Cov thyroid yog cov qog ua lub ntsej muag zoo li lub ntsej muag nyob hauv lub caj dab thiab ua cov thyroid hormones. Cov thyroid tsis zoo, uas yog thaum cov qog ua ntau dhau lossis tsawg dhau ntawm cov tshuaj hormone, tuaj yeem cuam tshuam ntau yam ntawm lub cev, los ntawm lub plawv dhia mus rau cov metabolism. Koj tus kws kho mob yuav sim ntsuas yog tias koj xav tias koj cov thyroid ua haujlwm ntau dhau lossis tsis muaj kev cuam tshuam. Nyeem cov ntawv xeem no yuav zoo li nyuaj; tab sis yog tias koj lees txais txoj hauv kev kom nkag siab thiab nkag siab tias txhua qhov kev ntsuas sawv cev, koj tuaj yeem txiav txim siab seb puas yog koj lub cev puas muaj cov thyroid tsis xws luag, thiab yam tsis meej pem. Nco ntsoov tias tsuas yog kws kho mob tuaj yeem tshuaj xyuas tus mob thiaj li paub tseeb tias koj tham txog cov txiaj ntsig kev sim nrog nws lossis tus kws kho mob thiaj tuaj yeem pib kho, yog tias xav tau.
Kauj ruam
Ntu 1 ntawm 3: Nkag Siab TSH Hasil Results
Kauj Ruam 1. Txheeb xyuas yog tias TSH qhov tshwm sim nyob hauv thaj tsam ib txwm muaj
Thawj qhov kev kuaj cov thyroid uas kws kho mob feem ntau ua yog TSH kuaj uas sawv rau "Thyroid Stimulating Hormone" (cov thyroid txhawb cov tshuaj hormone) uas yog tsim los ntawm cov qog ua qog thiab txhawb cov thyroid kom tso cov tshuaj T4 thiab T3.
- TSH tuaj yeem suav tias yog "lub cav" ntawm cov qog ua haujlwm vim nws txiav txim siab qhov nyiaj ntawm cov thyroid hormone tsim thiab tom qab ntawd tso tawm los ntawm cov thyroid thoob plaws lub cev.
- TSH qhov tseem ceeb yog nyob nruab nrab ntawm 0.4 - 4.0 mIU/L.
- Koj tuaj yeem ua pa ua pa ntawm kev pab yog tias koj qhov kev ntsuas TSH poob hauv qhov no; Txawm li cas los xij, nws tsis txhais tau tias tus tswv ntawm tus nqi TSH ib txwm tsis pub dawb los ntawm cov teeb meem thyroid. Tus TSH tus nqi uas nyob ntawm qib pib tuaj yeem qhia txog kev txhim kho ntawm cov thyroid tsis meej.
- Feem ntau cov teeb meem thyroid xav tau 1-2 qhov kev kuaj mob thiab kuaj pom vim muaj kev sib raug zoo ntawm ntau yam tshuaj hormones uas ua rau cov thyroid ua haujlwm.
- Yog tias koj xav tias koj muaj teeb meem thyroid, koj tus kws kho mob yuav ua haujlwm kuaj ntxiv txawm tias koj li TSH qhov tshwm sim zoo li cas.
Kauj Ruam 2. Nkag siab lub ntsiab lus ua tau ntawm qhov ntsuas TSH siab
TSH qhia cov thyroid tsim ntau T4 thiab T3, uas tso cov tshuaj hormones los ntawm cov thyroid (ntawm kev txiav txim ntawm TSH) los ua thoob plaws lub cev. Yog tias cov thyroid tsis ua haujlwm, nws txhais tau tias lub qog tsis tso T3 thiab T4 txaus yog li cov qog pituitary yuav tso TSH ntau dua los sim thiab them nyiaj.
- Yog li, TSH siab tuaj yeem yog lub cim qhia tias koj muaj teeb meem hypothyroid (ib qho xwm txheej uas tsis muaj cov tshuaj hormone txaus los ntawm cov qog qog).
- Txawm li cas los xij, koj yuav xav tau kev tshuaj xyuas ntxiv txhawm rau tshawb nrhiav ntxiv thiab lees paub qhov tseeb kuaj mob.
