{"id":10215,"date":"2011-04-05T18:00:00","date_gmt":"2011-04-05T18:00:00","guid":{"rendered":""},"modified":"2011-04-05T18:00:00","modified_gmt":"2011-04-05T18:00:00","slug":"suaugusiuju-hipotireoze","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/suaugusiuju-hipotireoze\/10215\/","title":{"rendered":"Suaugusi\u0173j\u0173 hipotireoz\u0117"},"content":{"rendered":"<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<div style=\"text-align: justify; line-height: 150%\"><b><span style=\"line-height: 150%; font-size: 10pt\">Dr \u017dydr\u016bn\u0117 Visockien\u0117<\/span><\/b><\/div>\n<div style=\"text-align: justify; line-height: 150%\"><span style=\"line-height: 150%; font-size: 10pt\">VUL SK Endokrinologijos centras<\/span><\/div>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\">&nbsp;<\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt; mso-ansi-language: EN-US\" lang=\"EN-US\">Suaugusi<\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">\u0173j\u0173 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a>, dar kitaip vadinama miksedema, literat\u016bros \u0161altiniuose apra\u0161oma jau nuo 1874 met\u0173. Tuomet Klinikin\u0117 Draugija Londone i\u0161studijavo ir apra\u0161\u0117 \u0161i\u0105 lig\u0105, pa\u017eym\u0117dama svarbiausius po\u017eymius, kurie puikiai tinka skydliauk\u0117s hipofunkcijai apibr\u0117\u017eti ir \u0161iomis dienomis. \u0160tai keletas i\u0161 j\u0173:<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">1.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Miksedema \u017eymiai da\u017eniau serga moterys, negu vyrai ir \u0161i liga da\u017eniausiai pasirei\u0161kia, sulaukus vidutinio am\u017eiaus.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">2.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Klinikiniai steb\u0117jimai rodo, jog \u0161i b\u016bkl\u0117 i\u0161sivysto d\u0117l skydliauk\u0117s audinio destrukcijos.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">3.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Pats da\u017eniausias pakitimas &ndash; jungiamojo audinio, pakei\u010dian\u010dio normal\u0173 liaukin\u012f skydliauk\u0117s audin\u012f, ve\u0161\u0117jimas.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">4.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Labai da\u017enai taip pat stebimas jungiamojo audinio ve\u0161\u0117jimas odoje bei vidaus organuose, kas leid\u017eia \u012ftarti sistemin\u012f u\u017edegimin\u012f proces\u0105. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">5.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Eksperimentiniuose modeliuose su gyv\u016bnais, miksedemai b\u016bdingi simptomai i\u0161sivystydavo po chirurginio skydliauk\u0117s pa\u0161alinimo. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">6.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Skydliauk\u0119 pa\u0161alinus \u017emon\u0117ms, taip pat i\u0161sivystydavo miksedemai b\u016bdingi simptomai. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\"><font size=\"2\">\u0160iandien <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a> apibr\u0117\u017eiama kaip skydliauk\u0117s hormon\u0173 nepakankamumas [1]. Ji klasifikuojama \u012f:<o:p><\/o:p><\/font><\/p>\n<ul>\n<li><font size=\"2\"><i style=\"mso-bidi-font-style: normal\">Pirmin\u0119 hipotireoz\u0119<\/i>, kuri atsiranda d\u0117l nepakankamos skydliauk\u0117s hormon\u0173 sintez\u0117s pa\u010dioje liaukoje. Tuomet tyrimuose nustatomas suma\u017e\u0117j\u0119s periferini\u0173 hormon\u0173 &ndash; tetrajodtironino (T4, tiroksino) ir trijodtironino (T3) bei padid\u0117j\u0119s tireotropinio hormono kiekis (TTH).<o:p><\/o:p><\/font><\/li>\n<li><font size=\"2\"><i style=\"mso-bidi-font-style: normal\">Antrin\u0119 hipotireoz\u0119<\/i>, kuomet sutrinka tropini\u0173 hormon\u0173 sintez\u0117 hipofiz\u0117je arba nustatoma pagumburio patologija. \u0160iuo atveju ma\u017e\u0117ja ir periferini\u0173 (T3, T4) hormon\u0173 ir TTH kiekis.<o:p><\/o:p><\/font><\/li>\n<li><font size=\"2\">&bdquo;<i style=\"mso-bidi-font-style: normal\">Periferin\u0119&ldquo; hipotireoz\u0119<\/i>, esant skydliauk\u0117s hormon\u0173 rezistencijos sindromui, kurio metu sutrinka periferini\u0173 audini\u0173 jautrumas T3 ir T4, tod\u0117l did\u0117ja j\u0173 sintez\u0117 bei koncentracija kraujyje.