Zvose Zvaunoda Kuziva Nezve Thyroid Kukurudzira Hormone Test
Utachiona hunokonzera kuongororwa kwehomoni-inozivikanwawo seTSH test-ndiyo chiedza chinokosha chinoshandiswa navanachiremba vanowanzoongororwa uye kurapa chirwere chetachiona. Zvakakosha kuti semurwere wehroroid, iwe unonzwisisa kuedza uku, zvinorehwa nemigumisiro yako, uye nharo dzinopoteredza TSH reference reference.
Chiyero cheTSH chii?
Iko TSH muedzo inotarisa utachiona hunokurudzira hormone kana TSH.
TSH inonzi hormone inosunungurwa nemucherechedzo wako wepituitary mukupindura mazinga ehomoni yehutachi muropa rako. Kana uwandu hwehutachiona hwehutachiona hunoonekwa, pituitary inodzinga zvakawanda TSH kukurudzira gland yako yeganda kuti ibudise mamwe hormone. Apo hutoni yakawanda kwazvo yehutori inowanikwa, pituitary inoderedza kushandiswa kweTSH.
Chiyero cheTSH ndechiedza chekutanga chekuyera ropa chinoshandiswa kuongorora chirwere chetachiona uye kurapa utano hwehutano. Panyaya yepamusoro-soro, mazinga akareba eTSH anoonekwa seuchapupu hwe hypothyroidism, utachiona husingaiti. Kuderera kweTSH kunoonekwa sehupupu hwe hyperthyroidism, utachiona hunopedza simba.
TSH Refer Ranges
A reference reference inowanikwa nokutora boka guru revanhu muhuwandu, runomhanya muedzo chaiwo, kuverenga maitiro, nekugadzira hutano hunofanirwa kuratidza "zviitiko" zvevanhu vasingasviki nechirwere chavo kana kusaremara .
TSH reference reference range inomiririra huwandu hwemaTSH mazinga evanhu avo vanofanirwa vasina ruswere chetachiona uye vane utachiona hwemazuva ose.
Pari zvino, pane ma laboratori akawanda muU.S., ruzivo rwekutaridzirwa kweTSH miedzo inenge 0.5 kusvika 5.0 mU / l. Zvichienderana nebasa racho, unogona kuonekwa shanduko dzakasiyana-siyana, kureva 0,4 kusvika ku55 mU / l, kana 0,6 kusvika ku4,5 mU / l, nezvimwewo, asi kazhinji, 0.5 kusvika 5.0 mU / l inofungidzirwa yakafanana neyemabhiza mazhinji.
Kazhinji, chiremba wako achadudzira chiyero chiri pasi apa 0.5 mU / l sechiratidzo che hyperthyroidism (chinyorwa chinopedza simba), uye chiyero chiri pamusoro pe 5.0 mU / l sechiratidzo che hypothyroidism (chine utachiona husingaiti .)
Chati chinotevera chinoratidzira chimiro chema laboratory TSH reference reference:
| TSH Reference Range | Tsanangudzo |
| 0.5 kusvika 5.0 mU / l | - Nhamba iri pasi pe 0.5 mU / l inoratidza hyperthyroidism - Nhamba iri kumusoro 5.0 mU / l inoratidza hypothyroidism |
Reference Range Controversy
Iko chaiyo TSH reference reference yakave yakakavhiringidza kwemaawa anopfuura gumi. Kudzoka muna 2003, mushure mokunge humwe uchapupu hwakaratidza kuti varwere vaiva neTSH mahara mumucheto wakakwirira weTSH reference reference vakaramba vachienderera mberi kukudziridza hypothyroidism kakawanda kune avo vari kumucheto wepasi, iyo American Association of Clinical Endocrinologists (AACE) akakurudzira kuti vanachiremba "vaone kurapwa kwevarwere vanoedza kunze kwemiganhu yemuganhu wakawandisa zvichienderana nechinangwa cheTSH chikamu che 0.3 kusvika ku 3.0 mU / l. Panguva iyo, AACE yaidavira kuti hutsva hutsva " huchaita kuti kuongororwa kwakakwana kwemamiriyoni evanhu Vanhu veAmerica vanotambura nehutano hwehutano hwakanaka, asi havana kutorwa. "
Maererano nomutungamiri weAACE Hossein Gharib, MD,
Kuwanda kwezvirwere zvehutano zvisingazivikanwi muUnited States zvinotyisa zvikuru ... Izvo itsva TSH inobva mumitemo yeAACE inopa vanachiremba ruzivo rwavanoda kuti vaongorore chirwere chetachiona chisati chaita zvisati zvaita kuti zvive nemigumisiro yakaipa pane utano hwomurwere, cholesterol yakakwirira, chirwere chemwoyo, osteoporosis, kusava nesimba, uye kuora mwoyo. "
Panguva iyoyo, chiziviso chinobva kuAACE chakaonekwa nevakawanda sekuvandudzwa kwemazuva mazhinji uye kudiwa kwevarwere.
