FEATURES OF CHANGES IN ENDOTHELIAL SYSTEM PARAMETERS IN PATIENTS WITH DIFFUSE TOXIC GOITER
Keywords:
diffuse toxic goiter, thyroidectomy, endotheliitis, endothelial dysfunction, complications after thyroidectomy, pathogenesis, molecular biochemistryAbstract
Background. The pathogenesis of diffuse toxic goiter is still not fully understood. In the literature, more and more attention is paid to issues related to the processes occurring in the thyroid gland itself: prolifera- tion, apoptosis, and angiogenesis. These changes are known to be based on the development of endothe- lial dysfunction or endotheliitis because of a long course of hormonal disorders.
Purpose. To reveal the features of changes in the endothelial system parameters in patients with diffuse toxic goiter.
Methods. The study involved 293 patients with diffuse toxic goiter. All patients were subdivided by us into 3 subgroups: I subgroup of patients received thyreostatic conservative therapy for up to 1 year; II subgroup - for 1 to 3 years; III subgroup - more than 3 years. The state of the endothelial system was studied in terms of nitrates, nitrites, as well as the enzymatic activity of NO-synthases and Willebrand factor in the blood.
Results. A relatively stable picture of the ratio of NO in the dynamics of the examination of patients, has significant changes in parameters within the structural components of the constituent parts. The early peri- ods of the survey were characterized by the prevalence of the nitrate component, and the later ones - by the nitrite component. At the same time, the average data on the activity of enzymes of the endothelial sys- tem were represented by bipolar values.
Conclusion. Compensatory changes aimed at utilization of the products of the nitroxidergic regulatory system, as shown by our observations, were of a differentiated nature. Lengthening the terms of conserva- tive therapy of diffuse toxic goiter contributes to the suppression of changes in this functional activity.
