4 (mahhala): kuyinsakavukela. I-hormone i-T4 (mahhala): isivivinyo igazi sama-hormone egilo

Lokubaluleke kakhulu ekusebenzeni ezivamile we indlala yegilo iyona hypothalamic-pituitary yegilo uhlelo. Linikeza ukulawula zamagama, ukukhiqizwa futhi umsebenzi kwama-hormone egilo.

Uhlolojikelele

Le ngxenye bukhipha FAT (tireotro-pin-ukukhulula isici). Ke, ngesikhathi, kuvusa ukukhululwa kanye synthesis yegilo inkanuko i-hormone (TSH - TTG). TSH ehilelekile izinqubo ezihlobene nezinye steroid. Ikakhulukazi, kukhuthaza uketshezi, ukunqwabelana, umzimba kanye synthesis triiodothyronine (T3) kanye thyroxine (T4). Over 99% kulezi ama ezimbili egazini afundwa kakhulu ezihlobene amaprotheni ezokuthutha fomu. bangaphansi kwamaphesenti angu-muntu ifomu khulula. Itho olukhululekile steroid amazinga e abantu abaningi kuhlobene ne isimo sokusebenza we indlala yegilo.

izakhiwo thyroxine

I-hormone i-T4 (mahhala) kusiza ukulawulwa nokukhula okuvamile nokuthuthuka, ukuqinisekisa nokugcinwa kokuthula izinga lokushisa komzimba nokugeleza kanjalo nokugcina ukugcwala ukushisa. Egcekeni kuyalithinta zonke izigaba carbohydrate umzimba, ngokwengxenye - kwi amavithamini lipid umzimba. I-hormone i-T4 (mahhala) kuyingxenye ebalulekile yentuthuko e utero nezikhathi ezisanda kubelethwa. Ubuningi kubonisa isimo basemtholampilo isimo yegilo, njengoba kungenzeka ushintsho ezingeni jikelele thyroxine kumele senziwa yokuphazamiseka umsebenzi indlala yegilo noma ushintsho inani amaprotheni ezokuthutha. Emini, okuqukethwe esiphezulu steroid kunqunywa kusukela amahora 8 kuya ku-12, futhi okungenani - ne 23 kanye 3. Kuwo lo nyaka, izinga eliphakeme 4 (mahhala) ifinyelela kusukela ngo-September kuya ku-February, ephansi - ehlobo. Ngo nenkathi kokubeletha (ngesikhathi sokukhulelwa) thyroxine lokuhlushwa yanda, ekufinyeleleni ezingeni esiphezulu senyanga kancane kancane lwesithathu. Phakathi nokuphila okuqukethwe thyroxin kubantu kungakhathaliseki ubulili uhlala kuqhathaniswa njalo. amazinga ama-hormone encishisiwe waphawula ngemva engamashumi amane.

Yini ukutshela ezingeni thyroxine?

Uma i-T4 (mahhala) anda ngokucacile, khona-ke kubhekwa isiqinisekiso i-hyperthyroidism. okuhlushwa encishisiwe kubonisa i-hypothyroidism. Ukuthola uzibuse okuqukethwe kwama-steroid ka thyroxine ngibopha globulin kwenza kube nokwenzeka ukuyisebenzisa njenge sivivinyo okunokwethenjelwa zokuxilonga. Lokhu kubalulekile ikakhulukazi ezimweni ukuthi ahambisana izinguquko amazinga globulin thyroxine-esibophezelayo. Lezi zihlanganisa izinto zokuvimbela inzalo setemlomo (temlomo), ukukhulelwa, ukuthola androgen noma i-estrogen. Izinguquko alandisa kulabo nge nezici ezithile lezinceku ukwandisa noma ukunciphisa lokuhlushwa globulin. Nikela igazi T4 khulula Kunconywa uphethwe uhlobo hypothyroidism yesibili ngenxa pathologies ezingeni hypothalamo-pituitary. Kulokhu TTG okuqukethwe akashintshi noma iyakhula. Ngokuvamile, amazinga aphakeme thyroxine kungaba ngenxa amazinga aphezulu serum bilirubin, ukukhuluphala, kanye tourniquet, lapho liyakuphumula ukuhlolwa igazi. 4 (mahhala) ayishintshi ngaphansi izifo ezinzima emsebenzini non-yegilo. Izinga thyroxine Imininingwane kungehlisa izinga.

