Ma qanjirkaaga tayroodhka ayaa u muuqda mid firfircoon oo yar? Aan ka hadalno Hyperthyroidism-ka Subclinical!

Dhakhtarkaagu ma sheegay in heerkaaga TSH uu xoogaa hooseeyo baaritaan dhiig oo dhawaan la sameeyay? Mise waxaad leedahay calaamado qariib ah oo ay adag tahay in la fahmo? Waxaa laga yaabaa inaad qabto xaalad la yiraahdo Hyperthyroidism-ka Subclinical. Ha welwelin, badanaa ma aha mid halis ah. Aan si fudud oo cad uga hadalno arrintan.

Waa maxay Hyperthyroidism-ka Subclinical?

Si fudud haddii loo dhigo, "Subclinical Hyperthyroidism" waa xaalad qanjirkaaga thyroid uu si ka badan sidii caadiga ahayd u ​​shaqeeyo. Laakiin ma aha mid daran sida " hyperthyroidism- ka cad".

Qanjirka 'pituitary gland' ee maskaxdeenna ayaa soo saara hoormoon la yiraahdo 'TSH' (Hormoonka Kiciya Thyroid-ka). 'TSH'-kan wuxuu u sheegayaa qanjirka 'thyroid' ee qoorteenna inuu sameeyo laba hoormoon oo loo yaqaan 'thyroxine' ('T4` - 'thyroxine') iyo triiodothyronine ('T3` - 'triiodothyronine'). Hoormoonadan 'T3` iyo 'T4` waa waxa caawiya dheef-shiid kiimikaadka jirkeenna, taas oo ah, inay cuntada aan cunno u beddelaan tamar oo ay u isticmaalaan jirkeenna.

Marka la eego 'Subclinical Hyperthyroidism', heerka 'TSH' ee dhiiggaagu waa hooseeyaa, laakiin heerarka 'T3' iyo 'T4' waa caadi. Taas macnaheedu waa in qanjirka 'thyroid' uu xoogaa firfircoon yahay, sidaa darteed qanjirka 'pituitary' wuxuu leeyahay, "Hagaag, uma baahni 'TSH' hadda, qanjirka 'thyroid'-kaygu si fiican ayuu u shaqeynayaa," waxayna yareysaa soo saarista 'TSH'. Laakiin hoormoonada qanjirka 'thyroid' ('T3`, 'T4`) weli si weyn uma kordheen. Taasi waa waxa 'subclinical' macnaheedu yahay - xaalad hoose oo aan muujin calaamado muuqda.

Xaaladdan mararka qaarkood waxay noqon kartaa mid ku meel gaar ah , taasoo la micno ah inay kaligeed ka soo fiicnaan karto dhowr maalmood gudahood. Si kastaba ha ahaatee, dadka qaar waxay u noqon kartaa mid joogto ah. Qof walba uma baahna daaweyn.

Yaa u badan inuu ku dhaco xaaladdan?

Qof kastaa wuu qaadi karaa "Subclinical Hyperthyroidism", laakiin dadka soo socda ayaa halis yar ugu jira:

• Dadka qaadanaya daaweynta beddelka hoormoonka tayroodhka (tusaale ahaan, levothyroxine) si loogu daaweeyo hypothyroidism. Mararka qaarkood tani waxay dhici kartaa haddii qiyaasta daawada la kordhiyo.
• Kuwa ka weyn 65 sano.

Sidee ayuu u badan yahay xaaladdan?

Xaaladani aad uma badna dalalka sida Ameerika.

Qiyaastii 0.7% dadka ayaa qaba "Hyperthyroidism-ka hooseeya", halkaasoo heerarka TSH ay ka yar yihiin 0.1 mIU/L. 1.8% kale ayaa leh heerarka 'TSH' oo ka yar 0.4 mIU/L.

Si kastaba ha ahaatee, wadamada ay ku yar tahay iodine-ka , gaar ahaan dadka da'doodu ka weyn tahay 70 sano, xaaladdan waxay gaari kartaa ilaa 15%. Sri Lanka, khatartani way yar tahay sababtoo ah badanaa waxaan isticmaalnaa milix iodine-ku ku jiro , laakiin waa wanaagsan tahay in la ogaado.

Waa maxay astaamaha?

Inta badan, dadka qaba "Subclinical Hyperthyroidism" ma muujiyaan wax calaamado ah . Taasi waa sababta loogu yeero "subclinical".