Zvinosuruvarisa, izvo zvaifungidzirwa kuti zvakakosha kukura kwevatachiona hwehutano hazvina kuita zvakakosha, nekuda kwezvikonzero zvakawanda:
- Laboratories haina kumbobvira yakagadzirisa hutsva huri shanduro yakarongeka, iyo inoreva kuti maitiro chete kunze kwevakuru, zvakasara zvakarongedzwa sevasina kujairika.
- Chirwere chekurapa chakaramba chichibvumirana pamusoro peTSH reference reference, sezvinopupurirwa nemazita maviri anozivikanwa akawanikwa mumagazini yaSeptember 2005 ye Journal of Clinical Endocrinology uye Metabolism , achipa mavhesi maviri emakakatanwa.
Vanachiremba Martin Surks, Gayotri Goswami naGilbert Daniels vakataura kuti iyo inotaridzirwa inofanira kunge yakafanana munyaya yavo "Kurwisana muKliniki Endocrinology: The Thyrotropin Reference Range Unofanira Kuramba Isina Kuchinja." Vakagadzirisa nharo dzavo pamashoko avo okuti "nokuti chirwere chekuita levothyroxine hachina kukurudzirwa ne subclinical hypothyroidism, hazvibvumirwi kune vanhu vane rutsigiro rwepamusoro TSH" mazinga e 2.5 kusvika ku4 mU / l.
Vanachiremba Leonard Wartofsky naRichard Dickey vakapikisa munyaya yavo, "Uchapupu hweNyeredzi Thyrotropin Reference Range ndiyo Inogunun'una," iyo yakagamuchirwa marongerwo emitauro haisati yakakodzera nokuti zvinotaurwa nevanhu vaimbofunga kuti zvakasvibiswa "zvakasvibiswa" nevanhu vane mazinga akasiyana-siyana yezvirwere zvehutano. Vakakakavadzana kuti zvikwereti zvekurapa zvakanyanya kudarika chero zvikanganiso zvishoma.
Vanachiremba Wartofsky naDickey vakadzivirira kuchinja kune hutsva hutsva, vachiti:
Tichizove tisina kumbobvira tine zvachose cutoff kukosha kweTSH kusiyanisa zvisizvo kubva kune zvisiri izvo, asi kuziva kuti zvinoreva tsika dzakanaka dzeTSH dzinongowanikwa pakati pe1,18 uye 1.4 mU / l uye kuti kupfuura 95% yevanhu vese vanogara vachave neTSH iri pasi kupfuura 2.5 mU / l zvinoreva zvakajeka kuti ani nani ane huwandu hunokosha anofanira kuongororwa zvakanyatsotaridzirwa kwekutanga kwetachiona kusakona.
