【摘要】 目的：分析超声引导下微波消融（MWA）治疗甲状腺良性结节（BTN）的体积缩小率（VRR）与随访时间的阈值效应。方法：回顾性分析2020年7月—2021年6月在我院接受超声引导下MWA治疗BTN的患者资料，以12月为随访终点，VRR≥50%为治疗有效并纳入本研究。使用广义相加模型分析VRR随时间的变化趋势，生成VRR-时间拟合曲线图，应用分段线性回归模型计算阈值。结果：185例患者共213个结节纳入本研究，VRR-时间拟合曲线图显示MWA治疗后结节逐渐缩小，VRR逐渐增加。VRR与随访时间为非线性关系，分析两者阈值效应显示折点即阈值为2.7月；VRR在2.7月内增长速度最快，每个月增长25.7%(P<0.001)；在2.7月后仍继续增长，但速度趋于平缓，每个月增长0.8%(P=0.018)。结论：超声引导下MWA治疗BTN的VRR与随访时间是非线性关系，存在阈值效应。更多还原

【Abstract】 Objective: To analyze the threshold effect of volume reduction ratio(VRR) and follow-up time in benign thyroid nodules(BTN) treated with ultrasound-guided microwave ablation(MWA). Methods: Patients with BTN who received ultrasound-guided MWA treatment in our hospital from July 2020 to June 2021 were retrospectively analyzed, with 12 months as the follow-up endpoint, and VRR≥50% was considered effective for treatment and included in this study. The trend of VRR with time was analyzed using the generalized additive model to generate the VRR-time fitting curve, and the segmented linear regression model was used to calculate the threshold value. Results: A total of 213 nodules in 185 patients were included in this study, and the VRR-time fitting curve showed a gradual decrease in nodule volume and a gradual increase in VRR after MWA. The relationship between VRR and follow-up time was nonlinear, and analysis of the threshold effect demonstrated the threshold value of 2.7 months, with the most significant growth rate of 25.7%/month(P<0.001) within 2.7 months after MWA and continued to grow at a slower rate of 0.8%/month after 2.7 months(P=0.018). Conclusion: Ultrasound-guided MWA for BTN has a nonlinear relationship between VRR and follow-up time, and there is a threshold effect.更多还原