TSH waa baaritaanka muhiimka ah ee lagu ogaanayo iyo la socoshada Functional Thyroid
Turjumidda heerarka TSH waa mid aan macquul ahayn, sidaa daraadeed keligaa ma tihid haddii aad ka fekereyso heerka tirakoobkaaga , iyo gaar ahaan heerarka sarreeya ee hooseeya ee daaweynta.
Tusaale ahaan, waxaad is waydiin kartaa sababta uu dhakhtarkaaga u doonayo inuu hooseeyo halkii aad kor u qaadi lahayd daaweynta dheef-shiid kiimikaad marka ay natiijooyinkaaga TSHu hooseeyaan, ama, si cad, sababta uu dhakhtarkaaga u kordhiyo daawada dheef-shiid kiimikaad sarreeya markaad kacsan tahay.
Naso hubaal, inkasta oo ay u muuqan karto dib u noqoshada, wax walbaa waa wax macno leh markaad eegto bayoolajiga wax soo saarka hoormoonka tayroodhka.
Asalka aasaasiga ah
Qanjirka qanjirka thyroid wuxuu soo saaraa hoormoon tayroodh. Marka uu si sax ah u shaqeeyo, qanjirkaagaagu wuxuu qayb ka yahay wareegga jawaab celinta qanjirka 'pituitary' kaas oo ku lug leh dhowr tallaabo oo muhiim ah:
- Marka hore, dareenkaaga pituitary wuxuu dareemaa heerka hoormoonka tayroodhka ee lagu sii daayo dhiigga.
- Daawada pituitary waxay sii deyneysaa hoormoon farabadan oo gaar ah: hoormoonka kor u qaada (TSH). Doorka TSH waa in la kiciyo qanjirada si loo sii daayo hoormoonka tayroodhka.
- Marka qanjiradaada, sabab kasta oo xanuun ah, culeyska, qalliin, ama xayiraad, tusaale ahaan - ma samayn karo ama aan soo saarin hormoon qotofoon oo kugu filan, pituitary-ku wuxuu ogaadaa heerka hoos u dhaca hoormoonka tayroodhka wuxuuna u dhaqaaqaa tallaabooyin badan oo ka dhigaya in ka badan TSH, taas oo markaa kicineysa qanjirkaaga si aad u sameyso hormoon tayo badan. Tani waa dadaalka pituitary ee kor loogu qaadayo heerarka hoormoonka tayroodhka kuna soo celiyo nidaamka si caadi ah.
- Haddii dheef-shiid kiimikaadkaagu uu yahay mid xad-dhaaf ah oo soo saaro hoormoonka tayroodhka-badan, sababtoo ah cudur, ama aad qaadato qiyaas aad u sareeya daawooyinka hormoonnada hormoonka tayroodh -hormarkaaga pituitary in uu jiro hoormoon aad u badan oo hoostiisa wareega oo gaabiya ama soo gala wax soo saarka TSH. Tani waxay hoos u dhacaysaa TSH waa isku day lagu soo celinayo heerarka hoormoonka tayroodhka ee caadiga ah.
Turjumidda Heerarka TSH
Marka aad fahamto aasaaska tayriyeyaashani, way sahlan tahay in la fahmo waxa hoos u dhiga TSH iyo darajo sare oo muujinaya shaqadaada qanjirkaaga.
Tan TSH waxay kor u qaadeysaa heerarka hoormoonka tayroodhka waxayna xajisaa nidaamka isku dheelitirka caadiga ah:
- Qadar sare ayaa soo jeedineysa in qanjirkaagu uu yahay mid aan firfircooneyn (hypothyroid) oo uusan samaynin shaqadiisa soo saaridda hoormoonka tayroodh ee ku filan. Qadarka xadidan wuxuu ka shaqeynayaa inuu kiciyo qanjirkaaga si uu u soo saaro hoormoon tayo badan.
- Qadar yar ayaa soo jeedineysa in qanjirkaagu uu yahay mid aan firfircooneyn (hyperthyroid) oo soo saaro hoormoonka tayroodhka ee xad-dhaafka ah. Qanjirka 'pituitary' ayaa xakameynaya TSH si markaasi tayroodhku uusan soo saarin wax ka badan.
S: Isku kalsooni darro?
Inta lagu jiro baaritaanka, dhakhaatiirta intooda badan waxay isticmaalaan imtixaanka TSH si ay u qiimeeyaan shaqadaada tirtirkaaga waxayna go'aamiyaan koorsada ugu fiican ee daaweynta.
Si kastaba ha ahaatee, si kastaba ha ahaatee, in qaar ka mid ah dhakhaatiirtu dareemaan in ay ku tiirsan yihiin Qadhi, iyadoon qiimeynin heerarka wareega ee hormoonnada thyroxid dhabta ah, sida tayriska (T4), waxaa laga yaabaa in aysan awoodin inay ogaadaan dhibaatooyinka tayroodhka ah ee aadka u daran.
