Uma unezibonakaliso noma izimpawu ze-hyperthyroidism, kubalulekile ukuthi uhlole ngokugcwele ukuze uphethwe ngokufanele futhi ngokushesha, uma kunesidingo. Udokotela wakho uzokwenza ucwaningo olunzulu ngokomzimba, ubuyekeze umlando wakho wezokwelapha, bese uqhuba ukuhlolwa kwegazi okuningiliziwe (njenge-TSH, T3, T4) ukuze kutholakale ukuxilongwa; Ukuhlolwa kwe-imaging, njenge-ultrasound ye-thyroid noma i-CT scan kungalawulwa.
I-Hyperthyroidism ingaphathwa kodwa ingabangela izinkinga uma ishiywa ingelashwa, ngakho-ke ukuxilongwa kokuqala kuhlale kungcono kakhulu.
Ukuhlolwa
Ngemuva kokubukeza izimpawu zakho kanye nezinkinga ezibangelwa isifo se-thyroid, uma udokotela wakho esola ukuthi kungenzeka ukuthi uhloliswe nge-hyperthyroidism, uzokwenza ucwaningo olunzulu olugxile kwi-thyroid yakho, kodwa nezinye izingxenye zomzimba wakho.
Ukuhlolwa kwe-Thyroid
Phakathi nokuhlolwa kwe - thyroid , udokotela wakho uzothinta (palpate) entanyeni yakho, efuna ukwandiswa kwe-thyroid kanye nama-nodules.
Uyothola futhi ukuthi yini eyaziwa ngokuthi "injabulo," echaza ukunyuka kwegazi egazini elingase lizwe. Udokotela wakho uzophinde alalele "umsindo" nge-stethoscope yakhe, okuyinto umsindo wegazi ogijimayo ukwanda kwegciwane.
Ukuba khona kwenjabulo ye-thyroid kanye / noma ukuzwakala kuyisisusa esikhulu seSifo se- Graves .
Ukuhlolwa Kwemvelo
Ngaphandle kokuhlolwa kwe-thyroid, udokotela wakho uzohlola lonke umzimba wakho ngezibonakaliso ze-thyroid engasebenzi.
Isibonelo, uzokuhlola ukucabanga kwakho, njengokucabanga okusheshayo noma okuphendulayo okungaqondakali kungaba uphawu lwe-hyperthyroidism. Uyophinde ahlole izinga lenhliziyo yakho, isigqi, nomfutho wegazi. Lokhu kungenxa yokuthi i- palpitations , i-fibrillation ye-atrial , ukushaya kwenhliziyo, noma ukucindezeleka kwegazi kungaphakamisa futhi i-hyperthyroidism.
Ezinye izingxenye zokuhlolwa komzimba zihlanganisa:
- Ukuhlolwa kwesikhumba sakho, njengoba isikhumba esingavamile futhi esibushelelezi, kungase kube uphawu lwe-hyperthyroidism. Amaphesenti amancane abantu abanezifo ze-Graves futhi ahlakulele ukushona emikhanyeni yabo (i-mytiema pretibial).
- Ukuqaphela inani eliphelele kanye nekhwalithi yezinwele zakho, njenge-thinning, kahle, noma izinwele zokuchitha kungase kubonise isimo se -roid
- Ukubhekwa kwanoma yikuphi ukuthuthumela, ukuzulazula ezandleni, noma ukunyakaza okune-hyperkinetic njengokudakwa kwetafula, ukushaya izinyawo, noma ukunyakaza okunamandla (ngokuvamile kuvame kakhulu ezinganeni)
- Ukuhlolwa kwamehlo akho, njengokubomvu, ukuthungatha, okomile, ukuvuvukala, ukukhukhumeza, nokubona amehlo kungaba izibonakaliso zenkinga ye -roid. Ngaphezu kwalokho, "i-lid lag" (uma ijwabu leso eliphakeme lingalandeli ukuhamba kancane kwelanga lapho ubheka phansi) kungabonakala ku-hyperthyroidism.
Ama-Labs nezivivinyo
Ukuhlolwa kwegazi kuhlanganisa ukuhlolwa kwe-hormone ye-thyroid (TSH), kanye ne-thyroxine (T4) ne-triiodothyronine (T3) yokuhlolwa. Udokotela wakho angase avivinye amazinga e-antibody we-thyroid ukuze aqinisekise ukutholakala kwesifo se-Graves.
