Cov thyroid caj pas yog ib qho tseem ceeb ntawm cov kab mob endocrine. Nws lub luag haujlwm tseem ceeb yog tsim cov tshuaj hormones tshwj xeeb (triiodothyronine, thyroxine), uas tswj cov metabolism hauv tib neeg lub cev thiab cuam tshuam rau tag nrho lub cev. Hauv kab lus no, peb yuav xav txog xws li kab mob xws li myxedema. Ua rau thiab cov tsos mob kuj yuav piav qhia.
myxedema yog dab tsi?
Cov kab mob thyroid ua rau kev loj hlob ntawm ob lub syndromes. Kev tsim cov tshuaj hormones tuaj yeem nce ntxiv - qhov no yog hyperthyroidism syndrome. Txawm li cas los xij, qhov tseem ceeb tshaj plaws yog qhov txo qis hauv cov thyroid hormones, uas yog hu ua hypothyroidism.
Myxedema yog ib qho mob hnyav heev ntawm hypothyroidism. Qhov mob no yog tshwm sim los ntawm mucous o ntawm cov ntaub so ntswg. Vim tsis muaj cov thyroid hormones, polysaccharide residues nyob rau hauv cov ntaub so ntswg, uas nyiam dej rau lawv tus kheej. Cov ntaub so ntswg puv nrog dej, thiab mucous edema tsim.
Dab tsi ua rau myxedema?
Myxedema tuaj yeem tshwm sim thaum twg los tau. Cov poj niam raug kev txom nyem los ntawm tus kab mob no ntau dua li cov txiv neej, qhov tshwm sim ntawm myxedema nyob rau hauv lawv feem ntau nrog menopause. Hypothyroidism yog qhov tseem ceeb tshwj xeeb hauv cov menyuam yug tshiab thiab cov menyuam yaus. Vim qhov kev poob qis hauv cov metabolism, kev loj hlob ntawm lub cev thiab lub siab lub ntsws ntawm tus menyuam raug cuam tshuam. Yog hais tias hypothyroidism yog congenital (nrog aplasia los yog hypoplasia ntawm lub caj pas) thiab tsis tau kho, cretinism tshwm sim - ib tug tshwj xeeb daim ntawv ntawm kev puas hlwb retardation nyob rau hauv cov me nyuam.
Hauv cov neeg laus, myxedema yog tshwm sim los ntawm kev puas tsuaj rau cov thyroid cov ntaub so ntswg - hypothyroidism hu ua thawj. Txawm li cas los xij, kev ua haujlwm ntawm lub caj pas yog tswj los ntawm cov qog pituitary los ntawm TSH - thyroid-stimulating hormone. Yog li, yog tias kev ua haujlwm ntawm lub caj pas pituitary raug cuam tshuam (mob qog nqaij hlav, kev ua haujlwm tsis zoo, kev raug mob, kab mob hauv lub cev), qhov tshwm sim thib ob hypothyroidism tshwm sim. Tsis tshua muaj heev, tertiary hypothyroidism yog tshwm sim los ntawm kev ua haujlwm ntawm lub hypothalamus.
Thaum tus kab mob "myxedema" ua rau thiab cov tsos mob sib cuam tshuam.
Yog li, cov laj thawj tseem ceeb ntawm myxedema yog raws li hauv qab no:
- cov txheej txheem atrophic hauv cov thyroid caj pas;
- mob qog nqaij hlav (thyroiditis);
- tumors;
- kev mob nkeeg;
- tshem tawm cov qog nqaij hlav (kev phais rau kev kho mob hyperthyroidism);
- hluav taws xob raug;
- kho nrog iodine radionuclides;
- tsis muaj iodine noj;
- noj qee yam tshuaj (amiodarone, corticosteroids, thyreostatics);
- kis mobkab mob (tshwj xeeb tshaj yog nyob rau hauv cov poj niam cev xeeb tub);
- mob thiab kab mob ntawm lub hlwb, thiab lwm yam.
Myxedema tuaj yeem tshwm sim. Ua rau thiab cov tsos mob tseem ceeb thaum xaiv kev kho mob.
Cov tsos mob dab tsi nrog myxedema?
Vim tias cov thyroid hormones cuam tshuam rau tag nrho lub cev, qhov tshwm sim ntawm myxedema yuav txawv.
Nyob rau hauv qhov tsis txaus ntawm cov thyroid hormones loj heev, ib tug neeg tau txais cov yam ntxwv zoo - "myxedematous face" yog tsim. Lub ntsej muag yog edematous, lub edema yog feem ntau pronounced ntawm daim tawv muag thiab daim di ncauj. Cov tawv nqaij yog daj ntseg, muaj icteric tint, txias rau qhov kov, tev tawm, poob ntawm pob muag, plaub muag thiab plaub hau ntawm lub taub hau yog sau tseg. Kev ua haujlwm ntawm cov leeg ntawm lub ntsej muag cuam tshuam - lub ntsej muag tsis ua haujlwm, muaj qhov tsis txaus ntseeg.