Pakazosvika gore ra2006, mapoka emagariro endocrinology akasiya mapurisa kuti awedzere TSH reference reference, Kunyange zvakadaro, nhaurirano yekare uye yakabuda yakapfuurira kwemakore anodarika gumi, uye kubva muna 2017, gakava rinoenderera mberi. Kunyange zvakadaro, ruzhinji rwevashandi vezvehutano vanowanzorayirwa kushandisa shanduro yakawanda yeTSH reference pakutsvaga nekurapa varwere vetachiona.
Kazhinji TSH uye Hypothyroidism
Zvakakosha kune varwere vetachiona kuziva kuti kutsvakurudza kwakaratidza kuti:
- Muyodini-yakakwana yevanhu, zvinoreva TSH ndi 1.5 mU / l
- Mukutsvaga kwemapoka evanhu vane hutachiwana hweHashimoto's thyroiditis, zvinoreva TSH ndeye 1.18 mU / l
- Apo vanhu vane maitiro akanaka antivithyroid kana kuti nhoroondo yemhuri yehutachiona hwehutachiona hwemotokari dzinenge dzisingabatanidzwi kubva kuhuwandu hwekutarisa mabhuku, iyo inowanzo inongororwa inotanga kubva kumativi anenge 0,4 kusvika ku 2.5 mU / l
- Panguva yekuzvitakura, mirayiridzo inotaura kuti mazinga eTSH haafaniri kumbomira kumusoro kwema 3.0, kuitira kuchengetedza hutano hwaamai namai.
- TSH mazinga mumucheto wakakwirira wereferensi yepamusoro yakabatanawo nehuwandu hwehutano hwekenza yekemapa, cholesterol yakakwirira, kusabereka, chirwere chemoyo, chirwere cheshuga cheshuga, uye zvimwe zvehutano hwehutano.
- TSH maitiro anowanzove akakwirira kare kare. Chiyero cheTSH chakaitwa mushure mezuva chinogona kuratidza mazinga ako sezviri mukati mekutarisa ruvara, asi chiitiko chekutanga mangwanani chinogona kuratidza hypothyroidism.
Kana yako TSH test result inowanikwa mukati mekutarisa uye iwe unoudzwa kuti "yako TSH yakajairika," iwe unogona kunge uchiri hypothyroid here? Vakawanda vanowanzogadzira vanachiremba vanoti kwete, uye vazhinji vanobatanidza uye vanoita zvese vanoti hongu. Pasinei nokuti iwe unogona kuva hypothyroid nechirwere chechidiki cheTSH pakupedzisira chinoramba chichikakavadzana.
Shoko Rinobva
Sezvawakadzidza, tsanangudzo ye "chimiro" yakatarisa TSH inobva kune chiremba wauri kutaurirana uye pfungwa dzake pamusoro pezvirwere zvehutano. Panguva imwe chete, kuedza kweTSH uye TSH nhungamiro yakakosha yakakosha kuhutano hwehutano hwako uye kurapwa. Somugumisiro, kune zvimwe zvinhu zvinokosha zvekuchengeta mupfungwa.
- Iwe unofanirwa kubvunza kuti TSH inoratidzei chiremba wako ari kukutarira iwe, uye sei. Iwe unogona kuva nechiremba anotenda kuti kukuchengetedza pamusoro pehutano ndicho chinangwa chega kana munhu ari kutarisa TSH iri pasi uye kuponeswa kwezviratidzo zvako. (Uyewo, vanachiremba vanotarisa zvakaderera kana kuti zvinoderedza TSH mizinga yevamwe vanopukunyuka chirwere chetachiona, senzira yekudzivirira kugadziriswa kwekenza.) Vakawanda vechiremba, zvisinei, vachiri kushandisa TSH nhungamiro yehutachire hwe 0.5 kusvika 5.0 yekuongorora uye kutarisira your thyroid disease.
- Iwe haufaniri kugamuchira mhinduro dzekuti "zvakajairika," "yakakwirira," kana "pasi" semushumo wekuongorora ropa rako. Pane kudaro, bvunzai nhamba chaiyo uye mubvunze bharatori inotarisa nzvimbo. Kunyange zviri nani zvakadaro, bvunza kopi yemhinduro chaiyo yeropa.
