Iodine Nutrition, Thyroid-stimulating Hormone, and Related Factors of Postpartum Women from three Different Areas in China: A Cross-sectional Survey

Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women.Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured.Results The median UIC of total and lactating participants were 142.00µg/L and 139.95µg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels.Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.

不同剂量TSH抑制疗法对围绝经期甲状腺癌术后患者骨密度及血清Tg、MIP-1α水平的影响

目的探究不同剂量促甲状腺激素(Thyroid stimulating hormone,TSH)抑制疗法对围绝经期甲状腺癌术后患者骨密度及血清甲状腺球蛋白(Thyroglobulin,Tg)、巨噬细胞炎性蛋白-1α(Macrophage inflammatory protein-1 alpha,MIP-1α)水平的影响。方法回顾性选取2021年9月~2023年7月在我院接受治疗的110例围绝经期甲状腺癌术后患者为研究对象。根据不同的TSH治疗剂量将患者分为高剂量组和低剂量组,每组55例。治疗后观察评估两组治疗疗效;比较两组患者的游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)、TSH、Tg、癌胚抗原(Carcinoembryonic antigen,CEA)、MIP-1α、钙、磷及骨密度水平。结果高剂量组临床总有效率为87.27%,显著高于低剂量组的70.91%(P<0.05);治疗后,两组TSH水平明显下降,且高剂量组显著低于低剂量组(P<0.05),FT3及FT4水平均上升,且高剂量组高于低剂量组(P<0.05);血清Tg、CEA及MIP-1α水平明显降低,且高剂量组低于低剂量组(P<0.05);治疗后钙、磷及骨密度各指标水平差异无统计学意义(P>0.05)。结论高剂量的TSH抑制疗法相比低剂量的疗效更好,能更有效地抑制患者TSH的分泌,间接降低血清Tg和MIP-1α水平,且两种疗法均对患者的骨代谢不产生明显影响。

^(99m)TcO4-SPECT/CT甲状腺核素显像联合超声及TSH对甲状腺结节性质的诊断价值

目的通过高锝酸钠-单光子发射计算机断层显像/电子计算机X射线断层扫描技术(^(99m)TcO4-SPECT/CT)核素显像提供甲状腺结节功能状态、结节解剖特点以及超声检查联合血清促甲状腺激素(TSH)水平进一步鉴别诊断甲状腺结节的良恶性,客观评价甲状腺结节的良恶性情况,对甲状腺结节的良恶性做出早期诊断。方法对因甲状腺结节同时行^(99m)TcO4-SPECT/CT甲状腺核素显像、甲状腺B超及TSH水平检查的患者共80例(92个结节)进行回顾性分析,对比不同方法及联合检查对甲状腺结节的诊断效能。结果92个结节中良性74个,恶性18个;^(99m)TcO4-SPECT/CT甲状腺显像与超声检查比较灵敏度(77.8%)高,特异度(70.2%)及准确度(71.7%)低,假阳性率(29.7%)高,假阴性率(22.2%)低,两者之间灵敏度、特异度、准确度、假阳性率、假阴性率差异均具有统计学意义(P<0.05);两者准确度比较差异无统计学意义(P>0.05)。^(99)mTcO4-SPECT/CT甲状腺显像与超声检查比较灵敏度高,特异性及准确度低,假阳性率高,假阴性率低,两者之间灵敏度、特异度、准确度、假阳性率、假阴性率差异均具有统计学意义(P<0.05);两者准确度比较差异无统计学意义(P>0.05);^(99m)TcO4-SPECT/CT甲状腺显像与超声检查联合较单独核素、单独超声检查灵敏度(88.9%)、特异度(87.8%)、准确度(81.5%)高,假阳性率(12.1%)、假阴性率(11.1%)低;联合检查与单独核素特异度、准确度、假阳性率比较差异有统计学意义(P<0.05),灵敏度与假阴性率比较差异无统计学意义(P>0.05);联合检查与单独超声灵敏度、准确度、假阴性率比较差异有统计学意义(P<0.05);特异度与假阳性率比较差异无统计学意义(P>0.05)。结论超声可以作为甲状腺结节的首选检查方法,其特异性高,但灵敏度低。^(99m)TcO4-SPECT/CT甲状腺显像在提供功能和代谢信息的同时,能提供解剖信息;而血清TSH水平则可为甲状腺结节的良恶性鉴别提供重要的参考依据,尤其对于核素冷结节且超声实性结节的患者,更应参考其TSH水平,将三者结合起来判断甲状腺结节的性质,为临床提供恰当的治疗方案,这具有重要意义。

