The purpose of the study. To study the nature and dynamics of changes in humoral and local immunity during laser photodynamic therapy in patients with diffuse forms of autoimmune thyroiditis. Materials and methods. Laboratory tests of blood plasma were performed on 160 patients with long-lasting autoimmune thyroiditis in different age groups to determine humoral and local immunity. Here, information on the level of immunoglobulins A, G, M (IgA, IgG, IgM), the amount of interleukin-1 β (IL-1 β), tumor necrosis factor α (TNF-α) was determined in blood samples by the immunoenzyme method. The dynamics of laboratory parameters in all three groups of patients were studied on days 7 and 15 of treatment. These values were determined using reactives from “VectorBest” LLC (Russia). Results. In elderly patients with long-term autoimmune thyroiditis, a downward trend in TNF indices has been observed, which is an indication of the severity of the pathological process. The higher the amount of α2-MG in autoimmune thyroiditis and diffuse toxic urination, and the slower the normalization during treatment, the higher the probability of recurrence of the process. Conclusion. The combined use of modern laser technology in the treatment of patients with autoimmune thyroiditis expands the possibilities of conservative therapy and complements the arsenal of effective methods of treatment of this disease. The simplicity of the methods, ease of application, reliability, the absence of thermal effects on the thyroid gland creates ample opportunities for the application of this method in clinical practice.
Background.Immediate postoperative complications in the surgical treatment of autoimmune thyroiditis range from 8.5 to 15.0% of the total number of operated patients. Aim.Improving the results of surgical treatment of patients with autoimmune thyroiditis through the introduction of advanced surgical techniques and the use of CO2 laser in surgical interventions. Material and methods.The immediate postoperative results of surgical treatment of patients with autoimmune thyroiditis at the clinical base of the Scientific Center for Surgery named after M.A.Topchibashev for 20152021 were studied. The analysis was carried out in two groups with the inclusion of data from 207operated patients aged 27 to 73years, mostly patients with hypertrophic form of AIT. There were 183(88.4%) women and 24(11.6%) men. The first group consisted of 96(46.4%) patients who underwent an advanced surgical technique using a CO2 laser. The second group included 111(53.6%) patients who underwent surgery using traditional methods. The immediate postoperative specific complications (paresis of the larynx and hypoparathyroidism) and the results of surgical treatment of patients in two groups were compared. To test the statistical significance of differences, nonparametric Pearson's 2 and Student's t tests were used. Differences were considered statistically significant at p0.050. Results.The number of patients with complications among the patients of the first group was 3(3.1%), among the patients of the second group 16(14.4%) (2=7.870, p=0.006). The greatest number of complications was noted in patients with large goiter and recurrence of the disease in those previously operated on for autoimmune thyroiditis. The proposed method using a CO2 laser in the surgical treatment of patients with autoimmune thyroiditis can reduce the incidence of laryngeal paresis (2=4.057, p=0.044), hypoparathyroidism (2=4.381, p=0.037) and mortality (2=3.840, p=0.050), reduce the duration of hospital stay by 22% from 9.6 to 7.4days (t=2.588, p=0.007). Conclusion.The use of advanced surgical techniques, the performance of the operation in an adequate volume and the use of a CO2 laser made it possible to reduce the number of postoperative complications and improve the results of treatment of patients with autoimmune thyroiditis.
