Hypothyroidism n'ime anụmanụ bụ ọrịa na-ebilite mgbe thyroid gland emepụtaghị homonụ zuru ezu. Homonụ thyroid na-agụnye triiodothyronine (T3) na thyroxine (T4).
Ọ bụrụ na ụkọ homonụ ndị a mere, mgbe ahụ metabolism na nkịta na nwamba ji nwayọ nwayọ nwayọ. Ihe akachasi egosiputa oria a bu na nkita ma obu nwamba, ihe egwu a gha enweta okwu di ilu.
Ihe kpatara hypothyroidism
Dịka iwu, hypothyroidism na-emetụtakarị nkịta, ọ naghị abụkarị nwamba. Agbanyeghị, n'oge a, emebeghị ka ọ bụrụ na ọ bụ ihe ketara eketa bụ ihe kacha akpata ọrịa a na nkịta. Ka o sina dị, hypothyroidism na-egosikarị n'ụdị ụdị nkịta dị ka:
- Onye ọzụzụ atụrụ Scottish;
- airedale;
- poodle
- oku okpu;
- Pomeranian
- kẹle ọphu;
- Onye ọzụzụ atụrụ Bekee;
- dachshund;
- Schnauzer
- Doberman
- Onye nrụpụta Irish
- Nnukwu Dane
- Ntughari ọla-edo.
N'ụzọ bụ isi, ọrịa ahụ na-etolite na afọ 5-8 nke ndụ anụmanụ, na afọ ewepụtara afọ bụ 4-10 afọ. Ọrịa ahụ nwere ike imetụta anụmanụ nke nwoke na nwoke. Mana ekwesịrị iburu n'uche na nkịta ma ọ bụ nwamba a pịrị apị nwere ụdị hypothyroidism.
Pathophysiology nke ọmụmụ nke hypothyroidism na nkịta
A na-ahụ hypothyroidism nke mbụ, nke a, inweta, na nkịta 90%. Ọzọkwa, ọrịa lymphocytic thyroiditis, usoro mkpali nke na-eme na ntinye nke lymphocytes na gland thyroid, na-eso akpata ya. A na-ahụ ihe mere n’ime ụmụ anụmanụ dị 50%.
A na - eme hypothyroidism enwetara n'ihi nsonathic follicular atrophy na 50% nke nkịta. Nnyocha na-egosi na enwere ọgwụ mgbochi megide T4 na T3 n'ime ọbara anụmanụ. Mana enwere ike ịchọpụta ụdị ọgwụ mgbochi ọrịa ahụ na euthyroid, ụmụ anụmanụ nkịtị na 13-40% nke ikpe.
Ihe dị egwu maka ọdịdị nke ọrịa a gụnyere erughi iodine n'ụdị nri na mbibi gland thyroid n'ihi akpụ ahụ ma ọ bụ mmebi ahụ gland site n'ọrịa dị iche iche.
Attentionaa ntị! Na nwamba, hypothyroidism na-abụkarị idiopathic; ọ na - aputa ihe na ikuku ma ọ bụ mgbe ewepụchara gland.
A na - eme hypothyroidism nke abụọ na nkịta n'ihi:
- nsogbu na njikọta nke homonụ na-akpali homonụ;
- n'ihi ọrịa;
- n'ihi ọdịdị nke akpụ na akwara thyroid.
Azọ nke hypothyroidism nwetara nke abụọ adịghị ewu ewu na nwamba na nkịta. Enwere ike ịrịa ọrịa a n'ihi mmebi nke njikọ nke gland na -akpata nke thyreroropin (TSH) ma ọ bụ homonụ na-akpali akpali, nke bụ ọrụ maka ịkwalite thyroid gland na synthesize T4 na T3.
Na mgbakwunye, nri nzuzo nke thyrotropin na-egbochi nri na-edozi ahụ, glucocorticoids na ọrịa ndị metụtara. Ya mere, mgbe a na-ahazi ọkwa glucocorticoids, mmepụta nke TSH na-achịkwa.
