thyroid gland yevanhu

Iyo thyroid gland idiki, asi ndiyo yakakura chikamu cheiyo endocrine system yemuviri. Iye "anobatidzwa" mumabhuku ekurapa ane mazita akasiyana-siyana enhetembo: anonzi "mambokadzi wehomoni" uye "tenzikadzi wemuviri." Sei?

Icho chokwadi ndechekuti thyroid gland inoburitsa mahomoni anodzora maitiro makuru emetabolism mumuviri wemunhu, anogadzirisa kugadzirwa kwesimba uye kupihwa kweokisijeni kumatishu.

- Mahomoni ehomoni anokanganisa kushanda kwenhengo dzose nehurongwa, - anotsanangura endocrinologist Elena Kulikova. - Kana basa rechirwere chetachiona richichinja, uremu hwemuviri, simba uye kuwanda kwekusagadzikana kwemoyo, kufema kwekufema uye basa remudumbu rinoshanduka. Kukurumidza kufunga uye mamiriro emanzwiro emunhu zvinoenderana nebasa reiyo thyroid gland. Uye kunyange kukwanisa kuita vana, pamuviri uye kuberekwa kwemwana ane utano kunoenderanawo zvikuru nehuwandu hwehomoni yehomoni.

Kana iwe ukaona kuchinja kwechitarisiko uye kunaka kweganda, kutaura kuzvimba kwemaziso, iwe unonetseka pamusoro pebvudzi rakasvibirira uye rinoputika, kurasikirwa kwebvudzi, zvinokwanisika kuti izvi zvinokonzerwa nezvinetso zvethyroid.

Chii chakakosha kuziva nezve thyroid gland yemunhu

Ko thyroid yemunhu iripi?

Iyo thyroid gland iri munharaunda yeanterior triangle yemutsipa, iyo yakasungwa kubva kumusoro nechepasi peshaya yezasi, kubva pazasi nejugular notch ye sternum, kumativi neanterior edges yekurudyi uye. kuruboshwe sternocleidomastoid tsandanyama¹.

Kusendamira ruoko kumutsipa, unogona kunzwa thyroid cartilage (iyo inonzi apuro yaAdhamu) - dense kana kunyange yakasimba protruding formation. Kana ikamedzwa, inotsvedza. Pazasi payo pane thyroid gland pachayo - kazhinji inonzwika nenzira ye "kukura" kwakapfava patrachea.².

Ko thyroid gland inoita sei uye inoshanda sei?

Chimiro chethyroid gland inowanzofananidzwa neshavishavi. Rudzi rwayo rworudyi uye rworuboshwe lobes rwakabatanidzwa neisthmus, uye mu 30% yezviitiko kunewo pyramidal lobe inotambanudza kubva kune isthmus.³.

Iyo thyroid gland ine zvimiro zvechimiro zvakafanana nemavhesi muchitarisiko - iyo follicle. Kune vanenge mamiriyoni makumi matatu vavo². Imwe neimwe follicle yakazadzwa nejeli-sechinhu chinonzi colloid. Iyo chete ine mahormone anogadzirwa nemasero. Zvose follicles dzakabatanidzwa ne 20-30 zvidimbu: mapoka akadaro anonzi thyreons.

Iyo thyroid gland inodzorwa ne3 nzira.

1. Nzira yekutanga ndeye hypothalamic-pituitary system, iyo iri muuropi. Kuchinjana kwemashoko pakati pechirwere chetachiona, hypothalamus uye pituitary gland kunoitika nerubatsiro rwethyroid-stimulating hormone (TSH) uye thyreoliberin (TRH).
2. Iyo yepakati tsinga system inobata chechipiri chekugadzirisa nzira. Muenzaniso wakanaka ndewekuwedzera kwemazinga ehomoni yethyroid panguva yekunetseka.
3. Iyo yechitatu nzira yekutonga ndeye zvirimo mune inorganic iodine munharaunda (kunyanya mvura uye chikafu). Nekusakwana kwekudya kweiodine mumuviri, mwero wehomoni yethyroid inoderera uye akasiyana pathologies eiyo thyroid gland inokura.

