Ku-hypothyroidism, ukugcoba kwe-thyroid kuhluleka ukukhiqiza ngokwanele i-hormone ye-thyroxine (ebizwa nangokuthi i-T4). Ngenxa yokuthi i-T4 ibaluleke kakhulu ekulawuleni umzimba, ukugaya umzimba, umsebenzi we-muscle, nokusebenza komzimba , i-hypothyroidism ihlale iyingqinamba enkulu.
I-gland yegciwane ngokwayo ilawulwa yi-hormone TSH (i-thyroid stimulating hormone).
Uma i-gland yegciwane ingakhiqizi ngokwanele i-T4, amazinga e-TSH ayanda ukwenzela i-thyroid ukuba isebenze kanzima. Ku-hypothyroidism-lapho i-thyroid ingenakukwazi ukwenza okwanele i-T4-amazinga e-TSH cishe aphakeme kakhulu.
I-subclinical hypothyroidism yisimo lapho amazinga ka-T4 ahlala khona ebangeni elijwayelekile (okungukuthi, ama-hypothyroidism angenamahloni akhona), kodwa amazinga e-TSH aphakanyisiwe: amazinga aphezulu e-TSH adingekayo ukuze alondoloze lelo zinga elijwayelekile le-T4. Ngakho-ke, i-hypothyroidism i-subclinical iveza ukuthi igciwane le-thyroid ayisebenzi kahle ngokujwayelekile. Kuwukuthi "ukushaya" i-thyroid (ngezinga eliphezulu le-TSH) ukuthi amazinga athile ka-T4 angagcinwa.
Kukhona ukungqubuzana okukhulu namuhla mayelana nokubaluleka kwangempela kwe-subclinical hypothyroidism. Ngenxa yokuthi amazinga e-T4 ejwayelekile ngempela kuleso simo, ngokwemfundiso, i-subclinical hypothyroidism akufanele ibe yinkinga enkulu.
Kodwa ubufakazi bubonisa ukuthi i-subclinical hypothyroidism iveza izinkinga zemitholampilo okungenani ngezinye izikhathi-ngakho-ke, kwezinye izimo, kufanele ilashwe.
Mhlawumbe ukukhathazeka okukhulu nge-subclinical hypothyroidism ukuthi kungathinta inhliziyo.
Indlela i-Subclinical Hypothyroidism Eyaziwa Ngayo
Lesi sifo sitholwa ngokuhlolwa kwegazi, ikakhulukazi, ngokulinganisa amazinga ka-T4 namazinga we-TSH.
I-subclinical hypothyroidism ikhona uma amazinga e-T4 ehlelekile (0.8 kuya ku 1.8 ng / L), futhi amazinga e-TSH angaphezu kwebanga elijwayelekile (0.3 kuya ku-3.04 mU / L). Kodwa-ke, ochwepheshe abaningi bacabangela ukuthi i-hypclinical hypothyroidism ibe "ephawulekayo" kuphela lapho amazinga e-TSH ephakanyiswa kakhulu: ngaphezulu kuka 10 mU / L.
Izimbangela
Kukholelwa ukuthi i-hypclinicalism e-subclinical ingumzimba omncane, noma uhlobo oluthile, lwezinkinga ezivame ukhiqiza u-frank hypothyroidism-ikakhulukazi i-autoimmune thyroiditis (i- Hashimoto's thyroiditis ). Ngempela, ngokuhamba kwesikhathi, ingxenye enkulu yabantu abaphethe i-subclinical hypothyroidism izoqhubeka nokuthuthukisa i-hyphenroidism enamahloni, enezinga eliphansi le-T4 nazo zonke izimpawu ezihambisana nayo . Ngakho-ke, esinye isizathu odokotela abathile baphatha i-subclinical hypothyroidism ukuvimbela ukuqhutshwa kokugcina kwesimo esibi kakhulu se-hypothyroidism yeqiniso.
Izimpawu Ezingenzeka?
Ngenkathi lesi simo singabonakali abantu abaningi, abanye bazovuma ukuthi izimpawu ezincane zibonisa ukuthi i-hypothyroidism, njengokuqothulwa, ukukhathala, noma ukutholakala kwesisindo esingachaziwe. Kuye kwaphakanyiswa ukuthi abantu abane-subclinical hypothyroidism bangase babe nesimo esiphezulu sokukhathazeka okukhulu, ukucindezeleka, noma ukuphazamiseka kwengqondo.
Indlela Ethinta Ngayo Inhliziyo
Ngaphandle kwengozi yokugcina i-frank hypothyroidism, ukukhathazeka okuyinhloko nge-subclinical hypothyroidism ukuthi kuhlotshaniswa nesifo se-cardiovascular disease.
Izifundo eziningana manje sezibonise ubudlelwane obuphakathi kwamazinga aphezulu e-TSH (amakhulu kunama-10 mU / L) nokuthuthukiswa kwe- coronary artery disease (CAD) . Ukuhlaziywa okuhlanganisiwe kwezifundo eziningana zemitholampilo ezazihlanganisa iziguli ezingaphezu kuka-25 000, izifo ezincane ze-subclinical hypothyroidism zazihlotshaniswa nokwanda kwe-heart attack, i-CAD ephawulekayo nokufa komzimba. Okunye ukuhlaziywa okuhlanganisiwe kwatholakala ingozi enkulu kakhulu yokwehluleka kwenhliziyo kwiziguli ezine-subclinical hypothyroidism.
