Graves tus kab mob

Mob Graves yog tus mob autoimmune uas ua rau yus cov thyroid caj pas ua haujlwm ntau (hyperthyroidism). Lub qhov ua rau lub cev ua kom tsis taus pa yog qhov mob uas tshwm sim thaum lub cev tiv thaiv tsis tau cov kab mob noj qab haus huv.

Cov thyroid caj pas yog ib qho tseem ceeb ntawm cov kab mob endocrine. Lub caj pas yog nyob ntawm sab xub ntiag ntawm lub caj dab saum toj qhov twg cov pob zeb caj dab tuaj sib ntsib. Cov qog no tso cov tshuaj hormones thyroxine (T4) thiab triiodothyronine (T3), uas tswj cov cev metabolism. Kev tswj cov metabolism hauv yog qhov tseem ceeb rau kev tswj hwm lub siab, qhov hnyav, thiab lub hlwb thiab lub zog ntawm lub cev.

Thaum lub cev ua rau cov thyroid hormones txaus ntau dhau, qhov xwm txheej no hu ua hyperthyroidism. (Ib qho ua tsis tau qog ua rau lub qog ua rau hypothyroidism.)

Cov kab mob graves yog qhov feem ntau ua rau hyperthyroidism. Nws yog vim muaj qhov tsis xws li tshuaj tiv thaiv kab mob hauv lub cev ua rau cov thyroid caj pas ua cov thyroid hormones ntau dhau. Cov kab mob Graves feem ntau tshwm sim rau cov poj niam hnub nyoog dua 20. Tab sis qhov kev puas tsuaj tuaj yeem tshwm sim tsis hais hnub nyoog li cas thiab tuaj yeem cuam tshuam rau tus txiv neej ib yam nkaus.

Cov neeg hluas yuav muaj cov tsos mob no:

• Kev ntxhov siab lossis tshee, zoo li muaj teeb meem pw tsaug zog
• O mis rau txiv neej (tau)
• Cov teeb meem kom pom tseeb
• Nkees
• Nquag nquag plob tsis so tswj
• Cov plaub hau poob lawm
• Kub tsis kam thiab tawm hws
• Muaj qab los ntxiv, txawm tias yuav poob phaus
• Kev coj khaub ncaws tsis xwm yeem rau poj niam
• Nqaij tsis muaj zog ntawm lub duav thiab xub pwg
• Kev txom nyem, nrog rau kev txob txob thiab npau taws
• Palpitations (kev hnov ​​ntawm lub plawv los sis qoj ua txawv)
  
• Lub plawv dhia nrawm lossis qog
• Ua tsis taus pa nrog kev ua ub no
• Tremor (txaj muag ntawm txhais tes)

Coob tus neeg muaj tus mob Graves muaj teeb meem nrog lawv lub qhov muag:

• Cov pob muag muag yuav zoo li ua rau sib thab tawm thiab tej zaum yuav hnov ​​mob.
• Ob lub qhov muag tuaj yeem hnov ​​khaus, khaus lossis nrawm dua.
• Ob lub zeem muag tuaj yeem pom.
• Tsis tshua pom kev thiab puas rau lub pob zeb kuj tuaj yeem tshwm sim hauv rooj plaub loj.

Cov neeg laus dua tuaj yeem muaj cov tsos mob no:

• Lub plawv dhia nrawm lossis qog
• Kev mob hauv siab
• Nco ploj lossis poob siab
• Tsis muaj zog thiab qaug zog

Tus kws kho mob yuav kuaj ib ce thiab yuav pom tias koj lub plawv nce siab. Kev kuaj mob ntawm koj lub caj dab yuav pom tias koj lub qog ua haujlwm loj (goiter).

Lwm yam kev ntsuam xyuas suav nrog:

• Kev kuaj ntshav los ntsuas theem ntawm TSH, T3, thiab pub dawb T4
• Lub xov tooj cua hluav taws xob iodine tshaj tawm thiab thaij duab

Tus kab mob no tseem tuaj yeem cuam tshuam cov kev sib tw hauv qab no:

• Orbit CT scan lossis ultrasound
• Lub qog stimulating immunoglobulin (TSI)
• Cov thyroid peroxidase (TPO) tiv thaiv
• Anti-TSH receptor antibody (TRAb)

Kev kho mob yog tsom rau tswj koj cov thyroid uas sib tshooj. Cov tshuaj noj hu ua beta-blockers feem ntau siv los kho cov tsos mob ntawm lub plawv dhia ceev ceev, tawm hws, thiab ntxhov siab kom txog thaum tswj hwm hyperthyroidism.

