Izifo Zamathuna

Isifo se-Graves sithinta u-16.7% wabantu abadala baseNdiya, okusenza sibe esinye sezifo ezivame kakhulu zokuzivikela komzimba. Izimpawu zesifo i-Graves zingahluka kumuntu nomuntu, ngokuvamile kuhlanganise nokukhathazeka, ukuthuthumela, kwesisindo, kanye nezinguquko ekushayeni kwenhliziyo. Ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele kusiza abantu abaningi ukuba balawule izimpawu zabo futhi baphile impilo evamile, eyanelisayo.

Siyini Isifo Samangcwaba?

Isifo se-Graves yisimo sokuzivikela komzimba lapho amasosha omzimba ehlasela ngephutha indlala yegilo evamile, okuyenza ikhiphe amahomoni amaningi egilo. Udokotela wase-Ireland uRobert Graves waqala ukuchaza lesi simo ngawo-1800, futhi simelela imbangela evamile ye-hyperthyroidism.

Indlala yegilo iyisitho esincane esimise okwemvemvane esitholakala ngaphambi kwentamo esidlala indima ebalulekile ekulawuleni imisebenzi ehlukahlukene yomzimba. Ngaphansi kwezimo ezijwayelekile, ikhiqiza amahomoni alawula:

• Ukulawulwa kwezinga lokushisa lomzimba
• Ukunakekelwa kwenhliziyo
• Ukulawulwa kwezinga le-Metabolic
• Ukuguqulwa kwamandla kusuka ekudleni
• Ukusebenza kwemisipha namathambo

Esifweni se-Graves, amasosha omzimba akhiqiza i-antibody ebizwa ngokuthi i-thyrotropin receptor antibody (TRAb). Le antibody iphazamisa ukusebenza okuvamile kwegilo ngokulingisa indima yehomoni ye-pituitary, okuholela ekukhiqizweni ngokweqile kwamahomoni egilo. Ukukhiqizwa ngokweqile kwala mahomoni kudala isimo se-hyperthyroidism, esingathinta izitho eziningi nezinhlelo zomzimba.

Lesi simo sihlukile kwezinye izifo zegilo ngoba sihilela ukusabela kokuzivikela komzimba lapho isimiso somzimba sokulwa nezifo singasebenzi kahle. 

Izimpawu Zezifo Zamathuna

Lokhu okulandelayo yizimpawu ezijwayelekile zesifo samathuna:

• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
• ukukhathazeka novalo
• Ukuncipha kwesisindo okungachazeki naphezu kokukhula kwesifiso sokudla
• Ukuphuma kwamathumbu njalo
• Izandla eziqhaqhazelayo
• Ukujuluka ngokweqile
• Kunzima ukulala
• Ubuthakathaka bemisipha
• Izinguquko emijikelezweni yokuya esikhathini kwabesifazane
• Ukungasebenzi kwe-Erectile emadodeni

Isici esiphawulekayo se-Graves' disease umphumela waso emehlweni, owaziwa ngokuthi i-Graves' ophthalmopathy. Kancane kancane, ezinye iziguli ziba ne-Graves' dermopathy, isimo sesikhumba esibonakala ngokuba bomvu kwesikhumba, ikakhulukazi ezinqeni naseziqongweni zezinyawo. 

Izimbangela Nezingozi Zokugula Kwamangcwaba

Abacwaningi bezokwelapha bathole ukuthi isifo sikaGraves siqala lapho amasosha omzimba ekhiqiza amasosha omzimba aqondise indlala yegilo. Lawa ma-antibodies, aziwa ngokuthi i-thyroid-stimulating immunoglobulins (TSI), akhohlisa indlala yegilo ukuba ikhiqize amanani amaningi amahomoni.

Kunezici eziningana ezandisa amathuba okuba nesifo se-Graves:

• Ubulili nobudala: Abesifazane banamathuba angama-7-8 okuba nalesi sifo, ikakhulukazi phakathi kweminyaka engama-30-50
• Umlando Womndeni: Abantu abanezihlobo ezinesifo i-Graves babhekene nengozi enkulu
• Ezinye izifo ze-Autoimmune: Izimo ezifana nesifo sikashukela sohlobo loku-1 noma i-rheumatoid arthritis zandisa ukuthinteka
• Ukubhema: Ukubhema ugwayi kwandisa kakhulu ubungozi futhi kungenza izinkinga zamehlo zibe zimbi kakhulu
• Ukukhulelwa: ukukhulelwa noma ukubeletha kwakamuva kungabangela ukuqala
• Ingcindezi Yomzwelo: Ukucindezeleka okukhulu ngokomzwelo noma ngokomzimba kungase kube nomthelela ekukhuleni
• Izici Zemvelo: Ukuchayeka kumagciwane athile noma amagciwane kungase kubangele lesi simo