Sei thyroid gland inogona kukuvadza muvanhu

Haasi munhu wese anogona kuziva chiratidzo kubva kune thyroid gland. Kazhinji, munhu anovhiringidza marwadzo munharaunda iyi nezviratidzo zve osteochondrosis kana kuti anofunga kuti ane kutonhora mumutsipa wake.

Nenzira, munhu haanzwi kurwadziwa nguva dzose. Kazhinji, kurwadziwa chiratidzo chechirwere chetachiona thyroiditis (kuzvimba), uye ne hypothyroidism uye hyperthyroidism, pamwe chete nekuumbwa kwetroroid nodules, sekutonga, hazvikuvadzi.

Uyezve, munhu angasateerera zviratidzo zvemuviri kwenguva yakareba uye asingafungi kuti ane matambudziko ehutano. Nokudaro, zvakakosha kuziva zviratidzo zvezvinetso zvethyroid. Izvi zvinosanganisira: kuderera kwekuita, kuwedzera kutsamwa, kuoma kwekumedza, kukanganisa kurara, kuzvidya mwoyo (kusvika paranoia), kuora muviri nechido chakanaka, etc. Zvirwere zvakasiyana-siyana zvine zviratidzo zvavo.

Chimwe chezvikonzero zvinowanzokonzera matambudziko ethyroid kushayikwa kweiodine mukudya.

"Kushaikwa kweiodine kwakajairika kumatunhu mazhinji enyika yedu: kubva kunyoro kusvika kune yakanyanya," anodaro Elena Kulikova. - Kudiwa kwekuwedzera kunwa kwemishonga ine iodine kana chikafu chakakwira muiodine inonyanya kukosha kuvana, vakadzi vane pamuviri uye vanoyamwisa. Kushandiswa panguva yakakodzera kwezvokudya zvine iodized ndiyo inonyanya kudzivirira kudzivirira zvirwere zvethyroid muvana nevakuru.

Pakati pezvikonzero zvechirwere chetachiona zvinogona kuva: mavhairasi uye mabhakitiriya, autoimmune aggression, oncology. Mhedzisiro yakanaka yekuitika kwezvinetso neiyo thyroid gland kushushikana kusingaperi, kushomeka kweiodine, uye isina kunaka ecology.

Zvirwere zvegomarara ndiyo yakajairika pathology ye endocrine system. Ivo vane 10-17 nguva yakawanda muvakadzi kupfuura varume.⁵.

Zvirwere zvese zvethyroid gland zvakakamurwa kuita mapoka matatu zvichienderana nehuwandu hwehomoni yethyroid:

1. Thyrotoxicosis chirwere chinoratidzwa nekuwedzera kwehuwandu hwehomoni yehomoni. Zvirwere zvakajairika izvo zvinoperekedzwa ne thyrotoxicosis syndrome ndeye Graves 'chirwere (kusvika 80% yezviitiko muRussia.⁶), paradzira goiter ine muchetura kana nodular toxic goiter.

   Kuwedzera kwehuwandu hwehomoni yehomoni inogonawo kutarisirwa nekuwedzera kwekusingaperi uye kuitika kweacute uye subacute thyroiditis.

2. Hypothyroidism. Inobatanidzwa nekuderera kukuru kwehutano hwehomoni. Muzviitiko zvakawanda, hypothyroidism inokura inopesana nemashure e autoimmune thyroiditis (kuzvimba kwethyroid gland) uye ingangodaro mushure mekubviswa (kubviswa kwechikamu) chetachiona gland.
3. Zvirwere zvegomarara zvinoitika pasina kukanganiswa kwehomoni (euthyroid goiter, tumors, thyroiditis).

Ngationgororei zvirwere zvakajairika.

Hypothyroidism

Hwaro hweiyi syndrome ndeye kuramba kushaikwa kwehomoni yethyroid, kana kuderera kwekuita kwavo pamatishu emuviri.⁷.

Primary hypothyroidism inowanzokura inopesana nemashure e autoimmune thyroiditis. Zviratidzo zvinogona kunge zvakasiyana zvakanyanya, uye kazhinji kunyangwe chiremba haango ongorora hypothyroidism. Boka rengozi rinosanganisira vanhu vakavhiyiwa utachiona, varwere vane chirwere cheshuga mellitus uye chirwere cheAdisonison, vanosvuta zvakanyanya. Vakadzi vanofanira kunyanya kungwarira mushure mekusununguka.

