Hypothyroidism
Thehypothyroidism ndi zotsatira za kupangamahomoni osakwanira ndi gland chithokomiro, chiwalo chooneka ngati gulugufe chomwe chili m’munsi mwa khosi, pansi pa apulo wa Adamu. Anthu omwe akukhudzidwa kwambiri ndi matendawa ndi amayi omwe ali ndi zaka 50.
Mphamvu ya gland chithokomiro pa thupi ndi yaikulu: udindo wake ndi kulamulira zofunika kagayidwe wa maselo a thupi lathu. Imayendetsa ndalama zogwiritsira ntchito mphamvu, kulemera, kugunda kwa mtima, mphamvu ya minofu, kutengeka maganizo, kuika maganizo, kutentha kwa thupi, chimbudzi, ndi zina zotero. Izi zimatsimikizira kukula kwa mphamvu zomwe zimapangitsa kuti maselo athu ndi ziwalo zigwire ntchito. Mu anthu ndi hypothyroidism, mphamvu imeneyi imagwira ntchito pang'onopang'ono.
Popuma, thupi limagwiritsa ntchito mphamvu kuti likhalebe logwira ntchito: kuyendayenda kwa magazi, ubongo, kupuma, kugaya chakudya, kusunga kutentha kwa thupi. Izi zimatchedwa kagayidwe kofunikira, yomwe mbali ina imayendetsedwa ndi mahomoni a chithokomiro. Kuchuluka kwa mphamvu zomwe zimagwiritsidwa ntchito zimasiyanasiyana malinga ndi kukula, kulemera kwake, zaka, jenda, ndi ntchito za chithokomiro. |
Ku Canada, pafupifupi 1% ya achikulire ali ndihypothyroidism, ndi akazi kukhudzidwa 2 mpaka 8 kuposa amuna. Kuchuluka kwa matendawa kumawonjezeka ndi zaka, kufika pa 10% pambuyo pa zaka 6014. Ku France, 3,3% ya amayi ndi 1,9% ya amuna amakhudzidwa ndi hypothyroidism (gwero: HAS: summary of professional recommendations 2007).
Congenital kapena neonatal hypothyroidism
Pafupifupi mwana mmodzi mwa ana anayi aliwonse, hypothyroidism imakhalapo kuyambira kubadwa chifukwa cha kusapanga bwino kapena kusagwira ntchito bwino kwa chithokomiro. Ngati sichitsatiridwa, chithahypothyroidism kobadwa nako ali ndi mavuto aakulu pa chitukuko cha thupi ndi maganizo a mwanayo. Mwamwayi, ku France, Canada ndi maiko ena otukuka, matendawa amapezeka mwadongosolo mwa ana obadwa kumene, chifukwa cha kuyezetsa magazi komwe kunapangidwa pakati pa zaka za m'ma 1970 ndi ofufuza a ku Canada. Kuwunika kumeneku kumapangitsa kuti chithandizo chiyambe kuyambira masiku oyambirira a moyo kuti ateteze zotsatira za matendawa.1.
Mahomoni a chithokomiro akulamulidwa 2 zazikulu mahomoni yolembedwa ndi chithokomiro ndi T3 (triiodothyronine) ndi T4 (tetra-iodothyronine kapena thyroxine). Onsewa amamvetsetsa mawu oti "iodine" chifukwa ayodini ndi chimodzi mwazinthu zawo, zofunika kuti apange. Kuchuluka kwa mahomoni opangidwa kumayendetsedwa ndi tiziwalo timene timatulutsa timadzi tambiri ta ubongo: hypothalamus ndi pituitary gland. Hypothalamus imalamula chithokomiro cha pituitary kupanga timadzi ta TSH (ya mahomoni olimbikitsa chithokomiro). Komanso, timadzi ta TSH timachititsa kuti chithokomiro chizitulutsa mahomoni a chithokomiro, kuphatikizapo T3 ndi T4. Matenda a chithokomiro osagwira ntchito kapena opitirira muyeso amatha kuzindikirika poyesa magazi kuti ayese mlingo wa TSH m'magazi. Mu hypothyroidism, mulingo wa TSH ndi wokwera chifukwa pituitary gland imayankha kusowa kwa mahomoni a chithokomiro (T3 ndi T4) potulutsa TSH yambiri. Mwanjira imeneyi, gland ya pituitary imayesa kulimbikitsa chithokomiro kuti apange mahomoni ambiri. Pankhani ya hyperthyroidism (pamene chithokomiro cha chithokomiro chili ndi timadzi tambiri), zosinthazo zimachitika: mlingo wa TSH umakhala wotsika chifukwa pituitary gland imazindikira kuchuluka kwa mahomoni a chithokomiro m'magazi ndikusiya kutulutsa chithokomiro. Ngakhale kumayambiriro kwa vuto la chithokomiro, milingo ya TSH nthawi zambiri imakhala yachilendo. |
Zimayambitsa
Zaka za m'ma 1920 zisanachitike, a kusowa ayodini chinali chifukwa chachikulu chahypothyroidism. Iodine ndi mchere wofunikira kuti ukhale ndi moyo komanso kupanga mahomoni a chithokomiro T3 ndi T4. Kuyambira kuwonjezera ayodini mchere wa tebulo - chizolowezi chobadwira ku Michigan mu 1924 chifukwa cha zochitika zambiri za hypothyroidism - kusowa kumeneku kumakhala kosowa m'mayiko olemera. Komabe, malinga ndi kuyerekezera kwa World Health Organisation, pafupifupi? Anthu 2 biliyoni akadali pachiwopsezo chosowa ayodini12. Imakhalabe nambala 1 chifukwa cha hypothyroidism padziko lapansi. M’mayiko otukuka kumene anthu amafunsidwa kuchepetsa kumwa mchere, pangakhale ngozi yoti akusowanso ayodini.
