Duk abin da kuke buƙatar sani game da gwaje-gwaje na Hormone na maganin Thyroid
Gwargwadon maganin horroid dinku wanda ake kira jarrabawar TSH-shi ne babban gwajin da ake amfani dasu na likitoci a cikin ganewar asali da kuma maganin cututtukan thyroid. Yana da mahimmanci cewa a matsayin mai maganin thyroid, ka fahimci wannan gwaji, ma'anar sakamakonka, da kuma matsalolin dake kewaye da tashar TSH.
Mene ne Test TSH?
A TSH gwajin matakan thyroid stimulating hormone ko TSH.
TSH an fito da hormone ta glandarka ta jikinka don amsa matakan thymone hormone a cikin jini. Lokacin da aka gano ƙananan nau'o'in hormone na thyroid, pituitary ya sake samun TSH don ƙarfafa glandon thyroid don samar da karin hormone. Lokacin da aka gano hormone mai yawan ciwon sanyi, pituitary ya rage saukar da TSH.
Tadarin TSH shine gwajin jini na farko da aka yi amfani dashi don gano asalin maganin thyroid kuma sarrafa maganin karoid. A mafi mahimmanci, matakan da aka taso daga TSH suna dauke da hujjojin hypothyroidism, rashin jin dadi. Ƙananan matakai na TSH suna dauke da alamun hyperthyroidism, maganin maganin ƙwayar cuta.
TSH Ranar Range
Ana samun hanyar yin amfani da ita ta hanyar ɗaukar babban rukuni na mutane a cikin yawancin jama'a, suna gudanar da gwaje-gwaje na musamman, ƙididdige dabi'un, da kuma samar da kewayon wanda ya kamata ya wakilci matakan "al'ada" waɗanda ba su da wata cuta ko rashin haɗari. .
Hanya ta TSH tana wakiltar kewayon matakan TSH na mutanen da ake zaton ba tare da yaduwar cutar thyroid ba kuma waɗanda ke da aikin maganin thyroid.
A halin yanzu, a mafi yawan ɗakunan gwaje-gwaje a Amurka, ƙayyadadden tarin gwaje-gwajen TSH shine kimanin 0.5 zuwa 5.0 mU / l. Dangane da Lab, za ka iya nuna wasu bambancin, watau 0.4 zuwa 5.5 mU / l, ko 0.6 zuwa 4.5 mU / l, da dai sauransu, amma a kullum, 0.5 zuwa 5.0 mU / l ana daukar nau'i na labs da yawa.
Yawanci, likitanku zai fassara matakin da ke ƙasa da 0.5 mU / l a matsayin alamar hyperthyroidism (wani maganin ciwon sanyi), kuma matakin sama da 5.0 mU / l a matsayin alamar hypothyroidism ( underactive thyroid .)
Shafin da ya biyo baya yana nuna labarun labaran TSH:
| Tad Reference Range | Fassara |
| 0.5 zuwa 5.0 mU / l | - Level a kasa 0.5 mU / l alamar hyperthyroidism - Level sama da 5.0 mU / l nunawa hypothyroidism |
Gudun Range na Magana
Tabbatacciyar tashar ta TSH ta kasance mai rikicewa fiye da shekaru goma. A baya a shekara ta 2003, bayan bayanan shaida sun nuna cewa marasa lafiya wadanda ke da matakan TSH a mafi girma daga cikin tashar TSH sun kasance suna ci gaba da inganta hypothyroidism fiye da wadanda ke cikin ƙarshen kewayon, Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Amurka (AACE) ya bada shawarar cewa likitoci "sunyi la'akari da magani ga marasa lafiya waɗanda suka gwada a waje da iyakoki na gefen ƙananan bisa tushen ƙwayar TSH na 0.3 zuwa 3.0 mU / l. A lokacin, AACE ya yi imanin cewa sabon layin zai" haifar da ganewar asali ga miliyoyin 'Yan Amurkan da ke shan wahala daga mummunar cuta, amma sun tafi ba tare da izini ba. "
A cewar shugaban AACE, Hossein Gharib, MD,
Cutar da cutar ta maganin karoid a Amurka tana da kyau sosai ... Sabuwar TSH daga sharuɗɗa AACE ya ba wa likitocin bayanin da suke buƙatar gano ƙwayar cutar ciwon sanyi kafin ya iya haifar da mummunar tasiri akan lafiyar mai lafiya, irin su tsadar cholesterol, cututtukan zuciya, osteoporosis, rashin haihuwa, da kuma bakin ciki. "
A wannan lokacin, sanarwa daga AACE ya gani da mutane da dama kamar yadda ake kyautatawa ga masu lafiya.