Kev swb ntawm lub paj hlwb yog qhia nyob rau hauv ib qho kev hloov hauv lub hlwb. Kev txav mus los ua tsis muaj kev sib koom ua ke, sluggish. Muaj kev nyuaj siab. Cov ntaub ntawv los ntawm sab nraud tsis pom zoo, cov tshuaj tiv thaiv rau cov xwm txheej yog qhia me ntsis lossis tsis quav ntsej. Drowsiness tau sau tseg, nco thiab mloog tsawg. Kev hais lus yog slurred thiab qeeb.
Muaj cov ntshav hloov pauv, feem ntau nqes. Kev ua haujlwm ntawm lub plawv cov leeg raug cuam tshuam, lub plawv dhia qis - "myxedematous heart" yog tsim. Lub plab zom mov kuj cuam tshuam - muaj cem quav ntev, ua haujlwm tsis zoo ntawm cov kab mob biliary.
Mucoid edema tsim.
Lub peev xwm ua pa ntawm lub ntsws txo qis, vim li ntawdmuaj lub sijhawm ua tsis taus pa thaum pw tsaug zog. Tsis tas li ntawd, cov kua dej feem ntau accumulates nyob ib ncig ntawm lub ntsws, uas tseem cuam tshuam rau kev ua pa. Qhov tshwm sim no hu ua "myxedematous polyserositis".
Txawm tias txo qis qab los noj mov, tus neeg mob uas muaj myxedema tsim kev rog, ntshav siab tau txiav txim siab. Kev hnov mob qis, hoarseness ntawm lub suab tshwm sim, qhov ntswg ua pa tsis zoo. Anemia feem ntau tshwm sim vim tsis muaj hlau lossis folic acid. Yuav tsum muaj tus kws kho mob endocrinologist zoo ntawm no.
Cov poj niam feem ntau muaj kev coj khaub ncaws tsis xwm yeem, txo qis fertility thiab libido. Kev mob caj dab tshwm sim, cov pob txha cov ntaub so ntswg yog depleted nyob rau hauv calcium, yog li cov pob txha tau yooj yim tsim. Cov menyuam yaus poob qis hauv kev loj hlob thiab kev loj hlob piv rau lawv cov phooj ywg.
Kev tshawb fawb ntxiv dab tsi?
Tus kws kho mob endocrinologist zoo tuaj yeem kuaj xyuas tus mob myxedema los ntawm tus neeg mob. Txawm li cas los xij, txhawm rau txheeb xyuas qhov ua rau ntawm tus kab mob, nrog rau kev txiav txim siab txog kev kho mob, ntau cov kev tshawb fawb xav tau. Kev kuaj mob ntawm myxedema feem ntau tsis nyuaj.
Txhim kho qhov tseem ceeb thiab pabcuam kev kuaj mob. Cov txheej txheem tseem ceeb tso cai rau koj txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm, nws, nws yog qhov tsim nyog yuav tsum tau txiav cov ceg ntoo, cov ceg ntoo ntawm cov ceg ntoo tuaj yeem ua rau myxedema.
Kev kuaj mob, thov hu rau: Moscow, Dmitry Ulyanov txoj kev, 11. Lub koom haum ntawm Endocrinology ua cov txheej txheem kuaj mob hauv qab no:
1. Basic:
- kuaj mob los ntawm tus kws kho mob endocrinologist;
- blood test for TSH and free thyroxine.
2. Pab:
- thyroid ultrasound;
- radioisotope scintigraphy;
- thyroid nqaij biopsy;
- kuaj pom cov tshuaj tiv thaiv tshwj xeeb rau cov thyroid hlwb.
Txhua txoj kev kawm txhais li cas?
Kev teem sijhawm kws kho mob endocrinologist pheej yig.
Tus kws kho mob tshuaj xyuas, palpates thiab mloog cov kab mob hauv nruab nrog cev (lub plawv, ntsws). Cov tsos mob uas tau piav saum toj no tuaj yeem pab tus kws kho mob hauv kev tshawb nrhiav kev kuaj mob zoo heev.
Hauv kev kuaj ntshav, kuaj pom qhov txo qis hauv cov ntsiab lus ntawm thyroxine dawb, tab sis qhov tseem ceeb tshaj plaws yog kuaj pom ntawm TSH siab. Muab faib subclinical hypothyroidism, uas tsis yog nrog los ntawm cov tsos mob thiab raug kuaj pom ntau zaus los ntawm lub sijhawm. Nws yog qib siab ntawm TSH uas yog thawj " tswb tswb" hais txog kev txhim kho hypothyroidism thiab myxedema tshwj xeeb.
YUltrasound
Thyroid ultrasound tso cai rau koj pom ntau yam tsim hauv cov ntaub so ntswg ntawm lub caj pas (nodules, qog, calcifications). Txoj kev no suav hais tias yog qhov yooj yim rau kev ua thiab pheej yig nrog cov ntaub ntawv txaus. Yog tias pom tus mob myxedema, kev kho mob yuav tsum tam sim.
