Проґнозування віддалених результатів хірурґічного лікування вузлового ендемічного зобу на тлі автоімунного тиреоїдиту

Abstract

Aim. Determination of markers for clinical course prediction and choice of surgical intervention in patients with nodular goiter againstthe background of autoimmune thyroiditis by studuing the activity of oxidant, autoimmune and apoptotic processes. Materials and Methods.Ninety-fivepatients with unilateral nodular and multinodulargoiter againstthe background of autoimmune thyroiditis after the operation and in the remote postoperative period were examined. The activity of peroxide oxidation and the state of antioxidant systems, the level of proinflammatory cytokines, the activity of apoptotic processes, the thyroid gland function, levels of thyroid peroxidase antibodies, and structural changes in the gland revealed by ultrasound were examined. Result and Discussion. The study shows that in patients with nodulargoiter againstthe background of autoimmune thyroiditis a significant increase in the index of peroxidation and decrease in the activity of antioxidant defense systems against the suppression of apoptotic processes and the activation of proinflammatory cytokines are seen in the remote period after the surgical treatment. These processes lead to functional failure, hyperplasia and progressive structural pathology of the thyroid gland,  leading ultimately to progressive functional thyroid gland failure and inadequate long-term outcome of treatment. Conclusions. The conducted study allowed clarifyingindications and contraindications to the selection of surgical procedures in patients with endemic nodular goiter against the background of autoimmune thyroiditis, considering the parameters of oxidative processes, the level of proinflammatory cytokines, apoptosis and the functional capacity of the thyroid gland.