Analysis of the value and safety of thyroid-stimulating hormone in the clinical efficacy of patients with thyroid cancer

BACKGROUND Thyroid cancer(TC)is a common malignant tumor in the endocrine system.In recent years,the incidence and recurrence rates of TC have been raising due to increasing work pressure and irregular lifestyles.Thyroid-stimulating hormone(TSH)is a specific parameter for thyroid function screening.This study aims to explore the clinical value of TSH in regulating the progression of TC,so as to find a breakthrough for the early diagnosis and treatment of TC.AIM To explore the value and safety of TSH in the clinical efficacy of patients with TC.METHODS 75 patients with TC admitted to the Department of Thyroid and Breast Surgery of our hospital from September 2019 to September 2021 were selected as the observation group,and 50 healthy subjects were selected as the control group during the same period.The control group was treated with conventional thyroid replacement therapy,and the observation group was treated with TSH suppression therapy.The soluble interleukin(IL)-2 receptor(sIL-2R),IL-17,IL-35levels,free triiodothyronine(FT3),free tetraiodothyronine(FT4),CD3+,CD4+,CD8+,CD44V6,and tumor supplied group of factor(TSGF)levels were observed in the two groups.The occurrence of adverse reactions was compared between the two groups.RESULTS After treatment with different therapies,the levels of FT3,FT4,CD3+,and CD4+in the observation group and the control group were higher than those before treatment,while the levels of CD8+,CD44V6,and TSGF were lower than those before treatment,and the differences were statistically significant(P<0.05).More importantly,the levels of sIL-2R and IL-17 in the observation group were lower than those in the control group after 4 wk of treatment,while the levels of IL-35 were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of FT3,FT4,CD3+,and CD4+in the observation group were higher than those in the control group,and the levels of CD8+,CD44V6,and TSGF were lower than those in the control group.There was no significant difference in the overall incidence rate of adverse reactions between the two groups(P>0.05).CONCLUSION TSH suppression therapy can improve the immune function of patients with TC,lower the CD44V6 and TSGF levels,and improve serum FT3 and FT4 levels.It demonstrated excellent clinical efficacy and a good safety profile.

Correlation analysis of serum thyroglobulin,thyroid-stimulating hormone levels,and thyroid-cancer risk in thyroid nodule surgery

BACKGROUND Thyroglobulin(Tg)is one of the markers of thyroid cancer,and its concentration may be elevated in patients with malignant thyroid tumors.Thyroid-stimulating hormone(TSH)is secreted by the pituitary gland,which has a significant impact on thyroid gland function.Excessively high or low TSH levels may be associated with an increased risk of thyroid cancer.Thus,in-depth studies on the association of serum Tg and TSH levels with thyroid cancer risk in patients with thyroid nodules are warranted.This can help determine whether Tg and TSH levels can predict the degree of malignancy of thyroid nodules,which can in turn guide doctors in making accurate diagnoses and treatment decisions.Furthermore,such studies can provide more accurate diagnostic methods for thyroid nodules and help patients become aware of the presence of thyroid cancer as early as possible,thereby improving the success rate of treatment and prognosis.AIM To investigate the association of serum Tg and TSH levels with the risk of thyroid cancer in patients undergoing thyroid nodule surgery.METHODS The clinical data and laboratory examination results of 130 patients who underwent thyroid nodule surgery were retrospectively analyzed.Furthermore,their preoperative serum Tg and TSH levels were recorded.Histopathological examination conducted during follow-up revealed the presence of thyroid cancer.Correlation analysis were used to analyze the association of Tg and TSH levels with the risk of thyroid cancer.RESULTS Of the 130 patients,60 were diagnosed with thyroid cancer.Statistical analysis revealed a significant positive correlation between serum Tg levels and the risk of thyroid cancer(P<0.05).This suggests that high serum Tg levels are associated with an increased risk of thyroid cancer.However,no significant correlation was observed between serum TSH levels and the risk of thyroid cancer(P>0.05).CONCLUSION In patients who underwent thyroid nodule surgery,serum Tg levels exhibited a significant correlation with the risk of thyroid cancer but serum TSH levels did not.These findings suggest that serum Tg can serve as an important biomarker for assessing the risk of thyroid cancer in these patients.

