Hypothyroidism ho liphoofolo ke lefu le hlahang ha tšoelesa ea qoqotho e sa hlahise lihormone tse lekaneng. Lihomone tsa qoqotho tsa qoqotho li kenyeletsa triiodothyronine (T3) le thyroxine (T4).
Haeba khaello ea li-hormone tsena e hlaha, joale metabolism ho lintja le likatse e fokotseha haholo. Matšoao a tšoanelehang a lefu lena ke hore lintja kapa likatse, setloholo se fumana polelo e utloisang bohloko.
Lisosa tsa hypothyroidism
Ha e le molao, hypothyroidism hangata e ama lintja, hangata likatse. Le ha ho le joalo, hajoale ha e e-so fumanoe hore ke eona ntho e ka sehloohong e ka re bakelang lefu lena ho lintja. Leha ho le joalo, hypothyroidism hangata e hlaha mefuteng e kang ea lintja e latelang:
- Modisa wa Scotland;
- airedale;
- poho
- lesole;
- Pomeranian
- cocker spaniel;
- Modisa wa Senyesemane;
- dachshund;
- Schnauzer
- Doberman
- Setter sa Ireland
- Great Dane
- Khauta ea Khauta.
Ha e le hantle, lefu lena le hlaha ho lilemo tse 5-8 tsa bophelo ba phoofolo, 'me lilemo tsa lilemo tse 4-10 li thehiloe. Boloetse bona bo ka ama phoofolo ea bong bofe kapa bofe. Empa ho lokela ho hlokomeloe hore lintja kapa likatse tse lahleloang li kotsing ea ho ba le hypothyroidism.
Pathophysiology ea sebopeho sa hypothyroidism ho lintja
Hypothyroidism ea mantlha, ke hore, e fumanoeng, e bonoa ho 90% ea lintja. Hape, lymphocytic thyroiditis, ts'ebetso ea ho ruruha e bang teng ka ho nka karolo ha li-lymphocyte tšoelesa ea qoqotho e thusa ho hlaha. Lebaka lena le bonoa ho 50% ea liphoofolo.
Hypothyroidism e ntseng e fumaneha e thehiloe ka lebaka la idiopathic follicular atrophy ho 50% ea lintja. Litlhahlobo li bonts'a hore ho na le li-antibodies khahlanong le T4 le T3 maling a phoofolo. Empa li-antibodies tse tšoanang li ka fumanoa ho euthyroid, liphoofolo tse tloaelehileng maemong a 1340%.
Mabaka a sa tloaelehang bakeng sa ponahalo ea lefu lena a kenyelletsa khaello ea iodine litareng ea lijo le ts'enyo ea tšoelesa ea qoqotho e etsoa ka lebaka la tšoaetso ea senya.
Ela hloko! Ho likatse, hypothyroidism hangata idiopathic; e etsahala ka lebaka la radiotherapy kapa ka mor'a ho tlosa gland.
Hypothyroidism ea bobeli ho lintja e thehiloe ka lebaka la:
- ho senyeha ho rarahaneng ha lihomone tsa qoqotho tse susumetsang;
- ka lebaka la ts'oaetso;
- ka lebaka la ponahalo ea hlahala ho tšoelesa ea qoqotho.
Mokhoa oa bobeli o fumanoeng oa hypothyroidism ha o tloaelehe likatseng le lintja. Boloetse bona bo ka hlaha ka lebaka la tlolo ea motsoako oa pituitary thyrethropin (TSH) kapa hormone e susumetsang ea qoqotho, e ikarabellang bakeng sa ho susumetsa tšoelesa ea qoqotho hore e etse T4 le T3.
Ho feta moo, secretion ea thyrotropin e kenngoa ka lijo tse sa lekanang, li-glucocorticoids le mafu a amanang le ona. Kahoo, ha boemo ba glucocorticoids bo tloaelehile, tlhahiso ea TSH le eona e laoloa.
Tertiary hypothyroidism, e ka 'nang ea hlaha ka lebaka la ho thibela ho lokolloa ha thyrotiberin ke hypothalamus kapa hormone ea tlhahiso ea thyrotropin, ha e so ngolloe ho fihlela joale.
Congenital hypothyroidism ho liphoofolo e hlaha ka lebaka la cretinism, hobane lihormone tse hlahisoang ke tšoelesa lia hlokahala molemong oa tlhaho ea ts'ebetso ea methapo ea methapo le skeleton. Hape, linyeoe tsa ho se be teng kapa ho se sebetse hantle hoa tšoelesa ea qoqotho, ho haella ha iodine kapa ho theha li-hormone tse fosahetseng.
Hypgenroidism ea bobeli ea Congenital, joalo ka molao, e etsahala ho balisa ba Jeremane ba nang le hypothalamus e tsoetseng pele - panhypopituitarism.
Hape, khaello ea tlhaho ea tlhaho ea hypothalamus e hlahisoang ke hormone ea thyrotropin e bontšitsoe ho li-risenschnauzers. Mme ho ruruha ha tšoelesa ea qoqotho (lymphocytic Familyal thyroiditis) hangata ho tsoella ka Danish Great Danes, greyhound le beagles.
