee- cancer ze-thyroid -e, i-papillary kunye ne-follicular-ivelisa i-thyroglobulin, kunye namazinga okwandisa i-thyroglobulin inokuba ngumqondiso wesifo somhlaza.
Ubungakanani benkalo: Ukuba ungenayo i-thyroid gland, kufuneka ibe ngaphantsi kwe-0.1 ng / ml. Ukuba usenayo i-gland, kufuneka ibe ngaphantsi okanye ilingane ne-33 ng / mL
Ukutolika okuqhelekileyo : Inqanaba eliphantsi le thyroglobulin liqhelekileyo kubantu abangenayo isifo se-thyroid. Amanqanaba aphakamileyo kumntu onomdlavuza we-thyroid uthetha ukuba amazinga e-thyroglobulin anokuqwalaselwa kamva ukukunceda ukufumana ukuphindaphinda. Amanqanaba e-Thyroglobulin kufuneka abe ngu-0 okanye aphantsi kakhulu emva kokuhlinzwa kwe- thyroid okanye emva kokunyanga kwe-iodine (RAI) . Ukuba zisabonakala, unyango olongezelelweyo lungadingeka. Ukuba amazinga aqala ukunyuka emva kokunyangwa komhlaza we-thyroid, oko kungabonakalisa ukuba umdlavuza uye waphinda.
Imiqathango eyenza ukuvuvukala kwe-thyroid-gland-oko kukuthi, i-goiter, thyroiditis , okanye i-hyperthyroidism-inokubangela amazinga aphezulu e-thyroglobulin. Uvavanyo aluqhelekanga ngokukodwa ngexesha lonyango le miqathango, nangona kunjalo.
TgAb / Thyroglobulin Antibodies
Malunga: I- Thyroglobulin-antibodies-eyaziwa ngokuba yi-TgAb-ziyi-antibodies against thyroglobulin.
Amanyathelo: Uvavanyo lwe-TgAb lusetyenziswa kwinqanaba le-antibodies ejikelezayo kwigazi.
Ubungakanani benkalo: Uluhlu lweenkcukacha lubangaphantsi kwe-4.0 IU / mL
Ukuchazwa okuqhelekileyo : Amanqanaba aphakamileyo e-TgAb atholakala kuma-10 ekhulwini abantu abaphethe umsebenzi oqhelekileyo we-thyroid, kunye nabangama-15 ukuya kuma-20 ekhulwini abantu abanomdlavuza we-thyroid. Amazinga e-TgAb aphakanyisiwe malunga neepesenti ezingama-60 zezigulane zikaHashimoto kunye neepesenti ezingama-30 zezigulane zamaGrives. Ukuba sele sele ufumene ukuba unesifo se-Graves, ukuphakama kwamazinga e-TgAb kuthetha ukuba unako ukugqithisa ukuba ube yi-hypothyroid.
I-TgAb inokuphazamisa iziphumo ze-thyroglobulin (Tg), kwaye ke kubalulekile ukuba abo abanomdlavuza we-thyroid babe namazinga e-TgAb ahlolwe kunye ne-Tg ngezikhathi eziqhelekileyo.
ILizwi
Amanqanaba okubhekiselela kunye neeyunithi zokulinganisa ezisetyenzisiweyo ziyahlukahluka kwibhulebhu kwibhuyibhile. Njalo makunqume iindawo zokujonga iinkcukacha kunye neempawu zokuvavanya kwibhubhoratri apho uvavanyo lwakho lwenziwe khona.
Abanye oogqirha okanye abasebenzi babo beefowuni bacela ukuba bakuxelele iziphumo zovavanyo lwezonyango. Unokuva "iziphumo zakho zilungile," okanye "iimvavanyo zakho ziqhelekileyo" njengesiphumo sokuvavanya. Oku akukwanele ulwazi. Njalo ucele ikopi yangempela nayiphi na iziphumo zovavanyo lwezonyango, kuquka iimvavanyo ze-thyroid. Ngokukodwa uvavanyo lwegazi lwe-thyroid, kufuneka ukwazi amaqondo akho okwenyani, kunye nebala lokubhekiselele, ukuze ukhuthaze ukunyamekela kangcono imeko yakho ye-thyroid.
> Imithombo:
> Bahn, R., Burch, H, Cooper, D, et al. I-Hyperthyroidism kunye Nezinye izizathu zeTrorotoxicosis: Izikhokelo zoLawulo lwe-American Thyroid Association kunye ne-American Association of Clinical Endocrinologists. I-Endocrine Practice. I-Vol 17 No. 3 ngoMeyi / ngoJuni 2011.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10 Edition. WLL / Wolters Kluwer; 2012.
> Garber, J, Cobin, R, Gharib, H, kunye. al. "Izikhokelo zeCliniki zoLwazi lwe-Hypothyroidism kubantu abadala: I-Cosponsored yi-American Association of Clinical Endocrinologists kunye ne-American Thyroid Association." I-Endocrine Practice. I-Vol 18 No. 6 uNovemba / Disemba 2012.