2012. – . 10, .2 616.441 – 07 (471.331) . . 1 , . . 2 АНАЛИЗ РАСПРОСТРАНЕННОСТИ ПАТОЛОГИИ ЩИТОВИДНОЙ ЖЕЛЕЗЫ В ТВЕРСКОМ РЕГИОНЕ 1 ( Кафедра эндокринологии, 2 кафедра общественного здоровья и здравоохранения ГБОУ ВПО «Тверская ГМА» Минздравсоцразвития России ) 2006- 2009 . - , . . , . . , - , , , - . : , , . ANALYSIS OF THYROID GLAND PATHOLOGY PREVALENCE IN THE TVER REGION D.V. Kileynikov, A.G. Ivanov Tver State Medical Academy The paper discusses the results of a study into the changes in the prevalence of thyroid gland diseases in the Tver Region in 2006–2009. The period under study saw an increase in the incidence of thyroid gland diseases in the region, which reflected the common trend in the Russian Federation. At the same time the incidence of primary diffuse euthyroid goiter tended to decrease. This fact can be explained by improvements in mass iodine-enrichment preventative measures carried out in the region. Therefore, the incidence of iodine deficiency pathologies can be managed on a population-based scale. The findings of the study can provide the basis for designing regional programs aimed at improving the performance of healthcare institutions, including those of primary level, in terms of effective medical treatment of thyroid gland diseases. Key words: thyroid gland pathology, prevalence, regional target programs. . ( [6]. 25 , - . 9,5% 21% 4 , , . 20 , 10 3 - . - , 3 100 . E.L. Mazzaferri et al. [10], 0,5–10 100 000. 18 000 , . - 60 – 3,3% [11]. – 7,7%, – 0,3%, , 16% ( 24% / ) [7]. 15 (1990–2006 .) 10,2 - , , 1200 - 4–21% [6, 8]. , ., ( ) , , (3,4 ). , ) 5,9%, [5, 8, 13]. NHANES-III ( ), 4,6%, – 4,3% [9]. 20% - , - , - , . - - 2012. – . 10, , - 100 . . 10% . , - ( ) 356,4 ( . 100 ; < 0,001) 24,3%, 2006 . – 470,6 ; < 0,001). .2 2009 . – , 1/3 . , - 100% , [3, 12, 13]. . 2006–2009 . . 2006- – 2009 . - 16,4% (546,3 ; < 0,001) 10,7% (73,1 66,0 < 0,001). 469,4 100 - 15,6% 2009 . 100 . ; 12,1% 2006 . , - . , , , , - , - . . ( . ) 2006–2009 . (2006 . – 88,7% 2009 . – 91,5%), (2006 . – 8,4% 2009 . – 5,9%), (2006 . – 2,9% 2009 . – 2009 . 1574,2 2006 . – 81,0 (1655,2 ; < 0,001). 100 1,3 (235,8 ; < 0,001), . 100 . , 185,0 2,6%). 2006499,5 (416,3 100 3,8% (15,0 2009 . 1,2 . ; < 0,001), 100 1,2 (39,6 32,3 ; < 0,01), . 11,2%). (13,5 - 14,4 100 . ; > 0,05). (2006- (2009 . – 29,9% 2006 . – 21,5%), ( 33,0 29,8%), (18,6 15,9%), (17,1 13,8%), (5,2 4,6%), (3,9 3,4%) (1,5 1,8%). - , 60,5 100 (4,0 4,3 . 100 2009- ) (64,4 ), . (4,7 3,1 100 ) ( > 0,05), ) . - , - , - (2009 . – 25,1% , . 2006 . – 39,7%). , ( 31,0%) (13,5 (13,9 7,8%), (5,5 5,0%), 3,5%) (2,1 2,9%). ( 36,7 10,1%), 2006 . – 250,0 (3,2 - 50,4%) (2006 . – 93,6 2009 . – 46,4 ; 100 1,2 . - (2009 . – 307,8 ; < 0,05). - (2009 . – 24,9 2006 . – 23,9 > 0,05). , (2006–2009 .) 