Kubalulekile ukubuyekeza imiphumela yakho yokuhlolwa nodokotela wakho. Ungesabi ukubuza imibuzo. Lena impilo yakho, ngakho-ke kubalulekile ukuthi uqonde ukuthi kwenzekani.
Imiphumela ye-TSH
Uhlobo olujwayelekile lwesilingo se-TSH lungaba amayunithi angu-0.5 ukuya ku-5.0 milli-international ngekreyi (mIU / L). Bonke abantu abane-hyperthyroidism eyinhloko bane-TSH ephansi; Nokho, izinga le-TSH lodwa alikwazi ukucacisa izinga le-hyperthyroidism. Yingakho udokotela wakho azohlola futhi amazinga akho we-T4 ne-T3.
Imiphumela yamahhala ephezulu ye-T4 ne-T3
Ukuxilongwa kwe-hyperthyroidism eyinhloko kuhambisana ne-TSH ephansi, nokuhlolwa kwe-T4 kanye / noma i-T3 yegazi ephezulu mahhala.
Njengengxenye, uma i-TSH yakho ijwayelekile noma iphakanyisiwe, futhi i-T4 yakho ne-T3 yakho ikhululekile, uzodinga i-MRI ye-pituitary gland ukuhlola ngesimo esibizwa ngokuthi i-hyperthyroidism ephakathi noma i-TSH.
I-T3 ephezulu kanye Nemiphumela ejwayelekile ye-T4 yamahhala
Uma i-TSH yakho iphansi futhi i-T3 yakho iphezulu (kodwa i-T4 yakho yamahhala ivamile), kungenzeka ukuthi ukuxilongwa kwakho kusekhona isifo se-Graves noma isigqomo se-thyroid esikhiqiza i-hormone kakhulu. Isivivinyo sokucabanga, esibizwa nge-scan activation iodine scan, singahlukanisa phakathi kwalezi zifo ezimbili.
Ukuthatha i-T3 kakhulu (ebizwa ngokuthi ukungenisa okuthe xaxa kwe-T3) kungenye indlela.
Okujwayelekile kwe-T3 kanye ne-High Free T4 Imiphumela
Uma i-TSH yakho iphansi, i-T4 yakho yamahhala iphezulu, kepha i-T3 yakho ijwayelekile, kungenzeka ukuthi uhlangabezana ne-hyperthyroidism ekutheni uthathe kakhulu i-T4 (levothyroxine) engavamile. Okunye ukuxilongwa okukhona okungenzeka kuyinkinga ye-thyroid-induced-induced.
Le nhlanganisela yelebhu ingabonakala kubantu abanesifo se-hyperthyroidism abanesifo esingavumelani ne-thyroidal (isibonelo, ukutheleleka okukhulu) okunciphisa ukuguqulwa kwe-T4 kuya ku-T3.
Imiphumela evamile ye-T4 kanye ne-T3
Uma i-TSH yakho iphansi, kodwa amazinga wakho we-T3 no-T4 avamile, ungase ube ne-hyperthyroidism emincane. Lokhu kungabonakala nakukhulelwa.
Imiphumela ye-Antibody
Ukuvivinya igazi lakho ngamagciwane, njenge-immunoglobulin ye -roid-stimulating noma i-TSH receptor autoantibodies, kubalulekile. Uhlolo oluhle luqinisekisa ukuxilongwa kwesifo se-Graves, nakuba abanye abantu abanesifo banesifo sokuzivivinya esingalungile. Kule nkinga, ukuhlolwa kwe-iodine ukuvuselela i-radio (RAIU) kungaqinisekisa ukuxilongwa.
Ukucabanga
Ezimweni eziningi, ukuhlolwa kwe-imaging , njenge-ultrasound, i-radioactive iodine uptake (RAI-U), i-CT scan, noma i-MRI izokwenziwa ukuze kutholakale ukuhlolwa okuphelele nokuqondile.
I-Scan Iodine Yomsakazo
Esivivinyweni se-iodine uptake (RAI-U) esivumayo, i-dose encane ye-iodine ye-i-radioactive 123 ilawulwa ephepheni noma ifomu eliketshezi.
Amahora ambalwa kamuva, inani le-iodine kwisistimu yakho lilinganiswa, lihambisana ne-X-ray. I-thyroid engasebenzi kakhulu ivame ukuphakamisa imiphumela ye-RAI-U (igciwane elingasebenzi ngokweqile lithatha inani eliphakeme le-iodine kunokujwayelekile, futhi lokho kutholakala kubonakala kwi-X).
