Congenital hypothyroidism yog hais txog ib pawg kabmob ua tsis taug kabmob. Nws ua tau nws tus kheej li qhov tsis txaus cov thyroid hormones, uas ua rau muaj txiaj ntsig ntawm dysgenesis ntawm hypovisary system lossis thyroid caj pas.
Qhov ua rau ntawm hypothyroidism tej zaum yuav yog tus kab mob yug los ua ke ntawm kev sib deev ntawm cov thyroid cov tshuaj hormones thiab txhua yam ntawm exogenous yam (niam tiv thaiv cov tshuaj tiv thaiv, tshuaj, thiab lwm yam).
Hauv cov lus yooj yooj yim, kev mob ntsws thaum yug los yog hypothyroidism thaum chiv keeb uas tshwm sim nws tus kheej thiab kuaj tau thaum yug.
Qhov Tseeb Ua rau txhawm rau Hypothyroidism
Kwv yees li ntawm 85% ntawm ntu kev yug tus mob hypothyroidism thaum ntxov mas nws tsis nco qab. Qhov ua rau feem ntau ntawm lawv yog dysgenesis ntawm lub qog ua haujlwm lub qog.
Kwv yees li 15% ntawm lub sijhawm ntawm kev mob qog nqaij hlav ntshav hauv lub cev yog vim muaj kev sib kis ntawm leej niam cov tshuaj tiv thaiv cov thyroid caj pas los yog rau cov qub txeeg qub teg ntawm pathologies ntawm T4 synthesis.
Qee hom kev mob qog ntshav siab hnub no muaj kev hloov caj ces uas ua rau muaj kev loj hlob ntawm tus kab mob.
Qhov tseem ceeb ua rau cov ntshav hauv lub ntsws
Lub qog dysgenesis (tab tom tsim kho):
- Kev Hypoplasia (25-35%).
- Agenesis (23-43%).
- Dystopia (35-43%).
Congenital pathologies ntawm T4 synthesis:
- Pendred's Syndrome.
- Cov kab mob pathology ntawm cov thyroid peroxidase.
- Pathology ntawm sodium iodide cov neeg txheeb ze.
- Pathology ntawm thyroglobulin.
- Cov kab mob pathology ntawm cov thyroid hormone deiodinase.
Congenital central hypothalamic-pituitary hypothyroidism.
Congenital hypothyroidism provoked los ntawm cov tshuaj tiv thaiv niam.
Yuav muaj dab tsi tshwm sim nrog hypothyroidism?
Kev xeeb tub hauv plab hauv plab, uas rau qee qhov vim li cas tus kab mob hlwb tsis tuaj yeem lossis tsis ua haujlwm, tshwm sim vim cov thyroid hormones ntawm leej niam, nkag mus rau hauv lub cev.
Thaum menyuam yaus yug los, cov theem ntawm cov tshuaj hormones hauv nws cov ntshav poob qis zuj zus. Hauv kev nkag mus rau hauv lub neej hauv plab, tshwj xeeb tshaj yog nyob rau lub sijhawm thaum ntxov, cov thyroid hormones yog qhov tsim nyog rau kev txhim kho kom zoo ntawm lub hauv nruab nrab lub paj hlwb ntawm tus menyuam.
Qhov no yog qhov tshwj xeeb tshaj yog rau cov txheej txheem ntawm myelination ntawm cov hlwb hlwb.
Nrog cov tsis muaj cov thyroid cov tshuaj hormones hauv lub sijhawm no, ib qho kev txhim kho ntawm cerebral cortex ntawm tus menyuam tau tsim, uas yog qhov tsis hloov pauv. Nws tshwm sim nws tus kheej hauv ntau qib ntawm lub hlwb ruamqauj ntawm tus menyuam nce mus rau cretinism.
Yog tias hloov pauv tau pib thaum lub sijhawm (thawj lub lim tiam ntawm lub neej), txoj kev txhim kho ntawm lub hauv nruab nrab ntawm lub paj hlwb yuav luag zoo li qub. Tib lub sijhawm ua ke nrog kev tsim cov teeb meem hauv lub hauv nruab nrab cov hlab hlwb, nrog concomitantly compensated Congenital hypothyroidism, kev txhim kho ntawm lub cev pob txha thiab lwm yam kev mob hauv nruab nrog thiab lub cev tiv thaiv.