100 . - 2012. – . 10, .2 , . - 52,7% 2006 . 2009 . – 54,4%). 1,2 43,5% 2009 ., (2006 . – 44,8% , , - . ) ( 26,6%. - , 2,5 , 2009 2,1%), . 2006– 23,3, ( < 0,01). . 2006 . 2009 . – 29,5 8,2 2006 . 167,4 100 . < 0,001), (131,8 133,8 ), ) 100 . > 0,05). (11,8 11,1 100 . ), (10,6 ), 100 . (1,2 1,0 100 . , 2006- . (1,0 1,1 100 . (5,1 5,5 ) ( 12,5 100 . (0,3 0,4 ) ) 5,9 ( < 0,01) 14,7 100 2006 . (3,5 2006 . 2009 .; > 0,05). 1 5000 0,6 100 , [2]. - 2009 . 283,0 ; < 0,001). 100 . 100 , (0,7 ). , 2009 . (62,1 55,8 100 . ; > 0,05). (2006 . – 6,7 100 . ) 1,7 46,6 35,3%, 51,0 4,7% . 2006- 2009 . – 3,9 ( < 0,01). 60,0% 2,4 23,4 . 16,1 ; < 0,001). 100 1,5 (18,4 ; < 0,001). - 100 2006 . 0,05). 2,6 . – 100 . ( 28,9 2006 . 2009 .; ( < 0,01), 1,8 ( 1,5 2009 .; ( < , (31,7 . 64,7 7,3 (274,6 100 . (8,4 2,3 2,2 > 0,05). , 19,7 2006–2009 100 - – 1,4 25,6 . 2,6 , 1,3 (217,4 40,0% (10,5 2009 .), , . . , 2006- . - ( > 0,05). - 100 . 2009 ., , . , ; 100 100 ( < 0,05) - 2009 . 55,4 (112,0 . 209,9 7,5 ; , - [1]. . - (76,4 2006 . 81,3 100 2009 .) (10,2 2006 . 11,8 100 . 2009 .) , ( > 0,05). [4]. ( - 100 . 33,5 ) ( > 0,05). 2 (1,8 3,8 100 < 0,05), 3 (0,3 0,1 ( < 0,01). . ; – 100 . - , . 2012. – . 10, , 2006–2009 . 4. , - , . . - , . , . - , , , . , - . . . . // . . – 2005. – 5. – . 40–42. 5. . . . : .– , 2002. – 216 . 6. . . . , , . – .: . – 2005. – 240 . 7. Canaris G.J. et al. The Colorado thyroid disease prevalence study // Arch. Intern. Med. – 2000. – V. 160. – 4. – P. 526–534. 8. Hollowell J.G. at al. Serum thyrotropin, thyroxine and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANESIII) // J. Clin. Endocrinol. Metab. – 2002. – V. 87. – P. 488–499. 9. Hollowell J.G. et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) // J. Clin. Endocrinol. Metab. – 2000. – V. 87. – 2. – P. 489– 499. 10. Mazzaferri E.L. et al. Current approaches to primary therapy for papillary and follicular thyroid cancer // J. Clin. Endocrinol. Metab. – 2001. – V. 86. – P. 1447–1463. 11. Sawin C.T. et al. The aging thyroid. Thyroid deficiency in the Framingham Study // Arch. Intern. Med. – 1985. – V. 145. – P. 1386–1388. 12. Tunbridge W.M. et al. The spectrum of thyroid disease in a community: the Whickham survey // Clin. Endocrinol. – 1977. – V. 7. – 6. – P. 481–493. 13. Vanderpump M.P. et al. Epidemiology and prevention of clinical and subclinical hypothyroidism // Thyroid. – 2002. – V. 12. – P. 839–847. .: , 1. .2 . // . – 2003. – . 1. – 1. – . 24–25. 2. . . . , . – 2006. – 28 . 3. . . [ . .]. – 1999. – 254 . . .– . - .– .: .: ( . . 8-910-640-93-51. )– -