Tusaale ahaan, T4 oo bilaash ah oo lagu daro TSH ayaa sidoo kale la baaraa haddii takhtar uu ka shakiyo in uu ka dhaco qanjirka 'thyroid' oo ka yimaada cudurka qanjirada 'hypothalamus' ama hypothalamus. Sidoo kale, haddii uu TSHku caadi yahay, laakiin qofku wuxuu leeyahay calaamadaha hyperthyroid ama hypothyroid, T4 lacag la'aan ah waa la baari karaa.
TSH sidoo kale ma aha mid ku filan in lagu kormeero hypothyroidism inta lagu guda jiro uurka , taas oo ah sababta T4 lacag la'aan ah iyo / ama guud ahaan T4 ayaa sidoo kale la baari doonaa.
Iyadoo ku xiran xaaladda caafimaad, baaritaanno kale oo tirakoob oo laga yaabo in lagu qiimeeyo waxaa ka mid ah triiodotyronine (T3), T3 , iyo baaritaanada antibody.
TSH Muuqaal Tixraacyo
Xeelad weyn oo ku xiran Qaaxada hypothyroidism iyo hyperthyroidism waa iska horimaad joogta ah ee adduunka caafimaadku ka badan yahay qiyaasta tixraaca ee imtixaanka TSH.
Heerarka ka hooseeya 0.4 ayaa loo tixgeliyaa caddaynta suurtogalka ah ee hyperthyroidism, iyo heerarka ka sareeya 5.0 ayaa sida caadiga ah loo tixgeliyaa caddaynta suurtagalka ah ee la xiriirta hypothyroidism, laakiin khubarada qaarkood waxay dareemayaan in arrinkani uu aad u ballaaran yahay waana in la dhajiyo 0.4 ilaa 2.5mU / L.
Go'aaminta Daaweynta Iyadoo ku Saleysan TSH
Marka lagugu daaweeyo hypothyroidism oo leh daroogo hormoon ah oo hormoon ah, dhakhaatiirtu waxay isku dayi doonaan inay ku daaweeyaan qiyaasta "caadiga ah" oo ah KH oo ah 0.3 / 0.5 ee hoose, ilaa 3.0 / 5.0 xagga sare.
Sidaas awgeed, markaad u baahato baaritaanka oo cagaarshaduna ay ka hooseyso caadi (taas oo macnaheedu yahay in TSH la jarayo sababta oo ah heerarka hoormoonka tayroodhka horayba u sarreeyey), dhakhtarkaagu waxaa laga yaabaa inuu rabo inuu yareeyo qiyaasta hormoonka thyroid sababtoo ah waxaad horeyba u jirtaa hyperthyroid . Tani waa sababta oo ah xakamaynta xad-dhaafka ah ee TSH (taasoo loola jeedo wax-soo-saarka hoormoonka hoormoonka sareeya) waxay kordhin kartaa khatarta uu qofku leeyahay khatarta foosha (xajmiga wadnaha) ama osteoporosis.
Haddii baaritaankaaga TSHku uu ka soo baxo sida caadiga ah, takhaatiirta qaarkood waxay doonayaan in ay kordhiyaan qiyaasta hormoonka thyroid, sababtoo ah heerarka ka sarreeya caadi ahaan waxa loo tixgeliyaa inuu yahay hypothyroid (aan firfircooneyn).
Ereyga
Marka la eego, baadhitaanka TSH waa baadhitaanka dhiigga ee ugu horreyn ka faa'iideysto labadaba baarista hypothyroidism iyo hyperthyroidism oo la socoshada daaweynta tayroodhka hoormoonka (haddii loo baahdo).
Iyadoo xaaladaha caafimaad, sida uurka ama isbitaal la dhigo, ayaa laga yaabaa inay ubaahdaan in T4 iyo T3 la qiyaaso, qabashada fikradda aasaasiga ah ee heerarka sarreeya ee heerarka Qaaxada ee roodhidaada tayada runtii waa waxa aad u baahan tahay inaad ogaato.
Taasi waxay tiri, haddii aad qabtid wax su'aalo ah oo ku saabsan shaqada dhiigga ee la xidhiidha dhiiggaaga, hubso inaad dhakhtarkaaga weydiiso.
> Ilo:
> Bahn, R., Burch, H, Cooper, D, et al. Hyperthyroidism iyo Sababaha kale ee Thyrotoxicosis: Tilmaamaha Maareynta ee Tiriimka Maraykanka ee Tirakoobka iyo Xiriirka Mareykanka ee Endocrinologists. Tababarka Indhaha. Vol 17 Maya 3 Maajo / Juun 2011.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10-aad. WLL / Wolters Kluwer; 2012.
> Garber, J, Cobin, R, Gharib, H, et. al. "Tilmaamaha Tababarka Caafimaadka ee loogu talagalay Hypothyroidism ee Dadka Qaan-Gaarka ah: Cosponsored by American American of Endocrinologists Clinical Association iyo Ururka Tiriida ee Maraykanka." Tababarka Indhaha. Vol. 18 No 6 Noofembar / Disembar 2012.
> DS DS. (2017). Qiimeynta shaybaarka ee hawlaha tayroodh. In: UpToDate, Cooper DS (Ed), UpToDate, Waltham, MA.