Izifo ze-gland yegciwane ngokuvamile ziveza izinkinga zenhliziyo. Eqinisweni, esinye sezizathu ezibaluleke kakhulu sokuthola nokuphatha isifo se-thyroid ukuvimbela izimo zenhliziyo ezingabangela kuwo.
Sibutsetelo
I-gland yegciwane ingumngcanyana omncane entanyeni engaphansi kwe-apple ka-Adam, futhi unesibopho sokulawula imisebenzi eminingi yomzimba ebalulekile.
Ngokukhiqiza inani elifanele le-hormone ye-thyroid, i-thyroid isiza ukulawula umzimba wesimiso somzimba wakho - okubaluleke kakhulu, umzimba wakho usebenzise kangakanani umoya-mpilo - kanye nomsebenzi wakho wokugaya umzimba, umsebenzi we-muscle, ne-tone yesikhumba.
Eqinisweni, i-thyroid ine okungenani umthelela kuzo zonke izitho zomzimba, kuhlanganise nenhliziyo.
Emuntwini oseduze nanoma yiluphi uhlobo lwesifo senhliziyo, ukuphazamiseka kwegciwane le-thyroid kungalimaza izimpawu zenhliziyo noma kubangele okusha, futhi kungasheshisa inkinga yomzimba. Isifo se-thyroid singakhipha nezinkinga zenhliziyo ezintsha kubantu abanezinhliziyo ezinempilo enye.
Isifo se-thyroid sithinta inhliziyo noma ngokukhiqiza i-hormone encane kakhulu ye-thyroid (isimo esibizwa ngokuthi i- hypothyroidism ) noma i-hormone ye-thyroid kakhulu (ebizwa nge- hyperthyroidism ). Zombili izinhlobo zezinkinga ze-thyroid zivamile futhi zombili zingaba nethonya elikhulu enhliziyweni.
I-Hypothyroidism
I-hormone ye-thyroid ibaluleke kakhulu emsebenzini ovamile wezinhliziyo. Uma kungekho hormone ye-thyroid eyanele, inhliziyo noma imithwalo yegazi zingasebenza ngendlela evamile.
E-hypothyroidism, izinga elincishisiwe lehomoni le-thyroid lenza ukuba imisipha yenhliziyo ibambe ngamandla futhi ekugcineni ibe buthakathaka.
Ngaphezu kwalokho, imisipha yenhliziyo ayikwazi ukuphumula ngokuphelele ngemva kokushaya kwenhliziyo ngayinye.
Lokhu ukwehluleka ukuphumula kungaveza ukukhubazeka kwe-diastolic, isimo esingabangela ukuhluleka kwenhliziyo . I-Hypothyroidism ibuye ibangele imithwalo yegazi ibe nzima, engabangela ukushisa komfutho wegazi .
Izimpawu ze-cardiac zingenzeka kunoma ubani onesifo se-hypothyroidism, kodwa ikakhulukazi kubantu abavele benesifo senhliziyo esivelele.
Izinkinga ezivamile zenhliziyo ezihlobene ne-hypothyroidism zihlanganisa:
- I- Dyspnea-Ukuphefumula kakhulu ekuzikhandleni nokuzivocavoca umzimba okubi kakhulu ku-hypothyroidism ngokuvamile ngenxa yobuthakathaka emisipha yamathambo. Kubantu abanesifo senhliziyo, kungase kube ngenxa yokwehluleka kwenhliziyo.
- I-slow heart rate ( bradycardia ) -Ukushaya kwenhliziyo kuhanjiswe ihomoni ye-thyroid. Ngakho-ke, nge-hypothyroidism, ukushaya kwenhliziyo kuvame ukushaya okungu-10 kuya kwe-20 ngomzuzu kancane kunejwayelekile. Ikakhulukazi ezigulini ezinesifo senhliziyo, noma kunjalo, i-hypothyroidism ingase ibe nzima kakhulu ukuthambekela kokushaya isikhathi esingaphansi kwesikhathi (njenge- PVCs ) futhi ingabangela ukufiphaza kwe-atrial.
