TSH, T4, Free T4, T3, Free T3, Reverse T3, Antibodies, nezinye Izivivinyo
Ukuhlolwa kwegazi ngomsebenzi we -roid kuyisici esibalulekile senqubo yokuthola isifo se-gyroid nokuphatha izimo ze-thyroid. Nasi isifingqo ukukusiza uthole ukuqonda kangcono izivivinyo zegazi zekhanda, ukuthi yini abayilingayo, ukuthi imiphi imiphumela kusho, kanye nomthelela ekuxilongweni nasekuphatheni isimo sakho se-thyroid. Ungakwazi ukungena kumininingwane ngayinye bese uthola ukuqonda kangcono ukuthi kusho ukuthini.
Isivivinyo se-Thyroid | I-Reference Range |
| I-TSH (i-Thyroid Stimulating Hormone) | 0.5-4.70 μIU / mL |
| Ingqikithi ye-T4 (Thyroxine) | 4.5-12.5 μg / dL |
| I-T4 yamahhala (i-Thyroxine yamahhala) | 0.8-1.8 ng / dL |
| Ingqikithi ye-T3 (i-Triiodothyronine) | 80 -200 ng / dL |
| I-T3 yamahhala (i-Triiodothyronine yamahhala) | 2.3- 4.2 pg / mL |
| RT3 (Reverse T3 / Reverse Triiodothyronine) | 10-24 ng / dL |
| I-TPOAb (Ama-Antibodies we-Thyroid Peroxidase) | 0-35 IU / mL |
| I-TSI (i-Immunoglobulins ye-Thyroid-stimulating) | 0-1.3 |
| I-Tg (i-Thyroglobulin) | Akukho gland ye-thyroid: 0-0.1 ng / ml. |
| I-TgAb (i-Thyroglobulin Antibodies) | 0-4.0 IU / mL |
I-TSH (I-Thyroid Stimulating Hormone)
Amanye Amagama: I- Serum Thyrotropin
Mayelana: I- hormone ye-Thyroid eyenza i-hormone (i-TSH) i-hormone ye-pituitary engumthumeli wegciwane le-thyroid. Uma i-pituitary ithola ukuthi i-gland ikhiqiza i-hormone encane kakhulu ye-thyroid, i-pituitary ikhiqiza i-TSH engaphezulu, okwenza ukuba igulane likhiqize i-hormone engaphezulu ye-thyroid. Lapho i-pituitary ithola i-hormone ye-thyroid enkulu, ihlisa i-TSH, njengomlayezo othomeni ukuze unciphise noma ayeke ukukhiqizwa kwe-hormone yegciwane.
Izindlela: Isivivinyo se-TSH sinquma inani le-TSH egazini legazi.
Izinga lokubhekisela : 0.5-4.70 μIU / mL. (Ezinye laboratories ziyi-0.3 kuya ku-4.5, noma ezinye izigaba ezifanayo.)
Ukuchazwa okuvamile: Ngaphezulu kobubanzi, futhi ngaphansi kwe-10 μIU / mL yi- "subclinical" hypothyroidism , ngaphezu kuka-10 μIU / mL i-overt hypothyroidism. Ngaphansi kuka-0.1 kuya ku-0.5 μIU / mL kubhekwa ubufakazi bokuthi i-hyperthyroidism engaphansi kwe-subclinical, ngaphansi kwe-0.1 ingaba ngaphezu kwe-hyperthyroidism.
"Amazinga ajwayelekile " we-TSH abhekwa njengengaphandle kwe-hypothyroidism noma i-hyperthyroidism.
Ukuhumusha okuhlangene: Izinga elingaphezulu kuka-1.5 kuya ku-2.0 μIU / mL lingase libonise ukungasebenzi komzimba we-thyroid. Izinga eliphezulu livela ku-1.0 kuya ku-1.5 μIU / mL.
Izingxabano: Kunezimpikiswano eziningi mayelana nokuhlolwa kwe-TSH nokuthi kusho ukuthini.
- Phakathi kwe-endocrinologists, kukhona impikiswano mayelana nokuthi ngabe uhla lwe-TSH lokubhekisela kufanele lube luphi . Ngokuvamile, ligijima ukusuka ku-0.4 / 0.5 ukuya ku-4.5 noma ngaphezulu. Kodwa ezinye ze-endocrinologists zikholelwa ukuthi ukuphela okuphezulu kwesigaba sokubhekisela kufanele kube ngu-3.0.
