Cov thyroid caj pas (TG) muaj 2 lobes thiab nqaim isthmus txuas rau lawv. Nws zoo li tus npauj npaim, nyob rau ntawm lub ntsej muag ntawm lub caj dab hauv qab lub larynx, npog nrog pob txha mos. Qhov loj ntawm lub qog yog 3-4 cm, thiab nws hnyav li ntawm 20 g.
Ib me ntsis ntawm lub cev
TG txiav txim siab ua haujlwm ntawm tag nrho cov kab mob endocrine. Tab sis nws tsis yog tias nws yog qhov tshwj xeeb. Cov thyroid caj pas yog tib lub cev uas tsim cov tshuaj hormones thiab khaws cia cia ua ntej lawv nkag mus rau hauv cov hlab ntsha. Cov kua qaub uas tsim tawm yog tso rau hauv cov hlab ntsha tsuas yog thaum tsim nyog.
Parenchyma muaj vesicles-follicles, uas tsuas muaj 1 txheej ntawm epithelium (thyrocytes). Qhov txawv txav yog tias thaum so lub epithelium yog tiaj tus thiab tsis tsim ib qho zais cia. Thaum cov reserves yog depleted, txheej yuav siv sij hawm ib tug cubic duab thiab synthesizes tus nqi ntawm cov tshuaj hormones. Lawv khaws cia rau hauv cov follicles hauv daim ntawv ntawm thyroglobulin kom txog thaum lawv tawm ntawm lub caj pas pituitary raws li kev ua ntawm TSH.xaiv.
Hauv cov hauv paus hniav muaj cov colloid. Nws yog cov kua nplaum uas thyroglobulin protein khaws cia. Cov thyroid hormones hu ua thyroxin, thiab thyroglobulin yog nws cov precursor.
Tus nqi ua haujlwm
Muab lub cev nrog lub zog, cov thyroid caj pas nws tus kheej yog tswj los ntawm lwm cov qog endocrine - lub qog pituitary. Nws tus kheej nyob ntawm lub hypothalamus. Cov tshuaj pituitary uas tswj cov haujlwm ntawm cov thyroid caj pas hu ua thyrotropin lossis TSH. Nws muaj nuj nqi yog txhawb nqa triiodothyronine (T3) thiab thyroxine (T4).
Cov thyroid hormones muaj iodine atoms, uas yog, lawv yog iodized. Kev tsis txaus ntawm cov tshuaj no ib txwm ua rau muaj kev cuam tshuam hauv kev ua haujlwm ntawm lub caj pas. Yog li, iodinated hormones hu ua iodothyronines lossis thyroids. Cov thyroid caj pas tsim ntau yam ntawm lawv, txhua tus muaj nws tus kheej lub luag haujlwm: T4, T3, thyroglobulin, calcitonin. Cov lej qhia tus lej ntawm iodine atoms.
T4 - thyroxine - lom tsis muaj zog, ua rau ntau tshaj - 92%. Cov tshuaj hormones nquag thiab tseem ceeb yog T3, uas yog tsim los ntawm T4 los ntawm kev faib tawm 1 atom ntawm iodine los ntawm nws. Cov tshuaj tiv thaiv tshwm sim thaum lub enzyme TPO - thyroperoxidase cuam tshuam. T3 yog 10 npaug ntau dua li cov tshuaj hormone T4.
YKev ua haujlwm ntawm cov thyroid hormones
Cov thyroid hormones muaj cov haujlwm hauv qab no:
- YThyroid boosts metabolism;
- tswj kev loj hlob thiab kev loj hlob ntawm fetus;
- poj niam cuam tshuam kev ua haujlwm ntawm kev ua me nyuam;
- nrog nws qhov tsis txaus, kev xeeb tub tuaj yeem txhim kho;
- koom nrog kev sib sauvitamin A;
- tswj kev ua haujlwm ntawm enzymes;
- lav rau ntawm daim tawv nqaij thiab plaub hau, lub cev pob txha thiab kev loj hlob ntawm lub cev;
- qhib lub hlwb thiab vascular system.
Lwm cov thyroid hormone hu ua calcitonin yuav piav qhia hauv qab no.
Ua haujlwm thiab tsim cov tshuaj hormone
Cov tshuaj hormones pub dawb tsuas yog 1%, tab sis lawv txiav txim siab tag nrho cov haujlwm ntawm cov thyroid caj pas, cov tshuaj hormones cuam tshuam tsis ua haujlwm.
