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Abstract
COMPARATIVE STUDY OF THYROID STATE IN NEW CASES OF PULMONARY TUBERCULOSIS AND TUBERCULOSIS CASES TREATED PREVIOUSLY Matveyeva S.L. Kharkiv national medical university, Kharkiv, Ukraine Abstract. An epidemic situation on tuberculosis in Ukraine is characterized the height of relapses of the disease. Because tuberculosis shows an immune deficient disease, and a thyroid actively participates in forming of antituberculosis immunity, comparative study of thyroid state in new cases of tuberculosis and cases previously treated is of currency. In 60 patients (30 persons with new cases of tuberculosis and 30 persons previously treated) echostructure of thyroid is studied, and also the levels of free thyroxine, thyroid stimulating hormone and antibodies to thyroglobulin and thyreoperoxides are measured by immune-enzyme method in a blood stream. Pathology of echostructure of thyroid is diagnosed in 53, 33% of new cases of tuberculosis and in 60, 66% of cases previously treated. The level of free thyroxine was significantly lower and level of thyroid stimulating hormone was significantly higher in new cases comparing with persons previously treated. The percentage of autoimmune thyroiditis and the percentage subclinical hypothyroidism were higher in new cases comparing with persons previously treated. The changes found is the ground for recommendation to screen thyroid state persons with tuberculosis relapsed and treatment failure. Keywords: pulmonary tuberculosis, relapse, thyroid pathology. ПОРІВНЯЛЬНА ОЦІНКА ТИРЕОЇДНОГО СТАТУСУ ПРИ ПЕРШІ ВИЯВЛЕНОМУ І РАНІШЕ ЛІКОВАНОМУ ТУБЕРКУЛЬОЗІ ЛЕГЕНІВ С.Л.Матвєєва Харківський національний медичний університет, м. Харків, Україна Резюме. Епідемічна ситуація по туберкульозу в Україні характеризується зростанням рецидивів захворювання. Оскільки туберкульоз виявляє імунодефіцитним захворюванням, а щитовидна залоза активно бере участь у формуванні протитуберкульозного імунітету, порівняльне вивчення тиреоїдного статусу при уперше діагностованому і раніше лікованому туберкульозі легенів представляється актуальним. У 60 хворих(30 осіб з уперше діагностованим туберкульозом і 30 осіб з раніше лікованим туберкульозом легенів) вивчена эхоструктура щитовидної залози, а також иммуноферментативным методом досліджені рівні змісту у вільному кровотоку вільного тироксину, тиреотропного гормону гіпофіза і антитіл до тиреоглобуліну і тиреопероксидазе. Встановлена патологія эхоструктуры щитовидної залози у 53,33% хворих уперше діагностованим туберкульозом і у 60,66% раніше лікованих хворих. Рівень вільного тироксину було вірогідно знижено, а рівень тиреотропного гормону гіпофізу було вірогідно підвищено у хворих з вперше діагностованим туберкульозом порівнянні з раніше лікованими хворими. Відсоток осіб з ознаками аутоіммунного тиреоїдиту і субклінічного гіпотиреозу був вищий в групі раніше лікованих хворих. Виявлені зміни є основою для рекомендації скринінгу тиреоїдного статусу у осіб з рецидивом туберкульозу і випадків невдачі лікування. Ключові слова: легеневий туберкульоз, рецидив, тиреоїдна функція. СРАВНИТЕЛЬНАЯ ОЦЕНКА ТИРЕОИДНОГО СТАТУСА ПРИ ВПЕРВЫЕ ВЫЯВЛЕННОМ И РАНЕЕ ЛЕЧЕНОМ ТУБЕРКУЛЕЗЕ ЛЕГКИХ С.Л.Матвеева Харьковский национальный медицинский университет, г. Харьков, Украина Резюме. Эпидемическая ситуация по туберкулезу в Украине характеризуется ростом рецидивов заболевания. Так как туберкулез являет иммунодефицитным заболеванием, а щитовидная железа активно участвует в формировании противотуберкулезного иммунитета, сравнительное изучение тиреоидного статуса при впервые диагностированном и ранее леченом туберкулезе легких представляется актуальным. У 60 больных (30 лиц с впервые диагностированным туберкулезом и 30 лиц с ранее леченым туберкулезом легких) исследована эхоструктура щитовидной железы, а также иммуноферментативным методом определены уровни содержания в свободном кровотоке свободного тироксина, тиреотропного гормона гипофиза и антител к тиреоглобулину и тиреопероксидазе. Установлена патология эхоструктуры щитовидной железы у 53,33% больных впервые диагностированным туберкулезом и у 60,66% ранее леченых больных. Уровень свободного тироксина был достоверно ниже, а уровень тиреотропного гормона достоверно выше в группе ранее леченых больных. Процент лиц с признаками аутоиммунного тиреоидита и субклинического г гипотиреоза был выше в группе ранее леченых больных. Выявленные изменения являются основанием для рекомендации скрининга тиреоидного статуса у лиц с рецидивом туберкулеза и случаев неудачи лечения. Ключевые слова: легочный туберкулез, рецидив, тиреоидная функция.
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