Wax kasta oo aad ubaahan tahay inaad ka ogaato wax ku saabsan baaritaanka qanjidhada ee hormoonada hormoonka
Baaritaanka hoormoonka kicinta hoormoonka ee tayroodhka-sidoo kale loo yaqaanno imtixaanka TSH - waa imtixaanka muhiimka ah ee ay isticmaalaan dhakhaatiirta caadiga ah ee ku jira ogaanshaha iyo daaweynta cudurka thyroid. Waxaa lagama maarmaan ah in bukaanka tayroodhka ah, aad fahamto imtixaanka, macnaha natiijooyinkaaga, iyo muranada ku hareereysan qiyaasta tixraaca ee TSH.
Maxay Tahay Imtixaanka TSH?
Tijaabada TSH waxay qiyaastay qiyaasta hoormoonka kor u kaca ama TSH.
TSH waa hormoon la sii daayo qanjirada pituitary ee jawaabta heerarka hoormoonka thyroid ee dhiiggaaga. Marka heerarka hoose ee hoormoonka tayroodhka la ogaado, pituitary waxay sii deynaysaa TSH dheeraad ah si ay ugu dhiirigeliso qanjiradaada qanjirada in ay soo saarto hormoon dheeraad ah. Marka la ogaado hoormoonka tayroodh aad u badan, pituitary wuxuu hoos u dhigayaa wax soo saarka TSH.
Tijaabada TSH waa baaritaanka dhiigga ee ugu horeeya ee loo isticmaalo in lagu ogaado cudurka thyroid-ka iyo daaweynta tayroodhka. Heerka asaasiga ah, heerarka sarreeya ee TSH waxaa loo tixgeliyaa caddaynta cudurka hypothyroidism, oo ah qanjir la'aan. Heerarka Qiimaha Cusub waxaa loo tixgeliyaa caddaynta hyperthyroidism, oo ah qanjir la'aan.
TSH Muuqaal Tixraacyo
Qeybaha tixraaca waxaa la helaa iyada oo la qaadanayo kooxo dad ah oo dadweynaha ah, iyagoo tijaabinaya tijaabo gaar ah, xisaabinta qiyamka, iyo abuurista kala duwan oo loo malaynayo in ay metelaan heerarka caadiga ah ee dadka ka xorooba cudur gaar ah ama aan caadi ahayn .
Qeybta tixraaca ee tixraaca MR waxay ka dhigan tahay heerar kala duwan oo ah dadka uurka leh ee loo yaqaan 'thyroid disease' oo leh shaqeyn qanjirka 'caadiga ah'.
Iminka, inta badan shaybaarada Mareykanka, tirada tixraaca ee imtixaanada TSH waa qiyaastii 0.5 ilaa 5.0 mU / l. Iyadoo ku xiran shaybaarka, waxaa laga yaabaa inaad u muuqato kala duwanaansho, tusaale ahaan 0.4 ilaa 5.5 mU / l, ama 0.6 ilaa 4.5 mU / l, iwm, laakiin guud ahaan, 0.5 ilaa 5.0 mU / l ayaa loo tixgeliyaa noocyo badan oo shaybaarro ah.
Caadi ahaan, dhakhtarkaaga ayaa kuu tarjumi doona heerka ka hooseeya 0.5 mU / l oo tilmaamaya hyperthyroidism (qanjirro badan oo ka tirtirma), iyo heer ka sareeya 5.0 mU / l oo tilmaamaya hypothyroidism ( qanjirro aan firfircoonayn .)