Qee cov thyroid hormones hu ua thyroid hormones. Cov no yog derivatives ntawm alpha-amino acids (tyrosine). Lub luag haujlwm tseem ceeb ntawm cov tshuaj hormones yog raws li hauv qab no:
- nws koom nrog kev loj hlob ntawm cov ntaub so ntswg;
- nce cov nqaij mos oxygen uptake;
- txhawb kev sib txuas ntawm cov qe ntshav liab los ntawm kev cuam tshuam cov pob txha;
- koom nrog kev sib pauv dej;
- cuam tshuam rau cov ntshav siab, ua kom ruaj khov, yog tias tsim nyog, ua kom lub zog ntawm lub plawv contractions (nrog rau ntau tshaj T3, lub plawv dhia tam sim ntawd nce 20%);
- nrawm cov txheej txheem kev xav thiab kev ua haujlwm ntawm lub hlwb;
- lav rau cov txheej txheem metabolic;
- koom nrog hauv thermoregulation;
- nce kev tiv thaiv thiab tshem tawm cov roj (cholesterol) phem;
- nce qabzib ntau ntxiv thiab cuam tshuam rau gluconeogenesis hauv daim siab thiab yog li inhibits glycogen synthesis.
Kev koom tes hauv cov metabolism yog qhia hauv kev nrawm ntawm lipolysis, tswj kev sib haum xeeb thiab qhov hnyav li qub. Cov tshuaj hormones ua raws li anabolic ntawm protein synthesis thiab ua kom nitrogen metabolism zoo (ib txwm). Thaum overabundant, lawv zoo li catabolics hauv lawv qhov kev ua, thiab qhov sib npaug nitrogen cuam tshuam.
T3 functions
Triiodothyronine dawb lossis dawb T3 yog lub npe ntawm cov thyroid hormone. Nws yog tus nquag tshaj plaws ntawm txhua tus. Ob lub ntsiab thyroid hormones (T3 thiab T4) yog inextricably txuas, vim ib tug yog tsim los ntawm lwm yam. Triiodothyronine tseem yog ib qho tseem ceeb, txawm hais tias nws yog tsim los ntawm me me. Raws li tau hais ua ntej, cov tshuaj hormones tseem ceeb tsim los ntawm cov thyroid caj pas hu ua thyroxine. Nws yog tus thawj ntawm T3 thiab dhau los ua "lub cav" rau kev ua haujlwm ntawm tag nrho cov kabmob:
- txhim kho kev thauj cov amino acids;
- tso cai rau koj zom cov vitamins, proteins, carbohydrates;
- pab hauv kev sib txuas ntawm vitamin A.
Lub npe ntawm cov thyroid hormone hauv gynecology yog dab tsi? Feem ntau, pub dawb FT3 thiab FT4 yog hu ua "poj niam", vim tias kev ua me nyuam hauv txhua qhov nws tshwm sim nyob ntawm lawv. Thaum tso tawm mus rau hauv cov hlab ntsha, T3 khi rau thauj cov proteins uas xa mus rau qhov chaw uas yuav tsum tau muaj.
T3 norm
Txhua cov tshuaj hormones nyob ntawm lub sijhawm xyoo, hnub, hnub nyoog thiab poj niam txiv neej. Qhov siab tshaj T3 tau sau tseg rau lub caij nplooj zeeg-caij ntuj no, thiab qhov qis tshaj plaws nyob rau lub caij ntuj sov. Nws qib nyob ntawm hnub nyoog:
- ntawm 1 txog 19 xyoo - mus txog 3.23 nmol / l;
- ntawm 20 xyoo - mus txog 3, 14 nmol / l;
- ntawm hnub nyoog 50 - mus txog 2.79 nmol / l.
YThyroxine
Hauv kev nkag siab lom neeg, nws tsis ua haujlwm, tab sis qhov tseem ceeb rau tib neeg. T4 yog tsim nyob rau hauv follicles. Nws yog noteworthy tiasthyroxine (lub npe hu ua lub ntsiab thyroid hormone) tsuas yog tsim nrog kev koom tes ntawm thyrotropin.
FT4 thiab T4 yog tib yam tshuaj hormones uas ncig hauv cov ntshav sib txawv. Nws yuav tsum raug sau tseg tias tus nqi ntawm T3 ib txwm nyob ntawm T4.