Si kastaba ha ahaatee, mararka qaarkood waxaa laga yaabaa inaad la kulanto calaamado fudud oo la xiriira hyperthyroidism. Waqtiyadaas oo kale, waxaa laga yaabaa inaad la kulanto waxyaabo ay ka mid yihiin:

• Dareemidda sida wadnahaagu si dhakhso ah u garaacayo (garaacyo).
• Waxay ila tahay in jidhkaygu gariirayo, oo aan dareemayo walwal.
• Miisaan lumis (inkastoo rabitaanka cuntada).
• Rabitaan xumo oo kordhay.
• Shuban ama saxaro soo noqnoqda.
• Maqaarku wuxuu dareemaa khafiif, diirran, iyo qoyan.
• Isbeddellada ku yimaada wareegga caadada haweenka ('Isbeddellada caadada').

Muhiim: Inaad yeelato calaamadahan macnaheedu maahan inaad qabto 'Subclinical Hyperthyroidism'. Si kastaba ha ahaatee, haddii calaamadahani sii jiraan, waa wax caqli gal ah inaad la kulanto dhakhtar.

Maxaa arrintani u dhacaysaa? Waa maxay sababaha?

Caadiyan, nidaamkayaga endocrine wuxuu u shaqeeyaa sidii koox. Uga fikir shirkad weyn.

Hypothalamus, oo ku taal saldhigga maskaxda, ayaa sii daaya hoormoon la yiraahdo TRH (Hormoonka sii daaya qanjirka thyroid). Tani waxay u sheegaysaa qanjirka pituitary inuu soo saaro TSH.

Dabadeed `TSH` ayaa tagaya oo u sheegaya qanjirka tayroodhka inuu sameeyo `T3` ​​​​(qiyaastii 20%) iyo `T4` (qiyaastii 80%). Marka `T3` ​​iyo `T4` ay ku kordhaan dhiigga, waxay mar kale u dirtaa calaamad qanjirka 'pituitary' oo leh, "Hagaag, jooji sameynta `TSH` hadda, waxaa jira hoormoon ku filan." Tan waxaa loo yaqaan ` wareegga jawaab celinta` . Marka `T3` ​​iyo `T4` ay yaraadaan, wareeggani wuxuu mar kale ka bilaabmaa bilowgii.

Si kastaba ha ahaatee, 'Subclinical Hyperthyroidism', sababtoo ah dhibaato ka jirta qanjirka thyroid, inkastoo heerka 'TSH' uu hooseeyo, soo saarista hoormoonada thyroid-ka ma yaraato sidii la filayay. Taasi waa sababta 'TSH' uu u hooseeyo, laakiin 'T3' iyo 'T4' ay yihiin heerar caadi ah.

Sababaha keena "Subclinical Hyperthyroidism" waxay inta badan la mid yihiin kuwa keena hyperthyroidism-ka daran. Waa kuwan qaar ka mid ah sababaha ugu waaweyn:

• Kordhinta qiyaasta daaweynta hoormoonka (levothyroxine) ee la siiyo hypothyroidism (tayroodh aan firfircoonayn). Tani waa sababta ugu badan.
• Goiter-ka sunta ah ee multinodular. Kani waa xaalad ay ku soo baxaan burooyinka aan kansarka ahayn (qanjidhada) qanjirka thyroid-ka, taasoo keenta inay soo saarto hoormoonka tayroodh oo aad u badan.
• Cudurka Graves. Kani waa xaalad isdifaac ah. Taas macnaheedu waa in habdhiska difaaca jirkeenu uu weeraro qanjirka thyroid, isagoo kicinaya inuu soo saaro hoormoono badan.
• Cudurka qanjirka thyroid: Marka qanjirka thyroid- ku uu bararo, heerarka hoormoonka ayaa si ku meel gaar ah u kordhi kara.

Sidee baad tan u aqoonsan kartaa?

Baaritaannada shaqada qanjirka 'thyroid' waa habka kaliya ee lagu ogaan karo inaad qabto 'Subclinical Hyperthyroidism' iyo in kale.(Baaritaannada shaqada qanjirka thyroid-ka oo keliya. Kuwani waa baaritaanno dhiig oo caadi ah.

Heerka caadiga ah ee heerarka TSH (sidoo kale loo yaqaan thyrotropin) ee qof weyn oo aan uur lahayn waa inta u dhaxaysa 0.4 iyo 4.5 milli-unugyo caalami ah halkii litir (mIU/L).

