Uvavanyo lwegazi lwe- hormone (TSH) lwe- hormone (TSH) lugqalwa ngamanye amagqirha ukuba abe yintloko-kwaye kwezinye iimeko uvavanyo oluphela kuphela olufunekayo ukuxilonga nokulawula i-thyroid engasebenzi okanye eyingozi, ebizwa ngokuba yi- hypothyroidism okanye i- hyperthyroidism . Iimvavanyo zeTSH ngamanye amaxesha zibhekiswa yi-endocrinologists eziqhelekileyo njenge-"standard standard" test for diagnostic and diagnosis.
Uvavanyo lweTSH lulingani?
Uvavanyo lulinganisa amanqanaba akho e-TSH, i-hormone eyenziwa kwaye ikhutshwe yi-pituitary gland. Iimpembelelo zakho zokuziphatha nokuba unayo i-hormone eyaneleyo yegazi lakho, kwaye xa ifumana amanqanaba anganeleyo, i-pituitary yakho ikhipha i-TSH ukuze ikhuphe i-thyroid ukuze ikhulule i-hormone ye-thyroid. Yingakho i-TSH yakho iphakama xa i-thyroid yakho ingasebenzi . I-TSH ephezulu ithetha ukuba i-pituitary gland ikhulula i-hormone yayo ukuzama ukwenza i-thyroid yakho iphendule ngokuvelisa i-hormone ephezulu ye-thyroid.
Kwiphepha eliphambene, xa i-pituitary gland iyabona ukuba kukho i-hormone ye-thyroid ejikelezayo, iyancipha okanye iyeke ukukhupha i-TSH. Ukuhlaselwa kwe-TSH kuthetha ukuba i-thyroid yakho ayifumaneli umyalezo wokukhulula i-hormone, kwaye ukuveliswa kwe-hormone ye-thyroid kuya kuhlaba.
I-TSH Reference Range
Ukususela ngo-2017, kwii-laboratories ezininzi e-US inqanaba lokubaluleka ngokusemthethweni lwe-TSH vavanyo luqala ukusuka malunga ne-0.5 ukuya ku-4.5 okanye i-5.0 (mIU / L).
Isigulane esinezinga le-TSH kwisalathiso yesithenjwa libizwa ngokuthi "euthyroid," kwaye libhekwa njengento eqhelekileyo ye-thyroid.
Uluhlu lwesithenjwa-ngamanye amaxesha lubizwa ngokuba "uluhlu oluqhelekileyo" -yingxenye ebalulekileyo yenkqubo yokuxilongwa kwe-thyroid kunye neyonyango, kuba ihlabathi eliqhelekileyo le-endocrinology libhekisela ekubeni liyintloko ekuxilongeni nasekulawuleni umsebenzi we-thyroid.
I-TSH Reference Range ichazwe njani?
Uluhlu lwesithenjwa se-TSH lufunyenwe ngokuthatha iqela labantu kubemi, ukulinganisa amazinga abo ase-TSH, nokubala uluhlu olufunekayo ukumela uluhlu lwezinga le-TSH kwindawo ephilileyo.
Ukusebenzisa uluhlu lwesibonakaliso oluqhelekileyo, i-TSH ngaphantsi kwe-0.5 (i-TSH ephantsi) inokubonisa ukuba i-hyperthyroidism (i-thyroid engapheliyo), kunye ne-TSH ngaphezu kwe-4.5 / 5.0 (i-TSH ephezulu) inokubonisa i-hypothyroidism (i-thyroid engasebenzi.)
I-TSH Reference Range Controversy
Enye yemibandela ephikisanayo yakuba ngumcimbi woluhlu olutshintshayo "oluqhelekileyo" lovavanyo lwe-TSH. Ekupheleni kwe-2002, i-National Academy ye-Clinical Biochemistry (NACB) yakhupha izikhokelo ezintsha zokuxilongwa nokuhlolwa kwesifo se-thyroid.