T4 norm
Norm T4 St. (dawb) hauv cov poj niam nyob ntawm 71.23 txog 142.25 nmol / l; Hauv cov txiv neej - los ntawm 60.77 mus rau 136.89 nmol / l. Tej ntu loj no nyob ntawm lub hnub nyoog. Qhov siab tshaj plaws ntawm T4 tau sau tseg txij li 8 teev sawv ntxov txog 12 teev tsaus ntuj - lub sijhawm no nws yog qhov zoo tshaj rau kev xeem. Los ntawm 11 teev tsaus ntuj, nws cov ntsiab lus poob, thiab qib qis tshaj yog pom thaum 3 teev sawv ntxov. Kev hloov pauv kuj tuaj yeem tshwm sim los ntawm ntau yam kab mob. Yuav ua li cas yog T4 St. thiab T3 tuaj yeem nce ntxiv? Qhov no tshwm sim thaum:
- ntau tus mob myeloma;
- obese;
- kab mob raum;
- mob qog nqaij hlav tom qab yug menyuam;
- thyroiditis;
- HIV;
- diffuse goiter;
- porphyria;
- daim siab pathology;
- tom qab hemodialysis.
Qhov no kuj ua tau thaum noj cov tshuaj analogues ntawm thyroxine, methadone, prostaglandins, "Cordarone", "Tamoxifen", radiopaque iodine-muaj tshuaj, "Insulin" thiab "Levodopa".
Txo qis hauv cov tshuaj hormones sau tseg ntawm:
- noj zaub mov tsis muaj protein;
- hypothyroidism;
- Sheehan syndrome;
- kev mob;
- kab mob goiter;
- mob khaub thuas nyob rau theem siab ntawm endocrine system - pituitary thiab hypothalamus;
- tom qab mob;
- adrenal ntshawv siab.
Kev noj qee yam tshuaj kuj ua rau txo qis hauv cov thyroid hormones. Ntawm lawv nws tsim nyog sau cia:
- "Tamoxifen";
- "Mercazolil";
- beta blockers;
- statins;
- steroids;
- anabolics;
- diuretics;
- "Propylthiouracil";
- muscle relaxants;
- X-ray contrast agents.
Yuav ua li cas thaum T3 nce?
Ua ntej, peb yuav tsum tsis txhob hnov qab txog qhov ua tau yuam kev hauv kev tshawb fawb. Qhov no tuaj yeem ua tau yog tias tsis ua raws li cov cai ntawm kev xeem dhau. Qhov thib ob, koj yuav tsum sab laj nrog kws kho mob endocrinologist tam sim.
Thyrotropic Hormone (TSH, TSH)
Thyrotropin yog ib yam tshuaj ntawm adenohypophysis. Nws plays lub luag haujlwm tseem ceeb hauv kev ua haujlwm ntawm cov thyroid caj pas. Kev sib raug zoo ntawm cov thyroid thiab TSH yog inverse. Cov qauv thoob ntiaj teb rau TSH yog thaj tsam ntawm 0.4 txog 4.0 µIU/ml.
YThyrocalcitonin hormone
Lwm yam tshuaj uas tsim los ntawm cov thyroid caj pas hu ua calcitonin lossis thyrocalcitonin. Nws yog tsim los ntawm parafollicular hlwb ntawm lub caj pas. Nws yog ib qho tseem ceeb rau calcium-phosphorus metabolism thiab yog parathyroid hormone antagonist.
Calcitonin txo qis qib P thiab Ca hauv cov ntshav, thiab tseem txhawb kev txhim kho thiab ua haujlwm ntawm osteoblasts (cov pob txha pob txha). Qhov no yog cov cim qog uas kuaj xyuas seb puas muaj cov thyroid cancer. Yog tias nws cov nyiaj ntau tshaj 100 pg / ml, ces qhov tshwm sim ntawm tus kab mob oncological yog siab.
Tsis tas li, calcitonin yog qhov qhia txog kev ua haujlwm ntawm kev kho mob qog noj ntshav. Kev tshuaj xyuas rau cov tshuaj hormone no tas li coj los ntawm cov neeg uasCov thyroid caj pas raug tshem tawm txhawm rau txhawm rau kuaj mob qog noj ntshav hauv lub sijhawm.
