Cov thyroid caj pas yog ib qho khoom nruab nrog ntawm cov kab mob endocrine lub luag haujlwm rau kev tsim cov tshuaj hormones uas muaj iodine. Nws zoo li tus npauj npaim thiab pom nyob rau pem hauv ntej ntawm lub caj dab. Cov thyroid hormones muaj ntau yam cuam tshuam rau tib neeg lub cev. Cov no suav nrog:
- Ymetabolism,
- kev loj hlob ntawm lub cev thiab kev xav-kev xav,
- ua haujlwm ntawm cov hlab plawv,
- tuav lub cev qhov kub thiab txias.
Congenital hypothyroidism yog ib yam kab mob uas tus menyuam yug los nrog qhov tsis txaus ntawm cov tshuaj hormone thyroxine (T4), uas tsim los ntawm cov thyroid caj pas. Cov tshuaj hormone no ua lub luag haujlwm tseem ceeb hauv kev tswj hwm kev loj hlob, kev loj hlob ntawm lub hlwb, thiab cov metabolism hauv (tus nqi ntawm cov tshuaj tiv thaiv hauv lub cev). Congenital hypothyroidism nyob rau hauv cov me nyuam yog ib qho ntawm feem ntau cov kab mob endocrine. Thoob plaws ntiaj teb, kwv yees li ib ntawm ob zaug hauv ib xyoosNtau txhiab tus menyuam yug tshiab tau kuaj pom tus kab mob no.
Feem ntau cov me nyuam yug los nrog hypothyroidism tshwm sim thaum yug los, feem ntau yog vim leej niam cov thyroid hormones tau txais hauv plab. Yog tias tus kab mob no tau kuaj pom thaum ntxov, nws yooj yim kho nrog tshuaj noj txhua hnub. Kev kho mob tso cai rau tus menyuam uas muaj cov thyroid caj pas los ua lub neej noj qab haus huv, muaj kev loj hlob zoo thiab loj hlob zoo li txhua tus menyuam yaus.
Ntau yam
Qee yam ntawm congenital hypothyroidism hauv cov menyuam yaus yog ib ntus. Tus me nyuam tus mob yuav zoo dua li ob peb hnub tom qab yug me nyuam. Lwm hom kab mob no nyob mus li. Lawv tuaj yeem tswj tau zoo los ntawm kev kho tshuaj hormone hloov pauv tas li. Kev puas tsuaj los ntawm kev tsis kho hypothyroidism yog irreversible, txawm tias kev kho yog pib me ntsis tom qab.
Yog vim li cas
Nyob rau hauv 75 feem pua ntawm cov neeg mob, qhov ua rau ntawm congenital hypothyroidism yog qhov tsis xws luag hauv kev loj hlob ntawm cov thyroid caj pas ntawm tus menyuam mos. Nov yog qee qhov ua tau:
- tsis muaj lub cev,
- wrong position,
- me me lossis tsis muaj kev tsim kho.
Qee zaum, cov thyroid caj pas ib txwm tsim tab sis tsis tuaj yeem tsim cov thyroxine txaus vim tsis muaj qee yam enzymes.
Lub ntsiab lus ntawm congenital hypothyroidism thiab caj ces muaj feem cuam tshuam. Yog tias cov niam txiv lossis cov txheeb ze muaj keeb kwm muaj teeb meem nrog cov thyroid caj pas, ces muaj kev pheej hmoo ntawm lawv qhov tshwm sim ntawm tus menyuam mos. Kwv yees li 20 feem pua ntawm cov neeg mobQhov tshwm sim ntawm congenital hypothyroidism yog vim cov caj ces.
Ib qho tseem ceeb yog qhov tsis muaj iodine hauv leej niam cov zaub mov thaum cev xeeb tub. Ntau yam tshuaj uas siv thaum cev xeeb tub kuj tuaj yeem cuam tshuam rau kev loj hlob ntawm tus menyuam cov thyroid caj pas.
Hypothyroidism kuj tuaj yeem tshwm sim los ntawm kev puas tsuaj rau lub caj pas pituitary. Nws yog lub luag haujlwm rau kev tsim cov thyroid-stimulating hormone, uas tswj kev ua haujlwm ntawm cov thyroid caj pas.