- Phakathi kwe-endocrinologists, kukhona ukungavumelani ngokuthi ngabe amazinga angaphansi kuka-10.0 kufanele aphathwe. Abanye odokotela bakholelwa ukuthi la mazinga avumela ukwelashwa ngemithi ye- hormone ye-thyroid esikhundleni- abanye bebheka ukuthi "i-subclinical hypothyroidism" -njalo leyo yokwelashwa idinga kuphela emva kwamazinga angaphezu kuka-10.0.
- Olunye ucwaningo lubonisa ukuthi ngisho nalapho i-TSH iwela ebangeni lokubhekisela, uma isiguli sinamabhodlela omzimba kaHashimoto, ukwelashwa kuqinisekisiwe .
- Odokotela abahlanganisayo bakholelwa ukuthi i-TSH ingenye yezinto eziningi zokuxilonga nokuphathwa kweziguli ze -roid. Bhekisela kokungaboni kahle kwi-TSH njenge-Tyranny ye-TSH.
- Odokotela abahlanganisayo bakholelwa ukuthi ukulinganisa okuyiqiniso komsebenzi we -roid kuyi-real, etholakalayo ama-hormone e-thyroid ejikelezayo egazini le-Free T4 nase-Free T3.
I-T4 / Thyroxine ne-Free T4 / Free Thyroxine
Mayelana: I- Thyroxine, eyaziwa nangokuthi i-T4, ingenye ye-hormone ye-thyroid eyinhloko. Iningi le-hormone elikhiqizwa yi-gland gland yi- thyroxine . I-Thyroxine ibhekwa njenge-"storage" hormone-kuleyo yedwa ayisebenzisiwa ngumzimba ukukhiqiza amandla nokukhipha i-oxygen kumaseli. Kumelwe ulahlekelwe i-athomu ye-iodine, inqubo ebizwa ngokuthi i- monodeiodination (noma i-T4 kuya ku-T3 ukuguqulwa), futhi iba i-triiodothyronine (T3) ukuze isetshenziswe ngamaseli.
Izindlela: Ingqikithi ye-T4 iyalinganisa inani le-thyroxine elijikelezayo egazini. I-T4 yamahhala inamba inani elitholakalayo, elingenakubalwa we-thyroxine egazini legazi.
I-gland yegciwane enempilo ikhiqiza ngokuyinhloko i-thyroxine, futhi i-thyroxine idinga ukuguqulwa ibe yi-triiodothyronine (T3) ukuze ihambise oksijini namandla kumaseli.
Izinga lokubhekisela : Inani le-T4: 4.5-12.5 μg / dL, i-Free T4: 0.8-1.8 Ng / dL
Ukuhunyushwa okuvamile: Odokotela abaningi abavamile abavivinyi i-Total T4 noma i-Free T4. Kodwa-ke, kwezinye izimo, kanye ne-TSH ephakeme, i-Total T4 noma yama-Free T4 amazinga angaphansi kwebanga lokubhekisela libhekwa njengobungqina be-hypothyroidism. Kanye namazinga aphansi / acindezelwe we-TSH, inani le-T4 noma ama-Free T4 amazinga angaphezu kwebala lokubhekisela libhekwa njengobufakazi be- hyperthyroidism .
Ukuhumusha okuhlangene: Ukuze uthole ukuxilongwa nokuphathwa kwe-hypothyroidism, amazinga engxenyeni ephezulu yohlu lokubhekisela libhekwa njengelungile kanye nobufakazi bokusebenza kahle kwe-thyroid.
Izingxabano: Abaningi be-endocrinologists abavamile basebenzisa kuphela izivivinyo ze-TSH ekuxilongweni nasekulawuleni izimo ze -roid, futhi ngenxa yalokho, musa ukuhlola amazinga aphelele noma amahhala we-T4.
I-T3 / Triiodothyronine ne-Free T3 / i-Triiodothyronine yamahhala
Mayelana: I- Triiodothyronine (T3) yi-hormone ye-thyroid esebenzayo. I-gland yegciwane enempilo ikhiqiza enye i-triiodothyronine-i-hormone esebenzayo ye-thyroid. Okunye okuwumphumela wokuguqulwa kwe-thyroxine ibe yi-triiodothyronine.
Izindlela: Isivivinyo esiphelele se-T3 sinquma inani eliphelele le-triiodothyronine elijikelezayo egazini. I-T3 yamahhala yenza izinyathelo zamahhala, ezingavaliwe ze-hormone triiodothyronine etholakalayo ukuze zisetshenziswe ngumzimba.