Kauj Ruam 3. Nrhiav cov cim thiab tsos mob ntawm hypothyroidism
Ntxiv rau qhov ntsuas TSH siab, ntau yam kev qhia hauv tsev kho mob kuj tseem tuaj yeem pom cov tsos mob ntawm hypothyroidism. Qhia rau koj tus kws kho mob yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no:
- Ua rau rhiab heev rau txias
- Qaug zog
- Ua kom hnyav vim tsis muaj laj thawj
- Cov tawv nqaij qhuav heev
- Cem quav
- Mob nqaij thiab nruj
- Mob sib koom thiab o
- Kev nyuaj siab thiab/lossis lwm yam kev hloov pauv
- Lub plawv dhia qeeb
- Plaub hau
- Kev hloov hauv kev coj khaub ncaws
- Ua qeeb ntawm kev hais lus lossis kev xav
Kauj Ruam 4. Ntsuas lub ntsiab lus tom qab TSH qis heev
Ntawm qhov tod tes, yog tias koj qhov kev ntsuas TSH qis heev, qhov no yuav yog lub cev teb rau cov qog ua haujlwm hauv lub cev kom tsim tawm tsawg dua TSH a result ntau dhau cov thyroid hormones hauv lub cev (T3 thiab T4). Yog li, qhov ntsuas TSH qis tuaj yeem qhia pom hyperthyroidism (ua haujlwm ntau dhau ntawm cov thyroid hormone).
- Ib zaug ntxiv, yuav tsum tau kuaj ntshav ntxiv txhawm rau txheeb xyuas qhov mob.
- Cov txiaj ntsig ntawm kev ntsuas TSH ib leeg tuaj yeem coj tus kws kho mob mus rau qee txoj hauv kev, tab sis feem ntau tsis yog kuaj mob.
Kauj Ruam 5. Saib xyuas cov cim thiab tsos mob ntawm hyperthyroidism
Ntxiv nrog rau qhov ntsuas TSH qis, hyperthyroidism tuaj yeem qhia ntau yam kev qhia kho mob. Qhia rau koj tus kws kho mob yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no ntawm hyperthyroidism:
- Lub plawv dhia nrawm dua li ib txwm
- Qhov hnyav poob vim tsis muaj laj thawj
- Ua kom qab los noj mov
- Tawm hws
- Kev tshee, feem ntau ntawm txhais tes
- Nyob tsis tswm, chim siab, thiab/lossis lwm yam kev hloov pauv
- Qaug zog
- Ntau zaus plab hnyuv
- Kev loj hlob ntawm cov thyroid caj pas (tuaj yeem hnov hauv caj dab, thiab hu ua "goiter")
- Pw tsis tsaug zog
- Qhov muag tawm los lossis tawm ntau dua li ib txwm (cov tsos mob no tshwm sim hauv hom hyperthyroidism hu ua Grave's disease; ntxiv mus, qhov mob ntawm lub qhov muag hu ua "Grave's ophthalmopathy")
Kauj Ruam 6. Siv TSH cov txiaj ntsig ntsuas los tshuaj xyuas kev kho cov thyroid tsis tu ncua
Yog tias koj tau kuaj pom tias muaj teeb meem thyroid thiab tseem tab tom kho, koj tus kws kho mob yuav pom zoo tias koj tau txais TSH cov kev kuaj ib txwm los tshuaj xyuas thiab xyuas kom meej tias kev kho mob zoo. Kev tshuaj xyuas tas li kuj tseem tuaj yeem ua kom TSH qib nyob hauv cov hom phiaj sib txawv.
- Kev kho mob hypothyroidism thiab hyperthyroidism sib txawv heev.
- Lub hom phiaj ntau rau kev kho cov thyroid feem ntau yog TSH ntawm 0.4 - 4.0 mIU/L, txawm hais tias qhov no yuav txawv nyob ntawm seb hom thyroid teeb meem koj muaj.
- Kev saib xyuas yuav muaj ntau zaus thaum pib kho, kom txog rau niaj hnub uas tswj hwm TSH sib xws tau tsim (nyob rau lub sijhawm no kev tshuaj xyuas tsis tas yuav nquag dhau, feem ntau txhua 12 lub hlis).