Kwizikhokelo, i-NACB ibike ukuba i- TSH yesithenjwa se-intanethi yayibanzi kakhulu kwaye yabandakanyeka abantu abanesifo se-thyroid. Xa kuninzi ukuhlolwa kwentsholongwane, okwakungabandakanyi abantu abanesifo se-thyroid, ama-95 ekhulwini lwabantu abavavanywa babe nezinga le-TSH phakathi kwe-0.4 no-2.5. Ngenxa yoko, i-NACB icebisa ukunciphisa ulwahlulo lobhekiselelo kulawo mazinga.
Izikhokelo ze-NACB zikhokelela kwinconywa ngoJanuwari 2003 yi-American Association of Clinical Endocrinologists (AACE), ecela oogqirha ukuba "baqwalasele unyango kwizigulana abavavanye ngaphandle kwemida yomda omncinci ngokusekelwe kwinqanaba elijoliswe kwi-TSH ye-0.3 ukuya ku-3.0. "U Le nkcazo yathi kwakhona: "I-AACE ikholelwa ukuba uluhlu olutsha luya kubangela ukuxilongwa ngokufanelekileyo kwizigidi zabantu baseMelika abahluphekileyo ngenxa yokugula kwengxaki ye-thyroid, kodwa abazange baphathwe kuze kube ngoku."
Kuphando olupapashwe kwiNcwadi ye-American Medical Association ngo-2003, uDkt. Vahab Fatourechi kunye nabaphandi abalingana nabo baqikelela ukuba ukuba uluhlu lwacutshungulwa ngokwemiqathango ye-AACE, inani labantu abanesifo se-thyroid liya kwanda ukusuka kuma-5 ekhulwini uluntu ngokuqikelelwa kweepesenti ezingama-20 zoluntu, kunye neninzi yesigulana esongeziweyo esibangelwa kwi-hypothyroid / isigaba esingasebenzi.
Oku kubonisa ukunyuka okukhulu kwenani lezigulane zegroid lonke, ukusuka kwii-15 ezigidi, ukuya kuma-Amamiliyoni angama-Amerika angama-60.
Ngexesha elifanayo, nangona kunjalo, ingqungquthela yokubambisana eyenziwe ngabameli abavela kumaqela aphambili aqeqeshiwe abandakanyekayo kwonyango lwe-thyroid-kubandakanywa noMbutho waseMerika we-Clinical Endocrinologists, i-American American Thyroid Association kunye ne-Endocrine Society-yashicilele iziphumo zabo ngo-2004, icebisa rhoqo unyango lwezigulane ezinezinga le-TSH ye-4.5 ukuya kwi-10.0 mIU / L. Isicwangciso esitsha soluhlu lwesithenjwa sahla.
Phantse emashumi mabini emva kamva, ii-laboratories zaseMelika zivavanyo zisasebenzisa uluhlu lwamaxesha aludala kunye noogqirha bahlala behlulwe. Phakathi kwamagqirha aqhelekileyo, abaninzi baqhubeka benqaba ukuxilonga i-hypothyroidism ngaphandle kokuba iziphumo zokuvavanya kwe-TSH zingaphandle kwebala lokubaluleka kwendabuko kwaye zivakaliswe ngokungavamile yi-laboratory.
UJeffrey Garber, MD, FACE, wachaza ingxabano egameni le-American Association of Clinical Endocrinologists (AACE). Ngokutsho kukaDkt. Garber, izikhokelo azibonakalwanga ukuba zisebenze njengento yokutshintshwa kwesigwebo somntu ngamnye. Ngethuba ekubhalweni kwakhe, uDkt. Garber uthe akavakalelwa kukuba unyango lwe- hypothyroidism lugqityiwe ngokuqinisekileyo, wathi ekusebenzeni, akaxhatyali ukunyanga isigulane kunye ne-TSH ngaphakathi kwinqanaba lokubhekisa ukuba uyayigweba nokuba luncedo.
Uthi Garber:
Uluhlu oluqhelekileyo lwe-TSH akufanele lube yinkinga ebangelisayo. Kodwa ngokuqhelekileyo kubonwa kwiyeza, kulula ukuvumelana ngokugqithiseleyo. Xa usondela ngakumbi kwinqanaba elincinane, libizo olukhuni. Sifanele siqaphele ukuba kuqhubeka. Ukuba abantu bayazi ukuba leli qela elithile linakho ukufumana isifo se-thyroid kunokuba iqela liphantsi, alinakukunyanga kwaye akutsho ukuba akufanelekanga, lithi kukulandela, kwaye mhlawumbi ungenelele.