Izinga lokubhekisela: Inani le-T3: 80-200 ng / dL, i-Free T3: (Triiodothyronine): 2.3- 4.2 pg / mL
Ukuhunyushwa okuvamile: Odokotela abaningi abavamile abavivinye inani le-Total T3 noma i-Free T3. Kodwa-ke, kwezinye izimo, kuhlanganise ne-TSH ephakeme, i-Total T3 noma ama-Free T3 angaphansi kwebanga lokubhekisela kubhekwe ubufakazi bokuthi i-hypothyroidism. Kanye namazinga aphansi / acindezelwe we-TSH, inani lama-T3 noma lama-Free T3 angaphezu kwebhedi lokubhekisela libhekwa njengobungqina bokwe-hyperthyroidism.
Ukuhumusha okuhlangene: Ukuze uhlolwe futhi uphathe ukwelashwa kwe-hypothyroidism, amazinga engxenyeni ephezulu yohlu lokubhekisela kubhekwa njengobungqina bokusebenza okwanele kwe-thyroid, futhi amazinga e-25 percentile ephezulu ebhekisini lokubhekisela ayabhekwa njengelungile. Ngombono wokubambisana, amazinga aphansi angase afanele ukwelashwa ngemithi yokwelapha i-hormone ye-thyroid, noma imithi ehlanganisa ngokuqondile iT3 .
Izingxabano: Ukuhlolwa kwe-T3 ne-T3 yamahhala kuyinkinga engaphezu kokuhlolwa kwe-T4 . Lokhu kubangelwa ukuthi odokotela abaningi abavamile abakholelwa ukuthi izinga le-T3 linomthelela emabonakalweni, nokuthi akukho ndawo yokwelapha nge-T3 hormone .
Ngenxa yokuthi amazinga angamahhala ka-T3 amelela i-hormone etholakalayo ngokushesha, i-T3 yamahhala icatshangwa ngabasebenzi abathile bokubambisana ukuze babonise isimo se-hormonal yesiguli, uma kuqhathaniswa ne-TSH kanye / noma inani le-T3.
RT3 / Reverse T3 / Reverse Triiodothyronine
Mayelana: Ukubuyela emuva kwe-T3 kuyindlela ye-T3 engasebenzi futhi ikhiqizwa ngamanani aphezulu ngesikhathi sokucindezeleka.
Izindlela: Ifomu elingasebenzi, elingenalusizo le-T3 elikhiqizwa lapho umzimba ucindezeleka.
Izinga lokubhekisela : Ngokujwayelekile 10-24 ng / dL
Ukuhunyushwa okuvamile: Lokhu kuhlolwa akuvamile ukwenza odokotela abavamile, abangaboni ukubaluleka kulesi silinganiso.
Ukuhumusha okuhlangene: Odokotela abahlanganisayo nalabo odokotela abathile abagxila ekulinganiseni kwe-hormone balance balinganisa i- RT3 ephakeme noma ukungalingani kwe -RT3 / T3 ukuze kube uphawu olubalulekile lwe-thyroid engasebenzi noma engasebenzi. Bakholelwa ukuthi i-T3 eguqukayo kufanele iwele engxenyeni engezansi yebanga elijwayelekile.
Izingxabano: Ukubuyela emuva kwe-T3 kuyilinga lokuphikisana . Odokotela abavamile banqamula inani le-RT3 ekuhloleni, ekuphatheni nasekulawuleni i-hypothyroidism. Odokotela abahlanganisayo nalabo abagxila ekulinganiseni kwe-hormone balance, Nokho, cabangela i-RT3 ephakanyisiwe ukuba ibe uphawu olubalulekile lwe-thyroid engasebenzi noma engasebenzi.
I-TPOAb / Anti-Peroxidase ye-Thyroid
Amanye Amagama: Ama-antibodies e-Antithyroid Peroxidase
Mayelana: Amagciwane e-peroxidase (TPO) we-Thyroid, futhi afingqiwe njenge-TPOAb, ama-antibodies ahlakulela ngenxa yokuhlaselwa okuzenzakalelayo kwi-gland yegciwane. Baqondisa i-gland, futhi kuvame ukuholela ekubhujisweni kwe-gland ngokuhamba kwesikhathi. Ama-antibodies we-TPOAb ahlasela i-peroxidase ye-thyroid, i-enzyme edlala indima ekuguqulweni kwe-T4 kuya ku-T3. Amazinga we-TPOAb aphakanyisiwe angaba ubufakazi bokuvuvukala kwegciwane, noma ukubhujiswa kwezicubu ezifana nesifo sikaHashimoto. Ngokuvamile, i-TPO ibonakala kwezinye izinhlobo ze-thyroiditis njenge- post-partum thyroiditis .
Izindlela: Lokhu kuhlolwa kulinganisa izinga lama-antibodies TPO.