<o:p><\/o:p><\/font><\/li>\n<\/ul>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\"><font size=\"2\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">Hipotireoz\u0117<\/a> pagal savo sunkum\u0105 gali b\u016bti labai \u012fvairi ir tai priklauso nuo savito skydliauk\u0117s hormon\u0173 metabolizmo. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\"><o:p><font size=\"2\">&nbsp;<\/font><\/o:p><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA\" lang=\"EN-US\">Skydliauk\u0117s hormonai, tiroksinas ir trijodtironinas sintezuojami, naudojant dvi pagrindines sud\u0117tines dalis &#8211; aminor\u016bg\u0161t\u012f tirozin\u0105 ir jod\u0105, bei dalyvaujant fermentui peroksidazei. Susintetinti hormonai jungiasi su baltymu tiroglobulinu, <\/span><st1:city><st1:place><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA\" lang=\"EN-US\">tampa<\/span><\/st1:place><\/st1:city><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA\" lang=\"EN-US\"> neaktyv\u016bs ir yra kaupiami skydliauk\u0117s l\u0105stel\u0117se. Kai reikia, \u0161is kompleksas skyla ir laisvi hormonai patenka \u012f krauj\u0105, kur <\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">i\u0161 karto jungiasi su baltymais &ndash; did\u017eioji dalis &ndash; su tiroksin\u0105 suri\u0161an\u010diu baltymu (TSB), likusi &ndash; su albuminu ir prealbuminu. Susijung\u0119 su baltymais neaktyv\u016bs hormonai transportuojami \u012f audinius-taikinius. Su savais didel\u012f giminingum\u0105 turin\u010diais receptoriais l\u0105steli\u0173 taikini\u0173 branduoliuose jungiasi ir s\u0105veikauja tik laisvi hormonai &ndash; LT4 ir LT3. Jie veikia gen\u0173 transkripcijos greit\u012f, skatina arba slopin\u0105 \u012fvairi\u0173 baltym\u0173 sintez\u0119. Pagrindinis skydliauk\u0117s hormonas yra T4, kurio \u012f kraujotak\u0105 patenka apie penkis kartus daugiau, negu T3. Periferiniuose audiniuose d\u0117l dejonizacijos proceso toliau vyksta skydliauk\u0117s hormon\u0173 metabolizmas &ndash; T4 virsta \u012f T3, kuris yra apie keturis kartus aktyvesnis. Dejonizacija taip pat gali sukelti ir T3 virtim\u0105 \u012f neaktyv\u0173 reversin\u012f T3 &ndash; rT3.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Periferini\u0173 hormon\u0173 sintez\u0119 reguliuoja TTH. Fiziologin\u0117mis s\u0105lygomis tarp periferini\u0173 ir centrinio hormono i\u0161laikoma pusiausvyra, kuri sutrinka esant \u012fvairioms patologin\u0117ms b\u016bkl\u0117ms.<\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\"><o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Taigi, sutrikus skydliauk\u0117s veiklai, laboratoriniai pakitimai atsiranda palaipsniui: pirmiausia did\u0117ja TTH, v\u0117liau ma\u017e\u0117ja LT4 (LT3 dar kur\u012f laik\u0105 gali i\u0161likti normalus ir kompensuoti hormon\u0173 tr\u016bkum\u0105), o galiausiai ma\u017e\u0117ja ir LT3 kiekis. Pagal \u0161iuos poky\u010dius hipotireoz\u0119 si\u016bloma klasifikuoti:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\"><o:p><font size=\"2\">&nbsp;<\/font><\/o:p><\/p>\n<table style=\"border-bottom: medium none; border-left: medium none; border-collapse: collapse; border-top: medium none; border-right: medium none; mso-border-alt: solid windowtext .5pt; mso-yfti-tbllook: 480; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext\" class=\"MsoTableGrid\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr style=\"mso-yfti-irow: 0\">\n<td style=\"border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.4pt; padding-right: 5.4pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><i style=\"mso-bidi-font-style: normal\"><font size=\"2\">Subklinikin\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a><o:p><\/o:p><\/font><\/i><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">TTH padid\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">LT4 norma<o:p><\/o:p><\/font><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">LT3 norma arba padid\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<\/tr>\n<tr style=\"mso-yfti-irow: 1\">\n<td