Effect Of Thyroid Function On Coagulation Function In Patients With Benign Thyroid Nodule

Objective: By analyzing three methods to calculate the initial dose of levothyroxine(LT4),the main related factors affecting the replacement dose of LT4 were predicted.The data model was established by multiple regression analysis,and the accurate dose formula to calculate the daily replacement dose of LT4 was obtained.Methods: We prospectively collected the data of patients with benign thyroid diseases who underwent total thyroidectomy from October 2019 to January2021 in the Department of breast and thyroid surgery,Affiliated Hospital of Qinghai University,and randomly gave them three different alternatives to calculate the dosage of levothyroxine: According to body mass index(Body mass index,BMI)(μg /kg /d)=(-0.018×BMI +2.13),20 patients were selected as BMI group.2.According to the method of administration per kg body weight(μg / kg /d),20 patients were selected as body weight group.3.According to the fixed dose administration method of empirical replacement therapy(75-150μg /d),20 patients were selected as the empirical group.The number of follow-up,the test value,the initial daily replacement dose of LT4,the daily replacement dose of LT4,the thyroid function index,BMI,age,gender,height,weight,nationality,chronic autoimmune thyroiditis were recorded.Results: According to the index of follow-up times when serum TSH reached normal for the first time after total thyroidectomy,14 cases in BMI group,7cases in body weight group and 3 cases in experience group were found to have TSH reached normal for the first time after taking LT4(4-6 weeks).The average follow-up level of BMI group was 1(1,2)times,the average follow-up level of weight group was 2(1,2.75)times,and the average follow-up level of experience group was 2(2,3)times,with statistical difference(P < 0.05).The age(r =-0.334;P < 0.05),height(r =0.557;P<0.05),body weight(r =0.708;P<0.05)、BMI(r=0.502;P < 0.05),In the multiple regression analysis,the best regression model to predict the effect of daily LT4 replacement dose was based on body weight and age,and the formula to calculate the daily LT4 replacement dose was obtained(μg/kg/d)=1.46× Body weight-0.59×Age+29.49.Conclusion:1.The factors influencing the replacement dose of levothyroxine were not only related to the weight but also BMI,age,height and so on.2.In the multivariate regression analysis,the factors of P < 0.05 were analyzed by multiple regression,and the variables were further screened.The best regression model affecting the initial dose of LT4 was based on weight and age.The formula obtained was that the daily replacement dose of initial LT4 was(μg / kg /d)=1.46 × Body weight-0.59×Age+29.49,for the model R=0.755,variance analysis F=37.80,P<0.05(confirm that the relationship presented by the model is not due to accident).3.It was found that the administration scheme based on body weight and age was better than that based on BMI,the administration method based on BMI was better than that based on body weight alone,and the administration method based on body weight alone was better than that based on experience.