Izinga lokubhekisela : Ibanga lokubhekisela livela ku-0-35 IU / mL
Ukuchazwa okuvamile: Uma amazinga we-TPOAb ewela ebangeni lokubhekisela, abhekwa njengokujwayelekile. Lokhu akukwenzi ngokuphelele isifo sikaHashimoto kodwa kwenza kube lula kakhulu. Amazinga we-TPOAb aphakanyisiwe afisa ukuvuvukala kwegciwane, ngokuvamile ngenxa ye-Hashimoto's thyroiditis noma ezinye izinhlobo ze- thyroiditis .
Kulinganiselwa ukuthi i-TPOAb iyatholakala ezingeni elingamaphesenti angama-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. Ngokombono ojwayelekile, Nokho, i-TPOAb ephakeme ayidingi ukwelashwa ngaphandle kokuba ihambisane ne-overt hypothyroidism noma i-hyperthyroidism.
Ukuhumusha okuhlangene: Ezinye iziguli ziye zaphakamisa i-TPOAb, kodwa ingenye "i-euthyroid," ngezinga elijwayelekile le-T4, T3, ne-TSH. Olunye ucwaningo luye lwabonisa ukuthi ukwelashwa okuvimbela i-levothyroxine kungase kuqinisekiswe kulawo gciwane, njengoba kunganciphisa ama-antibodies , futhi usize ukuvimbela ukuqhubekela phambili kwe-hypothyroidism.
Izingxabano: Abaningi be-endocrinologists abakholelwa ekuhlolweni kwe-TPOAb, bakhetha ukugxilisa ukuxilongwa kwe-thyroid kanye nokwelashwa emiphumeleni yokuhlolwa kwe-TSH kuphela.
I-TSI / Immunoglobulins evuselela i-Thyroid
Mayelana: I- Thyroid evuselela i-immunoglobulin-i-TSI-iyimithi evikela isifo se-thyroid ukuze ikhulise futhi ikhulule i-hormone yegciwane elidlulele, okubangelwa hyperthyroidism. Lelivivinyo ngezinye izikhathi libizwa nangokuthi i-TSH receptor stimulating antibody.
Izindlela: Isivivinyo se-TSI sinquma izinga lokujikeleza lala ma-antibodies egazini.
Izinga lokubhekisela: Ngaphansi kokulingana no-1.3
Ukuchazwa okuvamile: Amazinga e-TSI aphakanyiswe ngamaphesenti angama-75 kuya kwangu-90 amaGrives's disease. Ephakeme emazingeni, lapho kusebenza khona isifo se-Graves sika. (Ukungabi khona kwalezi zinhlobo zamagciwane akukona, kodwa ukulawula izifo ze-Graves.) Qaphela: abanye abantu abanesifo sikaHashimoto nabo banezikhukhula ezinamandla, futhi lokhu kungabangela iziqephu zesikhashana zesikhashana ze-hyperthyroidism.
Ukuhlolwa kwe-TSI kwenziwa ngokujwayelekile ukuthola isifo se-Graves nokuhlola i-goiter ye-multinodular enobuhlungu . Kuvame futhi kwenziwe owesifazane okhulelwe one-Graves's disease , ezinyangeni ezintathu zokugcina zokukhulelwa, ukuhlola ingozi yokuzalwa komntwana ngokuzalwa ne-hyperthyroidism noma isifo se-Graves.
I-Tg / Thyroglobulin
Mayelana: I- Thyroglobulin (Tg) iyiprotheni ekhiqizwa yi-gland yegciwane, futhi ukuba khona kwayo egazini kuyisibonakaliso sokuthi isiguli sisenomtholo we -roid-kungakhathaliseki ukuthi igulane noma insali ishiywe ngemuva kokuhlinzwa noma i- RAI) .
Izindlela: Isivivinyo se-Tg silinganisa izinga le-Tg egazini legazi. I- hyroglobulin ihlolwe ikakhulukazi ezigulini zomdlavuza we-thyroid, ukuthola ukuthi izicubu zomdlavuza zikhiqiza i-thyroglobulin ngaphambi kokwelashwa, ukuthola ukuthi ukwelashwa kusebenza yini, futhi ukusiza ukubona ukuphindaphinda ngemuva kokwelashwa. Njengoba iningi lama- cancer ejwayelekile we-thyroid- yea, i-papillary kanye ne-follicular-ikhiqiza i-thyroglobulin, futhi amazinga okwanda kwe-thyroglobulin angase abe uphawu lokuphindaphinda umdlavuza.