style=\"border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.4pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><i style=\"mso-bidi-font-style: normal\"><font size=\"2\">Lengva <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a><o:p><\/o:p><\/font><\/i><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">TTH padid\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">LT4 suma\u017e\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">LT3 norma<o:p><\/o:p><\/font><\/p>\n<\/td>\n<\/tr>\n<tr style=\"mso-yfti-irow: 2; mso-yfti-lastrow: yes\">\n<td style=\"border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.4pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><i style=\"mso-bidi-font-style: normal\"><font size=\"2\">Sunki <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a><o:p><\/o:p><\/font><\/i><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">TTH padid\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">LT4 suma\u017e\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<td style=\"border-bottom: windowtext 1pt solid; border-left: #d4d0c8; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 116.45pt; padding-right: 5.4pt; border-top: #d4d0c8; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt\" valign=\"top\" width=\"155\">\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><font size=\"2\">LT3 suma\u017e\u0117j\u0119s<o:p><\/o:p><\/font><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><o:p><font size=\"2\">&nbsp;<\/font><\/o:p><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 18pt\"><b style=\"mso-bidi-font-weight: normal\"><font size=\"2\">Pagrindin\u0117s hipotireoz\u0117s prie\u017eastys<o:p><\/o:p><\/font><\/b><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><i style=\"mso-bidi-font-style: normal\"><font size=\"2\">I. Pirmin\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a><b> <\/b><o:p><\/o:p><\/font><\/i><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 17.85pt\"><font size=\"2\">1. Skydliauk\u0117s funkcijos suma\u017e\u0117jimas d\u0117l audinio pa\u017eeidimo:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 82.65pt\"><font size=\"2\">&#8211; L\u0117tinis autoimuninis (Ha\u0161imoto) tiroiditas. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 129.6pt; tab-stops: 135.0pt\"><font size=\"2\">&#8211; Gr\u012f\u017etamoji <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a> (tylusis, pogimdyminis bei po\u016bmis tiroiditas).<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 129.6pt\"><font size=\"2\">&#8211; Skydliauk\u0117s chirurginis gydymas arba radiacija (gydymas J<sup>131<\/sup> arba i\u0161orinis ap\u0161vitinimas).<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 129.6pt\"><font size=\"2\">&#8211; Skydliauk\u0117s disgenez\u0117. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 17.85pt\"><font size=\"2\">2. Skydliauk\u0117s hormon\u0173 sintez\u0117s bei sekrecijos sutrikimai:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 82.65pt\"><font size=\"2\">&#8211; \u012egimtas skydliauk\u0117s hormon\u0173 sintez\u0117s defektas.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 82.65pt\"><font size=\"2\">&#8211; Jodo deficitas arba perteklius.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 129.6pt\"><font size=\"2\">&#8211; Vaistai: skydliauk\u0117s veikl\u0105 slopinantys, li\u010dio preparatai, jodo turintys preparatai (kordaronas).<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><i style=\"mso-bidi-font-style: normal\"><font size=\"2\"><span style=\"mso-bidi-font-weight: bold\">II. Antrin\u0117 (centrin\u0117s kilm\u0117s) <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a> <\/span><o:p><\/o:p><\/font><\/i><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 17.85pt\"><font size=\"2\">1. Funkcionuojan\u010dio audinio pa\u017eeidimas hipofiz\u0117je\/pogumburyje:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 129.6pt\"><font size=\"2\">&#8211; Tumorai (hipofiz\u0117s adenoma, kraniofaringioma, meningioma, disgerminoma, periferini\u0173 augli\u0173 mts).<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 46.95pt; margin: 0cm 0cm 0pt 82.65pt\"><font size=\"2\">&#8211; Galvos trauma.