Scintigraphy
Lub ntsiab lus ntawm radioisotope scintigraphy yog kev qhia txog cov xov tooj cua isotopes ntawm iodine intravenously thiab kev ntsuam xyuas ntawm nws cov tsub zuj zuj ntawm cov thyroid cov ntaub so ntswg, cov yam ntxwv ntawm nws tis nyob rau hauv nws thiab excretion. Yog tias nrog ultrasound tus kws kho mob tsuas yog ntsuas tus qauv ntawm lub caj pas, ces nrog scintigraphy nws txoj haujlwm raug tshuaj xyuas. Yog hais tias muaj tus kab mob "myxedema", ces ib tug neeg feem ntau muaj ib tug txo tsub zuj zuj ntawm iodine npaj ntawm ib lub zos los yog diffuse xwm. Ntxiv nrog rau kev ua haujlwm, txoj kev no ntsuas kev kho mob tsis tu ncua ntawm ntau yam kab mob ntawm lub caj pas.
Biopsy
Thyroid biopsy koom nrog kev noj cov ntaub so ntswg nrog cov koob tshuaj tshwj xeeb. Tom qab ntawd, nws tau raug mus rau microscopic thiab histochemical kev tshawb fawb. Qhov no tso cai rau koj txheeb xyuas ntau yam kab mob ntawm qib cellular thiab paub txog cov txheej txheem qog nyob rau lub sijhawm.
Kev txiav txim siab ntawm cov tshuaj tiv thaiv rau cov thyroid cov ntaub so ntswg ua qhov tseem ceeb thaum tsis pom qhov ua rau myxedema. Nws yog ib qho tseem ceeb kom paub tias feem ntau cov thyroid caj pas tsis ua rau muaj kev tiv thaiv cov protein, vim tias nws raug txwv los ntawm ib txheej ntawm cov ntaub so ntswg. Tab sis nyob rau hauv qee yam kab mob, cov tshuaj ntsiav no ua thinner, thiab cov qog nqaij hlav tuaj rau hauv kev sib cuag nrog lub cev tiv thaiv kab mob. Raws li qhov tshwm sim, cov tshuaj tiv thaiv raug tsim rau cov hlwb ntawm lub caj pas, uas inhibit nws txoj haujlwm yam tsis hloov cov qauv.
Yuav kho li cas rau myxedema?
Kev txais tos ntawm tus kws kho mob endocrinologist ua ntej pib kho yog qhov yuav tsum tau ua.
Kev kho mob myxedema yog ib qho yooj yim thiab yog kev kho tshuaj hormone hloov. Txawm li cas los xij, nws yuav tsum nco ntsoov tias feem ntau tsis tuaj yeem rov qab ua haujlwm ntawm lub caj pas nws tus kheej, yog li kev noj tshuaj yuav tsum tau ua thiab mus txog lub neej. Kev txhim kho ntawm tus mob yog pom tom qab 2-3 lub lis piam ntawm kev siv cov cuab yeej tshwj xeeb.
Txhawm rau txo cov tsos mob, L-thyroxine npaj ("Levothyroxine", "Eutiroks") thiablawv tus khub. Cov tshuaj no yog cov khoom siv hloov pauv rau cov thyroid hormones ntuj. Cov koob tshuaj yog xaiv los ntawm tus kws kho mob nyob rau hauv txhua rooj plaub.
Nws yuav tsum tau muab sau tseg tias kev noj tshuaj ntau dhau tuaj yeem ua rau tus mob myxedema rov qab - hyperthyroidism, thiab koob tshuaj tsis txaus yuav tsis muaj txiaj ntsig. Kev noj lwm yam tshuaj kuj tseem tuaj yeem ua rau tsis haum rau kev nqus lossis nce metabolism ntawm L-thyroxine, yog li lwm tus kws kho mob yuav tsum tau sab laj txog kev kho mob ua ke.
Kuv tuaj yeem mus pab tau qhov twg?
Tus kws kho mob tuaj yeem xav tias muaj kab mob thaum kuaj lub cev. Txawm li cas los xij, kev kho mob ntawm myxedema yog ua los ntawm tus kws kho mob endocrinologist hauv tsev kho mob tshwj xeeb. Cov no yuav yog cov chaw haujlwm endocrinological ntawm nroog lossis cov tsev kho mob hauv cheeb tsam. Cov neeg mob feem ntau raug xa mus rau cov chaw tshawb fawb hauv cov nroog loj rau txoj kev kuaj xyuas nyuaj. Ib qho ntawm cov chaw no yog "Endocrinological Research Center" (Moscow, Dmitry Ulyanov St., 11). Lub koom haum ntawm Endocrinology paub txog qhov tseeb tias cov kws tshaj lij muaj peev xwm muab kev pabcuam hauv kev kho mob myxedema thiab lwm yam kab mob, thiab cov txheej txheem kev kuaj mob thiab kev kho mob nyuaj tshaj plaws tau ua tiav.
Tus kab mob no yog dab tsi?
Feem ntau, myxedema (ua rau thiab cov tsos mob tau piav qhia) yog qhov kho tau tag nrho. Kev noj tshuaj tag tshem tawm cov tsos mob saum toj no. Txawm li cas los xij, kev mus ntsib kws kho mob tsis tu ncua thiab tsis ua raws li cov lus pom zoo tuaj yeem ua rau muaj kev puas tsuaj loj.
