Cov thyroid yog lub qog zoo li tus npauj npaim nyob hauv lub caj dab uas tsim cov thyroid hormone. Cov thyroid tsis zoo, uas cov qog ua rau ntau dhau lossis tsawg dhau ntawm cov tshuaj, tuaj yeem cuam tshuam ntau txoj haujlwm hauv koj lub cev, los ntawm koj lub plawv dhia mus rau koj cov metabolism. Yog tias koj tus kws kho mob xav tias koj raug kev txom nyem los ntawm cov thyroid ntau dhau lossis tsis muaj zog, nws tuaj yeem xaj kuaj. Nyeem cov txiaj ntsig tuaj yeem zoo li txoj haujlwm nyuaj; Txawm li cas los xij, yog tias koj muaj 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 muaj teeb meem cov thyroid thiab, yog tias muaj, qhov teeb meem yog dab tsi. Nco ntsoov tias tsuas yog koj tus kws kho mob tuaj yeem tshuaj xyuas kab mob thyroid, yog li nco ntsoov nrog koj tham nrog nws txog qhov txiaj ntsig yog li koj tuaj yeem pib kho yog tias tsim nyog.
Cov kauj ruam
Ntu 1 ntawm 3: Nkag Siab TSH Cov Ntsiab Lus
Kauj Ruam 1. Txheeb xyuas seb koj li kev nyeem TSH nyob hauv qhov ib txwm muaj
Thawj qhov kev kuaj cov thyroid uas feem ntau coj los ntawm kws kho mob yog TSH. TSH sawv rau "Thyroid Stimulating Hormone," uas yog tsim los ntawm cov caj pas pituitary thiab txhawb cov thyroid tsim thiab tso cov tshuaj hormones T4 thiab T3.
- TSH tuaj yeem xav tias yog qhov piv txwv "cav" ntawm cov thyroid caj pas, hauv qhov uas nws txiav txim siab tus nqi ntawm cov thyroid hormone uas tau tsim tawm thiab tom qab ntawd tso tawm ntawm cov thyroid mus rau hauv lub cev.
- Tus nqi ib txwm rau TSH yog nruab nrab ntawm 0.4 - 4.0 mIU/L.
- Yog tias koj TSH nyob hauv qhov no, qhov ntawd yog lub cim zoo; Txawm li cas los xij, tus nqi TSH ib txwm tsis txiav txim siab tag nrho cov teeb meem thyroid. TSH qhov tseem ceeb ntawm qhov kawg ntawm qhov ib txwm tuaj yeem qhia txog cov teeb meem thyroid uas tab tom hloov pauv.
- Feem ntau cov teeb meem thyroid xav tau ob lossis ntau qhov kev kuaj mob txhawm rau txheeb xyuas thiab kuaj mob, muab qhov sib cuam tshuam tsis sib xws ntawm ntau yam tshuaj hormones uas ua rau cov thyroid ua haujlwm.
- Koj tus kws kho mob yuav xaj ntau qhov kev sim, txawm tias koj TSH zoo li qub, yog tias nws tseem xav tias koj yuav muaj teeb meem thyroid.
Kauj Ruam 2. Txhais tau lub ntsiab lus ntawm kev nyeem TSH siab
TSH qhia cov thyroid tsim ntau T4 thiab T3, uas yog cov tshuaj hormones tso tawm los ntawm cov thyroid (ntawm cov lus txib ntawm TSH) ua thoob plaws lub cev. Yog tias koj cov thyroid tsis ua haujlwm, tom qab ntawd nws tsis tso tawm ntau txaus T4 thiab T3, thiab yog li koj cov qog pituitary yuav tso TSH ntau ntxiv los sim thiab them nyiaj.
- Yog li, TSH siab yuav yog ib qho cim ntawm hypothyroidism (qhov xwm txheej uas koj cov qog ua haujlwm hauv lub cev ua cov tshuaj tsis txaus).
- Koj yuav xav tau kev tshuaj xyuas ntxiv, txawm li cas los xij, txhawm rau tshawb xyuas ntxiv thiab kom paub tseeb qhov kev kuaj mob no.