Haddii baaritaannada dhiiggaagu muujiyaan in heerka TSH-gaagu hooseeyo (inta u dhaxaysa 0.1 iyo 0.4 mIU/L ama ka yar 0.1 mIU/L), laakiin heerarka T4 (thyroxine) iyo T3 (triiodothyronine) ay ku jiraan heerka caadiga ah, waxaad qabtaa Hyperthyroidism Subclinical.

"Hyperthyroidism-ka hooseeya" waxaa loo qaybin karaa laba qaybood oo waaweyn:

• Fudud: Heerarka TSH waa hooseeyaan, laakiin wali waa la ogaan karaa - badanaa inta u dhaxaysa 0.1 iyo 0.4 mIU/L. Heerkani wuxuu ku jiraa 65% ilaa 75% dadka qaba Hyperthyroidism-ka Subclinical.
• Daran: Heerarka TSH waxay ka yar yihiin 0.1 mIU/L. Tani waxay saameysaa inta u dhaxaysa 25% iyo 35% dadka.

Tani ma u baahan tahay daaweyn?

Runtii waxaa jira fikrado kala duwan oo ka dhexeeya dhakhaatiirta oo ku saabsan in la daaweeyo "Subclinical Hyperthyroidism" iyo in kale, sababtoo ah weli ma jirto cilmi-baaris ku filan oo ku saabsan faa'iidooyinka cad ee daaweynta.

Dhakhaatiirtu waxay inta badan ku taliyaan hab "sug oo arag" dadka qaba hyperthyroidism-ka aan kiliinikada ahayn. Taasi waa, waxay sugaan in xaaladdu iskeed u soo hagaagto iyagoon bilaabin daaweynta.

Si kastaba ha ahaatee, daaweynta waxaa lagula talin karaa kuwa heerarka TSH ay si joogto ah uga hooseeyaan 0.1 mIU/L, gaar ahaan xaaladaha soo socda:

• Haddii aad tahay 65 sano jir ama ka weyn.
• Haddii aad ka yar tahay 65 sano, aad qabto cudurka wadnaha, lafo-beelka, ama calaamadaha hyperthyroidism.
• Haddii aad tahay haweeney ka soo kabatay caadada, oo ka yar 65 sano, oo aan qaadan estrogen ama bisphosphonates (nooc daawo ah oo loo isticmaalo daaweynta dhibaatooyinka lafaha).

Hyperthyroidism-ka subclinical inta lagu jiro uurka badanaa uma baahna daaweyn.

Haddii daaweyn la bixiyo, waa maxay?

Haddii dhakhtarkaagu go'aansado in daaweyntu lagama maarmaan tahay, daaweyntu waxay ku xirnaan doontaa sababta hyperthyroidism-ka subclinical-ka ah.

• Haddii aad qabto goiter sun ah oo multinodular goiter ah (buro qoorta ku taal) ama hal buro oo ku taal qanjirkaaga, daaweynta ugu badan waa iodine shucaac ah . Kani waa daawo aad afka ka qaadato. Unugyada firfircoon ee xad-dhaafka ah ee qanjirkaaga thyroid-ka ayaa nuuga iodine-ka. Iodine-ka shucaaca leh wuxuu waxyeeleeyaa unugyadaas, taasoo keenta in qanjirkaagu uu yaraado heerarka hoormoonkaagana uu hoos u dhaco dhowr toddobaad gudahood.
• Haddii aad qabto cudurka Graves, daawaynta ugu badan waa daawooyinka antithyroid iyo iodine-ka shucaaca leh. Daawooyinka antithyroid-ka sida methimazole (Tapazole) iyo propylthiouracil (PTU) waxay ka shaqeeyaan inay xannibaan awoodda qanjirka thyroid-ka uu u leeyahay inuu sameeyo hoormoonada.

Ma laga hortagi karaa inay taasi dhacdo?

Inta badan, ma jirto wax aan sameyn karno si aan uga hortagno horumarka 'Subclinical Hyperthyroidism' ama 'Hyperthyroidism' oo muuqda.

Si kastaba ha ahaatee, haddii aadan helin iodine ku filan cuntadaada (ama aad u badan) , waxaad yeelan kartaa "Subclinical" ama "Outt Hyperthyroidism" sababtoo ah "goiter sun ah". Inkastoo tani aysan caadi ahayn wadamada sida Sri Lanka sababtoo ah waxaan isticmaalnaa milix iodine ah, waxaa laga arki karaa wadamada ay ku badan tahay yaraanta iodine.