Cov tsos mob
Feem ntau, kev soj ntsuam cov tsos mob ntawm lub ntsws Congenital hypothyroidism tsis yooj yim rau kev paub txog kev paub ntxov. Qhov mob Congenital hypothyroidism hauv tus menyuam mos yug tshiab tuaj yeem xav tias yog raws qhov ntsuas ntawm cov duab hauv chaw kuaj mob hauv tsuas yog 5% ntawm tus neeg mob xwb.
Cov tsos mob thaum ntxov ntawm tus mob hypothyroidism thaum ntxov:
- lub plab o;
- lub sijhawm ntev (ntau tshaj 7 hnub) hyperbilirubinemia;
- lub suab qis;
- hnoos qeev;
- tsam posterior fontanel;
- hypotension;
- lub qog ua kom loj ntxiv;
- macroglossia.
Yog tias kev ntsuas kho tsis tau ua raws sijhawm, tom qab 3-4 lub hlis cov tsos mob tshwm sim no:
- teeb meem nqos;
- tsis qab los noj mov;
- ua tsis taus pa;
- qhov hnyav tsis zoo;
- dryness thiab pallor ntawm daim tawv nqaij;
- kev mob siab qis;
- cov leeg mob hypotension.
Tom qab rau lub hlis ntawm lub neej, tus me nyuam qhia cov cim ntawm kev ncua ntawm lub cev, kev loj hlob ntawm lub hlwb thiab kev loj hlob tsis sib xws: hypertelorism, dav lub qhov ntswg sab hnub ntswg, lub qhov ntswg kawg ntawm tag nrho cov fontanels (saib duab).
Cov ntaub ntawv yuav pab tau, dab tsi yog cov tsos mob thiab kev kho mob ntawm hypothyroidism hauv cov poj niam, vim hais tias muaj tus kab mob qog nqaij hlav tseem nyob nrog tus neeg mob rau lub neej.
Kho kab mob
Hloov kev kho mob yuav tsum ua lub hom phiaj ntawm kev ceev ceev ntawm T4 hauv cov ntshav, tom qab ntawd xaiv cov koob tshuaj L-T4, uas ua kom muaj kev saib xyuas zoo ntawm kev saib xyuas zoo ntawm T4 thiab TSH.
Thawj qhov pom zoo koob ntawm L-T4 yog 10-15 mcg / kg lub cev hnyav ib hnub. Ntxiv mus, kev tshuaj xyuas thiab kev soj ntsuam tas li yuav tsum xaiv kom tau txais koob tshuaj L-T4 txaus.
Qhov ntsuas ntawm tus mob Congenital hypothyroidism
Cov kev ntsuas ntawm tus kab mob tsuas yog nyob ntawm lub sijhawm ua ntej pib L-T4 hloov txoj kev kho. Yog tias koj pib nws hauv thawj ob lub lis piam tom qab ntawm tus me nyuam lub neej, kev ua txhaum ntawm kev tsim kho lub cev thiab psychomotor yuav luag ploj mus.
Yog tias lub sijhawm pib hloov ntawm kev hloov kho tsis tiav, thiab nws tsis pib, qhov kev pheej hmoo ntawm kev loj hlob ntawm tus kab mob nce ntxiv, nce mus txog oligophrenia thiab nws cov ntawv hnyav.
Kev kho mob ntawm hypothyroidism yog qhov ua tau zoo nrog cov thyroid hormones npaj. Cov tshuaj txaus ntseeg tshaj plaws rau hypothyroidism yog suav tias yog cov thyroid hormones txaus synthetically (artificially).
Tib qho mob rau kev hloov pauv nrog cov tshuaj no yog kev mus ntsib kws kho mob, uas yuav tsum xaiv cov tshuaj ntawm lub sijhawm thiab kho nws thaum kho.
Cov tsos mob ntawm hypothyroidism pib ploj, feem ntau hauv thawj lub lim tiam ntawm cov tshuaj. Lawv qhov kev ploj tag nrho tshwm sim nyob rau hauv ob peb hlis. Cov menyuam yaus hauv thawj xyoo ntawm lub neej thiab thaum laus dua tsuas yog xav tau kev kho mob. Cov neeg laus thiab cov neeg mob uas tsis muaj zog teb rov qab qeeb dua los ntawm kev siv tshuaj.
