Cov thyroid caj pas hypothalamic-pituitary yog qhov tseem ceeb hauv kev ua haujlwm ntawm cov thyroid caj pas. Nws muab kev tswj hwm kev sib txuas, tsim khoom thiab kev ua haujlwm ntawm cov thyroid hormones.
cov ntaub ntawv dav dav
Lub hypothalamus secretes TRF (thyrotropin-tso yam). Nws, nyob rau hauv lem, txhawb kev tso tawm thiab synthesis ntawm thyroid-stimulating hormone (thyrotropin - TSH). TSH koom nrog cov txheej txheem cuam tshuam nrog lwm yam steroids. Hauv particular, nws stimulates lub secretion, tsub zuj zuj, metabolism thiab synthesis ntawm triiodothyronine (T3) thiab thyroxine (T4). Ntau tshaj 99% ntawm ob cov tshuaj steroids ncig hauv cov ntshav hauv daim ntawv cuam tshuam nrog kev thauj cov protein. Tsawg dua ib feem pua tseem nyob hauv daim ntawv dawb. Cov theem ntawm unbound steroid nyob rau hauv feem ntau cov neeg yog correlated nrog lub functionality ntawm cov thyroid caj pas.
YProperties ntawm thyroxine
Cov tshuaj hormone T4 (dawb) pab txhawb rau kev tswj hwm kev loj hlob thiab kev loj hlob, ua kom muaj kev saib xyuas ntawm lub cev kub thiab ua kom muaj cua sov. Kev sib txuas renderscuam tshuam rau tag nrho cov theem ntawm carbohydrate metabolism, nyob rau hauv ib feem - ntawm vitamin thiab lipid metabolism. Cov tshuaj hormone T4 (dawb) yog ib qho tseem ceeb ntawm kev loj hlob nyob rau hauv lub sij hawm cev xeeb tub thiab neonatal. Qhov concentration ntawm cov tshuaj qhia txog kev kho mob ntawm cov thyroid kab mob, vim tias qhov kev hloov pauv ntawm tag nrho cov thyroxin tuaj yeem tshwm sim los ntawm kev cuam tshuam ntawm kev ua haujlwm ntawm cov thyroid caj pas lossis kev hloov pauv ntawm cov protein thauj. Thaum nruab hnub, cov ntsiab lus siab tshaj plaws ntawm cov tshuaj steroid yog txiav txim siab los ntawm 8 mus rau 12 teev, thiab qhov tsawg kawg nkaus - los ntawm 23 mus rau 3. Lub xyoo, qhov siab tshaj plaws ntawm T4 (dawb) mus txog lub Cuaj Hli mus txog Lub Ob Hlis, qhov tsawg kawg nkaus - nyob rau lub caij ntuj sov.. Thaum lub sij hawm cev xeeb tub (thaum cev xeeb tub), qhov concentration ntawm thyroxin nce, maj mam nce mus txog qib siab tshaj plaws los ntawm peb lub hlis thib peb. Thoob plaws hauv lub neej, cov ntsiab lus ntawm thyroxine hauv tib neeg, tsis hais poj niam los txiv neej, tseem nyob tas li. Kev txo qis hauv cov tshuaj hormones raug pom tom qab plaub caug xyoo.
qib ntawm thyroxin qhia tau li cas?
Yog T4 (dawb) tau nce siab, ces qhov no yog qhov kev lees paub ntawm hyperthyroidism. Tsawg concentration qhia tias hypothyroidism. Kev ywj pheej ntawm cov ntsiab lus steroid los ntawm thyroxin-binding globulin ua rau nws muaj peev xwm siv nws raws li kev ntsuam xyuas txhim khu kev qha. Qhov no yog qhov tseem ceeb tshwj xeeb tshaj yog nyob rau hauv cov xwm txheej uas muaj kev hloov pauv hauv qib ntawm thyroxin-binding globulin. Cov no suav nrog kev noj tshuaj tiv thaiv kab mob (qhov ncauj), cev xeeb tub, tau txais androgens lossis estrogens. Cov kev hloov pauv kuj yog yam ntxwv ntawm cov neeg uas muaj keeb kwmpredisposition kom nce lossis txo qhov concentration ntawm globulin. Pub ntshav dawb T4 yog pom zoo rau kev kuaj mob ntawm ob hom hypothyroidism tshwm sim los ntawm pathologies ntawm qib hypothalamic-pituitary. Hauv qhov no, cov ntsiab lus ntawm TSH tsis hloov lossis nce. Raws li txoj cai, kev nce hauv cov ntsiab lus ntawm thyroxine tuaj yeem tshwm sim los ntawm qib siab ntawm bilirubin hauv cov ntshav, rog rog, nrog rau kev siv cov tourniquet thaum kuaj ntshav. T4 (dawb) tsis hloov cov kab mob hnyav uas tsis cuam tshuam nrog kev ua haujlwm ntawm cov thyroid caj pas. Nyob rau tib lub sijhawm, qib ntawm tag nrho thyroxine yuav txo qis.
Npaj rau kev tshawb fawb hauv chav kuaj
Ib hlis ua ntej pub ntshav, cov tshuaj hormones tsis suav nrog (tshwj tsis yog muaj cov lus qhia tshwj xeeb los ntawm tus kws kho mob endocrinologist). Ob lossis peb hnub ua ntej kev soj ntsuam, kev siv cov tshuaj uas muaj iodine raug tso tseg. Cov ntshav yuav tsum tau pub dawb ua ntej kev tshawb fawb X-ray siv cov tshuaj sib txawv. Nyob rau hnub ua ntej ntawm kev pub ntshav, koj yuav tsum tsis txhob tawm dag zog lub cev, tshem tawm cov xwm txheej ntxhov siab. Ua ntej txoj kev tshawb no, ib nrab teev, koj yuav tsum ua siab ntev, coj koj ua pa rov qab mus rau qhov qub. Kev tsom xam yog nqa tawm ntawm lub plab khoob. Yam tsawg kawg yog yim teev yuav tsum dhau ntawm cov pluas noj kawg (tab sis zoo dua 12 teev). Tsis pub haus kas fes, kua txiv los yog tshuaj yej. Tsuas pub dej xwb.