Umngeni Wabagulane: "I-TSH yakho iyinto eqhelekileyo"
I-TSH yesingqinisiso soluhlu lwesingqinisiso lubeka iingxaki kuwe njengesigulane.
Xa ugqirha wakho ufumana ingxelo yokuvavanya kwakho, nantoni na kwibala lesibheno ayiyi kukhankanywa ngokungavamile. Oku kuthetha ukuba, ukuba ugqirha wakho uthembele kumanqanaba afakwe kumanqaku kwaye usebenza kuphela kumanqanaba angaphandle kwoluhlu lwesalathiso, awuyi kufunyanwa okanye unyango lwakho lulungiswe.
Ekugqibeleni, uxelwa ukuba uvavanyo lwakho lwe-TSH "luqhelekileyo" alulona ulwazi oluncedo. Into oyifunayo ngokwenene kumgqirha wakho yiimpendulo zemibuzo emine ebalulekileyo:
- Yayiphi na inombolo yam ye- TSH yesiphumo somphumo ?
- Uluphi uluhlu lokubaluleka kwibhule apho iziphumo zam vavanyo zicutshungulwa?
- Uluhlu luni olulandelayo ekuhloleni nasekulawuleni izifo ze-thyroid?
- Iyiphi inqanaba lakho leTSH elijoliswe kuyo kwisisombululo esihle kakhulu nesiphephelo sezimpawu zam?
Qiniseka ukuba ufumanisa iimpendulo ezithile kule mibuzo ngaphambi kokuba uvumele ugqirha wakho aphumelele ingxaki ye-thyroid, okanye akuxelele i-thyroid yakho "yinto eqhelekileyo," ngakumbi xa ufumana iimpawu .
ILizwi
Xa ubhekene nama-endocrinologists okanye amanye amagqirha anqwenela ukuxilongwa nangayiphi na enye indlela kunokuchazwa ngokungqongqo kweziphumo ze-TSH, kusenokuba ixesha lokufumana umbono wesibini kwi-endocrinologist, okanye ukwandisa uphando lwakho ukuba luquke i-MD epheleleyo, ugqirha we-osteopathic , okanye i- naturopath eqeqeshiwe kunye nelayisenisi .
Iingcali eziqhelekileyo zizisa iinkalo ezininzi ngaphaya kovavanyo lwe-TSH ekuxilongweni nasekulawuleni izifo ze-thyroid, eziquka:
- Uvavanyo olongezelelweyo lwegazi , njenge- T4 yamahhala, i-T3 yamahhala kunye neeprofayili zengqungquthela
- Ukuvavanywa kweklinikhi yempawu zakho ezibonakalayo zesifo se-thyroid, kuquka ukuguquka kweengcamango, ukuvuvukala kunye ne-edema ebusweni bakho kunye nemiphetho, ukulahleka kweenwele entloko nasemzimbeni, ukulahlekelwa kweengcambu zangaphandle kweelishi, ukwandiswa kwe-thyroid, ukutshintsha kwamehlo, ukunyuka kwentliziyo, uxinzelelo lwegazi, kunye nezinye iimpawu ezinokulinganiswa
- Ukuphonononga iimvavanyo ukufumanisa ukwandiswa kwe-thyroid , i-atrophy, kunye neengqungquthela
- Imbali yonyango yonyango kunye nentsapho
- Injongo yonyango yezinga eliphezulu "zeTSH" kunye nesisombululo sezimpawu
> Imithombo:
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10 Edition. WLL / Wolters Kluwer; 2012.
> Fatourechi V, Klee GG, Grebe SK, et al. Imiphumo yokunciphisa umda ophezulu wexabiso eliqhelekileyo le-TSH. JAMA. 2003; 290: 3195-3196.
> 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.
> Gursoy A, kunye. al. "Yiyiphi i-hormone ye-thyroid-stimulation hormone ekufuneka ifunyanwe kwizigulane ze-hypothyroid phantsi kwe-L-thyroxine yonyango yokutshintshwa?" Int J Clin Pract. 2006 uJuni; 60 (6): 655-9