亚临床甲状腺功能减退症患者血脂和Hcy水平及其与TSH的关系分析

目的:分析亚临床甲状腺功能减退症患者血脂和Hcy水平及其与TSH的关系。方法:择取2020年3月至2023年3月于本院收治的亚临床甲减患者119例(亚临床甲减组)。另选取同期于本院体检,健康体检指标各项正常者121例为正常对照组。比较不同人群血脂代谢、Hcy、TSH水平。比较亚临床甲减组中亚1组、亚2组血脂代谢、Hcy水平。经偏相关系数、多元线性回归分析血脂代谢、Hcy水平与TSH水平的相关性。结果:亚临床甲减组TC、TG、LDL-C、Hcy、TSH水平均高于正常对照组(P<0.05)。亚临床甲减组、对照组HDL-C、FT3、FT4水平比较,差异无统计学意义(P>0.05)。亚2组TC、LDL-C、Hcy水平均高于亚1组(P<0.05)。亚2组、亚1组TG、HDL-C、FT3、FT4水平比较,差异无统计学意义(P>0.05)。校正性别、年龄、BMI、吸烟史、FPG及TSH因素,结果得知TSH是TC、TG、LDL-C、Hcy水平异常的危险因素,而TSH与HDL-C线性回归关系无统计学意义(P>0.05)。结论:亚临床甲减患者的血脂代谢和Hcy水平发生一定变化,且会受到TSH的影响,故应加强亚临床甲减患者的血脂代谢和Hcy水平监测,为临床医生提供了新的视角来评估和管理亚临床甲减患者的心血管风险。

Comprehensive treatment of thyroid-stimulating hormone(TSH)-secreting pituitary adenoma:one case report

Thyroid-stimulating hormone(TSH)-secreting pituitary adenoma is a rare type in all pituitary tumors.Recently we treated a TSH-secreting pituitary tumor in our hospital.The patient had been treated for hyperthyroidism,in which methimazole had been prescribed for 10 years,but the symptoms had not been alleviated.MRI imaging demonstrated the typical features of a sellar tumor,and the diameter was approximately 2.7 cm.Based on the laboratory studies:T3 at 6.27 nmol/L,T4 at 260.10 nmol/L,FT3 at 17.22 pmol/L,FT4 at 76.06 pmol/L,TSH at 9.93 Mu/L,the patient was diagnosed with a TSH-secreting pituitary tumor and central hyperthyroidism.After the patient was given octreotide for one week,he received resection of tumor via single-nostril transsphenoidal approach.After discharge,the patient received the radiation therapy two courses about 20 days.Through the comprehensive treatment of surgery,radiotherapy and drugs,the patient received a satisfactory result.

超声引导下细针穿刺联合血清TSH水平对不同直径甲状腺结节的诊断效能分析

目的:分析不同直径甲状腺结节诊断中超声引导下细针穿刺细胞学检查(ultrasound-guided fine needle aspiration cytology,US-FNAC)联合促甲状腺激素(thyroid stimulating hormone,TSH)的诊断效能。方法:分析于我院进行诊断治疗的68例患者为例,按照结节直径予以分组,均予以US-FNAC诊断和TSH水平检测,以手术后的病理组织检查结果为金标准,评估US-FNAC联合血清TSH水平在良恶性结节鉴别诊断中的应用价值。结果:Bethesda分类等级越高,恶性率越高;TSH水平>5 IU/L、≤5 IU/L的恶性率分别为83.33%、16.13%;联合检测的符合率和敏感性随着结节直径提升而提升,但是组间数据不存在统计学意义。结论:US-FNAC联合TSH水平检测在不同直径甲状腺结节的鉴别诊断中有良好的应用价值,但是对于≥30mm结节敏感性较低,临床需要按照实际情况针对性予以选择。