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 64.8pt; margin: 0cm 0cm 0pt 64.8pt\"><font size=\"2\">&#8211; Kraujagyslin\u0117s prie\u017eastys (i\u0161emija, hemoragija, aneurizma ir kt.).<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 129.6pt\"><font size=\"2\">&#8211; Infekcija (abscesai, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/tuberkulioze\/4450\">tuberkulioz\u0117<\/a>, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/toksoplazmoze\/56119\">toksoplazmoz\u0117<\/a>). <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 64.8pt; margin: 0cm 0cm 0pt 64.8pt\"><font size=\"2\">&#8211; Infiltraciniai pakitimai (sarkoidoz\u0117, histiocitoz\u0117, hemochromatoz\u0117)<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 64.8pt; margin: 0cm 0cm 0pt 64.8pt\"><font size=\"2\">&#8211; \u012egimtos anomalijos.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt; tab-stops: 45.0pt\"><font size=\"2\"><span style=\"mso-tab-count: 2\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>2. Funkciniai skydliauk\u0117s hormon\u0173 sintez\u0117s bei sekrecijos defektai:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt; tab-stops: 45.0pt\"><font size=\"2\"><span style=\"mso-tab-count: 3\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>&#8211; Genetin\u0117s TTH receptoriaus mutacijos.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><font size=\"2\"><span style=\"mso-tab-count: 2\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>&#8211; Vaist\u0173 poveikis: dopaminas, gliukokortikoidai. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><i style=\"mso-bidi-font-style: normal\"><font size=\"2\">III. &bdquo;Periferin\u0117&ldquo; <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a><o:p><\/o:p><\/font><\/i><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><font size=\"2\"><span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>1. Skydliauk\u0117s hormon\u0173 rezistencijos sindromas<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\"><o:p><font size=\"2\">&nbsp;<\/font><\/o:p><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><b style=\"mso-bidi-font-weight: normal\"><font size=\"2\">Klinikiniai hipotireoz\u0117s simptomai<o:p><\/o:p><\/font><\/b><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Hipotireoz\u0117s simptomai priklauso nuo ligos sunkumo bei trukm\u0117s, ta\u010diau bendras bruo\u017eas yra fizinio bei protinio aktyvumo bei \u012fvairi\u0173 organ\u0173 funkcij\u0173 sul\u0117t\u0117jimas [2]. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">D\u0117l skydliauk\u0117s hormon\u0173 tr\u016bkumo l\u0117t\u0117ja energijos apykaita bei termogenez\u0117, tod\u0117l atsiranda \u0161al\u010dio netoleravimas. \u012evairi\u0173 \u0161altini\u0173 duomenimis, energijos apykaita gali suma\u017e\u0117ti net iki 45<span style=\"mso-ansi-language: EN-US\" lang=\"EN-US\">% <\/span><span style=\"mso-ansi-language: EN-US\" lang=\"EN-US\">[3]<\/span><span style=\"mso-ansi-language: EN-US\" lang=\"EN-US\">, o tai s<\/span>\u0105lygoja svorio did\u0117jim\u0105 d\u0117l riebalinio audinio kaupimosi. D\u0117l pakitusio baltym\u0173 metabolizmo bei papdid\u0117jusio kraujagysli\u0173 sieneli\u0173 pralaidumo, tarpl\u0105steliniame tarpe kaupiasi glikozaminoglikanai, s\u0105lygojantys b\u016bdingus tinimus. D\u0117l sutrikusio gliukoz\u0117s pasisavinimo i\u0161 \u017earnyno ir sul\u0117t\u0117jusios skrand\u017eio evakuacijos, galima steb\u0117ti kiek ma\u017eesn\u0119 alkio glikemij\u0105 bei vang\u0173 atsak\u0105, atliekant gliukoz\u0117s tolerancijos m\u0117gin\u012f. Daugeliui pacient\u0173, sergan\u010di\u0173 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a> d\u0117l sul\u0117t\u0117jusio lipid\u0173 metabolizmo, did\u0117ja cholesterolio kiekis [4].