Kab mob uas nce qib calcitonin:
- pancreatitis;
- mob qog noj ntshav;
- plab;
- siab tsis ua hauj lwm;
- thyroiditis;
- pernicious anemia.
Calcitonin norm
Nws tus nqi yog nyob ntawm poj niam txiv neej. Nrog rau txoj kev ELISA, calcitonin hauv cov txiv neej yuav tsum yog 0.68-32.26 mg / ml. Rau cov poj niam, tus qauv yog: 0.07-12.97 pg/ml.
Qhia rau kev kuaj cov thyroid hormone
Kev sim yuav xav tau hauv cov xwm txheej hauv qab no:
- kuaj pom cov tsos mob ntawm thyrotoxicosis (tachycardia, poob phaus, tshee ntawm lub cev thiab tes, kua muag, ntshai, nce qab los noj mov, qhov muag bulging, extrasystole, thiab lwm yam);
- cim qhia ntawm hypothyroidism (bradycardia, qhov hnyav nce, xav qeeb thiab hais lus, tawv nqaij qhuav, txo libido);
- pom thiab ultrasound o ntawm caj pas;
- muaj cov nodes hauv nws;
- kev muaj menyuam;
- mob khaub thuas (menstrual disorders (amenorrhea);
- fetal nchuav menyuam;
- lub plawv dhia tsis zoo;
- lipid metabolism cuam tshuam nrog nce cov roj cholesterol;
- ntshav qab zib;
- txo qis kev sib deev;
- galactorrhea;
- me nyuam loj hlob qeeb;
- tswj kev kho mob qog noj ntshav;
- control tom qab phais thyroid;
- TSH tsom xam suav nrog hauv kev tshuaj ntsuam xyuas menyuam yaus, uas yog, nws yog qhov yuav tsum tau ua rau txhua tus menyuam yug tshiab hauv tebchaws Russia;
- baldness (alopecia);
- obesity.
Yuav ua li cas cov thyroid hormones kuv yuav tsum noj
Kev kuaj thyroid hormone hu ua dab tsi? Txhua yam yog yooj yim heev: cov no yog cov kev tshawb fawb hormonal. Kev tsom xam yog ib txwm ua nyob rau hauv ib tug complex yam. Qhov ntawd yog, T3, T4 thiab TSH yuav tsum txiav txim siab.
TSH yog qhov qhia txog kev ua haujlwm ntawm cov thyroid. Nws yog "tus neeg tseem ceeb hauv tsev neeg", thiab nws qib hauv cov ntshav yog txiav txim siab rau txhua yam pathology ntawm lub caj pas. Lub ntsiab lus ntawm TSH yog hu ua kev tshawb fawb ntawm hormonal status.
T3 St. - lub luag haujlwm rau oxygen metabolism ntawm cov hlwb thiab cov ntaub so ntswg. Kev txiav txim siab ntawm kev xav yog kev kawm nyuaj, yog li ua yuam kev feem ntau ua ntawm no.
T4 St. - lub luag hauj lwm rau protein synthesis thiab nws stimulation. Hauv kev kuaj ntshav, tus kws kho mob kuj tuaj yeem sau ntawv txiav txim siab ntawm AT-TG - tshuaj tiv thaiv rau thyroglobulin thiab AT-IPO - tshuaj tiv thaiv rau tipreoid peroxidase. Cov kev ntsuam xyuas no tso cai rau kev tshawb pom cov kab mob autoimmune thiab tseem ceeb hauv kev kuaj mob sib txawv. Norm AT-TG ntawm 0 txog 4, 11 IU/l.
AT-TPO yog qhov kev sim siab tshaj plaws rau kev kuaj xyuas cov txheej txheem autoimmune hauv caj pas. Sawv cev lub ntsiab txhais ntawm cov tshuaj tiv thaiv rau ib tug cellular enzyme. Cov qauv ntawm AT-TPO yog los ntawm 0 txog 20 IU / l. Qee lub chaw soj nstuam xav txog 120 IU / L los ua tus qauv, yog li cov txiaj ntsig ntawm cov qauv yuav tsum nyob hauv cov ntaub ntawv.
Transcript of analyses
Kev txiav txim siab yuav tsum tau ua los ntawm tus kws kho mob endocrinologist nkaus xwb, tsis yog tus kws kuaj mob.