Use of the “Veda-Lab Easy Reader+” for the Determination of T3, T4 and TSH Hormones in the Mountainous Population of Benin: Case of Natitingou

The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as selenium and certain vitamins. To assess the thyroid disturbances in the mountain population of Benin, a survey was conducted in Natitingou, a mountain town located in the department of Atacora, in the northwest of Benin, on a sample of thirty (30) adults (15 men and 15 women), most of whom are educated. The results of the questionnaire revealed that 43% of the surveyed population acknowledged having knowledge on the mentioned subject and have dietary habits based on the consumption of seafood, and also legumes (20%). The examination of the serum results of the dosage of T3, T4 and TSH hormones revealed cases of thyroid disturbances in the region (36.32% in men and 44.98% in women). The analysis of a comparative table including the “VEDALAB Easy Reader+” and five (05) other readers, presents the performance, reading techniques, principles, advantages and disadvantages of each device. Pending further studies, some recommendations were made at the end of this study to the academic authorities regarding probable cases of dysthyroidism for which additional examinations are required and an awareness for the improvement of dietary habits.

Role of TSH Inhibition Therapy in the Postoperative Management of Patients with Differentiated Thyroid Cancer

Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were selected for the study.TSH inhibition therapy was administered to the research group,while thyroxine replacement therapy was provided to the control group during the postoperative management phase.This allowed for a comparative analysis between the two groups.Results:In comparison with the control group,the research group exhibited significant decreases in serum TSH,T3,and T4 levels after treatment,while FT4 and FT3 levels significantly increased(P<0.05).Additionally,significant decreases in Tg,VEGF,TSGF,CD44V6,and sIL-2R levels were observed in the research group after treatment(P<0.05).No significant differences were found in pre-treatment thyroid function between the two groups(P>0.05).Conclusion:The application of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer demonstrates promising outcomes.

Effect of TSH Suppression Therapy on Sex Hormone Levels after Thyroid Cancer Surgery

Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing postoperative thyroid cancer treatment were selected for data analysis.TSH suppression therapy was implemented during the postoperative period.Patients were grouped according to the TSH level:TSH<0.1,0.1≤TSH<0.5,and TSH≥0.5.Results:Among male patients,there were no significant differences in sex hormone levels at different dosing times and TSH levels(P>0.05).For female patients,testosterone levels at different dosing times showed no significant differences under the same circumstances(P>0.05).The comparison of testosterone levels at different TSH levels over 5 years of TSH suppression therapy did not yield significant differences(P>0.05).However,the comparison of testosterone levels within 5 years of TSH suppression therapy yielded significant differences(P<0.05),with the lowest levels observed at 0.1≤TSH<0.5.Conclusion:The use of TSH suppression therapy in postoperative thyroid cancer treatment minimally affects sex hormone levels in male patients.However,it has a significant impact on female patients.Therefore,preoperative sex hormone testing is recommended,and postoperative monitoring should include regular sex hormone testing.

亚临床甲状腺功能减退症患者TSH与肾上腺皮质功能的关系

目的 分析亚临床甲状腺功能减退症患者促甲状腺激素(TSH)与肾上腺皮质功能的关系。方法 选取150例亚临床甲状腺功能减退症患者为研究组,甲状腺功能正常的健康人群150例为对照组。比较两组TSH、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、皮质醇(CORT)和促肾上腺皮质激素(ACTH)水平。采用Pearson法分析亚临床甲状腺功能减退症患者TSH水平与ACTH、CORT水平的相关性。结果 与对照组比较,研究组患者TSH、ACTH水平升高,CORT水平降低(P<0.05)。Pearson分析结果显示,亚临床甲状腺功能减退症患者TSH水平与ACTH水平呈正相关(P<0.05),与CORT水平呈负相关(P<0.05)。结论 亚临床甲状腺功能减退症患者血清TSH水平与肾上腺皮质功能指标ACTH、CORT水平存在相关性。

