Ukwelapha Ama-antibodies Uma i-TSH ijwayelekile
Ukwelashwa kwe-thyroid okuvimbela kuyinkinga engavumelani. Ingabe kukhona okunye ongakwenza ukuze uvimbele isimo se -roid, noma ugcine ungabi nakakhulu? Uma ubuza, ezinye ze-endocrinologists zizokumane zikuxoshe, noma zitshele ukuthi awunawo ongakhetha ukwelashwa. Kodwa-ke, ukutholakala kocwaningo, kusekela ukuqonda ukuthi i-Hashimoto's thyroiditis-isifo esizimele esenza i-hypothyroidism-ingase ivikeleke, ihambe kancane noma imiswe ngokuphelele ngaphambi kokuba iqhubekele ekubhujisweni kwengubo yakho yegciwane kanye ne-hypothyroidism.
Esikhathini isingqungquthela kwinkomfa ye-Endocrine Society yase-Endo 2005, uDkt. Ting Chang nabalingani bakhe babika ngokunikeza i-hormone esikhundleni sezidakamizwa i-levothyroxine (amagama ajwayelekile ahlanganisa i-Synthroid, Levoxyl, neTirosint) ezigulini zikaHashimoto's thyroiditis. Lezi ziguli zine- hormone ye-thyroid evuselelayo (TSH ), futhi yaqokwa ngokuthi "i-euthyroid, okusho ukuthi amazinga abo e-TSH aphakathi kohlobo olujwayelekile." Kodwa lezi ziguli nazo zaphakamisa amasosha omzimba we-peroxidase (TPO). okubonisa ukuthi i-Hashimoto's thyroiditis yenzeke ngokuzenzakalelayo.
Isiqingatha seziguli zanikwa i-levothyroxine izinyanga eziyisithupha kanti enye ingxenye ayitholanga ukwelashwa kwezidakamizwa. Izivivinyo zomsebenzi we-thyroid kanye neziqu ze-autoantibody zilinganisiwe ngaphambi nangemva kwesikhathi sezinyanga ezingu-6. Okubalulekile kwakubalulekile:
- Labo abathola i-levothyroxine babenciphisa kakhulu amazinga e-autoantibody , futhi amazinga e-antibody anyukile empeleni phakathi kweqembu elingaphenduliwe.
- Amazinga we-TSH ahlehlisiwe eqenjini eliphathwe, isilinganiso esingu-0.5 vs 2.5 eqenjini elingaphenduliwe.
Abacwaningi baphetha ngokuthi ukwelashwa kokuqala kwe-prophylactic (okuvimbela) i-levothyroxine kungase kube usizo ukusiza ukunciphisa ukuqhubekela phambili kwe- Hashimoto's thyroiditis.
Lokhu akusiyo isifundo sokuqala sokubonisa ukuthi ukwelashwa kokuvimbela kungavimbela ukuqhubekela phambili kukaHashimoto noma ukuthuthukiswa kwe-overt hypothyroidism.
Ngomagazini ka-March 2001 wephephandaba i- Thyroid , abacwaningi baseJalimane babika ngokutadisha kwabo iziguli ezine-euthyroid i-Hashimoto, nengxenye yazo eyaphathwa i-levothyroxine unyaka, enye ingxenye ingaphathwa. Emva kweminyaka engama-1, ama-antibody amazinga kanye nama-lymphocyte, okuyiwo ubufakazi bokuvuvukala, wehle kakhulu kakhulu eqenjini elithola imithi. Phakathi kweqembu elingaphenduliwe, ama- antibody amazinga aphakama noma ahlala efana.
Abacwaningi baphetha ngokuthi ukwelashwa kokuvimbela iziguli ze-euthyroid iziguli zikaHashimoto zanciphisa izimpawu ezihlukahlukene ze-thyroiditis . Baye bacabanga ukuthi ukwelashwa okunjalo kungase kukwazi ukuyeka ukuqhubeka kwesifo sikaHashimoto, noma mhlawumbe kuvimbele ukuthuthukiswa kwe-hypothyroidism.