Futhi izifundo eziningana ziye zahambisana ne-subclinical hypothyroidism ngezinga eliphezulu le-cholesterol.
Ngenkathi inhlangano ingabonakali imbangela-futhi-effect, kuyaphawuleka ukuthi ngokweqile i-hypothyroidism iveza isifo esibalulekile senhliziyo. Leli qiniso linikeza umbono wokuthi i-subclinical hypothyroidism ingathinta kabi inhliziyo. Ukwanda kwengozi yenhliziyo ebonwe nge-subclinical hypothyroidism ngempela kuyisici esibuhlungu kunazo zonke zalesi simo.
Ingabe I-Hypothyroidism Kufanele Iphathwe Ngaphansi Kwama-Subclinical?
I-subclinical hypothyroidism ingelashwa ngokunikeza ukwelapha okukhipha i-hormone ye-thyroid. Ukwelashwa kuqondiswa ngokuqapha ngokucophelela amazinga egazi le-TSH; i-hormone ye-thyroid eyanele inikelwa ukunciphisa amazinga e-TSH abuyele ebangeni elijwayelekile.
Kukhona ubufakazi obukhawulelwe obuvela ezifundweni zokwelapha ukuthi ukwelapha i-subclinical hypothyroidism kuthuthukisa izimpawu. Ezicwaningweni ezibonisa ukuthi linciphisa izimpawu, inzuzo elinganiselwe ibonakala iphelelwe kulawo maphuzu ayo amazinga okuqala e-TSH aphakeme kakhulu (okungukuthi, angaphezu kuka-10 mU / L).
Ngokufanayo, ubufakazi bokuthi ukwelapha i-hypclinical hypothyroidism kunciphisa ingozi yesifo senhliziyo nayo inqunyelwe. Esifundweni esenziwa e-Great Britain, phakathi kweziguli ezincane (ezingaphansi kweminyaka engama-70 ubudala) ne-subclinical hypothyroidism, ingozi yezifo zenhliziyo esilandelayo yayiphansi kakhulu kwiziguli ezathola ukwelashwa kwe-hormone ye-thyroid. Ayikho inzuzo yokwelashwa eyabonwa iziguli ezindala ezine-subclinical hypothyroidism.
Ngaphezu kwalokho, ukwelapha i-hypothyroidism engaphansi kwe-subclinical kakhulu kuthuthukisa izinkinga eziningana zempilo yengqondo, kuhlanganise namazinga e-cholesterol, amazinga e-CRP , nokusebenza kwamascular.
Okubalulekile
Ochwepheshe abaningi bancoma ukuphatha i-subclinical hypothyroidism lapho amazinga e-TSH angaphezulu kuka-10 mU / L, noma ngabe kukhona izimpawu noma cha.
Kungakhathaliseki ukuthi i-hypclinical subclinical i-hypothyroidism kufanele ilashwe uma amazinga e-TSH angaphansi kuka-10 mU / L ehlala iphuzu lokuxabana. Odokotela abaningi batusa ukwelashwa ngisho nakulolu hlu oluphansi uma iziguli zinempawu ezibonisa ukuthi i-hypothyroidism, noma uma ziphakanyise amazinga e-cholesterol noma ezinye izifo ezibangelwa isifo senhliziyo.
Ingabe Kufanele Uvivinywe?
Ezinsukwini zakudala (iminyaka eyishumi noma emibili eyedlule), ukuhlolwa komsebenzi we-thyroid kwakuyingxenye evamile yokuhlolwa kwezokwelapha. Kodwa ngenxa yenzuzo yokulondoloza izindleko, ngokuvamile akuyona isimiso.
Kunengqondo ukucela udokotela wakho ukuba ahlolwe ngegazi uma unezimpawu ezibonisa ukuthi i-hypothyroidism (bheka ngenhla), uma ukhulise amazinga e-cholesterol, noma uma nje ufuna ukuqiniseka ukuthi wenza konke ongakwenza ukuze unciphise ingozi yakho yomzimba .
Imithombo:
Rodondi N, den Elzen WP, uBauer DC, et al. I-subclinical hypothyroidism kanye nengozi ye-coronary disease and mortality coronary. I-JAMA 2010; 304: 1365.
Gencer B, Collet TH, Virgini V, et al. Ukungasebenzi kahle kwe-thyroid kanye nengozi yokukhubazeka kwenhliziyo: ukuhlaziywa kwedatha komunye umuntu okuvela kumalungu angu-6 angama-cohorts. Ukujikeleza ngo-2012; 126: 1040.
URazvi S, Weaver JU, Butler TJ, Pearce SH. Levothyroxine Ukwelashwa kwe-Subclinical Hypothyroidism, Izenzakalo Ezibulalayo Nezifo Zezinhliziyo, Nokufa. I-Arch Intern Med 2012.