Kauj Ruam 3. Saib xyuas cov cim thiab tsos mob ntawm hypothyroidism
Ntxiv rau kev nyeem TSH siab, hypothyroidism kuj nthuav tawm nrog ntau qhov kev qhia kho mob. Qhia rau koj tus kws kho mob yog tias koj tab tom ntsib ib qho ntawm cov tsos mob hauv qab no lossis cov tsos mob, uas tej zaum yuav ua rau tsis txaus ntseeg rau hypothyroidism:
- Ua kom txias txias heev
- Qaug zog
- Piav qhia qhov hnyav nce
- Cov tawv nqaij qhuav heev
- Cem quav
- Mob leeg thiab txhav
- Mob sib koom thiab o
- Kev nyuaj siab thiab/lossis lwm yam kev hloov pauv
- Ib qho qeeb dua li lub plawv dhia ib txwm
- Plaub hau
- Hloov pauv rau koj lub cev ntas
- Kev xav qeeb lossis hais lus
Kauj Ruam 4. Txheeb xyuas lub ntsiab lus ntawm kev nyeem TSH qis heev
Ntawm qhov tod tes, yog tias koj tau nyeem TSH qis heev, nws yuav yog koj lub cev teb rau koj lub caj pas los tsim tsawg dua TSH to an tshaj ntawm cov thyroid hormone hauv lub cev (T3 thiab T4). Xws li, TSH qis tuaj yeem yog qhov qhia ntawm hyperthyroidism (ntau lawm ntau lawm ntawm cov thyroid hormone).
- Ib zaug ntxiv, yuav tsum kuaj ntshav ntxiv kom paub tseeb qhov kev kuaj mob no.
- TSH nyeem ib leeg tuaj yeem taw koj tus kws kho mob mus rau qee txoj hauv kev, tab sis hauv nws tus kheej nws feem ntau tsis yog kuaj mob.
Kauj Ruam 5. Txheeb xyuas cov cim thiab tsos mob ntawm hyperthyroidism
Hyperthyroidism nthuav tawm nrog ntau qhov kev qhia kho mob, ntxiv rau kev nyeem TSH qis. Qhia rau koj tus kws kho mob yog tias koj tab tom ntsib ib qho ntawm cov tsos mob hauv qab no lossis cov tsos mob uas yuav qhia tau tias yog hyperthyroidism:
- Lub plawv dhia nrawm dua li ib txwm
- Piav qhia qhov hnyav poob
- Ua kom qab los noj mov
- Tawm hws
- Kev tshee, feem ntau ntawm koj txhais tes
- Kev ntxhov siab, chim siab, thiab/lossis lwm yam kev hloov pauv
- Qaug zog
- Ntau zaus plab hnyuv
- Cov qog ua qog loj (uas tuaj yeem hnov hauv koj lub caj dab, thiab hu ua "goiter")
- Teeb meem pw tsaug zog
- Qhov muag uas pom lossis nthuav tawm ntau dua li lawv ib txwm ua (cov cim no muaj nyob hauv qee hom hyperthyroidism hu ua Grave's disease - tshwj xeeb, qhov muag txawv txav hu ua "Grave's ophthalmopathy")
Kauj Ruam 6. Siv koj li TSH tus nqi los saib xyuas kev kho cov thyroid tsis tu ncua
Yog tias koj tau kuaj pom tias muaj teeb meem ntawm cov thyroid thiab tau txais kev kho mob txuas ntxiv rau nws, koj tus kws kho mob yuav muaj peev xwm qhia tias koj tau txais TSH kev kuaj ib txwm los tshuaj xyuas thiab lees paub qhov ua tau zoo ntawm koj kev kho mob. Kev tshuaj xyuas txuas ntxiv tuaj yeem ua kom ntseeg tau tias koj qib TSH nyob hauv cov hom phiaj.
- Kev kho mob rau cov mob hypothyroid thiab hyperthyroid sib txawv heev.
- Lub hom phiaj ntau rau kev kho cov thyroid yog ib txwm TSH nruab nrab ntawm 0.4. – 4.0 mIU/L, txawm hais tias qhov no yuav txawv nyob ntawm seb hom thyroid teeb meem koj muaj.
- Koj yuav muaj peev xwm tau txais kev saib xyuas ntau zaus thaum pib kho koj, kom txog thaum koj txiav txim siab ua ntu zus uas koj TSH dhau los zoo ib yam (nyob rau lub sijhawm uas tsis tshua muaj kev saib xyuas yuav tsim nyog, feem ntau yog ib zaug txhua 12 lub hlis).
