SANTRAUKA Sergančiųjų skydliaukės ligomis laboratorinių rodiklių analizė rajono ligoninėje Daugėjant sergančiųjų skydliaukės ligomis, vis jaunesniame amžiuje nustatant skydliaukės veiklos pakitimus, LT4 ir TTH koncentracijos kraujo serume nustatymas yra reikšmingas savo diagnostine prasme šių ligų diagnostikoje. Tyrimo tikslas – įvertinti sergančiųjų skydliaukės ligomis pacientų hormonų LT4 ir TTH koncentracijos kraujo serume pokyčius rajono ligoninėje. Tyrimo uždaviniai: įvertinti skydliaukės rodiklių pokyčius ir jų reikšmę vertinant hormonų LT4 ir TTH koncentracijos tirtų pacientų kraujo serume kitimą, priklausomai nuo tiriamųjų pacientų lyties, amžiaus ir sezono. Medžiaga ir metodai. VšĮ Rokiškio rajono ligoninės laboratorijoje LT4 ir TTH koncentracija kraujo serume ištirta 257 pacientams. Iš jų, tiriamąją grupę sudarė 157 pacientai, kontrolinę grupę – 100. Tyrimai atlikti automatiniu imunologiniu analizatoriumi „Elecsys 1010“. Imunofermentiniai hormonų koncentracijos kraujo serume tyrimai skirti laisvo tiroksino (LT4) ir tirotropino kiekio (TTH) nustatymui žmogaus kraujo serume ir plazmoje in vivo. Šių tyrimų nustatymo metodai pagrįsti elektrochemoliuminescentine imunologine analize. Laisvas tiroksinas yra nustatomas konkurenciniu principu, specifinio anti-T4 antikūno, žymėto rutenio kompleksu pagalba. TTH nustatymo tyrimas pagrįstas dvipusės, sluoksniuotos struktūros principu, kur naudojami du specifiniai monokloniniai antikūnai prieš žmogaus TTH. Rezultatai ir išvados... [toliau žr. visą tekstą] / SUMMARY Analysis of indicators of thyroid pathology in a district hospital Since the number of people suffering from thyroid pathology is increasing and thyroid dysfunction is being diagnosed at an increasingly younger age, the determination of LT4 and TSH concentration in blood serum is meaningful for the diagnosis of such diseases. Study objective. To evaluate changes in LT4 and TSH concentrations in blood serum in patients with thyroid pathology in a district hospital. Study goals. To evaluate changes in thyroid indicators and their significance for the evaluation of changes in LT4 and TSH hormone blood serum concentrations in patients, depending on the gender and age of the patients and the season. Material and methods. LT4 and TSH blood serum concentrations of 257 patients were tested in the laboratory of Rokiškis District Hospital. The study group involved 157 patients and the control group included 100 patients. Tests were performed with an Elecsys 1010 immunological analyser. Immunoenzyme assay of hormone blood serum concentration is designed to measure the level of free thyroxin (LT4) and thyrotropin (TSH) in human blood serum and plasma in vivo. These test methods are based on electrochemoluminescent immunological analysis. Free thyroxin is detected by concurrent assay, with specific anti-T4 antibody labelled with ruthenium complex. The test to detect TSH is based on the principle of a two-sided layered structure, using two specific monoclonal antibodies against... [to full text]

Backgrond: The thyroid is a hormone-producing endocrine gland which is located in the front of the throat. The thyroid gland tissue contains several microscopic and spherical cavities called follicles. Thyroid hormones thyroxine (T4) and triiodothyronine (T3) are produced from the follicle cells and regulated by a so-called three-hormone sequence. Thyroid stimulating hormone (TSH) is the second hormone in the sequence and is produced from the pituitary gland. During pregnancy, the thyroid gland produces a greater amount of hormone to cater the needs of the mother and her offspring. When the gland produces too little hormone, it is called hypothyroidism. The disease causes symptoms such as chills, dryness, depression, and hair loss. The disease is divided into different types depending on the underlying cause of the disease. It is called primary hypothyroidism when disorders are in the thyroid gland itself and secondary when the problem is elsewhere in the body, usually in the hypothalamus. Hypothyroidism during pregnancy increases the risk of obstetric complications and can also lead to reduced IQ development in the fetus. Levothyroxine is a synthetic T4 and is used as a first-line drug in the treatment of hypothyroidism. Aim: The aim of this study was to investigate whether treatment with levothyroxine in subclinical hypothyroidism in pregnancy reduces the risk of pregnancy complications and also to analyze how thyroid autoimmunity and subclinical hypothyroidism affect the pregnant woman. Method: The work is a literature study conducted using six relevant published articles retrieved from the medical database and the search engine PubMed. Results: The studies 2,4,5 concluded that subclinical hypothyroidism and thyroid autoimmunity increase the risk of pregnancy complications. Studies 1 and 6 could not show any connection between these groups. Levothyroxine treatment in pregnancy with TSH value greater than 4 mIU/L is effective and leads to reduced risk of miscarriage, admission to neonatal wards and premature birth. In addition, the studies showed that the levothyroxine treatment in patients with TSH value less than 4mIU/L is without any significant effect.   Conclusion: The evidence at present, is unclear and there is insufficient data to determine the efficacy of treatment in patients with TSH levels below 2.5 mIU / L. More and larger clinical randomized controlled trials in pregnant women with subclinical hypothyroidism and positive for thyroperoxidase antibodies are needed to increase the validity of the treatment. In contrast, levothyroxine treatment in mothers with a TSH level in serum greater than 4 mIU / L is effective and of significant importance for both the woman and her offspring.