Гормон ТТГ щитовидної залози. Що необхідно знати?

Гормон ТТГ щитовидної залози. Що необхідно знати?

Гормон ТТГ щитовидної залози: норма

Зміст

Гормон ТТГ щитовидної залози – тиреотропний гормон, що виробляється гіпофізом. Він регулює синтез активних речовин щитовидки (Т4 і Т3). Як це відбувається? Коли в крові скорочується рівень тиреоїдних гормонів, сигнал про порушення приходить в гіпофіз. Він у відповідь збільшує секрецію ТТГ, щоб той почав стимулювати щитовидну залозу на секрецію цих тиреоїдних гормонів. Якщо в крові збільшується рівень активних речовин щитовидки, знижується, відповідно, синтез ТТГ. І стимулюючу дію на щитовидну залозу зменшується.

Норма гормону ТТГ щитовидної залози

Якщо при розвитку патології всередині організму або впливі негативних чинників ззовні тиреоїднігормони реагують практично відразу, то гормон ТТГ щитовидної залози відповідає повільніше. Тобто, щитовидка майже негайно у відповідь на провокуючий фактор збільшує або зменшує секрецію своїх активних речовин. Щоб оцінити реакцію ТТГ на зміну кількості тиреоїдних гормонів, потрібно один-два місяці.

Сучасна діагностика все частіше використовує тести третьої генерації ТТГ. Вони дозволяють визначити з високою точністю дуже низькі концентрації тиреотропного гормону. Межа чутливості – 0,002 мкМЕ / мл.

Крім того, застосування тесту третьої генерації ТТГ дозволяє:

    виявляти субклінічні форми захворювань; більш ретельно контролювати проведену терапію; визначати дуже низькі концентрації ТТГ при оптимізації замісної гормонотерапії; визначати субнормальний тиреоїдний статус.

Норма гормону ТТГ – 0,4 – 4 мкМЕ / мл. Якщо результат не відповідає нормі, рекомендується повторний аналіз. Достовірність значення може бути перекручена по ряду причин. Так, завищення відбувається через:

    нещодавно проведеної корекції гормонами щитовидки (вільний Т4 в нормі); недостатньою гормонозаместительной терапії (вільний Т4 в нормі); некомпенсованою первинної надниркової недостатності (Т4 і Т3 підвищені або в нормі); вживання морфію; проведення діагностики з 20 до 2 годин; тотальної резистентності до тиреоїдних гормонів (клінічний еутіероз); важкої НЕ тиреоїдної патології (деяких соматичних і психічних захворювань).

Заниження значень можливо в наступних випадках:

    надлишок синтетичних гормонів щитовидної залози (вільний Т4 в нормі); прийом лікарських засобів, у складі яких є Т3; протягом чотирьох-шести тижнів еутиреоїдного стану в результаті лікування гіпертиреозу; завищений рівень кортизолу; артіфіціального тиреотоксикоз через самостійного лікування Т4.

Гормон ТТГ щитовидної залози: характеристика значень

Високий або низький ТТГ – це лабораторні симптоми, які свідчать про певні проблеми в системі гіпофіз – щитовидка. Захворювання самої щитовидної залози – це первинні захворювання, проблеми з гіпофізом – вторинні. Одного аналізу ТТГ для постановки діагнозу недостатньо. Так як достовірність значень може бути перекручена причинами іншого характеру, ніж проблеми зі щитовидкою або гіпофізом (перелік причин дивись вище). Необхідно повторне дослідження рівня ТТГ, а також аналіз рівня Т4 і Т3.

Причини високого ТТГ, пов’язані з патологіями в самій щитовидній залозі:

    післяопераційний гіпотиреоз; гіпотиреоз через лікування радіоактивним йодом або внаслідок аутоімунного тиреоїдиту; період відновлення при підгострому тиреоїдиті; прийом деяких лікарських препаратів (естрогени, церукал, аміодарон, еглоніл).

Таким чином, зниження роботи щитовидки призводить до підвищення рівня ТТГ.

Причини високого ТТГ, обумовлені захворюваннями гіпофіза або гіпоталамуса:

    аденома гіпофіза, ТТГ секретирующая (гормонально активна пухлина); відсутність чутливості гіпофіза до тиреоїдних гормонів (генетичне захворювання); відсутність чутливості до тиреоїдних гормонів всіх тканин організму.

Низькі значення ТТГ діагностуються значно рідше, ніж високі. Причому зниження гормону зустрічається як при зниженій роботі щитовидки, так і при посиленій діяльності. А при вагітності, наприклад, низький ТТГ – це варіант норми.

Низькі значення ТТГ можуть бути при:

    тиреотоксикозі (причини: дифузний токсичний зоб, фолікулярна аденокарцинома; йодіндуцірованного і трофобластной тиреотоксикоз, початкова стадія підгострого тиреоїдиту, гіпертиреоїдних фаза аутоімунного тиреоїдиту та ін.); вторинному гіпотиреозі (причини: пухлини гіпофіза або гіпоталамуса, травми черепа, пухлини мозку, опромінення та операції головного мозку, аутоімунне ураження гіпофіза і т. п.); синдромі еутіреоїдной патології (розвивається при соматичних та інших патологіях, не пов’язаних зі щитовидною залозою).

Кожен випадок низького або високого значення ТТГ вимагає індивідуального підходу і зіставлення лабораторних даних, скарг пацієнта і загальної симптоматики.

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