超声造影参数联合血清TSH对微小甲状腺结节性质的鉴别效能分析

目的 观察超声造影参数联合血清TSH对微小甲状腺结节性质的鉴别效能。方法 将2019年1月至2019年10月在我院进行住院治疗的94例微小甲状腺结节病例作为研究对象,所有病例均行超声甲状腺结节造影及血清TSH检测,获取超声造影参数(RT、MTT、TPH、WIS、TTP、PI、AUC)。全部患者在术中取病理组织并进行病理检查,并将检查结果作为“金标准”,同时对比超声造影联合血清TSH与病理检查结果的良恶性诊断符合率,同时进行超声造影参数联合血清TSH的结节良恶性诊断价值的ROC曲线分析。结果 手术后取病理组织显示,全部94例患者中,共有164个微小甲状腺结节中,其中良性结节有63例共108个结节,恶性结节中有31例共58个。良恶性微小甲状腺结节与血清TSH比较发现,比较差异无统计学意义。良、恶性微小甲状腺结节病例在RT、MTT、TPH、WIS、TTP上比较差异无差异性(P>0.05);恶性微小甲状腺结节病例的PI、AUC高于恶性微小甲状腺结节病例(P<0.05)。超声参数(PI、AUC)联合TSH鉴别诊断符合率(98.79%)高于超声参数PI联合TSH鉴别诊断(87.80%)、超声参数AUC联合TSH鉴别诊断(90.25%)(χ^(2)=13.129,P=0.001<0.05)。超声参数中Pl、AUC两项与血清TSH联合检测诊断的准确率、敏感性、特异性均相较于超声参数PI联合TSH较高(69.43%、72.48%、76.81%)、超声参数AUC联合TSH鉴别诊断(73.18%、85.63%、78.09%)(P<0.05)。结论 血清TSH有助于微小甲状腺结节鉴别,但超声造影参数(PI、AUC)联合血清TSH在微小甲状腺结节性质鉴别诊断中更具应用价值。

血清Tg、TgAb及TSH监测在分化型甲状腺癌^(131)I治疗随访中的意义

目的 分析血清甲状腺球蛋白(Tg)、甲状腺球蛋白抗体(TgAb)及促甲状腺激素水平(TSH)监测在分化型甲状腺癌(DTC)131I治疗随访中的意义。方法 选取2017年1月至2022年7月于江苏大学附属医院肿瘤外科确诊的DTC患者121例为研究对象,根据随访结果,将75例未发生转移患者纳入未转移复发组,46例发生转移患者纳入转移复发组。对比术前、术后3个月、术后6个月患者血清Tg、TgAb及TSH水平,分析影响DTC患者术后转移的单因素,采用多元Logistic回归分析血清Tg、TgAb及TSH水平对DTC患者术后发生转移的相关因素以及不同筛查方法的阳性率。结果 治疗后3个月以及治疗后6个月,患者的血清Tg、TgAb、TSH水平均低于治疗前,差异有统计学意义(P<0.05);转移复发组和未转移复发组两组性别、年龄、手术次数、病灶位置、病理类型比较差异无统计学意义(P>0.05);两组手术方式、Tg、TgAb、TSH测量值比较差异有统计学意义(P<0.05);经Logistic回归分析显示:手术方式为近全切、血清Tg>0.84 ng/mL、TgAb>62 U/mL、TSH>5.5 IU/mL均是影响DTC患者治疗后发生复发转移的危险因素(P<0.05);Tg+TgAb+TSH、^(131)I-WBS阳性筛查率均低于Tg、TgAb、TSH的阳性筛查率,差异有统计学意义(P<0.05)。结论 血清Tg、TgAb及TSH可用于评价DTC患者治疗后的疗效以及有无转移或复发,Tg+TgAb+TSH筛查可避免DTC患者治疗后假阳性的误诊,具有较高的临床价值。