Jaantuska soo socda ayaa muujinaya shaxda tixraaca ee "TSH" shaybaarka caadiga ah:
| TSH Range Reference | Turjumaadda |
| 0.5 ilaa 5.0 mU / l | - Heerka ka hooseeya 0.5 mU / l oo tilmaamaya hyperthyroidism - Heerka kor ku xusan ee 5.0 mU / l oo muujinaya hypothyroidism |
Khilaafaadka Range ee Tixraaca
Qeybta tixraaca ee tixraaca ah ee MA ayaa muran ka dhashay muddo toban sano ka badan. Dib ugu noqoshada 2003, ka dib markii caddayntu muujisay in bukaanada qaba heerarka dhimirka ee TSH ee dhammaadka sare ee tixraaca TSH waxay u muuqdaan inay sii wadi doonaan inay horumariyaan hypothyroidism inta badan kuwa ka hooseeya dhamaadka qaybta hoose, Xiriirka Mareykanka ee Dhakhaatiirta Caafimaadka ee Endocrinologists (AACE) waxay ku taliyeen in dhakhtarradu "tixgeliyaan daaweynta bukaannada tijaabinaya meel ka baxsan xudduudaha hoos u dhaca ku salaysan heerka heer- dhexaad ah ee udhexeysa heerka 0.3 ilaa 3.0 mU / l wakhtigaa, AACE waxay rumaysnayd in noocyada cusubi " ay keenayaan cilad ku habboon malaayiin Dadka Maraykanku ku dhaco qanjirro sahlan khafiifka ah, laakiin aan la daaweynin. "
Sida laga soo xigtay madaxweynaha AACE Hossein Gharib, MD,
Cudurka qanjidhka aan la ogaan karin ee Mareykanka waa mid aad u walaacsan ... Qaab cusub oo cusub oo ka mid ah xeerarka AACE ayaa siinaya dhakhaatiirta macluumaadka ay u baahan yihiin si ay u baaraan cudur khafiif ah oo ka soo horjeeda ka hor inta aanay u horseedi karin saameyn halis ah caafimaadka bukaanka, sida kolestaroolka sareeya, cudurka wadnaha, osteoporosis, infertility, iyo niyad-jabka. "
Waqtigaas, ogeysiiska AACE waxaa loo arkey dad badan oo ah mudo dheer oo waqti dheer ah oo aad loogu baahan yahay hagaajinta bukaanka.
Nasiib darro, waxa loo arkaa horumar aad u wanaagsan oo loogu talagalay bukaannada qanjirka 'thyroid' wax saameyn ah ma lahayn, sababo badan:
- Shaybaaradu waligood ma aqbalin qiyaasta cusub ee ah qaabka rasmiga ah, taas oo macnaheedu yahay heerarka kaliya ee ka baxsan qaangaarka weyn, ee ballaadhan ayaa lagu tilmaamaa mid aan caadi ahayn.
- Xarunta caafimaadku waxay sii waday in ay ka soo horjeeddo qiyaasta tixraaca ee TSH, sida lagu caddeeyey laba maqaayadood oo caan ah kuwaas oo u muuqday arrinta September 2005 ee Mawduuca Caafimaadka Indomiginoloji iyo Metabolism , oo soo bandhigay labada dhinac ee doodda.
Dhakhaatiirta Martin Surks, Gayotri Goswami iyo Gilbert Daniels ayaa ku dooday in kala duwanaanta tixraaca ay tahay in ay isku mid noqdaan maqaalkooda "Isku Khilaafsanaanta Endocrinology Clinic: Khariidadda Daawada Thyrotropin waa inay isbedesho." Waxay ku saleynayaan doodooda ku aaddan sheegistooda "sababtoo ah daaweyn joogto ah ee levothyroxin laguma talineynin hypotyroidism subclinical, hubaal maahan in shakhsiyaadka qaba qiyaasta sare ee tiirarka sare ee 2.5 ilaa 4.5 mU / l.
Dhakhaatiirta Leonard Wartofsky iyo Richard Dickey ayaa ku dooday maqaalkooda, "Caddaynta Nirotropin Rugta Khariidad Khafiifinta ah waa Mujaahid," in noocyada hore ee la aqbalay ayan ansax ahayn maxaa yeelay dadka la tixraacsanaa ee hore loo tixgeliyey waxay ahaayeen "faddareyn" shakhsiyaadka leh heerar kala duwan cudurka qaaxada. Waxay ku doodeen in faa'iidooyinka daaweynta ay aad uga badan yihiin khatarta ugu yar.
Dhakhaatiirta Wartofsky iyo Dickey ayaa difaacay isbeddelka cusub ee soo kala dhexgalay:
Waxaan u maleynayaa inaan marnaba laheyn wax qiimo dhimis ah oo loogu talagalay TSH dibaddiisa caadiga ah ee aan caadi ahayn, laakiin aqoonsiga in celceliska Qiimaha caadiga ah ee TSHku yahay kaliya inta udhaxaysa 1.18 iyo 1.4 m / l iyo in ka badan 95% dadka caadiga ah waxay yeelan doonaan heerka GB ka badan 2.5 mU / l oo si cad u qeexaya in qof kasta oo qiimo sarreeya uu si taxadar leh loo qiimeeyo horukac la'aanta hore.