- I-Diastolic hypertension -Okunye ongase acabange ukuthi, ngenxa yokuthi ukuntuleka kwe-hormone ye-thyroid kunciphisa umzimba, abantu abane-hypothyroidism bangase babe nesifo esiphansi segazi . Ngokujwayelekile, okuphambene kuyiqiniso-ukubhebhetheka komzimba okunamandla ku-hypothyroidism, okubangela ukuba i-diastolic yegazi ithinte.
- Ukwehluleka kokuhluleka kwenhliziyo noma ukuhluleka okusha kwenhliziyo -I-Hippothyroidism ingenza ukuhluleka kwenhliziyo ukulawulwa kahle futhi kungaveza ukuhluleka kwenhliziyo okokuqala kuziguli ezinesifo senhliziyo esincane.
- I-Edema (ukuvuvukala) -I-Edema ingenzeka ngenxa yokwehluleka kwenhliziyo. Ngaphezu kwalokho, i-hypothyroidism ngokwayo ingaveza uhlobo lwe-edema elibizwa ngokuthi i-myxedema, elibangelwa ukuqoqwa kwamaprotheni angavamile namanye ama-molecule emzimbeni wamanzi (ngaphandle kwamanzi amangqamuzana omzimba).
- Ukunciphisa i- coronary artery disease (CAD) -Nxa ukunciphisa i-hormone ye-thyroid kungenza ngempela i-angina (ukungabi kahle kwesifuba kuhambisana ne-CAD) kancane kancane ezigulini ezine-angina, ukwanda kwe-LDL cholesterol (i-cholesterol embi) naku -pro-protein esebenzayo ebonwe nge-hypothyroidism ingasheshisa noma iyiphi i-CAD engaphansi.
I-Hypothyroidism ivame ukuba yisimo esibucayi kakhulu . Ngokuvamile sekuqala kancane kancane, ngakho izimpawu zayo "zingagxila" kuwe. Ngaphezu kwalokho, ikakhulukazi kubantu asebekhulile, i-hypothyroidism ivame ukuvela ngaphandle kwe-constellation ejwayelekile yezibonakaliso "ezincwadini" odokotela ngokuvamile abalindele.
Futhi, i-hypothyroidism ivame ukwedlula odokotela abaningi abaqaphelayo. Ngakho-ke uma unayo izimpawu ezibonisa ukuthi i-hypothyroidism futhi udokotela wakho akanalo incazelo ekulungele noma ekholisayo (ikakhulukazi uma usuvele unesifo senhliziyo nganoma yiluphi uhlobo), kufanele ubuze udokotela wakho ukuthi ahlole ama-hormone e-thyroid.
I-Hypothyroidism iphathwa ngemithi ye-hormone ye-thyroid . Ukwelashwa okwanele kwe-hypothyroidism kuyinkimbinkimbi futhi iphikisana.
Hyperthyroidism
I-Hyperthyroidism ibangelwa ukwanda ngokweqile kwehomoni ye-thyroid. Uma kune-hormone ekhulu kakhulu ye-thyroid, imisipha yenhliziyo "ishaywa" njengehhashi futhi, ngoba umuntu onesifo senhliziyo kufana nokushaya ibhiza ekhathele.
Ukwandisa i-hormone ye-thyroid kwandisa amandla okuchotshozwa komzimba we-muscle futhi kwandisa inani le-oxygen elifunwa yinhliziyo. Futhi kwandisa isilinganiso senhliziyo. Ngenxa yalokho, umsebenzi wenhliziyo wanda kakhulu.
Izimpawu ze-cardiac zingenzeka kunoma ubani one-hyperthyroidism, kodwa kungaba yingozi kakhulu kubantu abanesifo senhliziyo esisezingeni eliphansi. Izimpawu ezivamile zihlanganisa:
- Ukushaya kwenhliziyo okusheshayo (i- tachycardia ) ne- palpitations -Umphumela (okungukuthi, ongathandeki) i-hyperthyroidism iyimbangela evamile yokuncipha kwenhliziyo ekuphumuleni nangokuzikhandla okuncane. I-Hyperthyroidism kufanele ihlale ingakhishwa ngaphandle kokuhlolwa kwegazi ngaphambi kokwenza ukuxilongwa kwe- sinus tachycardia engalungile . Ikakhulukazi ezigulini ezinesifo senhliziyo, i-hyperthyroidism ingabuye yenze amanye ama-arrhythmias, njenge-PVC, i-ventricular tachycardia, futhi ikakhulukazi i- frictional fibrillation . Ngempela, kubalulekile ukulawula i-hyperthyroidism kunoma ubani one-fibrillation ye-atrial ngaphandle kwesizathu esicacile esiyimbangela.