Ntu 2 ntawm 3: Kev Txhais T4 thiab T3 Kev Ntsuas Dawb
Kauj Ruam 1. Txheeb xyuas yog tias koj qhov kev xeem T4 nyob hauv thaj tsam ib txwm muaj
T4 yog cov tshuaj hormone uas feem ntau ntsuas vim tias nws tau tsim tawm ncaj qha los ntawm cov qog qog, thiab tau tso tawm tas li kom nthuav dav thoob plaws lub cev. Qhov ib txwm pub dawb T4 yog nyob nruab nrab ntawm 0.8 - 2.8 ng/dL.
- Tus naj npawb tseeb nyob ntawm chav kuaj thiab hom kev xeem tshwj xeeb uas tau ua.
- Feem ntau, feem ntau cov txiaj ntsig kev sim suav nrog ib puag ncig ib puag ncig ntawm qhov ntsuas ntsuas kom yooj yim rau cov neeg mob paub seb lawv qib T4 qis dhau, ib txwm muaj, lossis siab.
Kauj Ruam 2. Nkag siab T4 tus nqi cuam tshuam nrog TSH tus nqi
Yog tias TSH tus nqi siab txawv txav (qhia txog hypothyroidism ua tau), nce qib T4 qis yuav lees paub qhov kev kuaj mob ntawm hypothyroidism.
Raws li tau hais yav dhau los, cov txiaj ntsig no yuav tsum tau txhais ua piv nrog TSH qhov tseem ceeb thiab raws li kev qhia ntawm kws kho mob
Kauj Ruam 3. Txheeb xyuas T3 cov qhab nia rau qhov ua tau hyperthyroidism
T3 yog lwm yam tshuaj tsim los ntawm cov qog ua qog, tab sis feem ntau muaj tsawg dua li T4. T4 hormone yog thawj cov thyroid hormone hauv kev kuaj mob cov thyroid. Txawm li cas los xij, muaj qee qhov xwm txheej ntawm hyperthyroidism, nyob rau hauv uas T3 hormone nce ntau thiab T4 tseem nyob li qub (nyob hauv qee lub xeev kab mob); qhov no yog qhov ntsuas ntawm T3 dhau los ua qhov tseem ceeb heev.
- Yog tias T4 tus nqi yog ib txwm tab sis TSH qis, tus nqi T3 siab tuaj yeem lees paub qhov kev kuaj mob ntawm hyperthyroidism.
- Txawm hais tias T3 tus nqi tuaj yeem muab cov ntaub ntawv tseem ceeb hauv kev kuaj mob hyperthyroidism, nws tsis muaj txiaj ntsig hauv kev kuaj mob hypothyroidism.
- Qhov pub dawb T3 ib txwm feem ntau yog los ntawm 2.3–4.2 pg/mL rau cov neeg laus dua 18 xyoo.
- Ib zaug ntxiv, tus lej tseeb yuav txawv nyob ntawm lub chaw kuaj mob thiab hom kev xeem tshwj xeeb uas tau ua. Feem ntau cov txiaj ntsig kev sim teev npe ib puag ncig ib puag ncig ntawm qhov ntsuas ntsuas yog li koj tuaj yeem txiav txim siab yooj yim seb T3 tus nqi qis dhau, ib txwm muaj, lossis siab.
Ntu 3 ntawm 3: Nyeem Lwm Cov Ntsiab Lus Ntshav Qab Zib
Kauj Ruam 1. Koom nrog kws kho mob
Ib qho ntawm qhov zoo nkauj ntawm peb qhov kev kho mob yog tias cov neeg mob tsis tas yuav txhais lawv tus kheej cov txiaj ntsig kev xeem. Tus kws kho mob yuav ntsuas qhov ntsuas thiab txhais cov txiaj ntsig rau koj. Nws tuaj yeem muab kev kuaj mob thiab pib phiaj xwm kho mob, uas cuam tshuam nrog kev siv tshuaj thiab kev hloov pauv hauv lub neej. Muaj kev paub dav dav ntawm cov txiaj ntsig ntsuas thiab lawv lub ntsiab lus tuaj yeem pab koj nkag siab txog qhov tsis meej pem thiab kev kho mob uas koj tab tom ua.