Ukulungiselela ukuhlolwa laboratory

Esikhathini esingangenyanga ngaphambi kokunikeza igazi akufaki ekuphathweni hormone (ngaphandle kukhona iziyalezo eziqondile endocrinology). Kwaphela izinsuku ezimbili noma ezintathu ukuze uyeke ukusetshenziswa ukuhlaziywa izidakamizwa iodine-equkethe. Igazi ngizodabula ngaphambi izifundo radiology usebenzisa Ngokuphambene ejenti. Ngobusuku obandulela akunika igazi kufanele uyeke umsebenzi ngokomzimba, ukuqeda nezimo ezicindezelayo. Ngaphambi cwaningo, isigamu sehora, kufanele ukuzola, kubangele ukuphefumula kokuvamile. Uhlaziyo wenziwa esiswini esingenalutho. Nge esidlweni sokugcina kumele kube esingekho ngaphansi kwamahora angama ayisishiyagalombili (kodwa okungcono 12 amahora). Akuvunyelwe ukuba baphuze ikhofi, itiye noma isiphuzo sezithelo. Can amanzi kuphela.

yehlise amazinga thyroxine

4 (mahhala) (abesifazane evamile futhi amadoda - 9-19 pmol / l) zingancishiswa esikhathini postoperative, lapho i-hypothyroidism yesibili (ukuvuvukala pituitary tireotropinome, syndrome, Sheehan). Ukunciphisa lokuhlushwa ke Kuyaqapheleka futhi ngesisekelo reception anabolics, thyreostatics, izidakamizwa anticonvulsant, lithium amalungiselelo. Thyroxine ezingeni incipha uma usebenzisa izinto zokuvimbela inzalo temlomo, octreotide, methadone, clofibrate. Ezinye izinto okungenzeka futhi zihlanganisa ukudla nge okulinganiselwe amaprotheni, ukuntula iodine, ukusetshenziswa i-heroin, ukuchayeka ukuhola. 4 (mahhala) kungancipha nge ephakeme (nerve ngxenye TBI), aluthola, i-hypothyroidism azalwa naso (kwezinhlansi resection olubanzi isimila nendlala okuthiwa i-thyroid, thyroiditis sokuhlasela kwamasosha omzimba, goiter sendawo).

Ukwandisa lokuhlala

Izinga hormone ezifana T4 (mahhala) (abesifazane evamile futhi amadoda kuboniswe ngenhla) kungase kukhule lapho goiter anobuthi, TSH-ezimele i-hyperthyroidism, ukukhuluphala. Ukwandisa lokuhlushwa baphawula phezu zangokwasemuva zezinhlelo syndrome nephrotic, ukwelashwa heparin. Izizathu futhi zihlanganisa choriocarcinoma, reception we thyroxine ngesisekelo hypothyroidism, ushintsho emva kokubeletha emsebenzini we indlala yegilo, isifo sesibindi esingelapheki kubantu. 4 (mahhala) kungenziwa kwaphakanyiswa ukumelana yegilo syndrome steroid, zofuzo dizalbunemicheskoy hyperthyroxinemia, uthi, ingqondo lokuhlushwa ukwehla tiroksinsyazyvayuschego globulin.

Thyroxine nokukhulelwa

Ama-hormone egilo zinengxenye cishe kuzo zonke izinqubo emzimbeni. Njengoba kushiwo ngenhla, zezakhi alawule umzimba, ezithinta umsebenzi nezinye steroid. Thyroid zokugula kungenziwa ephelezelwa kokubili i ukwanda kanye ukwehla imisebenzi yayo. Okubaluleke kakhulu ayephuli imisebenzi isitho babe phakathi abantwana. Ushintsho we isimo sokusebenza we indlala yegilo kuthinta Yiqiniso yokukhulelwa, ubunjalo baso, futhi umphumela isimo ezisanda kuzalwa. Akuvamile vynashivanie sihamba uma eshiwo endocrine pathologies. Izifo yalolu hlobo, njengoba umthetho, kuholele ukungasebenzi zokuzala, ukungazali. Ngokuvamile kutholakala ukuthi uphethwe yini ngesikhathi ukhulelwe goiter (ukwanda yegilo imvelo ehlasela umzimba) nge euthyrosis ukulondolozwa, kanye thyroiditis sokuhlasela kwamasosha omzimba, ingqondo izinguquko ngemuva kwama-hormone. Ukuze isikhathi kokubeletha libhekene izinguquko isimo ukusebenza le ndlala.

izincomo

Ukuze kahle ukuhumusha imiphumela yokuhlolwa yase-laboratory ngesikhathi sokukhulelwa kufanele bacabangele abanye amaphuzu. Ukunqunywa T3 Imininingwane kanti i-T4 iyi-hhayi ulwazi. Lokhu kungenxa yokuthi ngesikhathi sokukhulelwa, ingqondo luyanda ngesigamu. Lapho uhlaka thyroxine yocwaningo ezingeni lokuhlushwa yayo kufanele azimisele ngokuhlanganyela okuqukethwe TTG. Thyroxine kancane anda-2% abesifazane abakhulelwe. Engxenyeni yokuqala ka isikhathi evamile kokubeletha imakwe wehlise TTG (cishe 20-30% kweziguli singletons futhi wonke amacala nokukhulelwa izingane eziningi ngasikhathi). Ekwelapheni hyperthyroidism T4 uphenyo kuphela (mahhala). Itho olukhululekile thyroxine ezingeni emabangeni kamuva ingase lake encishisiwe. Ngakho TSH lokuhlushwa izonakekelwa uhla evamile.