- Nrog nce TSH, ib tus tuaj yeem xav txog hypothyroidism hauv tus neeg mob, tab sis T4 thiab T3 yog qhov tseem ceeb.
- Nrog TSH nce thiabtxo T4 - pom tseeb overt hypothyroidism. Yog tias T4 yog ib txwm tiv thaiv keeb kwm yav dhau los ntawm TSH siab, qhov no yog subclinical hypothyroidism.
- Nrog TSH ib txwm tab sis qis T4, 99% ntawm lub sijhawm qhov tshwm sim yog qhov yuam kev hauv lab. Yuav tsum tau rov ua dua tshiab ntawm biomaterial rau kev tshuaj xyuas. Tsis tas li qhov yuam kev yuav yog tus qauv ntawm TSH thiab txo T3.
- Kev txo qis hauv TSH qhia txog kev ua haujlwm ntau dhau ntawm lub cev - hyperthyroidism. Tib lub sijhawm, T3 thiab T4 (thyroid hormones) tau nce. Yog tias lawv nyob hauv qhov ib txwm muaj rau qhov keeb kwm ntawm kev txo qis hauv TSH, qhov no yog subclinical hyperthyroidism.
YHormonal norm
Vim li cas qhov kev ua tau zoo ntawm cov chaw kuaj mob sib txawv? Vim tias txhua qhov chaw muaj qhov tshwj xeeb ntawm cov cuab yeej siv, cov qauv sib txawv ntawm cov khoom siv rau kev tshawb fawb, qhov sib txawv ntawm lawv qhov chaw, cov tshuaj reagents siv.
Tau kawg, cov qauv thoob ntiaj teb raug coj los ua lub hauv paus rau qhov muaj nuj nqis, tab sis txhua qhov chaw kuaj xyuas nws tus kheej hloov kho. Qhov sib txawv me me, tab sis nws tuaj yeem ua rau kev kuaj mob cuav. Yog li ntawd, cov nqi siv yuav tsum tau qhia rau hauv cov ntawv kuaj.
ntshav rau cov thyroid hormones: nws hu ua dab tsi
Cov thyroid hormones hu ua dab tsi, thiab lawv ua haujlwm li cas, peb pom nws. Tam sim no nws tseem ceeb heev uas yuav tsum tau nyob ntawm cov cai rau kev xeem. Lawv tsis nyuaj, tab sis lawv qhov kev paub thiab kev siv yuav pab kom tau txais txiaj ntsig tiag. Qee qhov ua rau tag nrho cov kev txwv tsis pub, uas, raws li kev soj ntsuam ze, yog me ntsis exaggerated. Tsis tas yuav txwv koj tus kheej hauv kev noj haus. Qhov tseeb yog tias cov zaub mov noj tsis cuam tshuam rau cov thyroid hormones - lawv ruaj khov heev uas qhov kev soj ntsuam tuaj yeem coj mus rautxhua lub sijhawm ntawm hnub thiab txawm tias tom qab noj mov. Tab sis qhov no tsuas yog tias tsis tas yuav pub ntshav rau lwm yam kev kawm.
Txog ib hnub, theem ntawm TSH hloov me ntsis. Feem ntau muaj cov lus pom zoo tias hauv kev kho cov tshuaj hormonal, lawv qhov kev noj yuav tsum tau nres ib hlis ua ntej txoj kev tshawb fawb. Qhov no yog ib qho kev lees paub tsis tseeb. Qhov kev ntsuas no tsuas yog ua rau raug mob xwb.
Koj tuaj yeem pom cov lus pom zoo txog kev txwv tsis pub noj cov tshuaj uas muaj iodine hauv ib lub lis piam ua ntej hnub yug. Txawm li cas los xij, lawv kuj tsis cuam tshuam kev ua haujlwm.
Cov poj niam yuav tsum nco ntsoov: qib ntawm cov thyroid hormones tsis nyob ntawm lub voj voog, yog li koj tuaj yeem pub ntshav rau txhua hnub yooj yim. Kev coj khaub ncaws tsuas yog cuam tshuam rau poj niam txiv neej cov tshuaj hormones.
Tab sis ntawm no yog qhov tseem ceeb! Ua ntej noj ntshav rau kev tsom xam, koj tsis tuaj yeem kuaj X-ray, ECG, ultrasound lossis physiotherapy. Tag nrho cov kev xeem no yuav tsum tau ua 2-4 hnub ua ntej txheej txheem.