超声引导下甲状腺细针穿刺活检联合血清降钙素、CEA、TSH对甲状腺癌的诊断价值

目的 探究超声引导下甲状腺细针穿刺活检联合血清降钙素、CEA、TSH对甲状腺癌的诊断价值。方法 选取2022年1月至2022年6月在北京市大兴区人民医院接受治疗甲状腺结节患者,50例甲状腺癌患者为观察组,并选取同期诊治的50例甲状腺良性结节患者为对照组。对比两组患者超声引导下甲状腺细针穿刺活检比例及血清降钙素、CEA、TSH水平,受试者操作特性(ROC)曲线分析超声引导下甲状腺细针穿刺活检联合血清降钙素、血清CEA、血清TSH诊断甲状腺癌的敏感性、特异性和准确性;诊断性试验四格表分析超声引导下甲状腺细针穿刺活检、血清降钙素、血清CEA、血清TSH分别评估及联合评估甲状腺癌的敏感性、特异性和准确性。结果 观察组的甲状腺细针穿刺活检阳性比例、血清降钙素、血清CEA、血清TSH水平均高于对照组,差异有统计学意义(χ^(2)=74.227,t=29.232、86.828、51.376,P均<0.05);根据回归结果显示,超声引导下甲状腺细针穿刺活检阳性、血清降钙素、血清CEA、血清TSH及各指标联合检测显著高于单独诊断的AUC(P均<0.05);超声引导下甲状腺细针穿刺活检、血清降钙素、血清CEA、血清TSH联合评估甲状腺癌的敏感性、特异性、准确性最高,分别为96.00%、90.00%、93.00%。结论 超声引导下甲状腺细针穿刺活检联合血清降钙素、CEA、TSH对甲状腺癌的诊断效能高于单独诊断效能。

脐动脉血流动力学指标、血脂、TSH对妊娠期糖尿病患者分娩结局的影响研究

目的探究脐动脉血流动力学指标、血脂、促甲状腺激素(TSH)对妊娠期糖尿病患者分娩结局的影响研究。方法选取我院2021年1月—2021年11月收治的妊娠期糖尿病患者138例,采用随机数字表法分为对照组和研究组,每组各69例。比较2组患者体内脐动脉血流动力学指标、血脂指标及TSH相关指标表达水平差异及妊娠结局,并通过多元线性回归分析探究脐动脉血流动力学指标、血脂指标、TSH等相关指标与妊娠期糖尿病患者不良妊娠结局的相关性。结果研究组孕妇脐动脉峰值流速/舒张末期流速(S/D)、阻力指数(RI)、三酰甘油(TG)、低密度脂蛋白(LDL)、TSH水平高于对照组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平低于对照组(P<0.05);研究组孕妇巨大儿、剖宫产、新生儿低血糖发生率及新生儿体质量均高于对照组(P<0.05);多元线性回归方程显示:S/D、RI、TG、LDL、TSH水平变化均与不良妊娠结局存在相关性(R 2=0.224,调整R 2=0.201;F=9.504,P<0.05),且影响顺序由大到小依次为TG、TSH、RI、S/D、LDL。结论妊娠期糖尿病孕妇体内的S/D、RI、TG、LDL、TSH水平异常可能会影响妊娠结局,临床可通过监测上述指标的变化,及时采取干预措施。

超声造影、DWI及血清TPO-Ab、TSH、TGA对甲状腺乳头状癌的诊断价值分析

目的 探讨超声造影(CEUS)、磁共振扩散加权成像(DWI)及血清抗甲状腺过氧化物酶抗体(TPO-Ab)、促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(TGA)对甲状腺乳头状癌(PTC)的诊断价值。方法 收集我院2019年1月至2022年1月92例经病理证实为PTC患者作为PTC组,92例为甲状腺良性肿瘤患者作为良性组。比较两组的血清TPO-Ab、 TSH、TG A水平、超声征象与表观扩散系数(ADC)值,评估血清TPO-Ab、TSH、TGA、CEUS以及DWI单项以及联合诊断与病理诊断结果 ,同时分析血清TPOAb、TSH、TGA、CEUS以及DWI对PTC的诊断价值。结果 PTC组的血清TPO-Ab、TSH、TGA水平均高于良性组(P<0.05);PTC组的淋巴肿大、钙化、回声不均匀、边界不清、形态不规则比例高于良性组(P<0.05);PTC组血流分级以Ⅱ-Ⅲ级为主,良性组以Ⅰ-Ⅱ级为主,两组血流分级比较,差异有统计学意义(P<0.05);PTC组的ADC值低于良性组(P<0.05)。本研究经Kappa一致性检测结果 显示,血清TPO-Ab诊断结果 和病理诊断结果 为一致性中等(P<0.05);血清TSH、TGA、CEUS、DWI诊断结果 和病理诊断结果 为高度一致性(P<0.05);联合检测诊断结果 和病理诊断结果 为一致性完全相同(P<0.05),并且联合检测的一致性最高。联合诊断的灵敏度(86.96%)、阴性预测值(86.36%)分别高于血清TPO-Ab、TSH、TGA、CEUS以及DWI的单一指标诊断。结论 PTC患者血清TPO-Ab、TSH、TGA水平升高,CEUS、DWI联合血清TPO-Ab、TSH、TGA在PTC诊断中具有较高的临床应用价值,可以提高诊断准确率。