- Kana yako TSH kuedza mazinga iri mukati mekutarisa, uye iwe une zviratidzo zvinoenderana ne hypothyroidism, ungada kukumbira mimwe miedzo kuti ubatsire mune zvakanyanya kuongororwa. Kunyange zvazvo vanachiremba vanowanzowanzovimba nechiyero cheTSH chete, vamwe vanachiremba vanowedzerawo mahomoni e-thyroxine (T4) uye triiodothyronine (T3) -sewo nehutachiona hwemashoko ehutachiona uye anoshandura T3. Ava vanachiremba vari kutsvaga zviyero zvinowedzera kuti vaongorore. Somuenzaniso, apo T4 yako uye T3 mahomoni ari pasi, hypothyroidism inofungidzirwa, uye kana yakakwirira, hyperthyroidism inofungidzirwa. Zvirwere-kunyanya utachiona peroxidase (TPO) zvinorwisa zvirwere zvinogona kuongorora chirwere cheHashimoto-dzimwe nguva dzinotaridzwa. A subset of practitioners vanodavira kuti chirwere chetoriya chiri mukugadzikana kwekudzivirira kwega-sezvakaratidzwa nepamusoro ye TPO antibody-levels zvinogona kukonzera hypothyroidism zviratidzo zvisati zvaitika kuti hypothyroidism inoratidzwa muTSH, kana kunyange Free T4 uye Free T3, miedzo. Vanodavirawo kuti kurapwa nehutachiona hwemishonga inoshandiswa zvinodhaka kunogona kubatsira kubvisa zviratidzo zvako, kuderedza varwi vako, uye kukudzivisa kuti usanyanya kuva hypothyroid.
- Kana yako TSH kuedza mazinga inowira pamagumo ekupedzisira ereferensi yezera, uye iwe une zviratidzo zvinopindirana ne hypothyroidism, funga kukurukura nezvekurapa kwetachiona chetrojoni replacement nechiremba wako.
- Kana chiremba wako akaramba kukwanisa kuwedzera mimwe miedzo kana kuramba kukubata iwe, funga kutsvaga chiremba mutsva mukurapa kwako kwetroyo. Vanachiremba vanobatana uye vanowanzobatanidza miedzo yakawanda mukuwedzera kuongororwa kweTSH, uye kutora nhoroondo yako yezvechiremba uye zviratidzo zviri munyaya, nechinangwa chekuwana TSH yakachengeteka uye yakanakisisa iyo inogona kubvisa zviratidzo zvako zvakachengeteka.
> Sources:
> Anderson et. al., "Kusiyana Kwemunhu Mumwechete muSerum T4 uye T3 muZvamwe Zvidzidzo: Chinhu Chinobatsira Kunzwisiswa Kwezvikamu Zvirwere Zvoutachiona," Journal of Clinical Endocrinology uye Metabolism, 87 (3): 1068-1072.
> Garber J, Cobin R, Gharib H, et al. Clinical Practice Guidelines for hypothyroidism muvanhu vakuru: Cosponsored neAmerica sangano remakiriniki endocrinologist uye American thyroid association. Endocrine Dzidzira. 2012; 18 (6): 988-1028. doi: 10.4158 / ep12280.gl.
> Guber HA, Farag AF. Kuongorora kwe endocrine basa. Mu: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis uye Kutungamirirwa neBrazil Method. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011: chitsauko 24.
> Surks, et.al. "Kurwisana muKliniki Endocrinology: The Thyrotropin Reference Range Unofanira Kuramba Usina Kuchinja," Journal of Clinical Endocrinology uye Metabolism 90 (9) / 5489-5496.
> Wartofsky & Dickey, "Kurwisana muKliniki Endocrinology: Uchapupu hweNorrower Thyrotropin Reference Range inokurudzira," Journal of Clinical Endocrinology uye Metabolism.