Izvo hazvingave zvakanyanyisa kuongororwa nezve hypothyroidism kana, pasina chikonzero chaicho, uremu hwakatanga kukura, kuneta, kurara, kusagadzikana kusingafungi uye kuora mwoyo kwakaonekwa. Uyewo, hypothyroidism inogona kuratidzwa nekuderera kwekuyeuka uye kutarisa, kuzvimba kwechiso nemakumbo, uye kurasikirwa kwebvudzi. Mune varume, chirwere ichi chinogona kuperekedzwa nekuderera kwe libido uye potency, muvakadzi - kukanganisa kwekuenda kumwedzi. Anemia chimwe chiratidzo chinowanzoitika che hypothyroidism.

Chirwere cheGraves (chinokonzera goiter ine chepfu)

Muchiitiko chechirwere ichi, maitiro ekudzivirira emuviri anobudisa ma antibodies ayo "anokurudzira" chirwere chetachiona kuti chishande nesimba kupfuura zvarinofanira. Nekuda kweizvozvo, kuwanda kwehomoni yethyroid kunoonekwa mumuviri, izvo zvinokanganisa nhengo dzakawanda uye masisitimu, kunyanya tsinga uye moyo.

Zviratidzo zvekutanga zvechirwere cheGraves ndezvi: palpitations, dikitira, kurasikirwa nehuremu kumusana wekuwedzera kwechido, kushaya simba kwemhasuru, kutsamwa uye kutsamwa.⁸. Muzviitiko zvakawanda, thyroid gland inowedzera uye inooneka. Kazhinji, chirwere cheGraves chinoperekedzwa ne endocrine ophthalmopathy, iyo inoratidzwa ne exophthalmos (meso anoputika) uye kuzvimba kwemaziso.

"Kuvapo kweophthalmopathy muhuwandu hwezviitiko chiratidzo chekupararira kune chepfu goiter," inodaro nyanzvi yedu. - Zvakakosha kuyeuka kuti chirwere cheGraves chirwere chekudzoka zvakare. Muzviitiko zvakawanda, inodzoka, izvo zvinoita kuti ufunge nezvekusarudza nzira yekurapa.

Diffuse uye nodular euthyroid goiter

Euthyroid goiter inonziwo isiri-chepfu. Mumamiriro ezvinhu aya, kune kuwedzera kwekukura kwechirwere chetachiona pasina kukanganisa basa rayo. Chiyero chechinetso chinogona kunge chakasiyana: goiter dzimwe nguva inongonzwika chete, uye dzimwe nguva inogona kuonekwa neziso rakashama.

Kune zvikonzero zvakawanda zvekuvandudzwa kwechirwere chakadaro, asi chinonyanya kukosha chazvo ndechekushaya iodine, iyo inofanirwa pakugadzirwa kwehomoni yehomoni. Kuwedzera kugadzirwa kwehomoni, thyroid gland inotanga kuwedzera muhukuru.

Negoiter inopararira, iron inowedzera zvakaenzana, uye nenodular goiter, maumbirwo akasiyana evolumetric kana node anoonekwa mairi. Dzinogona kuva dzimwechete kana dzakawanda. Panewo musanganiswa - diffuse-nodular fomu yechirwere. Mu 95% yevanhu, nodules vane benign. Nekudaro, iyi pathology inoda kunyatsoongororwa kuitira kuti isasanganise kenza yethyroid.

Autoimmune thyroiditis

Zvirwere zvehutachiona hwehutachiona hwe autoimmune etiology zvinogona kutungamirira ku hypothyroidism. Autoimmune thyroiditis inogona kuonekwa sezvinei uye kwete kuperekedzwa nekusashanda kweiyo thyroid gland.

Zvinhu zvinokonzera kukura kwechirwere ichi zvinosanganisira: nhaka, zvisikwa zvipenyu zvisingafadzi, kusashanda kwemasimba ezvirwere zvemuviri.

