Ukuqaphela isifo se-thyroid kuyinkqubo engabandakanya izici eziningi, kufaka phakathi ukuhlolwa kwemitholampilo, ukuhlolwa kwegazi okuhlukahlukene, ukuhlolwa kwe-imaging, i-biopsies, nezinye izivivinyo. Kulesi sihloko, uzofunda kabanzi mayelana nokuhlolwa kwegazi okusetshenziselwa njengengxenye yesifo segciwane lengculaza, ukwelashwa, nokuqhubeka okulandelwayo nokuphathwa.
Isivivinyo se-TSH
Isivivinyo se- thyroid esivamile kakhulu ukuhlolwa kwegazi okulinganisa inani le-hormone ye-thyroid-stimulating (TSH) egazini lakho legazi.
Isivivinyo ngezinye izikhathi sibizwa ngokuthi i-thyrotropin-stimulating test hormone.
I-TSH ephakanyisiwe, noma ngenhla evamile, ibhekwa njengokubonisa kwe-hypothyroidism. I-TSH "ethintekile" noma engaphansi kwejwayelekile, ibhekwa njengobufakazi be-hyperthyroidism.
Njengamanje, ibanga lokubhekisela lihamba kusukela ku-0.5 kuya ku-5.0. Izinga ezingaphezulu kwe-3.0 ziwubufakazi bokuthi kungenzeka ukuthi i-hypothyroidism, kanti amazinga angaphansi kuka-0.5 abufakazi bokuthi kungenzeka ukuthi i-hyperthyroidism ingenzeka. Qaphela ukuthi ibanga lokubhekisela lihlukile kwabesifazane abakhulelwe .
Thola okuningi mayelana nokuhlolwa kwe-TSH.
I-Free T4 / Free Thyroxine
I-Thyroxine, i-hormone ekhiqizwa yi-thyroid, iyaziwa nangokuthi i-T4. I-T4 yamahhala yenza izinyathelo zamahhala we-thyroxine mahhala, ezingenakubalwa egazini lakho legazi. I-T4 yamahhala ivame ukuphakanyiswa kakhulu ku-hyperthyroidism, futhi ihlaselwe ku-hypothyroidism.
Amazinga wama-T4 wamahhala noma angavulekile amelela izinga le-hormone etholakalayo yokuthola nokusetshenziswa ngamaseli. Amazinga anjeziwe amelela i-hormone okungenzeka ukuthi ayitholakali ngokushesha, ngoba ithinteka ezinye izidakamizwa, ukugula, nezinguquko zomzimba njengokukhulelwa.
Ngoba amazinga wamahhala we-T4 amelela ukuthi inani langempela le-hormone etholakalayo, i-T4 yamahhala icatshangwa ukuthi ibonise kangcono isimo se-hormonal yesiguli kunenani eliphelele le-T4 (ngezansi).
Ingqikithi ye-T4 / Ingqikithi ye-thyroxine / i-Serum Thyroxine
Lokhu kuhlolwa kulinganisa inani eliphelele lokujikeleza i-thyroxine egazini lakho. Inani eliphezulu lingabonisa hyperthyroidism, inani eliphansi lingabonisa i-hypothyroidism.
Ingqikithi yamazinga ka-T4 angakhuphuka ngenxa yokukhulelwa, nezinye izici eziphezulu ze-estrogen, kuhlanganise nokusetshenziswa kwe-estrogen esikhundleni noma amaphilisi okulawula ukuzalwa .
I-Free T3 / Free Triiodothyronine
I-Triiodothyronine yi- hormone esebenzayo ye-thyroid , futhi iyaziwa nangokuthi i-T3. I-T3 yamahhala ilinganisa amazinga wamahhala, angavulekile we-triiodothyronine egazini lakho legazi. I-T3 yamahhala ibhekwa njengelungile kunanoma yi-Total T3. I-T3 yamahhala ivame ukuphakama ku-hyperthyroidism, futhi ihlelwe ku-hypothyroidism.
Ingqikithi T3 / Ingqikithi ye-Triiodothyronine
Ingqikithi ye-T3 ivame ukuphakama kwi-hyperthyroidism, futhi iyanconywa ku-hypothyroidism.
I-T3 Resin Uptake (T3RU) / T7
Uma ukuhlolwa kwegazi kwenziwa nge-T3 no-T4, ukuhlolwa kwe-T3 resin (T3RU) ngezinye izikhathi kubizwa ngokuthi yi-T7 test. Lokhu kuhlola kulinganisa inani lezinsizakalo ezingabanjwanga ezingasetshenzisiwe kuma-hormone ezokuthutha (ezibophezelayo). Ukuphakama kwe-T3RU kuvame ukubonwa nge-hyperthyroidism.
I-Thyroglobulin / Tg
I-Thyroglobulin (Tg) iyiprotheni ekhiqizwa yi-thyroid. Izinga le-Tg liphansi noma alibonakali ngomsebenzi ovamile we-thyroid kodwa kungenziwa phezulu ku-thyroiditis, isifo se-Graves, noma umdlavuza we-thyroid. Ukuqapha amazinga kaTg kusetshenziselwa ukuhlola ukuphumelela kokwelashwa komdlavuza wegciwane kanye nokuqapha ukuphindaphindiwe komdlavuza wegciwane.