Abin baƙin ciki, abin da aka dauke da kyau tabbatacciyar ci gaba ga thyroid marasa lafiya bai yi babban tasiri, ga dalilai da yawa:
- Laboratories ba a taɓa samun sabon layi ba kamar yadda ake amfani da shi a matsayin mahimman bayanai, ma'anar cewa matakan da ke cikin tsofaffi ne kawai, ana iya nuna cewa an yi amfani da ita a matsayin abin ƙyama.
- Ƙungiyar kula da kiwon lafiya ta ci gaba da rashin amincewa game da batun TSH, kamar yadda yake nunawa ta hanyar manyan shafukan da aka bayyana a cikin watan Satumba na Journal of Clinical Endocrinology da Metabolism , suna gabatar da bangarori biyu na gardamar.
Doctors Martin Surks, Gayotri Goswami da Gilbert Daniels sun yi jayayya cewa zangon zartarwa ya kamata su kasance daidai a cikin kasidar su "Gudanarwa a cikin Clinical Endocrinology: Matsayin da ake kira Thyrotropin Reference Range Ya Kamata Ba Shi da Canji." Sun danganta hujjar su game da maganganunsu cewa "saboda ba a bada shawarar maganin levothyroxine na yau da kullum don maganin hypothyroidism ba, ba shakka ba a garanti a cikin mutane da ke dauke da matakan TSH" na 2.5 zuwa 4.5 mU / l.
Likitoci Leonard Wartofsky da Richard Dickey sun yi jayayya a cikin labarin su, "Ƙididdigar Ƙarƙashin Ƙarƙwararka Thyrotropin Reference Range yana da ƙarfin hali," cewa sharuɗɗan da aka yarda da shi a baya ba shi da amfani saboda ƙididdigar da aka yi la'akari da ita a al'ada an "gurbata" tare da mutane da dama. na thyroid cuta. Sunyi jaddada cewa amfanin lafiyar ba ta wuce duk wani mummunan hadarin ba.
Doctors Wartofsky da Dickey sun kare da matsawa zuwa sabon layi, suna cewa:
Ba za mu taba samun darajar cutoff ba ga TSH da ya bambanta daga al'aura, amma sanarwa cewa ƙimar adadin TSH na al'ada kawai tsakanin 1.18 da 1.4 mU / l kuma fiye da 95% na al'ada yawan zasu sami ƙimar TSH fiye da 2.5 mU / l a fili ya nuna cewa kowa da mafi girma darajar ya kamata a bincika a hankali don farkon thyroid maye.
A shekara ta 2006, ƙungiyoyin endocrinology sun watsar da shawarwarin don fadada tashar TSH, Duk da haka, muhawarar baya-da-gaba ya ci gaba har fiye da shekaru goma, kuma tun daga shekara ta 2017, gardamar ta ci gaba. Duk da haka, an umurci yawancin masu aikin kiwon lafiya na al'ada suyi amfani da mahimman bayanai na TSH a cikin bincikar maganin da kuma magance marasa lafiya.
Kullum al'ada TSH da Hypothyroidism
Yana da mahimmanci ga marasa lafiya na thyroid su sani cewa bincike ya nuna cewa:
- A cikin al'ummar Yedine-isasshen yawan, yawancin TSH shine 1.5 mU / l
- A cikin nazarin yawan jama'a tare da rashin tasiri na thyroiditis na Hashimoto, ma'anar TSH shine 1.18 mU / l
- A lokacin da mutane masu dauke da kwayoyin antithyroid masu guba ko tarihin iyali na rashin lafiyar thyroid cutar suna cire daga lissafin ƙididdiga, ƙayyadadden yanayin kulawa yana gudana daga kimanin 0.4 zuwa 2.5 mU / l
- A lokacin daukar ciki, jagororin sun nuna cewa matakan TSH ba za su tashi sama da 3.0 ba, don kare lafiyar duka uwa da jariri.
- Matakan TSH a cikin mafi girman ƙarshen ƙididdiga suna danganta da ƙananan hadarin ciwon daji na thyroid, ƙananan cholesterol, rashin haihuwa, cututtukan zuciya, iri na 2 da ciwon sukari, da kuma sauran al'amurran lafiya.
- TSH matakan sun kasance mafi girma a baya a ranar. Wani gwajin TSH da aka yi a baya a ranar zai iya nuna matakanka kamar yadda yake a cikin taswirar, yayin da gwaji na farko zai iya nuna hypothyroidism.
Idan ƙwaƙwalwar gwajin TSH ta kasance cikin layin zartarwar kuma an gaya maka "TSH dinka na al'ada," za a iya zama hypothyroid? Da yawa likitoci na al'ada sun ce ba, kuma da yawa haɗin kai da kuma cikakke practitioners ce a. Ko zaka iya zama hypothyroid tare da matakin TSH na al'ada ya kasance abin da ke rikicewa.