- Yog tias hypothyroidism tshwm sim los ntawm qhov tsis muaj cov thyroid caj pas, Hashimoto's disease, lossis hluav taws xob kho, nws yog qhov yuav los kho nws lub neej ntev. Muaj tseeb, muaj qee kis thaum, nrog Hashimoto's thyroiditis, txoj haujlwm ntawm lub pancreas tau rov qab zoo tiav.
- Yog tias lwm cov pathologies yog cov ua rau cov hypothyroidism, tom qab kev tshem tawm ntawm tus mob hauv qab, cov cim ntawm hypothyroidism kuj ploj.
- Qhov ua rau hypothyroidism tuaj yeem yog qee yam tshuaj noj, tom qab tshem tawm ntawm qhov uas cov thyroid caj pas normalizes.
- Mob Hypothyroidism hauv kev kho mob sai sai tej zaum yuav tsis tas muaj. Txawm li cas los xij, txhawm rau kom tsis txhob nco lub zuj zus ntawm tus kab mob, tus neeg mob xav tau kev saib xyuas mob tas li.
Cov ntaub ntawv muaj tseeb ntawm cov txiaj ntsig ntawm kev hloov pauv rau latent hypothyroidism tsis muaj nyob rau hnub no, thiab kev xav ntawm cov kws tshawb fawb ntawm cov teebmeem no sib txawv. Hauv cov xwm txheej zoo li no, thaum txiav txim siab txog qhov tsim nyog ntawm kev kho, tus neeg mob ua ke nrog tus kws kho mob sib tham txog kev them nyiaj ntawm cov nqi kho mob thiab cov kev pheej hmoo ntawm nws nrog cov txiaj ntsig tsim nyog.
Ua tib zoo mloog! Cov neeg mob uas tau mob los ntawm cov kab mob ntawm cov hlab plawv thiab ntshav qab zib mellitus, tshwj xeeb tshaj yog xav tau txoj kev noj tshuaj kom raug, vim tias kev noj tshuaj ntau dhau los yog fraught nrog qhov tshwm sim ntawm angina pectoris lossis atrial fibrillation (lub suab tsis sib haum lub plawv).
Kev Kho Mob
Nrog kev kuaj mob ntawm tus mob hypothyroidism thaum yug los, tus kws kho mob tau tshaj tawm cov tshuaj uas suav nrog sodium levothyroxine, uas yog cov tshuaj nquag:
- Levoxyl.
- Synthroid.
- Levotroid.
Cov tshuaj yuav tsum noj raws li cov lus qhia thiab teem sijhawm ntawm tus kws kho keeb. Tom qab 1.5-2 lub hlis ntawm kev kho mob, nws yog ib qho tsim nyog yuav tsum tau mus ntsib kws kho mob txhawm rau txhawm rau txheeb xyuas qhov tseeb ntawm cov koob tshuaj uas tau hais tseg. Yog tias nws hloov tawm tias koob tshuaj tsawg dhau, tus neeg mob muaj cov tsos mob ntawm hypothyroidism:
- Qhov hnyav nce.
- Cem quav
- Qaug zog.
- Ntsaug.
Yog tias cov koob tshuaj tau tshaj, tus tsos mob yuav txawv me ntsis:
- Insomnia
- Qhuas.
- Tsom.
Hauv cov neeg mob uas lub plawv tsis ua haujlwm, thaum pib kho, ib koob tshuaj levothyroxine feem ntau yog kws kho, uas yog maj mam nce ntxiv raws li qhov tsim nyog. Yog tias kev mob hypothyroidism hnyav heev thaum lub sijhawm kuaj mob, nws tsis tuaj yeem lees txais txhawm rau kho mob.
Tseem Ceeb! Thaum tsis muaj kev kho kom zoo txaus, mob ntshav qab zib (Congenital hypothyroidism) hauv cov menyuam yaus tuaj yeem ua rau muaj mob uas tsis tshua pom muaj, tab sis muaj kev phom sij heev rau lub neej - mob hypothyroid coma (myxedema coma). Cov kev kho mob ntawm tus kab mob no yog nqa tawm tshwj xeeb hauv tsev kho mob, hauv chav kho mob ntau ntxiv nrog kev tswj hwm ntawm cov thyroid hormones npaj.
