ЭНДЕМИЧЕСКИЙ ЗОБ В РЕСПУБЛИКЕ САХА (ЯКУТИЯ)

Abstract

The authors conducted a study of the prevalence and features of the course of endemic goiter in the Republic of Sakha (Yakutia). According to the classification, the area is considered endemic for goiter if a goiter-altered gland is observed in more than 10 % of the population. There are light, medium and severe goiter endemias. It was revealed that, on average, the prevalence of endemic goiter in the republic is 28 %, which corresponds to the average severity of endemia, but the level of endemia is heterogeneous: there are areas of Yakutia with a severe degree. The peculiarities of endemic goiter in the Republic of Sakha (Yakutia) should also include the predominance of euthyroid forms (92.8 %) and a high (up to 57.3 %) proportion of thyroid nodules in areas with severe endemia. An important feature is the significant frequency of histologically confirmed thyroid malignancies: 8.2 % of the number of operated. In addition to the lack of iodine and a number of other trace elements in the environment, the body as a whole and, in particular, the thyroid is affected by a number of specific features of Yakutia: extreme temperature and light conditions, pronounced seasonality of climate, anomalies of geomagnetic fields. The predominance of nodular formations of the thyroid gland in endemic areas, especially polynodose (up to 86.9 %), is one of the prerequisites for the more frequent development of cervical-thoracic goiter. Cervical-thoracic goiter requires surgical intervention due to manifestations of compression of the mediastinal organs or the threat of their development. Unlike cervical goiter, with cervical-thoracic goiter, there is a problem of differential diagnosis with other intra-thoracic formations.