Cudurka murqaha, oo loo yaqaan 'myopathy', ayaa laga yaabaa inuu ku dhaco sababtoo ah inuu qabo thyroid aan firfircooneyn (oo lagu magacaabo hypothyroidism) ama qanjirka 'overactive' (oo loo yaqaan hyperthyroidism).
Warka fiicani waa in calaamadaha loo yaqaan 'myopathies-related', sida muruq xanuun, daciifnimo, ama qallafsanaanta, guud ahaan waa mid khafiif ah waxayna yareyneysaa daaweynta degdega ah ee xanuunka thyroid-ka. Taasi waxay tidhi, xaalado badan oo soo noqnoqonaya, miyir-beelka la xidhiidha cudurka jirkooda thyroid wuxuu noqon karaa mid aad u daran oo loola jeedo.
Adoo helaya fahan wanaagsan oo ku saabsan calaamadaha muruqyada ee cudurka qanjirka (iyo sida loo heli lahaa oo loo daaweyn lahaa dhakhtarkaaga), waxaad rajeyn kartaa inaad hoos u dhigto raaxadaada iyo / ama daciifnimo.
Hypopyroid Myopathy
Astaamaha
Dhibaatada muruqyada, xanuun, iyo casiraad ayaa ku badan dadka qaba hypothyroidism. Inkasta oo daciifnimada guud ahaan la wadaago, dadku waxay caadi ahaan dareemaan muruqyada ku dhow xuddunta jirkooda, sida bowdada ama garabka . Tani waxay keeni kartaa dhibaatooyin fuulaya jaranjaro ama timo timahaaga.
Marka laga reebo calaamadaha muruqyada, qofku wuxuu yeelan karaa kinaseineine kinaseineine (CK) oo ku saabsan baaritaanka dhiigga. Creatinine kinase waa unugyada muruqyada ee kor u kaca muruqa. Waxaa xiiso leh, heerka CK ma aha mid ku xiran darnaanta muruqyada qofka.
Marar dhif ah, muqaalka muruqyada oo aad u xun oo ka yimaada hypothyroidism ayaa laga yaabaa inuu kobciyo. Mid ka mid ah tusaale ahaan waa Hoffman's syndrome kaas oo qofku yeesho murqo-gariirka muruqa (murqaha waaweyn) oo keena murqo-darro muruqa, daciifnimo, iyo xanuun.
Rhabdomyolysis (marka muruqu uu si dhakhso ah u jebiyo) waa calaacal dhif ah oo ka yimaada hypothyroidism. Waxaa badanaa keena isku-dhafid la'aanta cudurka hypothyroid oo leh jimicsi adag ama qaadashada dawada (daawada hoos u dhigta kolesteroolka).
Sabab
In kasta oo sababta dhabta ah ee loo yaqaan 'hypothyroidism-induced myopathy' weli wali caddayn, ayaa qaar ka mid ah khubarada ku xeeldheer in tufsigii (T4) uu ku yaraaday cudurka hypothyroidism uu keeno dheef-shiid kiimikaad aan caadi ahayn, taasoo ugu dambeyntii keento dhaawac muruq iyo hawl-xumo.
Ciladeynta
Ciladda 'hypothyroidism' ee loo yaqaan 'hypothyroidism-ka' ayaa ah kiliinikada, taasoo macnaheedu yahay in dhakhtarkaagu uu ku ogaanayo iyada oo ku saleysan calaamadahaaga iyo baaritaanka jirka. Imtixaanka dhiigga si loo qiyaaso kinineine kinase ayaa sidoo kale la sameyn doonaa.
Dhakhtarkaagu wuxuu kugula talin karaa baadhitaano kale, sida qalabka korontada ama dheecaanka laga jaray, si loo ogaado xaaladaha kale, gaar ahaan haddii calaamadahaagu daran yihiin.
Daaweynta
Uu ku qanco in beddelidda hormoonada hoormoonka tufaaxa ee la yiraahdo Synthroid (levothyroxine) ayaa badiyaa hagaajin karta calaamadaha muruqyada, sida casiraadyada iyo adkaanta, inkastoo horumarintani ay qaadan karto toddobaadyo. Murqaha daciifka murqaha guud guud ahaan wuxuu qaataa waqti dheer si uu u xalliyo, sida dhowr bilood.