- I-Systolic hypertension -Ukuqothulwa kwamandla enhliziyo kunamandla okwandisa umfutho wegazi we-systolic (ukucindezela ngaphakathi kwemithwalo yegazi ngesikhathi sokuvinjelwa kwenhliziyo).
- I-Dyspnea ngokuzikhandla okuncane -Ukuphefumula kungenziwa ngenxa yobuthakathaka obuthakathaka bemisipha obuhlobene ne-hyperthyroidism noma ukuhlukumeza kwenhliziyo.
- Ukuhluleka kwenhliziyo -I-Hyperthyroidism ngokwayo ingabangela ukwehluleka kwenhliziyo, kodwa kungavamile kakhulu. Ngakolunye uhlangothi, uma isifo se-heart esivele sisekhona, ukuwohloka kwenhliziyo okubi kakhulu nge-hyperthyroidism kuvamile futhi kungaba nzima kakhulu ukuphatha.
- I- angina ephuthumayo -Iziguli ezine-CAD zivame ukubhekana nokubi kakhulu kwezimpawu nge-hyperthyroidism. Lokhu kungabandakanya ukwanda kwe-angina noma ngisho nokuhlasela kwenhliziyo.
Njenge-hypothyroidism, i-hyperthyroidism ingaba khona ngaphandle kokukhiqiza izimpawu zokufunda zencwadi zakudala. Ngakho-ke noma ubani onayo yalezi zimpawu zomzimba ezingenakuchazwa kalula kufanele abe nomsebenzi wabo we-thyroid.
Indlela "engcono kakhulu" yokwelapha i-hyperthyroidism ingxabano. EU.S., odokotela abaningi baphoqelela ngokushesha ukugcoba isikhumba se-thyroid esingasebenzi ngokweqile nge-iodine e-radioactive . Bese banikeza isiguli se-hormone yegciwane lesifo segciwane kusukela lapho igciwane lengculazi lingasebenzi. Noma kunjalo, lokhu ngezinye izikhathi kungase kube iphutha kusukela ngezinye izikhathi i-thyroid engasebenzi ngokweqile isigaba sesiguli sesifo sikaHashimoto , lapho kwenzeka ukubhubhisa ingubo yegciwane kungadingekile.
Ngenkathi usebenzisa izidakamizwa ukuvimbela kancane igundane le-thyroid (njengeTapazole noma i-PTU e-US) kudala inkinga enkulu yokuphatha odokotela isikhathi eside, ochwepheshe abaningi bakholelwa ukuthi kungaholela ezigulini ezithokozile ekugcineni.
Izwi elivela
Isifo se-thyroid singaphazamisa ukusebenza okujwayelekile kwezinhlelo zomzimba zomzimba eziningana. Phakathi kwezinkinga ezinkulu kakhulu ezingabangelwa yisifo se-thyroid kukhona izinkinga ezithinta inhliziyo. Eqinisweni, isifo se-thyroid yisisusa esivame ukwelashwa kwezimo zenhliziyo. Noma ubani odala izimpawu zenhliziyo cishe cishe noma yiluphi uhlobo kufanele aqiniseke ukuthi udokotela wabo uhlola izivivinyo zabo zokusebenza ze-thyroid, nokuthi noma yisiphi isimo se -roid esingatholakala siyaphathwa ngokwanele.
> Imithombo
> Klein I, Ojamaa K. Hormone ye-Thyroid Nesimo Sezinhliziyo. N Engl J Med 2001 Feb 15; 344 (7): 501-9.
> Jonklaas J, Bianco AC, uBauer AJ, et al. Imihlahlandlela Yokwelashwa Kwama-Hypothyroidism: Ilungiselelwe I-American Thyroid Association Task Force On I-Hormone Replacement Replacement. I-Thyroid 2014; 24: 1670.
> Ross DS, Burch HB, Cooper DS, et al. I-2016 American American Association Association Imihlahlandlela Yokuqapha Nokuphathwa Kwe-Hyperthyroidism Nezinye Izimbangela Ze-Thyrotoxicosis. I-Thyroid 2016; 26: 1343.