Masiku ano, chikuchititsa mavuto hypothyroidism m'mayiko olemera ndi awa:
- A thyroiditis Hashimoto a. Matenda a autoimmune awa amachititsa kuti chithokomiro chiwonongeke ndi chitetezo. Asayansi sangathe kufotokoza chomwe chimayambitsa matendawa. Nthawi zina zimatha kuwoneka chifukwa cha kupsinjika kapena matenda a virus, mwa anthu omwe ali pachiwopsezo.
- Un chithandizo chomwe chimasintha chithokomiro. Chithandizo cha radioactive ayodini kuchiza a hyperthyroidism kapena opaleshoni kuchotsa chithokomiro (chifukwa cha nodule, chotupa kapena khansa ya chithokomiro) imayambitsa hypothyroidism yosatha pafupifupi 80% ya milandu. Komanso, chithandizo cha mankhwalawa khosi limayambitsa hypothyroidism yosakhalitsa pafupifupi 50% ya milandu, ndi hypothyroidism yosatha pafupifupi 25% ya milandu.
- A postpartum thyroiditis. Mu 8-10% ya amayi, machitidwe a autoimmune motsutsana ndi chithokomiro amatha kuchitika masabata angapo mpaka miyezi ingapo atabadwa.yobereka15. Izi zimatchedwa "postpartum" thyroiditis. Mu 40% ya milandu, chithokomiro ichi chimatsogolera ku hypothyroidism, zomwe zizindikiro zake zimakhala zochepa kapena zochepa. Nthawi zambiri amakhala osakhalitsa.
Zifukwa zina zosawerengeka
- Ena Mankhwala. Lithiamu, mwachitsanzo, yogwiritsidwa ntchito pazovuta zina zamisala, kapena amiodarone (mankhwala okhala ndi ayodini), omwe amaperekedwa kuti asokoneze kugunda kwa mtima, angayambitse hypothyroidism.
- Kusakhazikika kobadwa nako a chithokomiro, ndiko kunena kuti alipo kuyambira pakubadwa. Nthawi zina gland simakula bwino, kapena simagwira ntchito bwino. Pamenepa, hypothyroidism imazindikirika patatha masiku angapo mutabadwa chifukwa cha kuyezetsa magazi mwadongosolo.
- Kulephera kwa ntchitopituitary gland, gland yomwe imayang'anira chithokomiro ndi hormone TSH (imayimira zosakwana 1 peresenti ya milandu).
- A matenda bakiteriya kapena mavairasi ku chithokomiro.
- Onani magawo a Anthu omwe ali pachiwopsezo komanso Zowopsa.
Zovuta zotheka
Akapanda kuthandizidwa, matendawa amatha kukhala ndi zotsatirapo zokhalitsa. Kwa akuluakulu, a myxoedème, mtundu woopsa wa hypothyroidism, ukhoza kuchitika. Zizindikiro za myxedema ndi nkhope yodzitukumula, yachikasu, ndi khungu louma, lomwe limawoneka lokhuthala. Zikavuta kwambiri, zikhalidwe zina (matenda, kuzizira, kuvulala, opaleshoni, ndi zina zambiri) zitha kuchititsa kuti munthu asakhalenso ndi chikumbumtima. coma "Myxedema". Komanso, kafukufuku amasonyeza kuti anthu ndihypothyroidism kwa zaka zingapo ali pachiwopsezo chachikulu cha matenda amtima.
Mwa ana osalandira chithandizo, pali kuchedwa kwakukulu kwa kukula ndi kukula kwaluntha kosasinthika, komwe kumatchedwa. cretinism. Chithandizo chokwanira, choyambidwa msanga, nthawi zambiri chimapewa zovuta ndi zotsatira zake.