Yog tias kev ua pa tsis taus, lub tshuab ua pa lub ntsws siv. Tus neeg mob tau kuaj mob tag nrho rau lub xub ntiag ntawm qhov pom tseeb ntawm lub plawv. Yog tias lawv kuaj pom, kev kho tsim nyog raug kho.
Kev tiv thaiv ntawm hypothyroidism hauv menyuam yaus
Hypothyroidism thaum cev xeeb tub yuav tsum tau kho nrog kev saib xyuas tshwj xeeb, vim nws tuaj yeem cuam tshuam kev loj hlob ntawm tus me nyuam hauv plab thiab ua rau mob hnyav rau ntawm lub cev.
- Nrog hypothyroidism hauv tus pojniam cev xeeb tub, kev kho mob yuav tsum tau pib tam sim ntawd. Yog tias tus kab mob tau kuaj pom ua ntej cev xeeb tub, tus poj niam yuav tsum saib xyuas cov theem ntawm cov thyroid hormones txaus thiab nqa tawm kev kho kom tsim nyog ntawm cov tshuaj tau hais tseg. Thaum nqa menyuam yaus, qhov kev xav tau rau lub cev qoj ib ce tuaj yeem nce ntxiv txog 25-50%.
- Qhov xav tau kev kho mob tuaj yeem tshwm sim nrog kev tiv thaiv tom qab yug menyuam hypothyroidism. Nrog rau qhov pib ntawm txhua qhov kev xeeb menyuam tshiab, tus pojniam yuav tsum yauv mus kuaj mob tag nrho rau hypothyroidism. Qee lub sijhawm tom qab tus qauv ntawm hypothyroidism ploj mus ntawm nws tus kheej, thiab lwm yam, tus kab mob tsuas kav thoob plaws tus poj niam lub neej.
Kev kho txij nkawm
Feem ntau, kev kho mob ntawm hypothyroidism yog lub neej tag nrho, yog li cov tshuaj uas tus kws kho mob pom zoo yuav tsum ua raws li lub hom phiaj nruj me ntsis. Qee lub sij hawm yug cov hlab ntsws hypothyroidism loj zuj zus, yog li cov koob tshuaj hormone txij ua ke mus ua ke yuav tsum muaj kev nce ntxiv, ua raws li tus nqi ntawm qhov ua kom tsis haum cov thyroid muaj nuj nqi.
Hauv ntau cov neeg mob noj cov thyroid hormones npaj, tom qab lawv tshem tawm, cov tsos mob ntawm hypothyroidism pib nrog cov kev tawm dag zog tshiab. Thaum zoo li no, kev noj tshuaj yuav tsum tau rov ua dua.
Congenital hypothyroidism tuaj yeem tsim kho raws li kev cuam tshuam ntawm tus mob kis. Hauv qhov no, tom qab kho cov kabmob uas nyob hauv qab, lub qog ua haujlwm rov qab tau zoo tag nrho. Txhawm rau kuaj nws txoj haujlwm, kev cuam tshuam ib ntus ntawm kev siv cov thyroid hormones npaj tau ua.
Feem ntau ntawm cov neeg mob nrog qhov kev tshem tawm no tsom xam ib ntus rov qab los ntawm cov tsos mob tseem ceeb ntawm hypothyroidism. Qhov no yog vim hais tias lub cev, nrog qee qhov kev ncua, xa cov cim qhia rau cov thyroid caj pas hais txog qhov yuav tsum tau rov pib ua haujlwm.
Yog tias lub qog nws muaj peev xwm tiv thaiv nws tus kheej yav tom ntej, kev kho mob tuaj yeem raug tso tseg. Zoo, yog tias cov tshuaj hormone ntau lawm poob qis, koj yuav tsum rov pib siv cov tshuaj no.
Kev noj cov tshuaj thyroid los npaj yuav tsum ua rau tus neeg mob mus ntsib tsev kho mob 2 zaug hauv ib xyoos (rau kev txheeb xyuas qhov tseeb). Cov neeg mob mus kuaj cov thyroid stimulating hormone (TSH). Qhov tshwm sim ntawm txoj kev tshawb no qhia pom kev ua tiav ntawm cov tshuaj hormones concentration nrog tus qauv.
