Qaytarish

Tiroksin (T4), umumiy

Kod:9002|CPT:84436|LOINC:3026-2

Sinonimlar
Общий Т4тетрайодтиронинFree T4T4TetraiodothyronineThyroxineTotal T4Total tetraiodothyronine
KabiTiroksin (T4)

Tahlil ma'lumotlari

Tadqiqot usuli

  • Elektrokimyoluminessent immunoanaliz (ECLIA)
  • Kimyoluminessent immunoanaliz (CLIA)

Kutilayotgan natija topshirish vaqti

1 kun

Maxsus tayyorlik

  • Avoid high‑dose biotin (vitamin B7/B8, vitamin H, coenzyme R) for at least 72 hours before collection and inform the ordering clinician about any biotin use.
  • Do not eat for 2–3 hours before the blood draw; water is allowed.
  • With clinician approval, hold steroid and thyroid hormone medications for 48 hours prior to collection.
  • Avoid vigorous exercise and significant emotional stress for 24 hours before collection.
  • Do not smoke during the 3 hours preceding collection.

Qanday foydalanish

Umumiy tiroksin (T4) testi qalqonsimon bez funksiyasini baholash, shuningdek qalqonsimon bez kasalliklarini diagnostika va monitoring qilish uchun qo‘llanadi. Ko‘rsatkichlar gipotiroidizmda va og‘riqli subakut tireoiditning uchinchi bosqichida pasayadi; giper­tiroidizmda, subakut tireoiditning boshlang‘ich fazasida hamda Xashimoto kasalligi bilan bog‘liq tirotoksikozda oshadi. Natijalar odatda TSH bilan birgalikda va zarurat bo‘lganda qo‘shimcha qalqonsimon bez testlari bilan talqin qilinadi. Umumiy T4 (tetraiyodtironin) qalqonsimon bez disfunksiyasi bilan bog‘liq ayollardagi bepushtlikni baholashga ham hissa qo‘shadi va tug‘ma gipotiroidizm skriningi uchun qo‘llaniladi. Qalqonsimon bez kasalligini davolanayotgan bemorlarda terapevtik monitoring uchun qo‘llanadi.

Cheklovlar

Umumiy T4 bazal metabolik tezlik va energiya utilizatsiyasini boshqaruvchi asosiy gormonlardan biri bo‘lgan tiroksinning oqsilga bog‘langan va erkin fraksiyalarining yig‘indisini aks ettiradi. O‘lchanadigan konsentratsiya zardobdagi bog‘lovchi oqsillarga — ayniqsa tiroksin‑bog‘lovchi globulin (TBG) va albuminga — bog‘liq; shuning uchun bog‘lanish quvvati yoki miqdoridagi o‘zgarishlar biologik faol erkin fraksiyada mos ravishda o‘zgarish bo‘lmasdan ham umumiy T4 ni o‘zgartirishi mumkin. Umumiy T4 qalqonsimon bezdan tashqari (nontireoid) tizimli kasalliklarda g‘ayritabiiy bo‘lishi mumkin. Oilaviy disalbuminemik gipertiroksinemiya klinik jihatdan eutiroid bo‘lgan shaxslarda umumiy T4 ning oshishi va erkin tiroksin indeksining yuqoriligi bilan, T3 va T3 yutilishi normal bo‘lishi fonida namoyon bo‘ladi; talqinni yengillashtirish uchun T3 yutilishi ko‘pincha T4 bilan birga buyuriladi. Umumiy T4 subakut tireoiditda fazaga qarab o‘zgaradi. Yodning ortiqcha qabul qilinishi va ekzogen tiroksin umumiy T4 konsentratsiyalarini oshirishi mumkin.

O'lchov birligimcg/dL
Referens oraliq
YoshMinMaks
≤3d4.812.7
Ko'rsatmalarWorkup of suspected hyperthyroidism with symptoms such as tachycardia, irritability, weight loss, insomnia, tremor, diarrhea, photophobia or visual disturbance, periorbital edema, ocular dryness or erythema, or exophthalmos, Assessment of possible hypothyroidism presenting with weight gain, xerosis, constipation, cold intolerance, edema, alopecia, or menstrual irregularity; severe disease may lead to arrhythmia, myocardial ischemia, or myxedema coma; in children, risk of developmental delay/cretinism, Preventive screening of thyroid function in conjunction with other laboratory studies, Periodic monitoring of thyroid disease therapy together with TSH (at least every 3 months), Evaluation during pregnancy in individuals with thyroid disease or risk factors for thyroid dysfunction, Neonatal testing in the first days of life for infants born to mothers with thyroid disease

Natija og'ishlarining mumkin sabablari

Oshgan daraja

  • amiodarone
  • aspirin
  • biotin
  • danazol
  • familial dysalbuminemic hyperthyroxinemia
  • furosemide
  • iodine (excess intake)
  • levothyroxine
  • liver disease
  • propranolol
  • propylthiouracil
  • tamoxifen
  • valproic acid

Pasaygan daraja

  • decreased tbg
  • nonthyroidal illness

Namunangiz talablari

NamunangizZardob
ContainerOltin/yo'lbars qopqoqli probirka (SST, gel ajratgich)
Hajm1 mL (min 0.7 mL)
Saqlash tayyorlikXona harorati, Sovutilgan, Muzlatilgan

References

Franklyn JA, Davis JR, Ramsden DB, Sheppard MC. Phenytoin and thyroid hormone action. J Endocrinol. 1985 Feb;104(2):201-204. PubMed 3918137

Gharib H, Klee GG. Familial euthyroid hyperthyroxinemia secondary to pituitary and peripheral resistance to thyroid hormones. Mayo Clin Proc. 1985 Jan;60(1):9-15. PubMed 2981377

Gruhn JG, Barsano CP, Kumar Y. The development of tests of thyroid function. Arch Pathol Lab Med. 1987 Jan;111(1):84-100. PubMed 3541847

Surks MI, Chopra IJ, Mariash CN, Nicoloff JT, Solomon DH. American Thyroid Association guidelines for the use of laboratory tests in thyroid disorders. JAMA. 1990 Mar 16;263(11):1529-1532. PubMed 2308185