ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket20106154-62ketendo-4355Research ArticleСтатьиArticlesКлинико-лабораторные показатели и качество жизни пациентов с разной степенью компенсации гипотиреозаClinical and laboratory parameters and quality of life in patients with hypothyroidismMorgunovaT-ManuilovaYu-FadeyevV-20101503201061ТОМ 6, №1 (2010)5462Copyright © Morgunova T., Manuilova Y., Fadeyev V., 20102010Morgunova T., Manuilova Y., Fadeyev V.Morgunova T., Manuilova Y., Fadeyev V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/4355

В ходе исследования были оценены качество компенсации гипотиреоза, клинико-лабораторные показатели и качество жизни (MOS SF-36) пациентов с разной степенью компенсации, симптомы гипотиреоза, липидный спектр. У 200 пациентов с первичным гипотиреозом, наблюдавшихся в поликлиниках Москвы, определяли уровень ТТГ. Исходно гипотиреоз был компенсирован у 116 пациентов (58%), декомпенсирован – у 84 (42%), через 6 мес – у 75,5% пациентов, декомпенсирован – у 24,3%. В группе пациентов с уровнем ТТГ > 4 мЕд/л уровень физического функционирования был значимо ниже, чем у пациентов с компенсированным гипотиреозом (p = 0,019). Достижение компенсации сопровождалось значимым улучшением физического функционирования (p = 0,01). У пациентов с подавленным ТТГ показатели качества жизни не отличались от таковых при компенсированном гипотиреозе, однако достижение компенсации в этой группе больных сопровождалось улучшением ролевого эмоционального функционирования (W = -28; p < 0,016). В группе с ТТГ > 4 мЕд/л гиперхолестеринемия встречалась чаще, чем среди пациентов с компенсированным гипотиреозом (р =0,041), а через 6 мес отмечалось значимое снижение уровня общего холестерина (p = 0,09) и ЛПНП (p = 0,012). Несмотря на простоту заместительной терапии, большое число пациентов с гипотиреозом остается длительное время в состоянии декомпенсации. Активное динамическое наблюдение пациентов с гипотиреозом способствует улучшению компенсации заболевания. Компенсация гипотиреоза сопровождается улучшением качества жизни и показателей липидного спектра пациентов.

To evaluate the quality of compensation of hypothyroidism, clinical and labora-tory parameters and quality of life of patients with varying degrees of compensa-tion. Two hundred ambulatory patients with primary hypothyroidism receiving levothyroxine (L-T4) for more than one year participated in the study. Patients were examined at baseline and in 6 months. The scores for the Short-Form 36 (SF-36), symptoms of hypothyroidism and lipid profiles were analyzed. Only 58% (84/200) of patients were euthyroid. After 6 months of correction of replacement therapy, hypothyroidism was compensated in 75.5% of patients, decompensated – in 24.5%. We revealed lower level of scale of physical functioning (p = 0.019) among patients with increased level of TSH (>4 mU/l) in comparison with euthyroid patients. As soon as compensation was achieved patients showed better physical functioning (p = 0.01). There were no difference in the quality of life between the patients with decreased TSH and those with compensated hypothyroidism, however, the achievement of compensation was accompanied by improvement in role-emotional functioning (p < 0.016). In the group of patients with TSH > 4 mU/l hypercholesterolemia occurs more frequently than among patients with compensated hypothyroidism (p = 0.041), but the achievement of compensation led to significant reduction of total cholesterol (p = 0.09) and LDL (p = 0.012). Conclusion: In spite of relative simplicity of L-thyroxin replacement therapy many patients with hypothyroidism remain decompensate. Active followup of the patients with decompensated hypothyroidism improves the precision of thyroxine replacement and contribute to better quality of life and lipid profile.

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The authors declare that there are no conflicts of interest present.