Cov tsos mob thiab cov tsos mob
Feem ntau, cov menyuam yaus uas muaj lub cev xeeb tub yog yug los ntawm lub sijhawm lossis tom qab me ntsis thiab zoo li qub. Feem coob ntawm lawv tsis muaj qhov tshwm sim ntawm thyroxin deficiency. Qhov no yog ib feem yog vim leej niam muab cov thyroid hormones los ntawm cov placenta. Tsis pub dhau ob peb lub lis piam tom qab yug me nyuam, cov tsos mob thiab cov tsos mob ntawm hypothyroidism tshwm sim ntau dua. Lub paj hlwb ntawm cov menyuam yug tshiab muaj kev pheej hmoo ntawm irreversible puas. Vim tias qhov txaus ntshai no, nws tseem ceeb heev kom pib kho sai li sai tau.
Rau qhov laj thawj saum toj no, txhua tus menyuam yug los raug kuaj ntau yam. Ib qho ntawm lawv yog kev tshuaj ntsuam xyuas menyuam yaus. Nws tuaj yeem siv los kuaj xyuas hypothyroidism hauv ntau tus menyuam yug tshiab ua ntej cov tsos mob tshwm sim. Kev tshuaj xyuas yog ua tiav 4-5 hnub tom qab yug me nyuam. Yav dhau los, qhov kev tshawb fawb no tsis tau ua tiav vim muaj kev pheej hmoo kom tau txais qhov txiaj ntsig tsis raug.
Hauv lwm qhov xwm txheej, thaum muaj iodine tsis txaus rau lub cev ntawm tus poj niam thaum cev xeeb tub,tus me nyuam yuav muaj cov tsos mob ntxov ntawm hypothyroidism tom qab yug me nyuam, xws li:
- puffy face;
- swelling ncig ob lub qhov muag;
- ntau tus nplaig o;
- plab plab;
- cem quav;
- jaundice (daj ntawm daim tawv nqaij, ob lub qhov muag thiab mucous daim nyias nyias) thiab siab bilirubin;
- hoarse quaj;
- kev tshaib plab;
- txo qhov nqus reflex;
- umbilical hernia (protrusion ntawm txoj hlab ntaws sab nraud);
- pob txha loj hlob qeeb;
- caij nplooj ntoos hlav loj;
- tawv nqaij qhuav;
- kev ua haujlwm qis;
- nce pw tsaug zog.
Diagnosis
Txhua tus menyuam yug tshiab tau kuaj xyuas menyuam mos thawj ob peb hnub. Kev ntsuam xyuas yog ua los ntawm kev noj ob peb tee ntshav ntawm tus menyuam pob taws. Ib qho kev ntsuam xyuas yog los xyuas qhov ua haujlwm ntawm cov thyroid caj pas. Qhov taw qhia tseem ceeb rau kev kuaj mob ntawm congenital hypothyroidism yog qib qis ntawm thyroxine thiab nce qib ntawm cov thyroid-stimulating hormone (TSH) hauv cov ntshav ntshav ntawm tus menyuam mos. TSH yog tsim nyob rau hauv lub caj pas pituitary thiab yog lub ntsiab stimulant ntawm cov tshuaj hormones nyob rau hauv cov thyroid caj pas.
Kev kuaj mob thiab kev kho mob yuav tsum tsis txhob ua raws li cov txiaj ntsig ntawm kev tshuaj ntsuam xyuas menyuam yaus xwb. Txhua tus menyuam mos uas muaj cov thyroid pathology yuav tsum tau kuaj ntshav ntxiv. Qhov kev tshuaj ntsuam no yog coj ncaj qha los ntawm cov hlab ntsha. Sai li qhov kev kuaj mob tau lees paub, kev kho mob nrog tshuaj hormonal yog pib tam sim.
Tau ntxivKev kuaj mob ntawm congenital hypothyroidism tuaj yeem ua tau los ntawm ultrasound thiab scintigraphy (radionuclide scanning) ntawm cov thyroid caj pas. Cov txheej txheem no tso cai rau koj los ntsuas qhov loj me, qhov chaw ntawm lub cev, nrog rau kev txheeb xyuas cov qauv kev hloov pauv.
txoj kev kho
Kev kho mob tseem ceeb rau kev mob plab hauv plab yog los hloov cov thyroid hormone uas ploj lawm nrog tshuaj. Cov koob tshuaj thyroxine raug kho raws li tus menyuam loj hlob thiab raws li cov txiaj ntsig ntawm kev kuaj ntshav.