Ke litsamaiso life le litho life tse anngoeng ke hypothyroidism ho liphoofolo
Sebakeng sa kamohelo, ngaka ea liphoofolo e fana ka matšoao a kang:
- thermophilic;
- lethargy;
- ho hloka mamello ho batang;
- bofokoli
- ts'oaetso e phetang ea letlalo;
- 'dementia'
- Hyperpigmentation;
- boima ba mmele;
- dandruff;
- molt o matla;
- kobo e lerootho, e omeletseng;
- kholo ea moriri o liehang.
Matšoao a sa tloaelehang ke ho hloka thari, malaise e akaretsang, marotholi, hlooho ea hlooho le ho ts'oaroa ke letsoele la sefahleho.
Matšoao ohle a qala butle butle butle butle.
Kaha hypothyroidism e tsoela pele ka mokhoa o hlophisehileng, ts'ebetso ea 'mele e fetang e le' ngoe e ka lemala ho liphoofolo ka nako e le 'ngoe.
Ka hona, matšoao a hlakileng a ka bonoa ke:
- leihlo;
- mokhoa oa ho ikatisa;
- tsamaiso ea methapo;
- letlalo
- tsamaiso ea li-hormone;
- pampitšana ea ka mpeng;
- tsamaiso ea methapo ea pelo;
- tsamaiso ea endocrine;
- tsamaiso ea methapo le neuro-muscular.
Ho ka fumanoa eng ha ho hlahlojoa lintja bakeng sa hypothyroidism
Ho lintja le likatse, bilopal alopecia (symmetrical) e bonoa. Hangata qalong, baldness e ama mahlakore, libaka tsa moferefere (mpa, thipa, molala), litsebe le mohatla. Boemong ba pele ba lefu lena, ho hlaka ho ka ba le asymmetric le multifocal.
Baldness ha e tsamaisane le ho hasoa hangata, haeba ho se na tšoaetso ea boemo bo holimo kapa lintho tse ling tse etsang hore e hloekisoe. Tabeng ena, boea bo tsoa ntle le boiteko bo bongata.
Hape, nakong ea tlhatlhobo, ngaka ea liphoofolo e fumana matšoao a kang ho nchafala ntle le ts'enyo e fokolang ea tiske le oli kapa seborrhea e omileng, e ka bang multifocal, kakaretso kapa ea lehae. Hape, letlalo la phoofolo le ka ba makhopho, la bata, la eba le boreleli, kobo e na le 'mala o lerootho, e be brittle, e lerootho, e ome.
Ho feta moo, lintja kapa likatse li ka ba le matšoao a myxedema a nang le sefahleho se soabisang. Hyperkeratosis, hyperpigmentation le ho tiisa letlalo sebakeng sa likhohlano li ntse li bonoa. Ho feta moo, ngaka ea bongaka ea liphoofolo e ka bona pyoderma (hangata e le ntle le ho teba) le media tsa otitis.
Matšoao a tloaelehileng
Matšoao a atileng haholo a kenyelletsa hypothermia e leka-lekaneng, lethargy, boima ba 'mele le' dementia '. Ho tloha lehlakoreng la tsamaiso ea methapo ea pelo, bradycardia, moea o fokang ka matla le tšusumetso ea apole hangata li fumanoa. 'Me matšoao a ho beleha a tjena:
- ho otla ha litutulu le ho fokotsa libido ka har'a likhoele;
- ho hloka thari
- tlhahiso e fokolang ea lebese nakong ea lebone le liketong;
- ho haella ha estrus (elongated anestrus) ka li-bitches.
Lintho tse kotsi
Ho fallisoa ho ka eketsa monyetla oa hypothyroidism. Hape, kotsi e eketseha ka mor'a ho tlosoa ha tšoelesa ea qoqotho ka kalafo ea hyperthyroidism.
Liteko tsa moroto le mali
Maemong a 80%, ho na le k'holeseterole e ngata maling a phallo ea mali, mokokotlo o mongata oa li-triglycerides le ts'ebetso e atileng ea creatinine kinase. Maemong a halofo, ho fumanoe anemia e sa ntlafatseng ea "acidoc" ea "degree" e leka-lekaneng.
Tlhokomelo ea mamello
Kamora ho qala kalafo, ntlafatso ea bophelo ba phoofolo e bonoa ka matsatsi a 7-10. Boemo ba seaparo le letlalo li ntlafala kamora likhoeli tse 1.5-2. Haeba ho se liphetoho tse ntle tse etsahetseng, ngaka ea liphoofolo e lokela ho lekola boteng.
Nakong ea tlhahlobo, e leng libekeng tse 8 tsa kalafo, ngaka e hlahloba mahloriso a serum ea T4. Boemo bo phahameng ka ho fetisisa ba T4 maling kamora ho tsamaisoa ha L-thyroxine bo fihlelloa kamora lihora tse 4-8.