<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Labai b\u016bdingai kei\u010diasi i\u0161vaizda: hipotireoze sergan\u010dio paciento veidas bly\u0161kus, pabrink\u0119s, mimika skurdi. \u012e klausimus atsakin\u0117ja l\u0117tai, balsas storesnis ir grubesnis, negu \u012fprastai. Ap\u017ei\u016brint &ndash; lie\u017euvis didelis, jo \u0161onuose galima matyti dant\u0173 \u012fspaudus. Plaukai &#8211; sausi, l\u016b\u017ein\u0117jantys, da\u017enai i\u0161slink\u0119 net antaki\u0173 srityje. Oda sausa, \u0161alta, kiek pabrinkusi, bly\u0161ki. \u0160ie po\u017eymiai atsiranda ne tik d\u0117l energijos apykaitos sul\u0117t\u0117jimo, bet ir d\u0117l suma\u017e\u0117jusios prakaito ir riebalini\u0173 liauk\u0173 veiklos bei da\u017enai kartu esan\u010dios anemijos [5]. P\u0117dos ir pla\u0161takos gali atrodyti kiek padid\u0117jusios, bet ne d\u0117l patologinio kaul\u0173 augimo, o d\u0117l pabrinkim\u0173. Atsiranda bendras raumen\u0173 silpnumas, m\u0117\u0161lungiai, mialgijos. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Neurologin\u0117 simptomatika gali pasireik\u0161ti rie\u0161o kanalu sindromu, galvos svaigimu, \u012fvairiomis parestezijomis, sul\u0117t\u0117jusiais sausgysli\u0173 refleksais, o kartais net <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/depresija\/4455\">depresija<\/a> arba bipoliniais sutrikimais [6].<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">Hipotireoz\u0117<\/a> pa\u017eeid\u017eia ir \u0161irdies kraujagysli\u0173 sistem\u0105, sukeldama bradikadij\u0105, suma\u017e\u0117jusi\u0105 \u0161irdies i\u0161metimo frakcij\u0105, kartais &ndash; \u0161irdies nepakankamum\u0105. Kraujosp\u016bdis gali kiek suma\u017e\u0117ti arba atsirasti nedidel\u0117 diastolin\u0117 hipertenzija. Elektrokardiogramoje registruojamas retas ritmas, suma\u017e\u0117j\u0119s danteli\u0173 volta\u017eas, galimas QT intervalo prailg\u0117jimas bei T dantelio suplok\u0161t\u0117jimas arba inversija.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Vir\u0161kinimo sistema taip pat reaguoja \u012f skydliauk\u0117s hormon\u0173 tr\u016bkum\u0105 &ndash; atsiranda viduri\u0173 u\u017ekiet\u0117jimas, suma\u017e\u0117ja apetitas, gali b\u016bti nustatyta tul\u017eies p\u016bsl\u0117s hipokinezija bei sul\u0117t\u0117jusi \u017earnyno motorika.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Vaisingo am\u017eiaus \u017emon\u0117ms gali sutrinkti lytini\u0173 hormon\u0173 sintez\u0117 bei sekrecija, moterims &#8211; atsirasti antrin\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/amenoreja\/55011\">amenor\u0117ja<\/a> bei nevaisingumas. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Kraujodaros sistemos pa\u017eeidimas da\u017eniausiai pasirei\u0161kia anemija, kuri gali atsirasti d\u0117l daugelio veiksni\u0173: sutrikusio gele\u017eies bei vit B<sub>12<\/sub> pasisavinimo, prislopintos kraujodaros kaul\u0173 \u010diulpuose, suma\u017e\u0117jusios eritropoetino sintez\u0117s inkstuose. Jeigu n\u0117ra kit\u0173 anemijos prie\u017eas\u010di\u0173 (pvz. kraujavimo), klinikiniai ir laboratoriniai anemijos po\u017eymiai i\u0161nyksta, paskyrus gydym\u0105 tiroksinu. \u012evairi\u0173 \u0161altini\u0173 duomenimis, anemija hipotireoz\u0117s metu nustatoma nuo 20 iki 60% pacient\u0173 [5]. Granuliocit\u0173, leukocit\u0173 ir trombocit\u0173 kiekis paprastai i\u0161lieka normalus. Retais atvejais nustatoma leukopenija gali b\u016bti susijusi su vit B12 arba folin\u0117s r\u016bg\u0161ties deficitu.<span style=\"mso-ansi-language: EN-US\" lang=\"EN-US\"><o:p><\/o:p><\/span><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">I\u0161vardinti hipotireoz\u0117s simptomai yra nespecifiniai, da\u017enai labai nery\u0161k\u016bs arba pacientas gali j\u0173 nepasteb\u0117ti, nes liga vystosi palaipsniui ir organizmas adaptuojasi prie nuolat ma\u017e\u0117jan\u010dio skydliauk\u0117s hormon\u0173 kiekio. Tod\u0117l apie \u0161i\u0105 lig\u0105 reikia pagalvoti ir tikslingai atlikti specifinius tyrimus. <o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><o:p><font size=\"2\">&nbsp;<\/font><\/o:p><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><b style=\"mso-bidi-font-weight: normal\"><font size=\"2\">Hipotireoz\u0117s diagnostika<o:p><\/o:p><\/font><\/b><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 72pt; mso-list: l0 level2 lfo2; tab-stops: list 72.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">1.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Anamnez\u0117 &ndash; ypatingai svarbu, siekiant i\u0161siai\u0161kinti galimus simptomus.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 72pt; mso-list: l0 level2 lfo2; tab-stops: list 72.