Kwesinye isifundo, abacwaningi baseJapane bathola ukuthi ukwelashwa nge-levothyroxine kunganciphisa isifo se-Hashimoto's thyroiditis, kanye nokusiza ukunciphisa izimpawu zesifo.
Ekuhloleni iziguli ezine-euthyroid isifo sikaHashimoto, iqembu elilodwa leziguli lathola ukwelashwa kwe-levothyroxine, kanti elinye iqembu alizange lithole ukwelashwa. Ngemuva kwezinyanga ezingu-15, iqembu eliphathwayo liye lakhuphula kakhulu amazinga e-T4 wamahhala, amazinga we-TSH anciphisa kakhulu, nokunciphisa ama-anti-thyroglobulin antibody (Tg-Ab) namazinga okulwa ne-anti-thyroid peroxidase.
Ubukhulu bezigulane ze-thyroid nazo zancipha eqenjini eliphathwayo, kanti labo abangatholi ukwelashwa babe nokwanda kobukhulu be -roid , uphawu lokuvuvukala kwegciwane.
Abacwaningi babika ukuthi nakuba ukwelashwa kwe-levothyroxine "kunesidingo esikhwameni se- hypothyroid autoimmune thyroiditis , ukwelashwa okuboniswa ukuvimbela inqubo yokuzimela ngokuzenzakalelayo ezithombeni zezilwane kusekhona engqubuzana neziguli zesifo se-Hashimoto euthyroid lapho lesi sifo singabhubhisanga igciwane le-thyroid okwanele ukudala i-hypothyroidism. "
Kodwa-ke, bathola ukuthi ukwelashwa kwe-levothyroxine ngamazinga okugcina i-TSH kumazinga aphansi ajwayelekile kubonakala sengathi ayasebenza hhayi nje ekunciphiseni amazinga we- autoantibody kodwa nakwayizilinganiso ze-goiter, okuzogcina ekugcineni ukuvimbela ukuqhubekela phambili ekuziphatheni kwe-autoimmune hypothyroidism.
Izwi kusuka
Njengoba ubona, kukhona ucwaningo oluphawulekayo olubonisa ukuthi ukwelashwa kokuvimbela nge-levothyroxine kungase kuqinisekiswe kubantu abane-euthyroid yesifo se-Hashimoto, abanamazinga ajwayelekile we-TSH kodwa amazinga aphikisana nawo avela ubufakazi bokugula kwesifo sikaHashimoto . Ukwelashwa okunjalo ngezinye izimo kunganciphisa izimpawu ze-hypothyroidism, kunciphisa ukuphakama kwama-antibodies we-thyroid , kusize ekuvimbeleni ukuwohloka kwesifo somzimba , nokuvimbela ukuthuthukiswa kwe-hypothyroidism.
Uma unezimpawu ze-thyroid , izinga le-TSH "evamile", kodwa alihlolwanga ngama-antibodies we-thyroid, ugxile ekuhlolweni kwe-TPO okwenziwa ngudokotela wakho.
Uma unesifo se-thyroid, izinga le-TSH "elingajwayelekile", futhi uphakamise amasosha omzimba we-thyroid, cabanga ukucela ukwelashwa, futhi uma udokotela wakho engathandi, cabanga ukuthola udokotela owaziyo noma ovulekile .
Imithombo
En-Ting Chang, Du-An Wu, Dee Pei, Shi-Wen Kuo, Ming-Chen Hsieh. [P2-552] Ukuthonya kwe-L-Thyroxine Administration kulabo abagulayo abane-Euthyroid Hashimoto's Thyroiditis. I-Endocrine Society Endo ka-2005 Ama-albhamu
I-Thyroid, ngo-2001 Mar; 11 (3): 249-55, "Ukwelashwa kwe-One-year prophylactic ye-euthyroid i-Hashimoto's thyroiditis iziguli ezine-levothyroxine: ingabe kunenzuzo?"
Duygu Yazgan Aksoy, futhi. al. "Imiphumela ye-Prophylactic Hormone Replacement esikhundleni Euthyroid Hashimoto's Thyroiditis" Endocr J (Japan) Vol. 52: 337-343, (2005).