Kev xeem koj tus kheej tuaj yeem ua rau muaj kev phom sij thiab ua rau kev ua phem rau. Koj yuav tsis kho lub cav tsheb yog tias koj tsis tau txais kev qhia ua ntej; nws kuj yog tib yam
Kauj Ruam 2. Txhais cov thyroid cov tshuaj tiv thaiv kab mob txhawm rau sib txawv ntawm cov kab mob sib txawv ntawm cov thyroid
Yog tias koj tau kuaj pom tias muaj teeb meem thyroid, koj tus kws kho mob yuav xaj lwm cov kev tshawb nrhiav cov thyroid kom paub tseeb tias kuaj mob. Kev sim tshuaj tiv thaiv kab mob feem ntau ua tiav kom tau txais cov ntsiab lus tseem ceeb txog dab tsi tshwm sim hauv koj cov thyroid.
- Kev kuaj cov tshuaj tiv thaiv cov thyroid tuaj yeem pab sib txawv ntawm ntau hom thyroiditis nrog rau cov kab mob autoimmune thyroid.
- TPO (thyroid peroxidase antibody aka thyroid peroxidase antibody) tuaj yeem nce hauv cov kab mob autoimmune xws li Grave's Disease lossis Hashimoto's Thyroiditis.
- TG (thyroglobulin antibody aka thyroglobulin antibody) kuj tseem tuaj yeem ua rau mob Grave's Disease lossis Hashimoto's Thyroiditis.
- TSHR (TSH receptor antibodies aka TSH receptor antibodies) tuaj yeem ua rau mob Grave's Disease.
Kauj Ruam 3. Ntsuas koj li calcitonin
Ib qho kev ntsuas calcitonin tuaj yeem ua los tshuaj xyuas cov thyroid tsis txaus. Calcitonin tuaj yeem ua kom nce ntxiv hauv cov qog nqaij hlav qog noj ntshav (uas tuaj yeem yog qhov ua rau muaj ntau yam thyroid ua haujlwm tsis zoo). Calcitonin qhov tseem ceeb kuj tseem tuaj yeem ua rau mob C-cell hyperplasia, uas yog lwm daim ntawv ntawm kev loj hlob ntawm tes txawv txav hauv cov qog qog.
Kauj Ruam 4. Tau txais ib qho ultrasound, kuaj nqaij, lossis kuaj iodine kom paub meej tias muaj cov thyroid kuaj mob tshwj xeeb
Txawm hais tias cov kws kho mob tuaj yeem tau txais cov ntaub ntawv tseem ceeb ntau los ntawm kev kuaj ntshav txhawm rau txheeb xyuas thiab kuaj mob qog noj ntshav tsis zoo, qee qhov yuav tsum tau tshawb xyuas qhov tob ntxiv txhawm rau txiav txim siab qhov xwm txheej tiag. Tus kws kho mob yuav qhia rau koj paub yog tias yuav tsum kuaj ntxiv, xws li kuaj cov thyroid ultrasound, kuaj ntshav, lossis kuaj iodine.
- Ib qho thyroid ultrasound tuaj yeem siv los txheeb xyuas cov thyroid nodules. Yog pom qhov nodule, ultrasound tuaj yeem txiav txim siab seb lub nodule puas tau khov lossis cystic (muaj dej puv), thiab ob qho xav tau txoj kev kho mob sib txawv. Ultrasound tuaj yeem siv los tshuaj xyuas qhov kev loj hlob lossis hloov pauv hauv qhov nodule lub sijhawm.
- Ib qho thyroid biopsy tuaj yeem ua piv txwv cov nodules tsis txaus ntseeg thiab txiav tawm kev mob qog noj ntshav.
- Kev tshuaj xyuas iodine tuaj yeem ntsuas thaj tsam ntawm cov thyroid uas ua haujlwm (piv txwv li ua haujlwm tau zoo). Cov kev ntsuas no tseem tuaj yeem txheeb xyuas thaj chaw uas tsis ua haujlwm (tsis ua haujlwm) lossis ua haujlwm tsis zoo (ua haujlwm dhau).