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">2.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Ap\u017ei\u016bra.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 72pt; mso-list: l0 level2 lfo2; tab-stops: list 72.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">3.<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Hormoniniai tyrimai: TTH ir, jeigu reikia, LT4.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt 17.85pt\"><font size=\"2\">Hormonini\u0173 tyrim\u0173 interpretacija:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 71.85pt; mso-list: l1 level2 lfo3; tab-stops: list 71.85pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: Arial\" lang=\"EN-US\"><span style=\"mso-list: Ignore\">1.<span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><i style=\"mso-bidi-font-style: normal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">TTH normalus<\/span><\/i><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">. Nesant ai\u0161ki\u0173 klinikini\u0173 simptom\u0173, tolesnis paciento tyrimas netikslingas, nes normalus TSH kiekis leid\u017eia atmesti tiek pirmin\u0119, tiek antrin\u0119 hipotireoz\u0119. Jeigu pacientas turi b\u016bding\u0173 simptom\u0173, galima i\u0161tirti LT4 diagnoz\u0117s patikslinimui.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 71.85pt; mso-list: l1 level2 lfo3; tab-stops: list 71.85pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: Arial\" lang=\"EN-US\"><span style=\"mso-list: Ignore\">2.<span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><i style=\"mso-bidi-font-style: normal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">TTH padid\u0117j\u0119s, LT4 suma\u017e\u0117j\u0119s<\/span><\/i><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">. Tai klasikin\u0117 kombinacija, nurodanti pirmin\u0119 hipotireoz\u0119. Tikslingi papildomi tyrimai prie\u017easties nustatymui.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 71.85pt; mso-list: l1 level2 lfo3; tab-stops: list 71.85pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: Arial\" lang=\"EN-US\"><span style=\"mso-list: Ignore\">3.<span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><i style=\"mso-bidi-font-style: normal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">TTH padid\u0117j\u0119s, LT4 normalus<\/span><\/i><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">. Tokie rezultatai da\u017eniausiai nusako subklinikin\u0119 hipotireoz\u0119, kuomet skydliauk\u0117 dar paj\u0117gia sintetinti reikaling\u0105 hormon\u0173 kiek\u012f, bet tik esant padid\u0117jusiai stimuliacijai.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 71.85pt; mso-list: l1 level2 lfo3; tab-stops: list 71.85pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: Arial\" lang=\"EN-US\"><span style=\"mso-list: Ignore\">4.<span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><i style=\"mso-bidi-font-style: normal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">TTH padid\u0117j\u0119s, LT4 padid\u0117j\u0119s<\/span><\/i><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">. Reta kombinacija, leid\u017eianti \u012ftarti TTH gaminan\u010di\u0105 hipofiz\u0117s adenom\u0105 arba skydliauk\u0117s hormon\u0173 rezistencijos sindrom\u0105. <o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 71.85pt; mso-list: l1 level2 lfo3; tab-stops: list 71.85pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: Arial\" lang=\"EN-US\"><span style=\"mso-list: Ignore\">5.<span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><i style=\"mso-bidi-font-style: normal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">TTH suma\u017e\u0117j\u0119s, LT4 suma\u017e\u0117j\u0119s<\/span><\/i><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">. Centrin\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/suaugusiuju-hipotireoze-\/61185\">hipotireoz\u0117<\/a>, kuri\u0105 reikia diferencijuoti su esamu arba neseniai buvusiu tireotoksikoz\u0117s gydymu (J<sup>131<\/sup>, operacija, medikamentais) arba centrin\u0117s kilm\u0117s hormon\u0173 deficitu.