Ntu 2 ntawm 3: Txhais T4 Dawb thiab T3 Cov Ntsiab Lus
Kauj Ruam 1. Txheeb xyuas seb koj li kev nyeem T4 nyob hauv qhov ib txwm muaj
T4 yog qhov ntsuas ntau tshaj plaws uas tau tsim tawm ncaj qha los ntawm cov thyroid, thiab tom qab ntawd tso tawm kom nthuav dav thoob plaws hauv lub cev. Qhov ib txwm pub dawb T4 yog nyob nruab nrab ntawm 0.8 - 2.8 ng/dL.
- Cov zauv tseeb yuav txawv nyob ntawm qhov chaw kuaj ntshav thiab hom kev xeem tshwj xeeb uas tau ua.
- Txawm li cas los xij, feem ntau cov txiaj ntsig kev sim muaj, nyob ib sab ntawm koj qhov kev nyeem, xaiv qhov ntau yam kom koj tuaj yeem pom yooj yim seb koj li T4 qis, ib txwm muaj, lossis nce siab.
Kauj Ruam 2. Txhais koj tus nqi T4 hauv kev sib raug zoo rau koj tus nqi TSH
Yog tias koj tus nqi TSH txawv txav siab (qhia txog qhov ua tau hypothyroidism), a qis T4 yuav txhawb kev kuaj mob hypothyroidism. Ntawm qhov tod tes, yog tias koj tus TSH tus nqi txawv txav qis (qhia txog qhov ua tau hyperthyroidism), a siab T4 yuav txhawb kev kuaj mob hyperthyroidism.
Raws li tau hais yav dhau los, cov txiaj ntsig tau txhais zoo tshaj nrog TSH tus nqi thiab raws li kev qhia ntawm kws kho mob
Kauj Ruam 3. Ntsuas tus nqi T3 thaum muaj xwm txheej hyperthyroidism
T3 yog lwm yam tshuaj tsim los ntawm cov qog ua haujlwm hauv lub cev, tab sis feem ntau qis dua li T4. T4 yog lub qog cov thyroid tseem ceeb siv hauv kev kuaj mob cov thyroid. Muaj qee qhov xwm txheej ntawm hyperthyroidism, txawm li cas los xij, thaum T3 nce siab thiab T4 tseem nyob li qub (hauv qee lub xeev cov kab mob), thiab qhov no yog thaum ntsuas T3 dhau los tshwj xeeb.
- Yog tias T4 yog ib txwm tab sis TSH qis, T3 siab tuaj yeem lees paub qhov kev kuaj mob hyperthyroidism.
- Thaum T3 tuaj yeem muab cov ntaub ntawv muaj txiaj ntsig hauv kev kuaj mob hyperthyroidism, nws tsis pab txheeb xyuas qhov mob hypothyroidism.
- T3 dawb yog ib txwm nyob nruab nrab ntawm 2.3–4.2 pg/ml rau cov neeg laus dua 18 xyoo.
- Ib zaug ntxiv, tus lej tseeb yuav txawv nyob ntawm qhov chaw kuaj ntshav thiab hom kev xeem tshwj xeeb uas tau ua. Feem ntau cov txiaj ntsig kev sim muaj, tom ntej no rau koj nyeem, xaiv qhov ntau ib txwm yog li koj tuaj yeem pom yooj yim txawm tias koj T3 qis, ib txwm muaj, lossis nce siab.
Ntu 3 ntawm 3: Nyeem Lwm Cov Ntsiab Lus Ntshav Qab Zib
Kauj Ruam 1. Nrog koj tus kws kho mob tham
Qhov zoo nkauj ntawm peb qhov kev kho mob yog tias cov neeg mob tsis tas yuav txhais lawv tus kheej cov txiaj ntsig. Koj tus kws kho mob yuav hais kom kuaj thiab txhais koj cov txiaj ntsig. Nws tuaj yeem muab kev kuaj mob thiab pib txoj kev kho mob, uas yuav suav nrog kev siv tshuaj thiab kev hloov pauv hauv lub neej. Muaj kev paub ua haujlwm dav dav ntawm cov txiaj ntsig thiab lawv txhais li cas tuaj yeem pab koj nkag siab txog qhov tsis meej pem thiab pab nkag siab txog kev kho tus mob.