I-Reference Range: Uma ungenalo igundane le-thyroid, kufanele libe ngaphansi kuka-0.1 ng / ml. Uma usenayo igundane, kufanele ibe ngaphansi noma ilingane no-33 ng / mL
Ukuhunyushwa okuvamile: Izinga eliphansi le-thyroglobulin livamile kubantu abangenayo isifo se-thyroid. Amazinga aphakeme kunomuntu onomdlavuza wegciwane r kusho ukuthi amazinga e-thyroglobulin angahlolwa ngokuhamba kwesikhathi ukuze asize ukubona ukuphindaphindiwe. Amazinga e-Thyroglobulin kufanele abe ngu-0 noma aphansi kakhulu ngemva kokuhlinzwa kwe-orroid noma ngemuva kokwelashwa kwe-iodine (RAI) . Uma zisabonakala, ukwelashwa okwengeziwe kungadingeka. Uma amazinga eqala ukuvuka ngemva kokwelashwa komdlavuza wegciwane, lokho kungase kube uphawu lokuthi umdlavuza ubuye waphinduka.
Izimo ezenza ukuvuvukala kwe-gland yegciwane-okungukuthi, i-goiter, thyroiditis , noma i-hyperthyroidism-ingabangela namazinga aphezulu we-thyroglobulin. Ukuhlolwa akuvamile ukulalelwa ngenkathi ukwelashwa kwale mibandela, noma kunjalo.
I-TgAb / Thyroglobulin Antibodies
Mayelana: I- Thyroglobulin antibodies-eyaziwa ngokuthi i-TgAb-i-antibodies ngokumelene ne-thyroglobulin.
Izindlela: Isivivinyo se-TgAb silinganisa izinga lala ma-antibodies ejikeleza igazi.
Izinga lokubhekisela: Ibanga lesithenjwa lingaphansi kwe-4.0 IU / mL
Ukuchazwa okuvamile: Amazinga we-TgAb aphakanyisiwe atholakala kumaphesenti angama-10 abantu abane-functional evamile ye-thyroid, kanye nabantu abangaba ngu-15 kuya kwangu-20 abantu abanomdlavuza wegciwane. Izinga le-TgAb liphakanyisiwe ngamaphesenti angama-60 weziguli zikaHashimoto kanye namaphesenti angu-30 eziguli zikaGrives. Uma usuvele utholakala ukuthi unesifo se-Graves, ukuphakama kwamazinga e-TgAb kusho nokuthi cishe usuke ube yi-hypothyroid.
I-TgAb ingaphazamisa imiphumela ye-thyroglobulin (Tg), ngakho-ke kubalulekile kulabo abanomdlavuza wegciwane ukuthi babe namazinga e-TgAb ahlolwe kanye ne-Tg ngezikhathi ezithile.
Izwi elivela
Izigaba zokubhekisela kanye namayunithi wokulinganisa asetshenzisiwe zingashintsha kusuka ebhodini kuya kubhabhu. Nquma njalo izintambo ezithile zokubhekisela kanye namanani okuhlola ebhokisatri lapho kuhlolwa khona.
Abanye odokotela noma abasebenzi babo behhovisi bacela ukutshela imiphumela yakho yokuhlolwa kwezokwelapha. Ungase uzwe "imiphumela yakho ifanele," noma "ukuhlolwa kwakho kwakungokwejwayelekile" njengomphumela wokuhlola. Lokhu akulona ulwazi olwanele. Hlala ucela ikhophi yangempela yanoma yimiphi imiphumela yokuhlolwa kwezokwelapha, kuhlanganise nokuhlolwa kwe-thyroid. Ikakhulukazi nokuhlolwa kwegazi le-thyroid, udinga ukwazi amazinga akho wangempela, kanye nebala lokubhekisela, ukuze ukhuthaze ukuthi unakekelwa kangcono isimo sakho se-thyroid.
> Imithombo:
> Bahn, R., Burch, H, Cooper, D, et al. I-Hyperthyroidism nezinye izimbangela ze-Thyrotoxicosis: Iziqondiso Zokuphatha ze-American Thyroid Association ne-American Association of Endocrinologist Clinic. I-Endocrine Practice. I-Vol 17 No. 3 Meyi / Juni 2011.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. I-WLL / Wolters Kluwer; 2012.
> Garber, J, Cobin, R, Gharib, H, et. al. "Iziqondiso Zomtholampilo Zokusebenza Nge-Hypothyroidism Kubantu Abadala: I-Cosponsored yi-American Association of Endocrinologists Clinic kanye ne-American Thyroid Association." I-Endocrine Practice. I-Vol 18 No. 6 Novemba / Disemba 2012.