Emgodini we-Graves, i-RAI-U iphakeme futhi ungabona ukuthi kukhona ukutholakala kulo lonke igundane. Uma ngabe u-hyperthyroid ngenxa ye-hormone ye-thyroid eyandisa ngokweqile, ukuphakama kuzobonakala kulokho kutholakala khona. Uma unayo i-thyroiditis njengesizathu segciwane lakho le-thyroid elingasebenzi kakhulu, ukuphakama kuyoba phansi kuyo yonke ingqungquthela.
Nakuba i-iodine 123 ye-radioactive engeyona eyingozi kwigciwane lakho le-thyroid, akufanele linikezwe abesifazane abakhulelwe noma abancancisayo.
I-Ultrasound ye-Thyroid
I-ultrasound ye-thyroid ingakwazi ukubona i-goiter, kanye nama-nodules okungabangela i-hyperthyroidism. Kulabo besifazane abakhulelwe noma abancancisayo, i-ultrasound ye-thyroid ivame ukusetshenziswa njengendlela ehlukile yokuskena i-iodine.
I-CT Scan
I-CT scan, eyaziwa ngokuthi i-computed tomography noma ikati yeskena, iyinhlobo ekhethekile ye-X-ray engasiza ekutholeni i-goiter, kanye nama-nodules amakhulu kakhulu wegciwane.
Ukufaniswa kwe-Magnetic Resonance (MRI)
Njenge-CT scan noma i-ultrasound, i-MRI ayikwazi ukutshela udokotela ukuthi i-thyroid isebenza kanjani, kodwa ingasiza ukuthola i-goiter ne-nodules ye-thyroid.
I-MRI ngezinye izikhathi ifaneleka ku-CT scan ngoba ayidingi umjovo wokuphambene, oqukethe i-iodine futhi ongaphazamisa ukuskena kwe-iodine ye-radioactive.
Ukuhlonza okuhlukile
Nakuba izimpawu ze-hyperthyroidism zingase ziphuthelwe ngenxa yokwesaba okukhulu noma ukucindezeleka, zingase zilingise nezinye zezokwelapha ezivamile.
Isibonelo, ukulahleka kwesisindo esingachazwanga kungaba isibonakaliso sokugula komzimba wonke (isibonelo, ukutheleleka, isifo esingenayo i-autoimmune, noma umdlavuza). Kungaba isibonakaliso sokuqala sokugula kwengqondo, njengokucindezeleka noma ukuwohloka komqondo, ikakhulukazi uma umuntu ezwa ukuguquka kwemizwelo, ukucasula noma ukunganaki-uphawu oluvame kakhulu kubantu asebekhulile abane-hyperthyroidism.
Isilinganiso senhliziyo esisheshayo noma isigqi senhliziyo esingavamile kungaba isibonakaliso sokuqala senkinga yenhliziyo oyinhloko noma yamaphaphu noma i-anemia.
Lezi zibonelo ziyisiqephu se-iceberg, njengoba kuhlale kutholakala ukutholakala okuhlukahlukene. Izindaba ezinhle ukuthi udokotela angakwazi ukuqinisekisa noma ukunciphisa ukuxilongwa kwe-hyperthyroidism kalula futhi ngokushesha ngomlando wezokwelapha, ukuhlolwa ngokomzimba, nokuhlolwa kwegazi.
Okokugcina, uma udokotela wakho ekuthola ukuthi unesifo se-hyperthyroidism, uzobe esifuna ukucacisa imbangela ye-hyperthyroidism yakho (isibonelo, isifo se-Graves ne-thyroiditis). Lokhu kungalungiswa ngokuhlolwa okuningi kwegazi kanye nokuhlolwa kwe-imaging okubizwa ngokuthi i-radioactive iodine scan up scan.
> Imithombo:
> I-American Thyroid Association. (2018). Izifo ze-Graves 'FAQ.
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. I-WLL / Wolters Kluwer; 2012.
> Ama-Kravets I. I-Hyperthyroidism: Ukuxilongwa Nokunakekelwa. Am Fam Physician. 2016 Mar 1; 93 (5): 363-70.
> I-Ross DS. (2017). Ukuxilongwa kwe-hyperthyroidism. Cooper DS, ed. Kusesikhathini. Waltham, MA: UpToDate Inc.
> Ross DS et al. Imikhombandlela ye-American Thyroid Association Yokuqondisa Nokuphathwa Kwe-Hyperthyroidism Nezinye Izimbangela Ze-Thyrotoxicosis. I-Thyroid . 2016 Okthoba; 26 (10): 1343-1421.