Роль дефицита цинка в развитии сердечно-сосудистых осложнений у больных с диффузно-токсическим зобом

Abstract

Backgraund. The development of cardiovascular complications in patients with diffuse-toxic goiter (DTZ) is an actual problem of thyroidology. (SSS) in patients with DTZ. Aims. To assess the contribution of zinc deficiency in the formation of cardiovascular complications in patients with Graves’ disease. Methods. The study included 113 women aged 25–60 years with the diagnosis of DTZ: 54.0% ( n = 61) with an average severity of thyrotoxicosis, 46.0% ( n = 52) with severe. Duration of the disease is 1–5 years. The control group consisted of 37 women aged 25–60 years without pathology of the thyroid gland and CCC. All patients were evaluated: in the blood – the level of thyroid-stimulating hormone (TTG), free thyroxine (over T4), the concentration of antibodies to the thyroid-stimulating hormone receptor (AT to RTTG); in the hair – the concentration of zinc; ultrasound (ultrasound) of the thyroid gland, echocardiography (EchoCG), daily monitoring of electrocardiography (CM ECG). Results. At DTZ deficiency of zinc in hair was observed in 66.4% ( n = 75), in the control group – in 27.0% ( n = 10) patients ( p = 0.01). More often, zinc deficiency was found at a severe degree of DTZ in 82.7% ( n = 43), atrial fibrillation (AF) in 77.4% ( n = 24) cases, in CHF – 78.8% ( n = 41) cases. The diagnostic model and the table of risk factors of CHF in points, including the definition of the level of zinc in the hair, are developed with the help of logistic regression. It is advisable to use the table for all patients with DTZ to determine the degree of CHF risk, with an average and high risk of developing CHF in the treatment of DTZ, it is shown to include zinc preparations. Conclusion. The obtained data allow to consider that the zinc deficiency increases the probability of development of AF and CHF in patients with DTZ of severe severity, needs diagnostics and correction.