Phindela emuva T3
Lapho umzimba ucindezelekile, esikhundleni sokuguqula i-T4 ibe yi-T3 - uhlobo olusebenzayo lwe-hormone ye-thyroid - umzimba ugcina amandla ngokwenza okuyaziwa ngokuthi i- Reverse T3 (RT3), ifomu elingasebenzi lika-T3 hormone. Ukubaluleka kokuhlolwa kwe-RT3 okuxilongwa kuyinkinga, njengoba abanye odokotela bakholelwa ukuthi umzimba uqhubeka ukhiqiza i-RT3 esikhundleni se-T3 esebenzayo, okuholela ekutheni ukulimala okuphawulekayo emzimbeni osebenzayo we-T3 hormone.
Ama-Antibodies we-Thyroid Peroxidase (TPO) (TPOAb) / Antithyroid Peroxidase Antibodies
Ama-antibodies we-Thyroid Peroxidase (TPO), ayaziwa nangokuthi i-Antithyroid Peroxidase Antibodies.
(Esikhathini esedlule, lawa ma-antibodies ayebizwa nangokuthi i-Antithyroid Microsomal Antibodies noma i-Antimicrosomal Antibodies).
Lezi zinqamuzana ziphikisana ne-peroxidase ye-thyroid, i-enzyme edlala ingxenye ku-T4-kuya-T3 inqubo yokuguqulwa nokuhlanganiswa. Ama-antibodies we-TPO angaba ubufakazi bokubhujiswa kwezicubu, njengesifo sikaHashimoto, futhi ngokuvamile, kwezinye izinhlobo ze-thyroiditis ezifana ne-post-partum thyroiditis.
Kulinganiselwa ukuthi izifo ze-TPO zitholakala cishe ezingamaphesenti angu-95 eziguli ezine-Hashimoto's thyroiditis, kanti amaphesenti angu-50 kuya kwangu-85 weziguli ze-Graves '. Ukugxila kwamagciwane okutholakala neziguli ezinezifo ze-Graves ngokuvamile ziphansi kuneziguli ezine-Hashimoto's disease.
Ama-Antibodies / i-Antithyroglobulin Antibodies
Ukuhlolwa kwamagciwane okuvikela i-thyroglobulin (okubizwa nangokuthi i-antithyroglobulin antibodies) isetshenziselwa ukuhlola izimbangela ezizenzakalelayo zezimo ze-thyroid. Uma usuvele uthola ukuthi unesifo se-Graves, ukuba namazinga aphezulu we-antirogar thyroglobulin kusho ukuthi kungenzeka ukuthi ekugcineni ube yi-hypothyroid. Ama-antibodies we-Thyroglobulin anemiphumela emihle ngamaphesenti angama-60 weziguli zikaHashimoto kanye namaphesenti angu-30 eziguli ze-Graves.
I-Immunoglobulins ye-Thyroid-stimulating (TSI) / TSH Ekhuthaza ukulwa namagciwane (TSAb)
Ama-anti-abdominal TSH (TRAb) abonakala ezigulini eziningi ezinomlando, noma obani manje, isifo se-Graves. Ukuhlolwa kuvame ukwenza uhlobo oluthile lokukhuthaza i-TRAb ehamba ngamagama amaningana ahlukene, kufaka phakathi:
- I-Immunoglobulins ye-Thyroid-stimulating (TSI)
- Ama-antibodies we-TSH (TSAb)
I-immunoglobulins (stimulating immunoglobulins) ye-thyroid ingatholakala kubantu abaningi abaneSifo se-Graves, futhi ukulinganisa kufinyelele kumaphesenti angu-75 kuya kwangu-90 weziguli ze-Graves '. Ephakeme emazingeni, lapho kusebenza khona isifo se-Graves sika. (Ukungabikho kwalezi zinqamuzana akukona, kodwa ukulawula izifo ze-Graves.)
Ngokuvamile, abanye abantu abanesifo sikaHashimoto nabo banezi-antibodies, futhi lokhu kungabangela iziqephu zesikhathi esifushane ze-hyperthyroidism.
Lapho kuqapha i-TSI, amazinga aphakanyisiwe angasiza ukubikezela ukuphindaphinda kwesifo se-Graves, futhi ukwehlisa amazinga e-TSI kungabonisa ukuthi ukwelashwa kwezifo ze-Graves kusebenza.
Ukuqapha kwe-TSI kubaluleke kakhulu ngesikhathi sokukhulelwa, ngoba amazinga aphakeme, ikakhulukazi ekukhulelweni kokuqala kanye nangesithathu yesithathu, iyisici esibangelwa ukukhubazeka kwesifo sokubeletha noma se-neonatal. Amantombazane e-TSI omama angadlulisela emntwaneni ongakazalwa nge-placenta, okwenza ingane i-hyperthyroid ku-utero, noma ekuzalweni. Ucwaningo luye lwabonisa ukuthi amaphesenti amaningi angama-10 abesifazane abakhulelwe abane-TSI ephakeme ababeletha abantwana abane-hyperthyroidism eseduze.
Imithombo:
UBraverman, MD, Lewis E., noRobert D. Utiger, MD. Werner and Ingbar's The Thyroid: Umbhalo Eyisisekelo Nezokwelapha. 9th ed. , Philadelphia: Lippincott Williams & Wilkins (LWW), 2012.
Roti, Elio, et. al. "I-TSH Receptor Anti Measurement in the diagnosis and management of the Graves 'Isifo Kubalulekile," Journal of Clinical Endocrinology & Metabolism, Vol. 83, No. 11 3781-3784 http://jcem.endojournals.org/cgi/content/full/83/11/3781
USpencer, uCarol. "I-Assay ye-Hormone ye-Thyroid nezimo ezihlobene," Umphathi we-Thyroid . Februwari 6, 2004. http://www.thyroidmanager.org/chapter/assay-of-thyroid-hormones-and-related-substances/