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 71.85pt; mso-list: l1 level2 lfo3; tab-stops: list 71.85pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: Arial\" lang=\"EN-US\"><span style=\"mso-list: Ignore\">6.<span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><i style=\"mso-bidi-font-style: normal\"><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">TTH suma\u017e\u0117j\u0119s, LT4 padid\u0117j\u0119s arba normalus<\/span><\/i><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">. Klinikin\u0117 arba subklinikin\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/hipertireoze\/72674\">hipertireoz\u0117<\/a> <\/span><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">[7]<\/span><span style=\"line-height: 150%; font-family: Arial; color: black; font-size: 10pt; mso-ansi-language: EN-US; mso-fareast-language: JA; mso-fareast-font-family: \\'MS Mincho\\'\" lang=\"EN-US\">.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Laboratoriniai tyrimai turi b\u016bti kartojami dinamikoje, priklausomai nuo rezultat\u0173 bei taikomo gydymo.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 17.85pt; margin: 0cm 0cm 0pt\"><font size=\"2\">Jeigu klinikini\u0173 ir laboratorini\u0173 tyrim\u0173 duomenys leid\u017eia \u012ftarti hipotireoz\u0119, tuomet reikalingi papildomi tyrimai prie\u017easties nustatymui:<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">&#8211;<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Antik\u016bnai prie\u0161 skydliauk\u0117s peroksidaz\u0119 (anti-TPO) &ndash; padid\u0117j\u0119s j\u0173 kiekis b\u016bdingas l\u0117tiniam autoimuniniam tiroiditui.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">&#8211;<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Skydliauk\u0117s echoskopija &ndash; reikalinga skydliauk\u0117s audinio strukt\u016bros ir galim\u0173 mazgini\u0173 pakitim\u0173 \u012fvertinimui.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 36pt; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt\"><span style=\"mso-fareast-font-family: Arial\"><span style=\"mso-list: Ignore\"><font size=\"2\">&#8211;<\/font><span style=\"font: 7pt \\'Times New Roman\\'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><font size=\"2\">Skydliauk\u0117s skenograma parodo geb\u0117jim\u0105 sukaupti radioaktyv\u0173 jod\u0105 (J<sup>131<\/sup>). Pirmin\u0117s hipotireoz\u0117s metu J<sup>131<\/sup> kaupimas da\u017eniausiai suma\u017e\u0117j\u0119s.<o:p><\/o:p><\/font><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><b style=\"mso-bidi-font-weight: normal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Hipotireoz\u0117s gydymas<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Gydymui skiriama pakaitin\u0117 hormon\u0173 terapija T<sub>4<\/sub> (L-tiroksinu). Doz\u0117 koreguojama pagal TSH, siekiant koncentracijos <span style=\"color: #333333\">0.4&ndash;4.5 mU\/L (normos ribos).<\/span><o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Terapin\u0117 L-tiroksino doz\u0117 pasiekiama palaipsniui, ypa\u010d vyresnio am\u017eiaus \u017emon\u0117ms. Rekomenduojama prad\u0117ti nuo 25 mikrogram\u0173\/dienai ir doz\u0119 didinti po 25 mikrogramus kas 3-4 savaites. Jaunesnio am\u017eiaus \u017emon\u0117ms galima prad\u0117ti nuo 50 mikrogram\u0173 ir didinti grei\u010diau, priklausomai nuo atsako <\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">[8]<\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: 18pt; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Retais atvejais gydymui galima skirti L<sub>3<\/sub> (liotironin\u0105). Jo veikimas identi\u0161kas L-tiroksinui, ta\u010diau metabolizmas daug greitesnis, tod\u0117l naudojamas esant miksedeminei komai.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><a name=\"sec12-ch152-ch152f-323\"><\/a><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><b style=\"mso-bidi-font-weight: normal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">Literat\u016bros s\u0105ra\u0161as:<o:p><\/o:p><\/span><\/b><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">1.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Roberts, C.G. and P.W. Ladenson, <i style=\"mso-bidi-font-style: normal\">Hypothyroidism.<\/i> Lancet, 2004. <b style=\"mso-bidi-font-weight: normal\">363<\/b>(9411): p. 793-803.