Hyperthyroidism raug kho nrog ib lossis ntau yam hauv qab no:

• Cov tshuaj antithyroid tuaj yeem thaiv lossis hloov pauv li cas cov thyroid caj pas siv iodine. Cov no yuav raug siv los tswj kev sib tshooj ntawm lub qog ua ntej kev phais mob lossis kho radioiodine lossis ua kev kho mob ntev.
• Txoj kev kho radioiodine nyob rau hauv xov tooj cua uas yog tsim los ntawm lub ncauj. Nws tom qab ntawd mloog zoo hauv kev sib tw ntawm lub qog thiab ua rau kev puas tsuaj.
• Kev phais mob yuav raug tshem tawm kom tshem tawm cov qog.

Yog tias koj tau muaj kev kho mob los ntawm kev siv tshuaj loog iodine los yog phais mob, koj yuav tsum tau hloov cov thyroid hormones txaus rau tas koj lub neej. Qhov no yog vim hais tias cov kev kho mob ua rau rhuav tshem lossis tshem tawm lub qog.

KHO QHOV MUAG LOS NTAWM YOOJ YIM

Qee qhov teeb meem qhov muag cuam tshuam nrog Graves kab mob feem ntau txhim kho tom qab kev kho mob nrog tshuaj, hluav taws xob, lossis phais mob los kho cov thyroid uas muaj ntau. Kev kho mob radioiodine qee zaum tuaj yeem ua rau qhov muag tsis zoo. Cov teeb meem qhov muag muaj qhov tsis zoo rau cov neeg haus luam yeeb, txawm tias tom qab kho hyperthyroidism.

Qee zaum, prednisone (qhov kev siv tshuaj steroid uas ua rau lub cev tiv thaiv kab mob) xav tau los txo qhov muag thiab o.

Koj yuav tsum kaw koj ob lub qhov muag kaw thaum hmo ntuj kom tsis txhob ziab. Cov tsom iav thiab qhov muag yuav txo qhov muag tsis pom kev. Muaj qee zaus, kev phais mob lossis kho hluav taws xob (txawv ntawm lub xov tooj cua iodine) yuav xav tau kom tiv thaiv kev puas tsuaj ntxiv rau lub qhov muag thiab tsis pom kev.

Cov kab mob Graves feem ntau teb tau zoo rau kev kho mob. Lub qog ua ntshav lossis lub zog iodine ntau zaus yuav ua rau lub qog ua tsis tau zoo (hypothyroidism). Yog tias tsis tau txais cov tshuaj ntau ntawm cov thyroid hormones txaus hloov, hypothyroidism tuaj yeem ua rau:

• Kev Nyuaj Siab
• Kev nyuaj siab thiab lub cev qeeb
• Qhov hnyav nce
• Qhuav ntawm daim tawv nqaij
• Cem quav
• Txias intolerance
• Kev coj khaub ncaws tsis ncaj ncees rau poj niam

Hu rau koj tus kws kho mob yog tias koj muaj cov tsos mob ntawm Graves kab mob. Kuj tseem hu yog tias koj qhov muag teeb meem lossis lwm cov tsos mob hnyav dua lossis tsis zoo nrog kev kho.

Mus rau chav kho mob ceev lossis hu rau tus xovtooj xwm ceev hauv zos (xws li 911) yog tias koj muaj tsos mob hyperthyroidism nrog:

• Txo hauv kev nco qab
• Ua npaws
• Lub plawv dhia ceev ceev, tsis ncaj ncees
• Ua pa siav

Diffuse thyrotoxic goiter; Hyperthyroidism - Graves; Thyrotoxicosis - ntxa; Exophthalmos - Graves; Ophthalmopathy - Graves; Exophthalmia - Graves; Exorbitism - ntxa

• Cov qog endocrine
• Lub qog ua kom loj hlob - scintiscan
• Graves tus kab mob
• Lub qog ua haujlwm

Hollenberg A, Wiersinga WM. Cov mob hyperthyroid. Hauv: Melmed S, Auchus RJ, Golfine AB, Koenig RJ, Rosen CJ, eds. Williams Phau Ntawv ntawm EndocrinologyCov. Xab 14th. Philadelphia, PA: Elsevier; 2020: chap 12.

Jonklaas J, Cooper DS. Lub qog. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 213.

Marcdante KJ, Kleigman RM. Mob qog noj ntshav. Hauv: Marcdante KJ, Kliegman RM, eds. Nelson Cov Ntawv Tseem Ceeb ntawm PediatricsCov. 8 tus ed. Elsevier; 2019: cha 175.

Marino M, Vitti P, Chiovato L. Graves 'kab mob. Hauv: Jameson JL, De Groot LJ, de Kretser DM, li al, eds. Endocrinology: Cov Neeg Loj thiab PediatricCov. 7 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 82.

Ross DS, Burch HB, Cooper DS, li al. 2016 American Thyroid Association cov lus qhia rau kev kuaj mob thiab kev tswj hwm ntawm hyperthyroidism thiab lwm yam ua rau thyrotoxicosis. Lub qogCov. 2016; 26 (10): 1343-1421. PMID: 27521067 pubmed.ncbi.nlm.nih.gov/27521067/.