Maxaan ka filan karnaa xaaladdan? Ma jiraan wax khatar ah?

Hyperthyroidism-ka aan kiliinikada ahayn si dhif ah ayuu u gudbaa hyperthyroidism-ka. Si kastaba ha ahaatee, khatartani waxay xoogaa ka sarreysaa dadka leh heerarka TSH ee aadka u hooseeya (ka yar 0.1 mIU/L).

Maadaama ay jiraan sababo badan, "Hyperthyroidism-ka Subclinical" ee qof walba wuu ka duwan yahay.

Xitaa haddii aysan u gudbin 'Hypert Hyperthyroidism', 'Subclinical Hyperthyroidism' waxay sababi kartaa dhibaatooyin. Qaar ka mid ah waa:

• Garaaca wadnaha oo aan caadi ahayn (atrial fibrillation ).
• Wadne istaag (khatarta ah inuu wadne istaago ).
• Cudurka wadnaha ee halbowlaha wadnaha (cudurka halbowlaha wadnaha ).
• Lumis iyo jab.
• Waallida ( xaalad xasuus la'aan ah oo dhici karta marka da'da la gaaro).

Khatarahani waxay si gaar ah ugu badan yihiin dadka da'doodu ka weyn tahay 65 sano iyo kuwa qaba hyperthyroidism daran oo daran.

Haddii aad ka walaacsan tahay khatarahaas, waxaa ugu wanaagsan inaad dhakhtarkaaga kala hadasho arrintan.

Goorma ayaan dhakhtar u tagaa?

Inta badan, haddii baaritaannadaadu muujiyaan inaad qabto "Hyperthyroidism-ka hooseeya," dhakhaatiirtu waxay qaadan doonaan habka "sug oo arag".

Si kastaba ha ahaatee, haddii aad bilowdo inaad la kulanto calaamadaha hyperthyroidism (walwal, nasasho la'aan, wadno garaac), hubi inaad la kulanto dhakhtarkaaga. Isaga ama iyadu waxay samayn doonaan baaritaan kale oo dhiigga qanjirka thyroid si ay u ogaadaan haddii aad qabto 'Hyperthyroidism oo aad u daran'.

Xusuusnow, weli waxaa jira fikrado badan oo kala duwan oo ku saabsan in la daaweeyo 'Subclinical Hyperthyroidism' iyo in kale. Qof walba, xaalad kasta way ka duwan tahay. Sidaa darteed, waxa ugu fiican ee la sameeyo waa inaad kala hadasho dhammaan su'aalahaaga iyo cabsidaada dhakhtarkaaga. Isaga ama iyadu waa diyaar oo diyaar u ah inay ku caawiyaan.

Fariinta Guriga La Qaadanayo

Hagaag, markaa waa kuwan waxyaabo aad u baahan tahay inaad xasuusato wixii aan ka hadalnay:

• "Hyperthyroidism-ka hooseeya" waa xaalad qanjirka thyroid-ka uu si xad dhaaf ah u firfircoon yahay, laakiin uusan lahayn astaamo waaweyn.
• Tan waxaa lagu ogaadaa baaritaan dhiig oo muujinaya heer TSH oo hooseeya (laakiin caadi ah T3 iyo T4).
• Maadaama aysan badanaa lahayn astaamo, daaweyntu lagama maarmaan ma noqon karto. Dhakhtarkaagu wuxuu qaadan karaa hab "sug oo arag".
• Dadka qaar, gaar ahaan dadka waayeelka ah ama kuwa qaba dhibaatooyin caafimaad oo kale, waxay u baahan karaan daaweyn.
• Haddii aad la kulanto astaamaha hyperthyroidism (sida garaaca wadnaha oo kordha, gariir, miisaan lumis), isla markiiba la tasho dhakhtar.
• Waxa ugu muhiimsan waa inaadan argagaxin, si furan ula hadal dhakhtarkaaga, oo raac taladiisa.

Waxaan rajeynayaa inaad macluumaadkan u aragto mid waxtar leh. Caafimaad qab!

' Hyperthyroidism-ka hoose ee kiliinikada, qanjirka thyroid, TSH, T3, T4, hoormoonada, cudurka Graves', goiter