Gestational TSH Levels and Their Association with Obstetric and Neonatal Outcomes in Lebanon: A National Observational Retrospective Study

Objectives: Gestational hypothyroidism is associated with obstetric complications and disturbances in the offspring development;however, it remains easy to treat. The objective of the study was to describe thyroid-stimulating hormone (TSH) levels in pregnant women and analyze their association with pregnancy course and outcome. Design: This national, observational, retrospective study analyzed data on Lebanese pregnant women visiting their obstetrician as part of their routine follow up. Participants, Setting and Methods: Enrolled subjects were all pregnant women who visited the obstetrics clinic from 01 September 2017 until 31 August 2018, as part of their routine follow up and have a TSH level record. In 2020, during their routine follow-up visit, the participants signed an informed consent to allow the investigator to access the data retrospectively and enter them into his database. Relevant participant characteristics and outcome data were collected from clinic files of the private clinic of Dr Abi Tayeh, at the Department of Obstetrics and Gynecology, H?tel-Dieu de France University Hospital, Beirut, Lebanon. Results: A total of 419 women were enrolled, 11.5% of them reported at least one comorbidity prior to pregnancy, most often the antiphospholipid syndrome, followed by thrombophilia and hypothyroidism. At least one complication was reported for 18.4% of participants. Around 87.6% of participants delivered a full-term baby with normal birth weight for most. The average TSH value for all participants was within the normal range at all time-points. Highest TSH values were recorded during the first trimester. As treatment was immediately initiated in women with abnormal TSH levels, no correlation was observed between TSH levels and pregnancy outcomes or pregnancy complications at any time-point. Conclusions: This study highlights satisfactory routine practice in the management of thyroid disorders in pregnancy and underscores the need for routine TSH screening for all pregnant women.

2019-2022年菏泽市新生儿足跟血TSH水平检测结果变化及分析

目的:探究及分析2019—2022年菏泽市新生儿足跟血促甲状腺激素(TSH)水平检测结果变化情况。方法:选取菏泽市2019年1—12月的1150例新生儿为A组,2020年1—12月的1161例新生儿为B组,2021年1—12月的1156例新生儿为C组,2022年1—12月的1130例新生儿为D组。检测及比较四组足跟血TSH水平,比较四组中不同性别、出生季度及早产/足月新生儿的检测结果。结果:C组及D组中足跟血TSH≥6.0 mU/L者占比均显著低于A组及B组,差异均有统计学意义(P<0.05),而A组与B组、C组与D组中足跟血TSH≥6.0 mU/L者占比比较,差异均无统计学意义(P>0.05),且四组中不同性别、出生季度及早产/足月新生儿的检测结果比较,差异均无统计学意义(P>0.05)。结论:2019—2022年菏泽市新生儿足跟血TSH水平检测结果持续改善,且不同性别、出生季度及早产/足月新生儿的检测结果无明显差异,但仍需进一步加强监测及干预。

TgAb联合TSH指标检测在甲状腺癌患者术前诊断中的应用价值分析

研究TgAb联合TSH指标检测在甲状腺癌患者术前诊断中的应用价值分析。方法 选取2022年3月-2023年3月在我院就诊的66例疑似甲状腺癌症的患者,经过病理诊断,发现33例为良性,33例为恶性。分为良性组和甲状腺癌组,一般资料无差异,有对比性,比较两组患者TgAb和TSH指标。结果 甲状腺癌组指标大于良性组(P<0.05)。结论 采用TgAb联合TSH指标检测,对甲状腺癌患者术前诊断有重要价值。