Longitudinal trajectory of perioperative changes in thyroid-stimulating hormone and recovery after microwave ablation of benign thyroid nodules
10.3969/j.issn.1009-9905.2025.06.001
- VernacularTitle:促甲状腺激素围手术期变化纵向轨迹与甲状腺良性结节微波消融术后恢复的关系
- Author:
Bao-yu LUO
1
;
Jun JIANG
1
Author Information
1. 西南医科大学附属医院 甲状腺外科(四川 泸州 646000)
- Publication Type:Journal Article
- Keywords:
Benign thyroid nodules;
Thyroid-stimulating hormone;
Trajectory of change;
Microwave ablation
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(6):421-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the longitudinal trajectory of perioperative changes in TSH and recovery after microwave ablation of benign thyroid nodules.Methods:251 BTN patients admitted to our hospital from October 2021 to October 2024 were selected as the study subjects,and the group-based trajectory mod-eling(GBTM)model grouping principle was applied to determine the development trajectory of TSH levels.Multiple lin-ear regression was used to analyze the relationship between thyroid function and serum inflammatory factors before and after surgery in patients with different TSH level development trajectories;Cox regression was used to analyze the relationship between TSH level change trajectories and therapeutic efficacy and trend test was performed;binary log-binomial regression model was applied to calculate the relative risk(RR)of postoperative complication rates in different groups of patients.Results:In patients with BTN,four different trajectories of TSH level development were identified:low-stable(90 cases),low-growth(47 cases),medium-growth(63 cases),and high-growth(51 cases).There was a sta-tistically significant difference in surgical efficacy between the developmental trajectories of different TSH levels(P＜0.05),and the low-stable type had the highest apparent and overall efficacy rates,followed by the low-growth type.The postoperative and preoperative thyroid function indexes and serum inflammatory factors of patients with different TSH level development trajectories showed statistical differences(P＜0.05),the postoperative index levels of FT3 and FT4 were lower than preoperative,and the postoperative index levels of IL-8,hs-CRP,and TNF-α were higher than the preoperative ones,and the postoperative indexes of thyroid function(FT3,FT4)and serum inflammatory factors of the four groups of patients(IL-8,hs-CRP,TNF-α)showed statistically significant differences(P＜0.05).The results of multiple linear regression showed that TSH levels were negatively correlated(P＜0.05)with thyroid function indices(FT3,FT4)and positively correlated(P＜0.05)with serum inflammatory factors(IL-8,hs-CRP,TNF-α).The results of COX re-gression analysis showed that the difference in trend test was statistically significant(P＜0.001)among low-growth,medium-growth,and high-growth types,using low-stable type as a reference.The difference in the total postopera-tive complication rate among the four groups was statistically significant(P＜0.05),and the risk of total postoperative complications was elevated in patients with low-growth,medium-growth,and high-growth types compared with low-stable types(RR>1,P＜0.05).Conclusion:TSH levels were closely associated with recovery after microwave ablation of benign thyroid nodules,TSH levels were negatively correlated with FT3 and FT4,and positively correlated with IL-8,hs-CRP,and TNF-α.The low-stabilized type had the highest apparent and total efficiency,followed by the low-growth type.