Hyperthyroid Myopathy
Astaamaha
Murqaha muruqyada waxaa laga yaabaa inuu ku dhaco dadka qaba hyperthyroidism. Sababtoo ah daciifnimada, qofku waxaa laga yaabaa inuu ku adkaado inuu fuulo jaranjarada, ka soo kiciyo kursi, haynta ama sheyga wax lagu qabto, oo gaarsiiyo gacmahooda kore madaxooda. Marar dhif ah, miyir-qabka ka yimaada hyperthyroidism , muruqyada ay saameysey waxaa ka mid ah kuwa kaa caawiya inaad liqo oo neefsato.
Waxaa xiiso leh, iyadoo muruqyada iyo xanuunada ay dhici karaan, maaha sida caadiga ah maadaama ay ku jiraan cudurka myopathy ee la xidhiidha hypothyroidism.
Heerka kinineineineineineine ee dhiigga waa caadi, inkastoo xaqiiqda, waxaa jira muruq go'a.
Sida kudhaca maadada 'hypothyroidism-myopathy', lambarka looma gudbiyo calaamadaha muruqyada qofka.
Sabab
Sida cudur muruqa ah ee loo yaqaan 'hypothyroidism', "sababta" ka dambeeya myopathy ee hyperthyroidism sidoo kale ma cadda. Waxay u badan tahay heerka sarreeya ee hoormoonka tayroodhka ee jirka ku jira si toos ah uga qaybqaata. Si khaas ah, heerarka hoormoonka tayroodhka ee sarreeya wuxuu u horseedi karaa kor u kaca muruqyada murqaha iyo isticmaalka tamarta muruqyada.
Ciladeynta
Sida myopathy ee hypothyroidism, dhakhtarkaagu wuxuu sameyn doonaa baaritaan jireed wuxuuna weydiin doonaa su'aalo la xiriira calaamadaha muruqa. Waxa kale oo laga yaabaa inuu ku dalbado baaritaanka dhiigga, gaar ahaan guddi hawleedka tayroodh, wuxuuna kugula talin karaa qalabka korontada .
Daaweynta
Daaweyntaada hyperthyroidism waxay guud ahaan daaweyneysaa miyir-qaadka; Si kastaba ha noqotee, waxay qaadan kartaa waqti, illaa dhowr bilood oo suuro gal ah, xitaa ka dib marka qanjiradu dib ugu noqoto dawladeeda caadiga ah.
Ereyga
Farriinta guriga ee halkan ka socda ayaa ah in cabashooyinka muruqyada ay ku badan yihiin cudurka thyroid-ka waxaana guud ahaan lagu yareyn karaa caadigeynta hawlahaaga tirtirka.
Hase ahaatee, waa muhiim in la arko dhakhtarkaaga haddii aad dareento muruqyo cusub ama / ama murqo daran ama daciifnimo. Inkastoo qanjirkaagu uu noqon karo dembiilaha, waxaa jira xaalado caafimaad oo kale oo keeni kara calaamadaha muruqyada, xaaladdaana waxay u baahan yihiin qorshe daaweyn oo ka duwan.
> Ilo:
> Kim TJ et al. Kiis keli ah oo loo yaqaan 'thyrotoxic myopathy' oo leh nooca xad dhaafka ah ee 2 fibriyowga. Cunitaanka neurobiol . 2013 Sep; 22 (3): 232-34.
> Miller ML, Rubin DI. (2017). Hypopyroid myopathy. Aminoff MJ, Shefner JM, Ross DS, eds. UpToDate. Waltham, MA: UpToDate Inc.
> Sindoni A, Rodolico C, Pappalardo MA, Portaro S, Benvenga S. Miyir-qabtinka Hypothyroid: Soo bandhigid daaweyn qotodheer oo ku saabsan dhego-la'aanta: Dib-u-eegista suugaanta. Rev Rev. 2016 Dec; 17 (4): 499-519.
> Villar J, Finol HJ, Torres SH, Roschman-Gonzalez A. Myopathy ee bukaanada qaba cudurka Hashimoto. Kormeerka Maalgelinta . 2015 Mar; 56 (1): 33-46.