Ho bohlokoa hore pontšo pele ho kenyelletsoa ha lichelete e ne e le ntho e tloaelehileng. Haeba kamora ts'ebetso ea lithethefatsi boemo bo lula bo amoheleha, le pele ho tsamaiso, khatello e ne e le tlase, joale khafetsa ea taolo ea lithethefatsi e lokela ho eketsoa.
Haeba matšoao ka bobeli a theotsoe, mohlomong sena se bontša:
- litekanyetso li sa lokang;
- mong'a eona ha a tsamaise sethethefatsi sena ho peteleng;
- malabsorption ka mpeng;
- tšebeliso ea moriana oa boleng bo tlase (o felloa ke nako, o bolokiloe ka mokhoa o sa lokelang).
Li-antibodies tse potileng hantle ho T3 le T4 hangata li kena-kenana le lipalo tse nepahetseng tsa litekanyetso tsa li-hormone. Maemong ana, ngaka ea bongaka e sebelisa litšobotsi tsa bongaka ho bona hore na kalafo e lekana le tekanyo ea moriana hakae.
Mehato ea thibelo, mathata le bokuli
Bakeng sa thibelo, ho hlokahala hore nako le nako ho lekola boemo ba lihormone tsa qoqotho ho thibela tšoaetso ea lefu lena. Pheko ke ea bophelo bohle.
Mathata a ka hlaha ka lebaka la overdose ea L-thyroxine:
- tachyarrhythmia;
- boemo ba ho phomola;
- lets'ollo
- polyuria;
- ho theola boima ba 'mele
- polydipsia.
Bakeng sa likatse tse kholo le lintja tse nang le hypothyroidism ea mantlha ka tšebeliso e nepahetseng ea kalafo e nkeloang sebaka, phetoho ena e ntle. Ka hona, nako ea bophelo ba phoofolo ha e fokotsehe.
Tabeng ea hypothyroidism ea tertiary kapa ea sekondari, tsoelo-pele eo ha e lumelle, hobane lefu lena le bonahala bokong. Ka mofuta oa lefu lena le le tsoaloang, bokuli bo boetse bo fosahetse.
Phekolo
Pheko ha ho e-na le myxedema coma ha e felloe ke nako. Ka koetliso e nepahetseng ea mong'a phoofolo, hypothyroidism ho lintja le likatse e na le ts'ebetso e ntle. 'Me ho eketsa nako ea bophelo ea mokuli, ho sebelisoa tlatsetso ea li-hormone.
Bohlokoa! Nakong ea kalafo, lijo tse nang le mafura a mangata li lokela ho qojoa.
Mabapi le litekanyetso tsa moriana, e ka fapana 'me ea khethoa ka bomong. Ka hona, ho ithuta khafetsa ka boemo ba lihormone maling ke tiiso ea ho hlaphoheloa ka katleho le lefu lena. Karabelo ea 'mele kalafo e ea butle-butle, ka hona, bakeng sa tlhahlobo e felletseng ea sephetho, ho hlokahala likhoeli tse tharo.
Ka lebaka la phapang e kholo lits'ebetsong tsa metabolic ea batho le liphoofolo, litekanyetso tsa lihomone tsa qoqotho bakeng sa lintja le likatse li fapane haholo.
Ho buoa ka hypothyroidism ha ho sebelisoe.
Moriana oa hypothyroidism
Ha ho phekoloa lefu lena, ho sebelisoa levothyroxine sodium (L-thyroxine). Tekanyetso ea pele ke 0.02-0.04 mg / kg / letsatsi. Hape, tekanyetso e baloa ho latela boima ba phoofolo kapa katse ho ipapisitse le litekanyetso tsa bokaholimo ba mmele - 0,5 mg ka 1 m2 ka letsatsi ka tekanyetso tse peli tse arohaneng.
E le molao, ho fumana mmuso o tsitsitseng, moriana o nooa nako e ka bang khoeli e le 'ngoe.
Contraindication
Ha ho na lithibelo tšebeliso ea sodium ea levothyroxine.
Litemoso
Lefu la tsoekere ho lintja kapa likatse, kapa lefu la pelo - maloetse ao ho ona u hlokang ho fokotsa tekanyetso methapong ea pele ea kalafo ka lebaka la ho fokola hoa mmele oa ts'ebetso ea metabolic. Pele a qala kalafo ka L-thyroxine, ngaka ea bongaka ea liphoofolo e beha adrenocorticoids ho bakuli ba nang le hypoadrenocorticism (parallel).
Ho sebelisana le lithethefatsi
Ts'ebeliso e tšoanang ea lithethefatsi e liehisang ts'ebetso ea ho tlama liprotheine tsa Whey (fentoin, salicylates, glucocorticoids) e hloka phetoho ho litekanyetso tse tloaelehileng tsa L-thyroxine ho ts'ebeliso e phahameng ea lithethefatsi kapa hangata.
Li-analog
Mekhoa e meng e kenyelletsa triiodothyronine. Leha ho le joalo, e laetsoe ka seoelo haholo, kaha lithethefatsi li kenya letsoho ho hlaha ha iatrogenic hyperthyroidism mme e na le halofo ea bophelo.