A hypothyroidism nke obere, nke nwere ike tolitere n'ihi igbochi ntọhapụ nke tayrotiberin site na hypothalamus ma ọ bụ homonụ nke na-ewepụta thyotropin, edebeghị ya ruo taa.
Azụ hypothyroidism n'ime ụmụ anụmanụ na-etolite n'ihi nkọcha, ebe ọ bụ na homonụ nke gland na-emepụta dị mkpa maka nguzobe nke akwara na akwara etiti. Ọzọkwa, a na-edenye akwụkwọ banyere enweghị ma ọ bụ mmebi nke gland thyroid, erughi iodine ma ọ bụ mmebi homonụ.
Ọkpụkpụ hypothyroidism nke dị ugbu a, dịka iwu, na - ebilite na ndị ọzụzụ atụrụ ndị German nwere hypothalamus nke enweghị nsogbu - panhypopituitarism.
Ọzọkwa, a chọpụtara erughi erupụta na njikọ nke hypothalamus site na homonụ nke ewepụtara thyrotropin na risenschnauzer. Ọrịa mbufụt thyroid (lymphocytic familial thyroiditis) na-enwekarị ọsịsọ na Danish Great Danes, greyhounds na beagles.
Kedu usoro na akụkụ ahụ nke hypothyroidism na-emetụta ụmụ anụmanụ
N’ememe nnabata ahụ, onye na-ahụ maka anụ ahụ na-ewepụta ihe mgbaàmà dịka:
- thermophilic;
- ike;
- oyi ekweghị ha;
- adịghị ike
- ugboro ugboro ọrịa nke anụ ahụ;
- dementia
- hyperpigmentation;
- uru dị arọ;
- dandruff;
- molt siri ike;
- dull, akwa mkpuchi;
- na-eto ngwa ngwa ntutu.
Udiri oria a na-enwekarighi bu amaghi aru, oria aru, oria, isi n’onu na ito ntu ahu.
Ọrịa niile na-amalite nwayọ nwayọ nwayọ.
Ebe ọ bụ na hypothyroidism na-aga n'ihu n'usoro, ọtụtụ ihe otu ahụ nwere ike imebi na anụmanụ n'otu oge.
Ya mere, enwere ike ịhụ ihe mgbaàmà doro anya site na:
- anya;
- usoro ịtụ ụjọ;
- sistemụ ụjọ;
- anụ ahụ
- usoro homonụ;
- eriri afọ;
- sistem obi;
- sistemu endocrine;
- usoro ịmụ nwa na akwara ozi.
Ihe enwere ike ịchọta mgbe ị na-enyocha nkịta maka hypothyroidism
Na nkịta na nwamba, a na-ahụ alopecia (Symmetrical). Ọtụtụ mgbe na mbido, isi nkwọcha na-emetụta akụkụ, akụkụ mgbagha (afọ, akpa, olu), ntị na ọdụ. Na nmalite mmalite nke ọrịa ahụ, isi nkwọcha nwere ike ịbụ asymmetric na multifocal.
Isi anaghị enwe isi mgbe niile, ma ọ bụrụ na enweghi ọrịa purulent nke abụọ ma ọ bụ ihe ndị ọzọ na-akpalite itching. N'okwu a, ajị anụ ahụ na-agbaji n'enweghị nnukwu mbọ.
Ọzọkwa, n’oge a na-eme nyocha ahụ, onye na-ahụ maka anụ ahụ na-achọpụta ihe mgbaàmà ndị dị ka ịmụzigharị mkpụrụ na obere mmebi anụ ahụ na mmanụ ma ọ bụ seborrhea na-adịghị, nke nwere ike ịbụ multifocal, izugbe ma ọ bụ mpaghara. Ọzọkwa, anụ ahụ nke anụmanụ nwere ike ịbụ nke puff, oyi, dent, uwe ahụ nwere agba dull, bebi, dull, akọrọ.