Cov lus pom zoo rau kev kho mob rau lub cev xeeb tub yog tias kev kho mob yuav tsum tau pib sai li sai tau thiab txuas ntxiv mus rau lub neej. Kev pib lig ntawm kev kho mob tuaj yeem ua rau muaj kev puas siab puas ntsws. Qhov no yog vim kev puas tsuaj rau lub hlwb thiab lub paj hlwb.
Qee yam ntawm kev kho mob
Kev hloov kho yog ua tiav nrog cov tshuaj hu ua "Levothyroxine" ("L-thyroxine"). Nws yog ib hom hluavtaws ntawm cov tshuaj hormone thyroxine. Txawm li cas los xij, nws cov qauv tshuaj yog zoo ib yam li cov thyroid caj pas.
Muaj qee yam ntawm kev kho mob ntawm congenital hypothyroidism:
- tshuaj hloov tshuaj hormones yuav tsum tau muab txhua hnub rau tus menyuam.
- Cov tshuaj yog crushed thiab yaj nyob rau hauv ib tug me me npaum li cas ntawm mis nyuj, mis nyuj los yog lwm yam kua.
- Cov menyuam yaus uas muaj cov thyroid caj pas yuav tsum tau sau npe nrog tus kws kho mob endocrinologist thiab kws kho mob hlwb. Thiab tseem raug kuaj xyuas raws sij hawm los saib xyuas thiab kho kho.
koob tshuaj thiab zaus ntawm cov tshuajyuav tsum tsuas yog txiav txim los ntawm tus kws kho mob. Yog tias siv tsis raug, cov kev mob tshwm sim tuaj yeem tshwm sim. Nrog rau qhov ntau dhau ntawm cov tshuaj hormones, tus menyuam yuav muaj cov tsos mob hauv qab no:
- kev nyuaj siab,
- kua quav,
- poob qab los,
- poob phaus,
- kev loj hlob sai,
- nrawm nrawm,
- ntuav,
- insomnia.
Yog tias qhov koob tshuaj "Levothyroxine" tsis txaus, cov tsos mob hauv qab no tshwm sim:
- drowsiness,
- qaug zog,
- cem quav,
- puffiness,
- nce nrawm nrawm,
- kev loj hlob qeeb.
Cov qauv kua mis thiab cov tshuaj muaj hlau tuaj yeem txo qhov concentration ntawm cov tshuaj hormones hauv cov ntshav. Hauv cov xwm txheej no, tus kws kho mob tshwj xeeb yuav tsum kho qhov koob tshuaj.
Txhais tau
Yog tias kev kho mob pib hauv thawj ob lub lis piam tom qab tus menyuam yug los, muaj teeb meem kev noj qab haus huv hnyav tuaj yeem tiv thaiv xws li:
- ncua kev loj hlob tseem ceeb,
- kev puas hlwb,
- kev loj hlob tsis zoo,
- hnov tsis hnov.
Kev kho mob qeeb lossis tsis muaj qhov ntawd, sai lossis tom qab ua rau cov tsos mob hauv qab no:
- ntxhib, o ntawm lub ntsej muag;
- teeb meem ua pa;
- suab husky;
- ncua sijhawm psychomotor thiab kev loj hlob ntawm lub cev;
- txo qab los noj mov;
- pua hnyav thiab qhov siab nce;
- goiter (nrog rau cov thyroid caj pas);
- ntshav qab zib;
- slow heart rate;
- sib sau ua kua hauv qab ntawm daim tawv nqaij;
- hnov tsis hnov;
- flatulence thiab cem quav;
- lig kaw ntawm fontanelles.
Cov menyuam yaus uas tsis tau kho yuav ua rau lub hlwb tsis zoo, muaj qhov siab thiab qhov hnyav tsis sib xws, hypertonicity thiab tsis khov kho. Feem ntau muaj lus qeeb.