Txo qis thyroxine qib
T4 (dawb) (tus qauv rau cov poj niam thiab txiv neej yog 9-19 pmol / liter) tuaj yeem txo qis hauv lub sijhawm tom qab phais, nrog rau cov thyroid hypothyroidism (mob ntawm lub caj pas pituitary, thyrotropinoma, syndrome). Sheehan). Kev txo qis hauv cov concentration kuj tseem raug sau tseg vim kev noj cov tshuaj anabolic, thyreostatics, anticonvulsants, thiab lithium npaj. Qib ntawm thyroxine txo qis nrog kev siv cov tshuaj tiv thaiv qhov ncauj, octreotide, methadone, clofibrate. Lwm qhov ua rau muaj xws li kev noj zaub mov kom tsawg ntawm cov protein, tsis muaj iodine, siv tus heroin, raug lead. T4 (dawb) tuaj yeem txo qis nrog tertiary (mob ntawm hypothalamus, TBI), kis tau, congenital hypothyroidism (tawm tsam keeb kwm ntawm kev phais thiab qog ntawm cov thyroid caj pas, autoimmune thyroiditis, endemic goiter).
Txhawj xeeb ntxiv
Cov qib ntawm cov tshuaj hormones xws li T4 (dawb) (tus qauv rau cov poj niam thiab cov txiv neej tau qhia saum toj no) tuaj yeem nce ntxiv nrog cov kab mob toxic goiter, TSH-kev ywj pheej thyrotoxicosis, thiab rog rog. Kev nce hauv concentration tau sau tseg tawm tsam keeb kwm ntawm nephrotic syndrome, heparin kho. Cov laj thawj kuj suav nrog choriocarcinoma, kev noj thyroxine vim hypothyroidism, kev hloov pauv tom qab yug me nyuam hauv kev ua haujlwm ntawm cov thyroid caj pas, thiab mob siab rau lub siab. T4 (dawb) tuaj yeem nce siab hauv cov thyroid steroid resistance syndrome, genetic disalbunemic hyperthyroxinemia, cov xwm txheej uas ua rau txo qis hauv cov concentration ntawm thyroxine-binding globulin.
YThyroxin thiab cev xeeb tub
Cov thyroid hormones koom nrog yuav luag txhua yam hauv lub cev. Raws li tau hais los saum no, cov tebchaw tswj cov txheej txheem metabolic, cuam tshuam rau lwm yam steroids. Pathology ntawm cov thyroid caj pas tuaj yeem nrog ob qho tib si nce thiabtxo nws txoj haujlwm. Kev ua txhaum ntawm cov dej num ntawm lub cev yog qhov tseem ceeb tshwj xeeb thaum lub sij hawm yug me nyuam. Cov kev hloov pauv hauv kev ua haujlwm ntawm cov thyroid caj pas cuam tshuam rau lub sijhawm cev xeeb tub, nws qhov xwm txheej, qhov tshwm sim thiab qhov xwm txheej ntawm tus menyuam mos. Tsis tshua muaj, gestation tshwm sim nrog hnyav endocrine pathologies. Cov kab mob ntawm hom no, raws li txoj cai, ua rau kev ua txhaum ntawm kev ua haujlwm ntawm kev ua me nyuam, infertility. Feem ntau thaum cev xeeb tub, goiter raug kuaj pom (qhov nce hauv cov thyroid caj pas ntawm qhov txawv txav) nrog kev khaws cia ntawm euthyroidism, nrog rau cov kab mob autoimmune thyroiditis, uas provokes kev hloov pauv hauv keeb kwm hormonal. Lub sij hawm cev xeeb tub yog tus cwj pwm los ntawm kev hloov pauv hauv lub cev ua haujlwm ntawm lub qog.
Recommendations
Yuav kom txhais tau qhov tseeb ntawm cov kev sim kuaj thaum cev xeeb tub, ob peb lub ntsiab lus yuav tsum raug coj mus rau hauv tus account. Lub ntsiab txhais ntawm tag nrho T3 thiab T4 tsis qhia. Qhov no yog vim lub fact tias thaum lub sij hawm cev xeeb tub lawv concentration yog nce los ntawm ib tug thiab ib nrab zaug. Thaum kuaj xyuas cov qib ntawm unbound thyroxine, nws cov concentration yuav tsum tau txiav txim siab ua ke nrog cov ntsiab lus ntawm TSH. Thyroxine nce me ntsis hauv kwv yees li 2% ntawm cov poj niam cev xeeb tub. Nyob rau hauv thawj ib nrab ntawm lub sij hawm cev xeeb tub, muaj ib qho kev txo qis hauv TSH (kwv yees li 20-30% ntawm cov neeg mob nrog ib leeg thiab tag nrho nrog ntau yam cev xeeb tub). Hauv kev kho thyrotoxicosis, tsuas yog kuaj T4 (dawb) xwb. Cov qib ntawm thyroxine tsis muaj nyob rau hauv cov theem tom qab tuaj yeem txo qis qis. Tib lub sijhawm, qhov concentration ntawm TSH yuav nyob twj ywm hauv qhov qub.