Na mgbakwunye, nkịta ma ọ bụ nwamba nwere ike ịnwe mgbaàmà nke myxedema nwere ihu dị njọ. A ka na-ahụ hyperkeratosis, hyperpigmentation na imechi akpụkpọ ahụ na mpaghara ọgụ. Ọzọkwa, ọgwụgwọ anụ ahụ nwere ike ịchọpụta pyoderma (ọ na - esighi ike, nke na - adịkarịghị omimi) yana mgbasa ozi otitis.
Mgbaàmà ndị a na-ahụkarị
Mgbaàmà ndị a na-ahụkarị bụ hypothermia na-erughị ala, ike ọgwụgwụ, ibu ibu, na dementia. Site n'akụkụ nke usoro akwara obi, bradycardia, ahụ ike na - adịghị ike na nsogbu apical na - achọpụtakarị. Ma ihe omumu omumu bu:
- atrophy nke testicles na mbelata libido n'ime eriri;
- amụghị nwa
- mmepụta mmiri ara ehi na-adịghị mma n'oge a na-enye nwa ara;
- enweghi estrus (anestrus na-adi ogologo) na bitches.
Ihe ihe egwu
Ihe nkedo n’enwe ike iwelite ike hypothyroidism ike. Ọzọkwa, ihe ize ndụ na-abawanye mgbe ewepụchara gland thyroid na ọgwụgwọ hyperthyroidism.
Nnyocha ure na ọbara
N'ime pasent 80%, enwere oke cholesterol n'ọbara ọbara, nnukwu mkpali nke triglycerides na ụba ọrụ chineinine. Na ọkara nke ikpe, achọpụtara anaemiatic nomocytic anaemia nke ogo dị ala.
Nlekota Ndidi
Mgbe ịmalite ọgwụgwọ, a na-achọpụta ọganihu na ahụike anụmanụ na ụbọchị 7-10. Ọnọdụ nke uwe na akpụkpọ ahụ dị mma mgbe ọnwa 1,5-2 gasịrị. Ọ bụrụ na enweghị ezigbo mgbanwe emere, mgbe ahụ, onye na-ahụ maka anụ ahụ kwesịrị ịtụle nchọpụta ahụ.
N'oge nleba anya, ya bụ n'izu asatọ nke ọgwụgwọ, dọkịta ahụ na-atụle ịta ọbara ọbara nke T4. Ogo nke T4 dị n'ọbara mgbe nchịkwa nke L-thyroxine na-enweta mgbe awa 4-8 gachara.
Ọ dị mkpa na onye gosipụtara tupu iwebata ego bụ ihe nkịtị. Ọ bụrụ na mgbe nchịkwa ọgwụ na ọkwa a ka na-anakwere, ma tupu nchịkwa ahụ, ịta ahụ dị ala, mgbe ahụ, ekwesịrị ịbawanye ugboro nke nchịkwa ọgwụ.
Y’oburu na egosiputa ihe n’adiri abuo, ikekwe nke a na - egosi
- onunu ogwu adighi nma;
- onye nwe ya anaghị enye ya ọgwụ;
- malabsorption na eriri afọ;
- iji ọgwụ dị ala (emebiela, echekwa nke ọma).
Ọkpụkpọ ọgwụ mgbochi na T3 na T4 na-egbochikarị ịgbakọ ogo hormone. N'ọnọdụ ndị a, ọgwụgwọ anụ ahụ na-eji njimara ụlọ ọgwụ iji chọpụta izu oke nke ọgwụgwọ yana ị theụ ọgwụ.
Ihe mgbochi, nsogbu na prognosis
Maka mgbochi, ọ dị mkpa ka ị nyochaa ọkwa nke homonụ thyroid oge ụfọdụ iji gbochie nlọghachi ahụ ọrịa ahụ. Usoro ọgwụgwọ na-adị ogologo ndụ.
