基于轨迹分析的Graves病患者甲状腺体积动态变化对抗甲状腺药物治疗反应的预测价值OA

Objective To investigate the dynamic changes of thyroid volume and their relationship with treat-ment response in newly diagnosed adult patients with Graves'disease(GD)undergoing antithyroid drug(ATD)therapy.Methods A retrospective analysis was conducted on thyroid function,thyrotropin receptor antibody(TRAb)levels,and thyroid volume at baseline and at 3 and 6 months of ATD treatment.Latent class growth modeling(LCGM)was used to identify thyroid volume trajectories,and independent factors asso-ciated with ATD efficacy were analyzed.Results Baseline thyroid volume was positively correlated with free triiodothyronine(FT3),free thyroxine(FT4),TRAb levels,GREAT score,and time to FT4 normalization(P<0.05).The reduction in thyroid volume during treatment was positively correlated with decreases in FT4 and TRAb,but negatively correlated with baseline GREAT score(P<0.05).LCGM identified two distinct volume trajectories.Compared with the high-level trajectory group,the low-level group had lower baseline FT3,FT4,TRAb,and GREAT scores,as well as shorter time to achieve FT4 and overall thyroid function normalization(P<0.05).The low-level trajectory was an independent factor for FT4 normalization at 3 and 6 months(OR=3.92,95％CI:[1.40,11.28];OR=8.82,95％CI:[1.61,65.73]).Conclusion Regular monitoring of thyroid volume changes during ATD therapy is clinically valuable for evaluating treatment response.