Comprehensive treatment of patients with autoimmune thyroiditis using laser technologies

Abstract

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.