Sannadkii 2006, kooxaha loo yaqaan 'endocrinology' ayaa ka tagay taladii si ay u ballaariso kala duwanaanshaha tixraaca ee TSH, Hase yeeshee, dooddii dambe iyo kuwii sii socdey ayaa sii waday muddo ka badan toban sano, illaa iyo 2017, muranka ayaa sii socota. Hase yeeshe, badi shaqaalaha daryeelka caafimaadka ee caadiga ah waxaa lagu barayaa inay isticmaalaan tixraaca tirada tixraaca ee TSH ee lagu ogaado iyo daaweynta bukaannada qanjidhada.
Caadiida caadiga ah iyo Hypothyroidism
Waxay muhiim u tahay bukaannada tayroodhka inay ogaadaan in cilmi-baaristu ay muujisay in:
- Qiyaasta iodine-ku filan, celceliska TSH waa 1.5 mU / l
- Daraasadaha kooxaha tirada dadka oo leh dhacdooyin hooseeya ee Hashimoto's thyroiditis, celceliska TSH waa 1.18 mU / l
- Marka dadka qaba antithyroid antibiyootikada ama taariikhda qoyska ee xanuunka thyroid-ka ee laga yaabo in laga saaro xisaabinta tixraaca tixraaca, kala duwanaanta tixraaca caadiga ah waxay ka socotaa qiyaastii 0.4 ilaa 2.5 mU / l
- Xilliga uurka, tilmaamaha waxay tilmaamayaan in heerarka TSH in aysan marnaba kor u dhaafin 3.0, si loo ilaaliyo caafimaadka hooyada iyo ilmaha.
- Qeybaha tixraaca ee heerarka sare ee tixraaca ayaa sidoo kale lala xiriiriyaa khatarta sii kordhaysa ee kansarka thyroid, kolestaroolka sare, dhalmo la'aanta, cudurada wadnaha, nooca 2aad ee sonkorowga, iyo arrimo dhowr ah oo caafimaad.
- Heerarka TSH waxay u muuqdaan kuwo ka sarreeya maalinta hore. Imtixaanka QT ee la sameeyay dhammaadka maalintii wuxuu muujin karaa heerarkaaga marka la eegayo qiyaasta tixraaca, halka baaritaanka hore ee subaxdii laga yaabo inuu muujiyo hypothyroidism.
Haddii natiijada baaritaanka QM ay ku dhacdo dhexda tixraaca oo laguu sheego "Your TSH waa caadi," miyaad weli noqon kartaa hypothyroid? Dhakhaatiirta caadiga ah ee caadiga ah waxay yiraahdaan maya, dhakhaatiir badan oo isku dhafan iyo kuwo ficil ah waxay yiraahdaan haa. Haddii aad noqon karto hypothyroid oo ah heerka caadiga ah ee TSH waxay ugu dambeyntii noqotaa arrin khilaaf ah.
Ereyga
Sidaad u baratay, qeexidda heerka caadiga ah ee "TSH" ayaa ku xiran dhakhtarka aad la tashanayso iyo fikradihiisa ama fikradiisa ku saabsan cudurka thyroid. Isla mar ahaantaana, baaritaanka TSH ee TSH iyo Qaybta tixraaca ee TSH waxay muhiim u yihiin caafimaadkaaga iyo daaweyntaada tirtirka. Natiijo ahaan, waxaa jira waxyaabo muhiim ah oo maanka lagu hayo.
- Waxaad u baahan tahay inaad waydiiso heerka darajada TSH ee uu takhtarku ku beegsanayo adiga, iyo sababta. Waxaa laga yaabaa inaad haysatid takhtar aaminsan in ku haynta sarre ee xadka uu yahay ujeedada keliya ama midka diirada saaraya KH ka hooseeya iyo gargaarka calaamadahaaga. (Sidoo kale, dhakhaatiirtu waxay bartilmaameedsan yihiin heerarka TSHK ee loogu talogalay qaar ka mid ah kuwa ka badbaaday cudurka kansarka, si ay uga hortagaan soo noqoshada kansarka.) Inta badan dhakhaatiirta, waxay wali isticmaalayaan qiyaasta tixraaca ee LA ilaa 0.5 illaa 5.0 si loogu ogaado cudurka iyo maamulka cudurkaaga thyroid-ka.
- Waa inaadan aqbalin jawaabaha "caadi", "sare," ama "hooseeya" sida warbixinta dhiiggaaga. Bedelkeed, waydiiso lambarrada dhabta ah oo waydiiso qiyaasta tixraaca shaybaarada. Xitaa wali way fiican tahay, weydii nuqul ka mid ah natiijooyinka baaritaanka dhiigga.
