4 (pub dawb): cov cai. Lawm T4 (pub dawb): cov ntshav mus kuaj rau thyroid hormones

Ntawm kuj zoo kawg tseem ceeb nyob rau hauv lub qub hauj lwm ntawm lub thyroid caj pas yog lub hypothalamic-pituitary thyroid system. Nws muab kev tswj ntawm lub synthesis, ntau lawm thiab kev ua si ntawm lub qog cov tshuaj hormones.

Txheej txheem cej luam

Lub hypothalamus secretes ROG (tireotro-pin-tso tau). Nws, nyob rau hauv lem, nkoos qhov kev tso tawm thiab synthesis ntawm thyroid stimulating lawm (TSH - TTG). TSH yog muab kev koom tes nyob rau hauv cov txheej txheem uas txuam nrog lwm yam tshuaj steriods kho. Nyob rau hauv kev, nws nkoos secretion, txuam, metabolism thiab synthesis ntawm triiodothyronine (T3) thiab thyroxine (T4). Nyob 99% ntawm cov ob steroids nyob rau hauv cov ntshav circulating nyob rau hauv cov kab thauj cov nqaijrog daim ntawv. Tsawg tshaj li ib feem pua yog nyob rau hauv free daim ntawv. Unbound steroid theem nyob rau hauv feem ntau cov neeg yog sib thooj, nrog rau cov kev haumxeeb lub xeev ntawm cov thyroid caj pas.

zog thyroxine

Lawm T4 (free) tswj kev cai ntawm tej kev loj hlob thiab kev loj hlob, kom ntseeg tau tus txij nkawm ntawm lub cev kub thiab yog li tswj lub tshav kub buildup. Cov compound muaj ib cov nyhuv rau txhua theem ntawm carbohydrate metabolism, nyob rau hauv ib feem - nyob rau vitamin thiab lipid metabolism. Lawm T4 (pub dawb) yog ib qho tseem ceeb feem ntawm kev loj hlob nyob rau hauv utero thiab neonatal sij hawm. Lub concentration qhia cov kev soj ntsuam mob ntawm lub qog raws li txoj cai, raws li cov kev hloov nyob rau hauv lub dav dav theem ntawm thyroxine yuav tau triggered thaum uas teeb nyob rau hauv cov kev ua ntawm cov thyroid caj pas los yog qhov kev hloov nyob rau hauv lub xov tooj ntawm thauj proteins. Thaum lub sij hawm hnub, lub siab tshaj plaws cov ntsiab lus ntawm steroid yog txiav txim los ntawm 8 rau 12 teev, thiab yam tsawg kawg nkaus - nrog 23 thiab 3. Thaum lub sij hawm hauv lub xyoo, lub siab tshaj plaws qib 4 (free) nce mus txog ntawm Cuaj hlis mus rau Lub ob hlis ntuj, tus nqi qis tshaj - lub caij ntuj sov. Nyob rau hauv thaum lub sij hawm (lub sij hawm hnub) thyroxine concentration nce, ncav ib qib siab tshaj plaws los maj mam peb peb lub hlis. Thoob plaws hauv lub neej ntawm thyroxin cov ntsiab lus nyob rau hauv cov neeg tsis hais poj niam txiv neej tseem nyob ntawm qhov. Txo lawm ntau ntau cai tom qab plaub caug xyoo.

Yuav ua li cas yuav qhia tau rau cov theem ntawm thyroxine?

Yog hais tias T4 (pub dawb) kom meej meej zog, ces nws yog suav tias yog ib tug qhia txog hyperthyroidism. Txo concentration qhia hypothyroidism. Lub ywj pheej ntawm cov steroid cov ntsiab lus ntawm thyroxine losis tswvyim dabtsi globulin ua rau nws tau siv nws li ib tug txhim khu kev qha diagnostic kuaj. Qhov no yog tshwj xeeb yog ib qho tseem ceeb nyob rau hauv tej yam kev mob uas nrog kev hloov nyob rau hauv theem ntawm thyroxine-losis tswvyim dabtsi globulin. Cov no muaj xws ncauj contraceptives (qhov ncauj), cev xeeb tub, tau txais androgen los yog cov tshuaj no. Hloov cov yam ntxwv thiab rau cov neeg nrog ib tug roj ntsha predisposition mus nce los yog yuav txo tau cov concentration ntawm globulin. Pub cov ntshav dawb T4 pom zoo rau mob hom ntawm ob hypothyroidism vim pathologies nyob rau hauv lub hypothalamo-pituitary theem. Nyob rau hauv cov ntaub ntawv no TTG cov ntsiab lus tsis hloov los yog yuav tsub kom. Feem ntau, cov txhawb theem ntawm thyroxine yuav tau them rau theem ntawm ntshiab bilirubin, rog, raws li zoo raws li ib tug tourniquet, thaum yuav tus cov ntshav mus kuaj. 4 (pub dawb) tsis hloov nyob rau hauv kev mob loj cov kab mob nyob rau hauv uas tsis yog-thyroid kev ua si. Cov theem ntawm tag nrho cov thyroxine yuav txo tau.