Izinkinga ze-Graves' disease

Izinkinga ezibaluleke kakhulu zihlanganisa:

• Izinkinga Zenhliziyo: Lesi simo singabangela ukushaya kwenhliziyo okungajwayelekile (arrhythmia), okwandisa ingozi yokushaywa unhlangothi kanye nokuhluleka kwenhliziyo. I-hormone yegilo eyeqisayo yenza inhliziyo isebenze kanzima, okungase kuholele ezinkingeni ezinkulu zenhliziyo nemithambo yegazi.
• Izinkinga Zethambo: Lesi sifo singabangela i-osteoporosis, okwenza amathambo abe mncane ngendlela engavamile futhi abe buthakathaka, okwandisa ingozi yokuphuka.
• I-Thyroid Storm: Lesi simo esingavamile kodwa esisongela ukuphila kwenzeka lapho amazinga e-hormone yegilo eba phezulu kakhulu. Kudinga ukungenelela kwezokwelapha ngokushesha futhi kungabangela ukushisa okukhulu, ukushaya kwenhliziyo okusheshayo, nokuphelelwa ngamandla kwamanzi emzimbeni.
• Izinkinga Zombono: Cishe u-25% weziguli uba ne-Graves' ophthalmopathy (isifo samathuna samehlo), esingabangela ukuqunjelwa kwamehlo, ukushintsha kombono, futhi, ezimweni ezimbi kakhulu, ukulahlekelwa ukubona uma kungelashwa.
• Izingozi Zokukhulelwa: Isifo se-Graves esingalashiwe ngesikhathi sokukhulelwa singadala izinkinga ezinkulu, okuhlanganisa ukuphuphuma kwesisu, ukuzalwa ngaphambi kwesikhathi, kanye ne-pre-eclampsia.
• I-Goitre: Ukukhula kwe-goitre (indlala yegilo ekhulisiwe) kungenye inkinga engaba khona engabangela ubunzima bokugwinya noma ukuphefumula. 

Sifo

Inqubo yokuxilonga ngokuvamile ihilela ukubuyekezwa okuningiliziwe komlando wezokwelapha kanye nokuhlolwa ngokomzimba, ukunaka ngokukhethekile izici zegland yegilo kanye nezimpawu zamehlo.

Amathuluzi okuxilonga ayinhloko ahlanganisa ukuhlolwa kwegazi okuningana:

• Ukuhlolwa Komsebenzi Wegilo: Lezi zikala amazinga e-TSH (i-thyroid-stimulating hormone) namahomoni egilo (i-T4 yamahhala ne-T3 yamahhala)
• Ukuhlolwa kwe-Antibody Ye-thyroid: Lokhu kuthola i-TSI (amasosha omzimba avuselela igilo) kanye ne-TBII (i-thyrotropin ebopha ama-immunoglobulins avimbelayo)
• Ukutholwa kwe-iodine ene-Radioactive: Lokhu kuhlola kubonisa ukuthi i-iodine engakanani eqoqwa yindlala yegilo, okusiza ukuhlukanisa isifo sika-Graves kwezinye izimo zegilo
• I-Doppler Ultrasound: Ezigulini ezingakwazi ukuhlolwa kwe-radioactive, njengabesifazane abakhulelwe, odokotela bangasebenzisa i-Doppler ultrasound ukuhlola amaphethini okugeleza kwegazi endlaleni yegilo. Lokhu kuhlola okungahlaseli kungaveza ukugeleza kwegazi okwenyuka okujwayelekile ku-Graves' disease.

Ukwelashwa

I-Endocrinologists ibheka izindlela ezintathu eziyinhloko zokwelashwa kwezifo zamathuna:

• Imithi ye-Antithyroid: Le mithi isebenza ngokuvimbela ikhono legilo ukukhiqiza amahomoni. Zivame ukukhetha okokuqala ezinganeni nakubantu abadala.
• I-radioactive Iodine Therapy: Lokhu kwelashwa kubhubhisa amangqamuzana egilo asebenza ngokweqile kancane kancane. Odokotela bavame ukutusa ukwelashwa nge-iodine enemisebe kubantu abadala abangaphezu kweminyaka engama-40 nalabo abangazange basabele kahle emithini.
• Ukuhlinzwa Kwegilo: Ukungenelela ngokuhlinzwa, noma i-thyroidectomy, kususa ingxenye noma yonke indlala yegilo. Odokotela ngokuvamile batusa i-thyroidectomy ezigulini ezine-goiter enkulu noma lezo ezingakwazi ukubekezelela ezinye izindlela zokwelapha.