"Sezvo chirwere ichi chichifambira mberi, chirwere chetachiona chinopinda sclerotic shanduko uye zvishoma nezvishoma chinoderedza basa rayo," anodaro endocrinologist Elena Kulikova. - Nzira yechirwere inogona kunonoka uye nekukurumidza. Iwe haugone kuziva pachine nguva kuti nekukurumidza sei thyroid gland icharasikirwa nebasa rayo. Kuti usapotsa nguva ino uye wotanga kutsiva kurapwa nenguva, tinokupa zano kuti upe ropa reTSH kamwechete pagore.

Yekenza yeCancer

Kenza yegomarara muzviitiko zvakawanda inosiyaniswa zvakanyanya. Izvi zvinoreva kuti kukura uye kukura kwebundu kunonoka. Nekudaro, kunewo hutsinye mafomu echirwere, saka iwe unofanirwa kungwarira zvakanyanya uye panguva yakakodzera ultrasound yethyroid gland uye, kana zvichidikanwa, ita yakanaka-tsono aspiration biopsy.

Zvichienderana nekwakabva, kune papillary, follicular uye medullary thyroid cancer. Muzviitiko zvakawanda, maitiro asina hasha epapillary uye follicular cancer anoitika. Nekurapwa kwenguva yakakodzera, hupenyu hwemurwere hunenge husingatamburi. Mumamiriro ezvinhu akadaro, nzira dzisina kukwana dzekurapa kwekuvhiya dzakakwana. Nekudaro, kana chirongwa chiri kushanda kana kusaonekwa munguva, kuvhiya kwakakomba kunodiwa.

Ko thyroid yemunhu inorapwa sei?

Zvirwere zvine chekuita nekushaikwa kwehomoni yerurindi zvinoenderana ne "gold standard" inoratidza kutsiva kurapwa. Inowanzoshandiswa levothyroxine sodium⁹. Chiratidzo chekugadzwa kweL-thyroxine inongova hypothyroidism. Mune mamwe mamiriro ezvinhu, kugadzwa kwayo hakuna musoro uye kunogona kuva nengozi.

Thyrostatic mishonga inoshandiswa kurapa huwandu hwezvirwere zvethyroid zvine chekuita nekushanda kwayo kwakanyanya.

Nzira dzakasimba dzekurapa dzinosanganisira radioiodine therapy uye kupindira kwekuvhiya. Kuti unzwisise kuti ndeipi nzira yekurapa yakakunakira iwe, unofanirwa kuonana nachiremba.

Kutsiva kurapwa

Mhando iyi yekurapa inorayirwa mumamiriro ezvinhu apo basa retroroid gland rakaderedzwa, uye kuchinjwa kwayo zvachose kana chikamu kunokosha. Basa remahomoni ekutsiva kurapwa ndere kudzikamisa mwero wehomoni yethyroid.

Mushonga wekusarudza ndeye L-thyroxine. Zvinonyanya kukosha kusarudza muyero wakakwana wega wega uye kutora mushonga nenzira kwayo: zvakanyanya padumbu risina chinhu, mangwanani, maminitsi makumi matatu musati madya, nemvura. Kana mirairo ikatyorwa, kugara zvakanaka kunogona kuwedzera.

Normal thyroid hormone mazinga anonyanya kukosha panguva yekuzvitakura. L-thyroxine inonyorerwa kuvakadzi vane pamuviri kana zvichidikanwa, yakachengeteka zvachose kuna amai uye fetus.

Thyrostatic kurapwa

Inoshandiswa kurapa thyrotoxicosis. Muchiitiko ichi, mishonga ye thiourea (thiamazole, propylthiouracil) inoshandiswa. Vanounganidza mugomba retroroid uye vanovhara kuumbwa kwehomoni yethyroid. Thyrostatic therapy inorongerwa kosi yemakore 1-1,5, kana inoshandiswa sedanho rekugadzirira musati mavhiyiwa.

Paunenge uchitora thyreostatics, mune dzimwe nguva, migumisiro kubva pachiropa uye circulatory system inogoneka. Nokudaro, panguva yekuongorora kuongorora, zvakakosha kutora kuongororwa kweropa kwete chete nehuwandu hwehomoni yehomoni, asiwo kliniki yekuongorora ropa uye zviropa zveropa.