The relevance of the problem is due to the continuous increase in morbidity and the lack of effectiveness of existing treatment methods. The aim of the study is to improve the treatment results of patients with autoimmune thyroiditis by introducing modern laser technology. The study was conducted retrospectively from 2008 to 2021 and is based on data from the examination and treatment of 481 patients with autoimmune thyroiditis. The patients were divided into groups according to the applied treatment methods: the first group - 129 (29,19%) patients, the second group - 106 (23,98%) patients, and the third group - 207 (46,83%) patients. The concentrations of thyroid hormones, pituitary gland and antibodies to thyroid tissues in the blood serum of patients before and after treatment were studied and compared. Long-term treatment results were studied in 340 (70,7%) patients (t=8,8, p≤0,001). Photodynamic therapy, in combination with sessions of intravenous laser blood irradiation with lowintensity laser radiation, contributed to the normalization of thyroid hormone levels (TSH, FT4 and FT3) of the thyroid gland on the 15th day of treatment. Combining conservative treatment of patients with autoimmune thyroiditis with photodynamic therapy allows to obtain good and satisfactory results in 77,5% of cases, which gives reason to recommend photodynamic therapy in combination with sessions of intravenous laser blood irradiation with low-intensity laser radiation as an effective way to complement traditional conservative treatment
Background. The frequency of autoimmune thyroiditis reaches up to 40% among all thyroid gland diseases and ranks second among endocrinological diseases. Aim. Carrying out a comparative evaluation of the effectiveness of laser photodynamic therapy and traditional conservative treatment in diffuse form of autoimmune thyroiditis. Material and methods. The work is based on the examination and treatment data of 235 patients hospitalized in the Scientific Center of Surgery named after M.A. Topchubashov for the period from 2008 to 2021. Patients were divided into two groups based on the applied methods of treatment. Patients of the main group (106 people, 45.1%) received sessions of laser photodynamic therapy in combination with intravenous laser blood irradiation with low-intensity laser radiation. Patients in the control group (129 people, 54.9%) received a course of conservative therapy in combination with sessions of intravenous laser blood irradiation with low-intensity laser radiation. To test the statistical significance of differences in the concentrations of thyroid hormones, pituitary gland and antibodies to thyroid tissues in the blood serum of patients before and on the 15th day after treatment, Pearson's 2 test was used. In each group, the mean values of the analyzed clinical parameters, their mean error (m), 95% confidence interval, and the significance of intergroup differences were calculated according to Pearson's 2, MannWhitney U, and Student's t criteria. Differences were considered statistically significant at p 0.050. Results. In the main group on the 5th day of treatment, normalization of the main indicators of the inflammatory response occurred in 26 (24.5%) patients, in the control group in 16 (12.4%) patients (2=5.9, p=0.010). In patients of the main group, the levels of antibodies to thyroperoxidase on the 15th day after treatment, compared with their values before treatment, decreased by 5.65 times (t=8.4, p 0.001), the content of thyroid-stimulating hormone decreased by 2.18 times (t=6.9, p 0.001), free thyroxine increased 2 times (t=3.4, p 0.01), free triiodothyronine increased 1.71 times (t=1.4, p 0.05). The average values of antibodies to thyroperoxidase in the main group after treatment were within the normal range (31.575.75 IU/ml). Conclusion. The use of laser photodynamic therapy provides the best results in the treatment of patients with diffuse autoimmune thyroiditis.
Objective.This research ismeant to study the features of the clinical course and to developanoptimal algorithm for the diagnosis of autoimmune thyroiddiseases. Material and methods.The work is based on the examination and treatment data of 481 patients with autoimmune diseases of the thyroid gland, treated in the clinic.Diagnosis and treatment results of 481 patients were analyzed to develop an optimal algorithm for diagnosingautoimmune thyroiditis.The differential diagnostic capabilities of clinical, laboratory, and morphological examination methods of patients withautoimmune thyroiddiseases have been specified.The study of long-term results of treatment was carried out on 340patients, taking into account the various methods of treatment they underwent. Results.The analysis of existing diagnostic tools and methods allowed us to develop an optimal algorithm for diagnosingautoimmune thyroiddiseases, which is a complex of clinical, laboratory, and morphological methods that can reliably verify the diagnosis of autoimmune thyroiditis. Based on the examination results, it is possible to predict the likelihood of surgical treatment and to identify a group of patients in whom autoimmune processes can progress in the thyroid residue, contributing to the development of postoperative recurrence of the disease or causing its atrophy. Conclusion. Based on the study’s results, a rational algorithm for diagnostic search has been developed. The proposed algorithm allows, in the shortest possible time, to identify the presence of a form of autoimmune thyroiddisease and to determine the optimal tactics to treat patients withautoimmune thyroiditis based on clinical, laboratory, immunological tests and instrumental examinations.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.