Uzoyibona Nini Udokotela

Iziguli kufanele zifune ukunakekelwa okuphuthumayo uma zithola izimpawu ezinzima ezihlobene nenhliziyo, njengokushaya kwenhliziyo okusheshayo noma okungajwayelekile noma kungazelelwe. umbono izinguquko. Abesifazane abakhulelwe abane-Graves' disease badinga ukunakwa okukhethekile futhi kufanele baxoxe ngezinketho zokwelapha eziphephile nethimba labo lezempilo.

Prevention

Odokotela batusa ukuguqulwa okuningana kwendlela yokuphila okungasiza ukunciphisa ingozi yokuthuthukisa noma ukubhebhethekisa isifo sika-Graves:

• Okucatshangwayo Kwezokudla: Nciphisa ukudla okune-iodine ephezulu, njenge-kelp nokhula lwasolwandle. Gwema izithako ze-iodine ngaphandle uma kunikezwe udokotela
• Ukuzivocavoca Okuvamile: Gcina indlela yokuphila esebenzayo ukuze uthuthukise umsebenzi we-thyroid kanye nempilo yonke
• Ukulawula Ukucindezeleka: Zijwayeze amasu okunciphisa ingcindezi njengokuzindla noma ukuvivinya umzimba okuvamile
• Ukuyeka Ukubhema: Yeka ukubhema, njengoba kwandisa ingozi yezifo futhi kungandisa izinkinga zamehlo
• Ukuphathwa kwe-Vitamin D: Qinisekisa amazinga anele kavithamini D ngokudla noma izithasiselo
• Impilo yamathumbu: Gxila ekudleni okunomsoco okuphansi kokudla okugayiwe kanye noshukela

Isiphetho

Abantu abanesifo i-Graves bangaphila ukuphila okuvamile, okunempilo ngokugadwa njalo kwezokwelapha kanye nokulungiswa kwendlela yokuphila. Ukuhlolwa njalo, ukubambelela emithini nemikhuba enempilo njengokudla okufanele nokulawula ingcindezi kudlala indima ebalulekile emiphumeleni yokwelapha eyimpumelelo.

Imibuzo Evame Ukubuzwa

1. Isifo sikaGraves sithinta bani?

Lesi simo sihlasela kakhulu abesifazane, kanti abesifazane banamathuba aphindwe kahlanu okuba naso kunabesilisa. Ubudala obujwayelekile bokuqala buba phakathi kweminyaka engama-30 nengama-60, nakuba kungenzeka kunoma iyiphi iminyaka. Abantu abanezinye izimo ze-autoimmune, njenge-rheumatoid arthritis noma uhlobo 1 sikashukela, babhekane nethuba elikhulayo lalesi simo.

2. Sivame kangakanani isifo se-Graves?

Isifo se-Graves sithinta cishe u-2-3% wabantu bomhlaba. Imelela imbangela evame kakhulu ye-hyperthyroidism, ibalwa ku-60-80% yazo zonke izimo. 

3. Ingabe isifo sikaGraves siwufuzo?

Nakuba singazuzwa ngokuqondile njengefa, isifo sikaGraves sinengxenye yofuzo. Ukuba nelungu lomndeni elinalesi simo noma okunye ukuphazamiseka kwe-autoimmune kwandisa ubungozi. Iphethini yefa iyinkimbinkimbi, ihlanganisa izici eziningi zofuzo nezemvelo.

4. Sibi kangakanani isifo sikaGraves?

Isifo se-Graves sidinga ukuphathwa ngokucophelela njengoba singaholela ezinkingeni ezinkulu uma singelashwa. Lesi simo singathinta amasistimu omzimba amaningi, okungase kubangele:

• Izinkinga zenhliziyo nokushaya kwenhliziyo okungajwayelekile
• bone ubuthakathaka kanye ne-osteoporosis
• Ukushintsha kokubona kanye nezinkinga zamehlo
• Izinkinga zokukhulelwa

5. Uyini umehluko phakathi kwe-hyperthyroidism kanye nesifo sikaGraves?

Isifo se-Graves wuhlobo oluhlukile lwe-hyperthyroidism olubangelwa impendulo ye-autoimmune. Nakuba zonke iziguli ezine-Graves’ disease zine-hyperthyroidism, akuzona zonke izimo ze-hyperthyroidism ezibangelwa isifo sika-Graves.

6. Ingabe isifo sikaGraves singelashwa ngokudla?

Ukudla kukodwa akukwazi ukwelapha isifo se-Graves, kodwa ukudla okunomsoco kusekela ukwelashwa okuphelele. Iziguli kufanele:

• Gada ukuthathwa kwe-iodine
• Gcina i-calcium eyanele futhi i-vitamin D amazinga
• Gwema ukudla okudala izimpawu

UDkt. Srinivas Kandula

MBBS, MD (General Medicine), DNB (Endocrinology)
Izibhedlela iGurunanak CARE, Musheerabad, Hyderabad, CARE Hospitals, Nampally, Hyderabad, CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529