Kutarisana nekumashure kwe thyreostatic therapy, allergic ganda rashes inogoneka. Zvinonyanya kukosha kutarisa dosi uye maitiro ekutora mishonga.

Nzira dzokuvhiya

Kudiwa uye chiyero chekuvhiya zvinoenderana nerudzi rwechirwere chetachiona. Negoiter ine chepfu yakapararira, thyroidectomy inoratidzwa (kubviswa kwakakwana kweiyo thyroid gland). Pamamota akasiyana-siyana, angave thyroidectomy kana hemithyroidectomy (chikamu kubviswa). Kuwanda kwekupindira kwekuvhiya kunotsanangurwa nechiremba-endocrinologist kana nyanzvi endocrinologist.

Iko kuvhiyiwa kunogona kuitwa nenzira yakavhurika (yekirasi) kana zvishoma invasive (endoscopic). Endoscopic nzira (pasina kuchekwa kukuru) zvine zvakanakira zvisingarambiki pakuvhiyiwa kwakavhurika: kukuvadzwa kwetishu kushoma, nguva pfupi yekuvandudza, mavanga asingaonekwi epashure.

Kuvhiya kurapwa kwethyroid pathology ine yayo yakasimba zviratidzo. Kune akati wandei mamiriro (semuenzaniso, colloid node) izvo zvisingadi kurapwa kwekuvhiya uye zviri pasi pekutarisisa kwakasimba.

Radioiodine kurapwa

Kurapa neradioactive iodine ndiyo imwe nzira yekurapa kwakanyanya kwemhando dzakasiyana dzechepfu goiter. Inoshandiswa muchiitiko icho chirwere chinoramba chichidzoka, uye thyreostatic therapy haina kupa migumisiro. Radioiodine therapy inokurudzirwa kune diki goiter kudzivirira kuvhiyiwa. 

Vanachiremba vane chokwadi chekuti kurapa kweradioactive iodine hakukanganisi njodzi yekuva negomarara rethyroid¹⁰. Contraindications: pamuviri, lactation, endocrine ophthalmopathy.

Maitiro ekuchengeta thyroid yako ine hutano kumba

Chinhu chinonyanya kukosha chekushanda kwethyroid gland iodine. Zvinodiwa zvezuva nezuva pairi zvinoenderana nezera: kusvika kumakore mashanu - 5 mcg, kusvika kumakore gumi nemaviri - 90 mcg, kubva pamakore gumi nemaviri - 12 mcg, kuvakadzi vane nhumbu uye vanoyamwisa - 120 mcg.¹¹.

Kwete nguva dzose chikamu chezuva nezuva cheiodine chinogona kuwanikwa kubva pakudya, saka vanachiremba vanowanzopa mishonga ine iodine. Zvisinei, munhu haafaniri kushingairira kutora magadzirirwo ayodhini. Mune zvimwe zviitiko, muyero wezuva nezuva unogona kuwanikwa nekushandisa iodized kana gungwa munyu mukudya.

Zvirwere zvegomarara zvinogona kukonzerwa nekunetseka, kushanda zvakanyanya, zvirwere zvehutachiona uye mabhakitiriya, zvirwere zvisingaperi zvepamusoro pekufema. Kana iwe uchida kuti thyroid gland yako inzwe zvakanaka uye ishande pasina kukanganisa, iwe unofanirwa kusimbisa immune system yako, rarama hupenyu hune hutano, kudzivirira kushushikana uye kurara zvakakwana.

Maiwe, zvimwe zvinhu (semuenzaniso, genetic predisposition) hazvigone kukanganiswa. Saka, kana iwe uchiziva kuti une nhoroondo yemhuri yechirwere chetachiona, tarisa mamiriro acho ne ultrasound yegore negore uye kuongorora ropa kweTSH.

Mibvunzo nemhinduro dzakakurumbira

Nyanzvi yedu, endocrinologist Elena Kulikova, anopindura mibvunzo ine chekuita nekushanda kwethyroid gland.

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