Kalma Daga
Kamar yadda ka koya, ma'anar matakin "TSH" na al'ada "ya dogara da likitan da kake tuntuba da ra'ayoyi game da cutar thyroid. A lokaci guda, jarrabawar TSH da TSH suna da mahimmanci ga lafiyarka da magani. A sakamakon haka, akwai wasu abubuwa masu muhimmanci don tunawa.
- Kuna buƙatar ku tambayi abin da TSH yake ƙaddamar da likitanku don neman ku, kuma me yasa. Kuna iya samun likita wanda ya gaskanta cewa adana ka a saman kewayon shine makasudin makasudin ko wanda ke mayar da hankali ga ƙananan TSH da taimako daga alamun bayyanarka. (Har ila yau, likitoci sun yi la'akari da ƙananan ƙwayoyin ciwon daji na thyroid, kamar yadda za a hana maganin ciwon daji.) Mafi yawan likitoci, duk da haka, suna amfani da layin TSH na kusan 0.5 zuwa 5.0 don ganewa da kuma kula da your thyroid cuta.
- Kada ku yarda da amsoshin "al'ada," "high," ko "low" a matsayin rahoto game da gwajin jininku. Maimakon haka, nemi lambobin lambobi kuma ka nemi gabar wurin binciken dakin gwaje-gwaje. Har ma mafi kyau duk da haka, tambayi kofin ainihin sakamakon gwajin jini.
- Idan matakan TSH ɗinku suna cikin layin kulawa, kuma kuna da alamomin da ke dace da hypothyroidism, kuna iya buƙatar ƙarin gwaje-gwaje don taimakawa wajen ganewar asali. Duk da yake likitoci na al'ada sun dogara ne akan gwajin TSH kawai, wasu likitocin sun auna ainihin hormones na thyroid-thyroxine (T4) da triiodothyronine (T3) - da maganin thyroid antibody da baya T3. Wadannan likitoci suna neman karin ma'auni don yin ganewar asali. Alal misali, lokacin da matakan ka na T4 da T3 ba su da kyau, an yi tsammanin ana amfani da hypothyroidism, kuma idan sun kasance masu tsayi, an yi tsammanin rashin hyperroid. Magunguna-musamman thyroid peroxidase (TPO) kwayoyin da za su iya gano asalin cutar Hashimoto-ana kuma auna wasu lokuta. Wani ɓangare na masu aiki sunyi imanin cewa glanden sanyi da ke cikin ɓarna na ƙaranci-kamar yadda aka tabbatar da matakan TPO - wanda zai iya haifar da bayyanar cututtukan hypothyroidism kafin an yi amfani da hypothyroidism a cikin TSH, ko kuma Free T4 da Free T3, gwaje-gwaje. Sun kuma yi imanin cewa magani tare da kwayoyin maye gurbin maganin horroone na iya taimakawa wajen taimaka maka bayyanar cututtuka, ƙananan matakanka na ƙwayar cuta, da kuma hana ka daga yin amfani da hypothyroid.
- Idan matakan TSH dinku sun fadi a saman ƙarshen wurin kulawa, kuma kuna da alamun cututtuka da suka dace da hypothyroidism, la'akari da tattauna wani gwajin warkewa na maye gurbin karamar karoid tare da likitanka.
- Idan likita ya ƙi yin ƙarin gwaje-gwaje ko kuma ya ƙi kula da ku, yi la'akari da gano sabon likita don maganin thyroid. Masu haɗaka da cikakkun likitoci sukan haɗa da gwaje-gwaje da dama a cikin TSH, kuma suna ɗaukar tarihin lafiyar ku da asibitoci, tare da burin samun mafaka da kuma TSH mafi kyau wanda zai sauke lafiyar ku.
> Sources:
> Anderson et. al., "Nuna Bambanci na Mutum daya a cikin Serum T4 da T3 a cikin al'amuran al'ada: A Ƙarƙashin Ƙwarewar Batirin Thyroid," Journal of Clinical Endocrinology and Metabolism, 87 (3): 1068-1072.
> Garber J, Cobin R, Gharib H, et al. Ka'idodin aikin kwantar da hankali na hypothyroidism a cikin manya: Cosponsored by American association of clinical endocrinologists and the American thyroid association. Endocrine Practice. 2012; 18 (6): 988-1028. Doi: 10.4158 / ep12280.gl.
> Guber HA, Farag AF. Binciken aikin endocrine. A cikin: McPherson RA, Pincus MR, eds. Binciken Bincike na Henry da Gudanarwa ta Hanyar Laboratory. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011: chap 24.
> Surks, et.al. "Magana a cikin Endocrinology Clinical: Matsayinka na Thyrotropin Ya Kamata Ya Ci gaba da Canji," Jaridar Clinical Endocrinology da Metabolism 90 (9) / 5489-5496.
> Wartofsky & Dickey, "Gudanarwar a cikin Clinical Endocrinology: Shaida ga Narrower Thyrotropin Reference Range shi ne Ƙira," Journal of Clinical Endocrinology da Metabolism.