Kev sib tw
Cov menyuam yaus uas muaj lub cev xeeb tub hypothyroidism muaj kev pheej hmoo siab ntawm qhov tsis xws luag. Feem ntau cov kab mob plawv, pulmonary stenosis, atrial lossis ventricular septal defects.
tswj hwm Hormone
Ib feem tseem ceeb ntawm kev kho mob yog saib xyuas cov thyroid hormones hauv cov ntshav. Tus kws kho mob uas tuaj koom yuav tsum saib xyuas cov ntsuas no kom paub meej tias kev hloov kho raws sijhawm ntawm cov tshuaj noj. Kev kuaj ntshav feem ntau yog ua txhua txhua peb lub hlis mus txog rau hnub nyoog ib xyoos, thiab tom qab ntawd txhua ob mus rau plaub lub hlis mus txog rau thaum muaj hnub nyoog peb xyoos. Tom qab hnub nyoog peb xyoos, kev kuaj sim tau ua txhua txhua rau lub hlis mus rau ib xyoos kom txog thaum tus menyuam loj hlob tiav.
Tsis tas li ntawd, thaum mus ntsib kws kho mob tas li, kev soj ntsuam ntawm tus menyuam lub cev ntsuas, kev loj hlob ntawm kev xav thiab kev noj qab haus huv yuav raug ua.
Risk group
Ib tug me nyuam muaj kev pheej hmoo rau congenital hypothyroidism yog tias lawv muaj ib yam ntawm cov hauv qab no:
- Chromosomal abnormalities xws li Down syndrome,Williams lossis Turner syndrome.
- Cov kab mob autoimmune xws li mob ntshav qab zib hom 1 lossis kab mob celiac (gluten intolerance).
- Thyroid raug mob.
Huab cua
Hnub no, cov menyuam uas yug los nrog lub cev xeeb tub tsis muaj kev loj hlob thiab kev loj hlob qeeb. Tab sis rau qhov no nws yog ib qho tsim nyog yuav tau pib kho sai li sai tau - tsis pub dhau ob peb hnub tom qab yug me nyuam. Cov me nyuam mos uas tsis tau kuaj pom lossis raug kho ntau tom qab muaj IQs qis dua thiab muaj teeb meem kev noj qab haus huv lub cev.
Yav dhau los, thyroxine deficiency tsis tau kuaj pom thaum yug los thiab tsis tau kho nrog kev kho tshuaj hormone hloov. Yog li ntawd, qhov tshwm sim ntawm congenital hypothyroidism yog irreversible. Cov menyuam yaus muaj kev ncua loj hauv kev puas siab puas ntsws thiab kev loj hlob ntawm lub cev.
Cov me nyuam mos uas muaj cov thyroid caj pas nrog kev kho mob raws sij hawm nrog cov tshuaj xaiv kom raug nrog kev saib xyuas kev kho mob tas li yuav loj hlob thiab loj hlob ib txwm, zoo li txhua tus menyuam noj qab haus huv. Rau qee tus menyuam mos, thyroid hormone deficiency yog ib ntus, yuav tsum tau kho ob peb lub hlis mus rau ob peb xyoos.
Txhawm rau tiv thaiv qhov tshwm sim ntawm hypothyroidism hauv tus menyuam yug tshiab, tus poj niam cev xeeb tub yuav tsum tau noj tshuaj uas muaj iodine.
Thyroid hormone deficiency kuj tuaj yeem tshwm sim hauv cov menyuam yaus, txawm tias qhov ntsuas tau zoo li qub thaum yug los. Yog tias koj tus menyuam muaj cov tsos mob thiab cov tsos mob ntawm hypothyroidism, nrhiav kev kho mob tam sim ntawd.
Bxaus
Cov thyroid hormones ua lub luag haujlwm tseem ceeb hauv kev tswj qhov siab thiab qhov hnyav, kev loj hlob ntawm lub hlwb thiab lub paj hlwb. Hormone deficiency ua rau hypothyroidism. Thaum ntxov thaum yau, tus kab mob yog qhov ua rau muaj kev puas siab puas ntsws thoob ntiaj teb. Txoj kev vam meej ntawm kev kho mob yog nyob rau hauv kev kuaj mob raws sij hawm thiab kev siv tam sim ntawm cov tshuaj hormone hloov kho. Synthetic thyroxine yog cov tshuaj muaj kev nyab xeeb tshaj plaws los kho qhov tsis muaj cov thyroid hormones. Tsis muaj kev kho mob ua rau kev loj hlob ntawm kev puas hlwb.