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">2.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><i style=\"mso-bidi-font-style: normal\">Screening for thyroid disease: recommendation statement.<\/i> Ann Intern Med, 2004. <b style=\"mso-bidi-font-weight: normal\">140<\/b>(2): p. 125-7.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">3.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Tagliaferri, M., et al., <i style=\"mso-bidi-font-style: normal\">Subclinical hypothyroidism in obese patients: relation to resting energy expenditure, serum leptin, body composition, and lipid profile.<\/i> Obes Res, 2001. <b style=\"mso-bidi-font-weight: normal\">9<\/b>(3): p. 196-201.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">4.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Ineck, B.A. and T.M. Ng, <i style=\"mso-bidi-font-style: normal\">Effects of subclinical hypothyroidism and its treatment on serum lipids.<\/i> Ann Pharmacother, 2003. <b style=\"mso-bidi-font-weight: normal\">37<\/b>(5): p. 725-30.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">5.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Antonijevic, N., et al., <i style=\"mso-bidi-font-style: normal\">[Anemia in hypothyroidism].<\/i> Med Pregl, 1999. <b style=\"mso-bidi-font-weight: normal\">52<\/b>(3-5): p. 136-40.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">6.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Guimaraes, J.M., et al., <i style=\"mso-bidi-font-style: normal\">Depression symptoms and hypothyroidism in a population-based study of middle-aged Brazilian women.<\/i> J Affect Disord, 2009. <b style=\"mso-bidi-font-weight: normal\">117<\/b>(1-2): p. 120-3.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">7.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Dayan, C.M., <i style=\"mso-bidi-font-style: normal\">Interpretation of thyroid function tests.<\/i> Lancet, 2001. <b style=\"mso-bidi-font-weight: normal\">357<\/b>(9256): p. 619-24.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; text-indent: -56pt; margin: 0cm 0cm 0pt 56pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">8.<span style=\"mso-tab-count: 1\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Baskin, H.J., et al., <i style=\"mso-bidi-font-style: normal\">American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism.<\/i> Endocr Pract, 2002. <b style=\"mso-bidi-font-weight: normal\">8<\/b>(6): p. 457-69.<o:p><\/o:p><\/span><\/p>\n<p style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt\" class=\"MsoNormal\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\"><o:p>&nbsp;<\/o:p><\/span><\/p>\n<p><a href=\"https:\/\/pasveik.lt\/ligos-ir-sindromai\/5;system;11\">&nbsp;Endokrinin\u0117s sistemos ligos<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p style=\"text-align: justify\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt; mso-ansi-language: EN-US\" lang=\"EN-US\">Suaugusi<\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt\">\u0173j\u0173 hipotireoz\u0117, dar kitaip vadinama miksedema, literat\u016bros \u0161altiniuose apra\u0161oma jau nuo 1874 met\u0173. Tuomet Klinikin\u0117 Draugija Londone i\u0161studijavo ir apra\u0161\u0117 \u0161i\u0105 lig\u0105, pa\u017eym\u0117dama svarbiausius po\u017eymius, kurie puikiai tinka skydliauk\u0117s hipofunkcijai apibr\u0117\u017eti ir \u0161iomis dienomis. <\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[322,173,259,2021,138],"site":[],"post_item_type":[27345],"class_list":["post-10215","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-laboratoriniai","tag-plaukai","tag-preparatai","tag-tiroiditas","tag-vaistai"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/10215","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=10215"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/10215\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=10215"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=10215"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=10215"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=10215"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=10215"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}