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Заболевания щитовидной железы в пери- и постменопаузе (обзор литературы)

https://doi.org/10.33667/2078-5631-2019-4-33(408)-48-53

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Аннотация

Во время пери‑ и постменопаузы результаты исследований функции щитовидной железы должны интерпретироваться очень внимательно в связи с физиологическими изменениями секреции и метаболизма тиреотропного гормона и гормонов щитовидной железы. У женщин в постменопаузе увеличивается частота заболеваний щитовидной железы. Нет единого мнения в отношении обследования женщин в постменопаузе, хотя имеются данные о влиянии тиреоидного статуса на когнитивные функции, сердечно‑сосудистый риск, метаболизм костной ткани и продолжительность жизни. Постановка диагноза при любом заболевании щитовидной железы является сложной задачей у пожилых пациенток, так как симптомы схожи с менопаузальными. Лечение требует большего внимания в этой популяции, чем у молодых пациенток, так как высокие дозы L‑тироксина могут приводить к сердечно‑сосудистым осложнениям и увеличению скорости костного ремоделирования. Кроме того, радиоактивный йод является предпочтительным в лечении гипертиреоза у пожилых пациентов. В этой группе повышен риск развития узловых заболеваний и рака щитовидной железы. Риск оперативного лечения выше, а прогноз заболеваний хуже. Решение о необходимости применения менопаузальной гормональной терапии должно быть принято индивидуально независимо от наличия заболеваний щитовидной железы.

Об авторах

Я. З. Зайдиева
ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»
Россия
д. м. н., проф., рук. отделения гинекологической эндокринологии

г. Москва



А. В. Глазкова
ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»
Россия
м. н. с., отделение гинекологической эндокринологии

г. Москва



Е. В. Кручинина
ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»
Россия
н. с., отделение гинекологической эндокринологии 

г. Москва



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Для цитирования:


Зайдиева Я.З., Глазкова А.В., Кручинина Е.В. Заболевания щитовидной железы в пери- и постменопаузе (обзор литературы). Медицинский алфавит. 2019;4(33):48-53. https://doi.org/10.33667/2078-5631-2019-4-33(408)-48-53

For citation:


Zaidieva Y.Z., Glazkova A.V., Kruchinina E.V. Thyroid disease in peri‑ and postmenopause period (literature review). Medical alphabet. 2019;4(33):48-53. (In Russ.) https://doi.org/10.33667/2078-5631-2019-4-33(408)-48-53

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