Ọgbenye nwere ike ịdapụta n'ihi oke ọgwụ nke L-thyroxine:
- ụnyaahụ;
- ọnọdụ enweghị nsogbu;
- afọ ọsịsa
- polyuria;
- ifelata
- polydipsia.
Maka ụmụ nwamba na nkịta nwere hypothyroidism nke mbụ yana iji usoro ọgwụgwọ nnọchi anya, prognosis dị mma. Yabụ, afọ ndụ anụmanụ anaghị ebelata.
N'ihe banyere hypothyroidism nke ụlọ akwụkwọ sekọndrị ma ọ bụ nke nke abụọ, a na-anabata prognosis, ebe ọ bụ na ụbụrụ gosipụtara usoro mmụta a. Site n'ụdị ọrịa ọrịa ọgbụgba n'oge ịmụ nwa, prognosis ahụ adịghịkwa njọ.
Ọgwụgwọ
Ọgwụgwọ na-enweghị myxedema coma bụ outpatient. N’inye ọzụzụ dị mma banyere onye nwe anụmanụ ahụ, hypothyroidism na nkịta na nwamba nwere amụma dị mma. Na iji mee ka ndụ onye ọrịa dịkwuo elu, a na-eji emeju homonụ.
Dị Mkpa! N'oge ọgwụgwọ, a ga-ezere nri ndị nwere nnukwu abụba.
Banyere usoro ị drugụ ọgwụ ahụ, ọ nwere ike ịdị iche iche wee họrọ ya n'otu n'otu. Ya mere, omumu ihe banyere omumu nke homonu n’ime obara bu ihe nkwa n’ilegharia nke oma na oria. Nzaghachi anụ ahụ maka ọgwụgwọ bụ nke nwayọ, yabụ, maka nyocha zuru ezu nke nsonaazụ ahụ, ọnwa atọ ka achọrọ.
N'ihi nnukwu ọdịiche dị na sistemụ metabolism nke mmadụ na anụmanụ, usoro nke homonụ thyroid maka nkịta na nwamba dị iche iche.
Ejighị ịwa ahụ hypothyroidism.
Ọgwụ maka hypothyroidism
N'ịgwọ ọrịa ahụ, a na-eji svothyroxine sodium (L-thyroxine) eme ihe. Usoro ọgwụgwọ oge mbụ bụ 0.02-0.04 mg / kg / ụbọchị. Ọzọkwa, a na-agbakọ dose ahụ dabere na ịdị arọ nke anụmanụ ma ọ bụ nwamba dabere na akụkụ nke ahụ dị elu - 0,5 mg kwa 1 m2 kwa ụbọchị na usoro abụọ kewara.
Dịka iwu, iji nweta ọnọdụ kwụsiri ike, a na-a theụ ọgwụ ahụ ihe dị ka ọnwa 1.
Ihe ngbanwe
Enweghị mgbochi ọ bụla na ojiji nke sodium levothyroxine.
Ingsdọ aka na ntị
Ọrịa shuga mellitus na nkịta ma ọ bụ nwamba, ma ọ bụ ọrịa obi - ọrịa nke ịchọrọ iji belata usoro onunu ogwu nke mbu n’ihi mbelata mmezi nke usoro metabolism. Na tupu ịmalite ọgwụgwọ na L-thyroxine, onye na-ahụ maka ọgwụgwọ anụ ahụ na-edepụta adrenocorticoids nye ndị ọrịa nwere hypoadrenocorticism (parallel).
Njikọ Ọgwụ
N'otu oge eji ọgwụ eji eme ka usoro nke ejikọtara whey protein (fentoin, salicylates, glucocorticoids) na-achọ mgbanwe na ojiji nke ọgwụ L-thyroxine ka ọ dị elu ma ọ bụ karịa.
Analogs
Ndị ọzọ gụnyere triiodothyronine. Agbanyeghị, etinyere ya ọgwụ adịkarịghị ala, ebe ọ bụ na ọgwụ ahụ so eme ka enwee hyperthyroidism nke ọrịa iatrogenic ma belata ọkara ndụ.