Kev xaj koj tus kheej qhov kev sim tuaj yeem ua rau txaus ntshai thiab feem ntau ua rau kev kho tsis raug. Koj yuav tsis sim kho lub cav yog tias koj tsis tau kawm - qhov no tsis txawv
Kauj Ruam 2. Txhais cov thyroid tshuaj tiv thaiv kab mob txhawm rau sib txawv ntawm ntau hom kab mob thyroid
Yog tias koj tau kuaj pom tias muaj teeb meem thyroid, koj tus kws kho mob yuav yuav xaj ib qho ntawm lwm cov kev tshawb nrhiav cov thyroid txhawm rau txhawm rau tshuaj xyuas kom meej thiab paub meej tias koj kuaj mob li cas. Kev sim tshuaj tiv thaiv kab mob feem ntau tau ua, thiab tuaj yeem ua rau cov ntsiab lus tseem ceeb hais txog dab tsi tshwm sim nrog koj cov thyroid.
- Kev ntsuam xyuas cov tshuaj tiv thaiv cov thyroid tuaj yeem pab sib txawv ntawm hom thyroiditis thiab tseem muaj cov kab mob autoimmune ntawm cov thyroid.
- TPO (thyroid peroxidase antibody) tuaj yeem ua rau cov kab mob autoimmune thyroid xws li Grave's Disease lossis Hashimoto's Thyroiditis.
- TG (thyroglobulin antibody) kuj tseem tuaj yeem ua rau mob Grave's Disease lossis Hashimoto's Thyroiditis.
- TSHR (TSH receptor antibodies) tuaj yeem ua rau mob Grave's Disease.
Kauj Ruam 3. Kom ntsuas koj cov calcitonin
Ib qho kev ntsuas calcitonin tuaj yeem ua los tshuaj xyuas cov teeb meem thyroid ntxiv. Calcitonin tuaj yeem ua rau muaj mob qog noj ntshav qog noj ntshav (uas tej zaum yuav yog qhov ua rau tom qab ntau yam ntawm cov thyroid tsis ua haujlwm). Tus nqi calcitonin kuj tseem tuaj yeem ua rau mob C-cell hyperplasia, uas yog lwm hom kev txawv txav ntawm cov cell hauv cov qog qog.
Kauj Ruam 4. Tau txais ib qho ultrasound, kuaj nqaij, lossis kuaj iodine kom paub tseeb tias qee yam kuaj mob thyroid
Thaum kuaj ntshav tuaj yeem muab cov kws kho mob nrog cov ntaub ntawv muaj txiaj ntsig txhawm rau txheeb xyuas thiab kuaj mob cov teeb meem hauv cov thyroid, muaj qee kis uas xav tau kev tshuaj xyuas ntau ntxiv txhawm rau txiav txim siab qhov tseeb yog dab tsi. Koj tus kws kho mob yuav qhia rau koj paub yog tias nws lossis nws pom zoo kuaj ntxiv, xws li kuaj ntshav qog ntshav, kuaj ntshav, lossis kuaj iodine.
- Ib qho thyroid ultrasound tuaj yeem siv los txheeb xyuas cov thyroid nodules. Yog tias muaj cov nodules pom, ultrasound tuaj yeem muab kev pom pom seb lawv puas khov lossis cystic (cov kua dej puv) nodules, ob qho tib si uas xav tau hom kev kho mob sib txawv. Ultrasound kuj tseem tuaj yeem siv los tshuaj xyuas ib qho kev loj hlob lossis hloov pauv hauv cov nodules raws sijhawm.
- Ib qho thyroid biopsy tuaj yeem ua piv txwv ntawm qhov tsis txaus ntseeg thiab txiav txim siab lossis txiav tawm qhov ua rau muaj mob qog noj ntshav.
- Kev tshuaj xyuas iodine tuaj yeem ntsuas qhov twg ntawm cov thyroid yog qhov tsim nyog ua haujlwm (piv txwv li ua haujlwm tau zoo). Nws tseem tuaj yeem txheeb xyuas thaj chaw twg uas tsis ua haujlwm (tsis ua haujlwm) lossis tsis muaj zog (ua haujlwm ntau dhau).