Kev npaj rau kev kuaj

Ib lub hlis ua ntej yuav muab cov ntshav excludes tus thawj coj ntawm cov tshuaj hormones (tshwj tsis yog tias ho muaj tej cov lus qhia endocrinologist). Rau ob los yog peb hnub los nres rau qhov kev siv ntawm tus tsom xam ntawm iodine-muaj tshuaj. Ntshav yuav tsum xeem dhau ua ntej moj cov kev tshawb fawb uas siv cov zoo nrog. Nyob rau lub tswv yim uas muab cov ntshav yuav tsum caiv los ntawm lub cev kev ua si, tshem tawm stressful lub sijhawm. Ua ntej rau txoj kev tshawb, ib nrab ib teev, koj yuav tsum calm down, ua ua tsis taus pa li qub. Qhov tsom xam yog ua rau ib qho kev npliag plab. Nrog rau lub xeem noj mov yuav tsum tsis tsawg tshaj li yim teev (tab sis dua li 12 teev). Nws yog tsis tau tso cai rau haus dej haus kas fes, tshuaj yej los yog kua txiv. Ua tau tsuas yog dej.

Txo theem ntawm thyroxine

4 (free) (qub poj niam thiab cov txiv neej - 9-19 pmol / l) yuav txo tau nyob rau hauv lub postoperative lub sij hawm, thaum ob hypothyroidism (o ntawm lub pituitary, tireotropinome, syndrome, Sheehan). Txo cov concentration nws yog kuj muab sau rau hauv lub hauv paus ntawm kev txais tos anabolics, thyreostatics, anticonvulsant tshuaj, lithium npaj. Thyroxine theem txo thaum uas siv cov qhov ncauj contraceptives, octreotide, methadone, clofibrate. Tau ua kuj muaj xws li ib tug khoom noj nrog ib tug tsawg tus nqi ntawm cov protein, iodine deficiency, heroin siv, raug mus ua. 4 (pub dawb) yuav raug muab txo nrog tertiary (paj hypothalamus TBI), nrhiav, congenital hypothyroidism (amid uas nws kim heev resection ntawm lub qog thiab thyroid, autoimmune thyroiditis, teb goiter).

Ua ntau

Cov theem ntawm xws hormone li T4 (free) (qub poj niam thiab cov txiv neej qhia saum toj no) yuav muab tau ntau zog thaum tshuaj lom goiter, TSH-ywj siab hyperthyroidism, rog. Ua lub concentration pom nyob rau hauv lub keeb kwm yav dhau ntawm nephrotic syndrome, heparin txoj kev kho. Yog vim li cas tseem yuav muaj tej choriocarcinoma, txais tos ntawm ib tug thyroxine rau lub hauv paus ntawm hypothyroidism, post-Natal hloov nyob rau hauv kev ua si ntawm lub qog caj pas, mob siab tus kab mob. 4 (pub dawb) yuav tsum tsa nyob rau hauv lub qog kuj syndrome steroids, caj dizalbunemicheskoy hyperthyroxinemia, hais tias, provoking ib tug txo tiroksinsyazyvayuschego globulin concentration.

Thyroxine thiab cev xeeb tub

Thyroid hormones yog muab kev koom tes nyob rau hauv yuav luag txhua txhua txheej txheem nyob rau hauv lub cev. Raws li hais saum toj no, lub tebchaw tswj metabolism, kev cuam tshuam rau cov kev ua ntawm lwm yam steroids. Thyroid pathology yuav tsum tau nrog los ntawm ob qho tib si ib qho kev nce thiab ib tug txo nyob rau hauv nws cov kev khiav dej num. Ntawm kev tseem ceeb nyob rau hauv yuam cai ntawm kev hloov kev ua ub no muaj thaum lub sij hawm nyuam. Cov kev hloov ntawm tej lub xeev ntawm cov thyroid caj pas muaj feem xyuam rau cov chav kawm ntawm cev xeeb tub, nws tus cwj pwm, thiab lub sij hawm ntawm tus txheej xwm ntawm tus me nyuam mos. Feem ntau yeej tsis vynashivanie kis thaum qhia endocrine pathologies. Cov kab mob no yam, raws li ib tug txoj cai, ua rau me nyuam kawg, ntxiv lawm tshob. Feem ntau cov feem ntau thiaj paub hais tias thaum lub sij hawm cev xeeb tub goiter (ib qho kev nce nyob rau hauv lub qog diffuse xwm) nrog euthyrosis preservation, raws li zoo raws li autoimmune thyroiditis, provoking hloov nyob rau hauv lub hormonal tom qab. Rau thaum lub sij hawm yog yus muaj los ntawm cov kev hloov nyob rau hauv tej lub xeev ntawm lub caj pas.

tswv yim pom zoo

Yuav kom raug txhais cov ntsiab lus ntawm laboratory kev ntsuam xyuas thaum lub sij hawm cev xeeb tub yuav tsum coj mus rau hauv tus account ib co ntsiab lus. Kev txiav txim ntawm tag nrho cov T3 thiab T4 yog tsis tuav. Qhov no yog vim lub fact tias thaum lub sij hawm cev xeeb tub, lawv concentration yog muaj zog los ntawm ib nrab. Thaum lub unbound thyroxine theem txoj kev tshawb no nws concentration yuav tsum tau txiav txim nyob rau hauv nrog cov ntsiab lus TTG. Thyroxine dog dig nce nyob rau hauv hais txog 2% ntawm cev xeeb tub cov poj niam. Nyob rau hauv thawj ib nrab ntawm ib tug qub thaum lub sij hawm cim txo TTG (kwv yees li 20-30% ntawm cov neeg mob nrog singletons thiab txhua tus neeg mob los ntawm ntau yam uas cev xeeb tub). Nyob rau hauv cov kev kho mob ntawm hyperthyroidism T4 soj ntsuam xwb (free). Unbound thyroxine theem nyob rau hauv lub tom qab ua sawv tej zaum yuav marginally txo. Yog li TSH concentration yuav khaws cia kom nyob rau hauv lub cev ntau.