- Haddii heerarka baaritaanka TSH-ga ee ku jira qiyaasta tixraaca, oo aad leedahay calaamado la mid ah hypothyroidism, waxaad u baahan kartaa inaad codsato baaritaanno dheeraad ah si ay u caawiyaan baaritaanka guud. Inkasta oo dhakhaatiirta caadiga ah ay badanaa ku tiirsan yihiin imtixaankii TSH, haddana dhakhaatiirta qaarkood waxay sidoo kale cabbiraan thyroid-thyroxine-thyroxine (T4) iyo triiodotyronine (T3) -waxaa sidoo kale heerarka antibody-da ee tirtira T3. Takhaatiirtaasi waxay raadinayaan cabbiraadyo dheeraad ah si ay u sameeyaan baaritaan. Tusaale ahaan, marka heerarka hormoonka T4 iyo T3 uu hooseeyo, waxaa la tuhunsan yahay hypothyroidism, iyo marka ay sarreeyaan, hyperthyroidism ayaa looga shakiyay. Antibodies-gaar ahaan habka difaaca jirka ee tirakoobka (TPO) ee lagu ogaan karo cudurka Hashimoto-ayaa mararka qaarkood lagu qiyaasaa. Qayb ka mid ah xirfadlayaashu waxay aaminsan yihiin in qanjidhka thyroid-ka ee ku jira habka foosha 'autoimmune failure' - sida lagu caddeeyey heerarka antibody-ga sareeya-waxay sababi karaan calaamadaha hypothyroidism inta dheer ka hor intaan la isku qaadsiin hypothyroidism in TSH, ama xataa bilaash T4 iyo Free T3, imtixaannada. Waxay sidoo kale aaminsan yihiin in daweynta bedelka hormoonnada hormoonka ah ee tayroodhka laga yaabo inuu kaa caawiyo ciribtirka calaamadahaaga, hoos u dhigo heerarka antibiyo, oo kaa horjoogsanaya inaad noqotid hypothyroid si xun.
- Haddii heerarka baaritaankaaga TSH dib u dhaco dhammaadka sare ee xariirka tixraaca, oo aad leedahay calaamado la mid ah hypothyroidism, tixgeli inaad ka wada hadashaan tijaabada daweynta daaweynta thyroid hormoonka dhakhtarkaaga.
- Haddii dhakhtarkaagu diido inuu baaro baaritaan dheeri ah ama uu diido inuu ku daweeyo, tixgelin sidii aad u heli lahayd dhakhtar cusub oo loogu talagalay daryeelkaaga thyroid. Dhakhaatiirta isku dhafan iyo kuwa hiddaha leh waxay badanaa ku jiraan baaritaano badan oo lagu daro imtixaanka TSH, iyo taariikhdaada caafimaad iyo calaamadahaaga tixgelin, ujeeddaduna tahay in la helo nabadgelyo iyo habboonaanta TSH oo si ammaan ah u yareeya calaamadahaaga.
> Ilo:
> Anderson et. al., "Iskudarida Shakhsiyaadka Shakhsiyadeed ee Serum T4 iyo T3 ee Maaddooyinka caadiga ah: Faafinta fahamka xuubka 'Thyroid Theroid Disease', 'Journal of Endocrinology and Metabolism, 87 (3): 1068-1072.
> Garber J, Cobin R, Gharib H, iyo al. Tilmaamaha tababarka caafimaadka ee loogu talagalay hypothyroidism ee dadka qaangaarka ah: Cosponsored by ururka American ee qalliinka indocrinologists iyo ururka tyroid American. Tababarka Indhaha. 2012; 18 (6): 988-1028. doi: 10.4158 / ep12280.gl.
> Guber HA, Farag AF. Qiimeynta waxqabadka endocrine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis iyo Maareynta Hababka Shaybaarka. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011: cutub 24.
> Surks, et.al. "Isku Khilaafsan Dhakhtarka Xanuunka Dhimashada: Rugta Tixraacsiga Daawada Thyrotropin waa inuusan isbeddelin," Journal of Endocrinology iyo Metabolismis 90 (9) / 5489-5496.
> Wartofsky & Dickey, "Dhexdhexaadinta Endocrinology Clinic: Caddeyn loogu talagalay Nirotropin Rugta Tirotropin Risku waa Ereyga," Journal of Endocrinology Clinical and Metabolism.