体检人群甲状腺功能异常的调查研究
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摘要
目的探讨体检人群甲状腺功能异常的发病率,并分析甲状腺功能异常对自身血脂、血糖、外周血三系细胞产生的影响。方法选取2017年1月1日至12月31日在淄博市第一医院查体中心体检的人员1 304例,并设立统一问卷调查表。受检人员分别在清晨空腹抽取静脉血,检测血清促甲状腺激素(TSH)、游离甲状腺素3(FT3)、游离甲状腺素4(FT4)、血脂、血糖(GLU)、血常规等项目,并根据FT3、FT4、TSH的检测值分为甲状腺功能亢进(简称:甲亢)组、亚临床甲亢组、甲状腺功能减退(简称:甲减)组、亚临床甲减组及无任何既往病史的对照组,并对检测结果进行统计学分析。结果 1 304例受检人员中甲状腺疾病的发病率女性高于男性,60岁以上人群发病率高,且随着年龄的增长,甲状腺功能降低,其中亚临床甲减组的检出率最高,与其他组比较差异有统计学意义(P<0.05);亚临床甲减组60岁以上人群的发病率明显高于60以下人群,且女性发病率高于男性。甲减组及甲减组+亚临床甲减组患者的血总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)、红细胞平均分布宽度(RDW)、TSH水平高于对照组,高密度脂蛋白胆固醇(HDL-C)、红细胞(RBC)、血红蛋白(Hb)、血细胞比容(Hct)低于对照组,差异有统计学意义(P<0.05);甲亢组及甲亢组+亚临床甲亢组患者的FT4、GLU水平高于对照组,HDL-C、TSH、Hct水平低于对照组,差异均有统计学意义(P<0.05)。结论女性甲状腺疾病的发病率高于男性,且随着年龄的增长发病率增高,尤其是亚临床甲减患者检出率最高,且其严重影响患者的血脂代谢,其贫血的发病率也明显增高,临床应予重视。
Objective To investigate the incidence of thyroid dysfunction in the physical examination population and to analyze the effect of thyroid dysfunction on the blood lipid,blood glucose and peripheral blood three lines.Methods A total of 1 304 cases of physical examination of the physical examination center of Zibo No.1 Hospital from Jan 1,2017 to Dec 31,2017 were selected and a unified questionnaire was set up.The subjects were given fasting venous blood in the morning and detected serum thyrotropin(TSH),free thyroxine 3(FT3),FT4,blood lipids,blood glucose,blood routine and other items,and according to FT3,FT4,TSH detection value is divided into hyperthyroidism group,subclinical hyperthyroidism group,hypothyroidism group,subclinical and the normal control group without any previous history,the statistical analysis of the test results.Results The incidence of female thyroid disease was higher in the 1 304 subjects than in men.The incidence of thyroid dysfunction was higher in the population over 60 years old,and the hypothyroidism was reduced with age,and the detection rate of subclinical hypothyroidism was the highest group was statistically significant;subclinical hypothyroidism group over 60 years of age the incidence of the population was significantly higher than the following 60,and the incidence of women than men.The levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),uric acid(UA),erythrocyte mean distribution width(RDW)and TSH were significantly higher in the subclinical hypothyroidism group and hypothyroidism,subclinical hypothyroidism group than in the control group high density lipoprotein cholesterol(HDL-C),erythrocyte(RBC),hemoglobin(Hb)and hematocrit(Hct)were significantly lower than those in the control group.The serum FT4 and blood glucose were significantly higher in the subclinical hyperthyroidism group and hyperthyroidism,subclinical hyperthyroidism group than in the control group,HDL-C,TSH,Hct were significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion Through a retrospective analysis of 1 304 cases of thyroid function of medical personnel,found that the incidence of female thyroid disease is higher than men,and with the increase in the incidence of age increased,especially in subclinical hypothyroidism patients with the highest detection rate,and its serious impact patients with lipid metabolism,the incidence of anemia is significantly increased,clinical attention should be paid.
Objective To investigate the incidence of thyroid dysfunction in the physical examination population and to analyze the effect of thyroid dysfunction on the blood lipid,blood glucose and peripheral blood three lines.Methods A total of 1 304 cases of physical examination of the physical examination center of Zibo No.1 Hospital from Jan 1,2017 to Dec 31,2017 were selected and a unified questionnaire was set up.The subjects were given fasting venous blood in the morning and detected serum thyrotropin(TSH),free thyroxine 3(FT3),FT4,blood lipids,blood glucose,blood routine and other items,and according to FT3,FT4,TSH detection value is divided into hyperthyroidism group,subclinical hyperthyroidism group,hypothyroidism group,subclinical and the normal control group without any previous history,the statistical analysis of the test results.Results The incidence of female thyroid disease was higher in the 1 304 subjects than in men.The incidence of thyroid dysfunction was higher in the population over 60 years old,and the hypothyroidism was reduced with age,and the detection rate of subclinical hypothyroidism was the highest group was statistically significant;subclinical hypothyroidism group over 60 years of age the incidence of the population was significantly higher than the following 60,and the incidence of women than men.The levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),uric acid(UA),erythrocyte mean distribution width(RDW)and TSH were significantly higher in the subclinical hypothyroidism group and hypothyroidism,subclinical hypothyroidism group than in the control group high density lipoprotein cholesterol(HDL-C),erythrocyte(RBC),hemoglobin(Hb)and hematocrit(Hct)were significantly lower than those in the control group.The serum FT4 and blood glucose were significantly higher in the subclinical hyperthyroidism group and hyperthyroidism,subclinical hyperthyroidism group than in the control group,HDL-C,TSH,Hct were significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion Through a retrospective analysis of 1 304 cases of thyroid function of medical personnel,found that the incidence of female thyroid disease is higher than men,and with the increase in the incidence of age increased,especially in subclinical hypothyroidism patients with the highest detection rate,and its serious impact patients with lipid metabolism,the incidence of anemia is significantly increased,clinical attention should be paid.
引文
[1]梁利波,何訸,吕瑞雪,等.成都地区体检人群甲状腺功能异常及血脂异常的调查研究[J].国际检验医学杂志,2013,34(9):1103-1105.
[2]冯志伟,李胜亮,孙利忠,等.甲状腺功能检测异常954例结果分析[J].临床军医杂志,2014,42(11):1202-1203.
[3]张志利,彭国英,李树堂.太原地区健康体检人群甲状腺功能紊乱患病情况调查[J].中华内分泌代谢杂志,2002,18(6):446-448.
[4]袁帅,江璐,朱力,等.上海地区6 112例健康体检者血清甲状腺激素和甲状腺自身抗体检测结果分析[J].检验医学,2015,30(3):219-223.
[5]李跃松,朱亚妮,殷政芳,等.血清甲状腺过氧化物酶抗体在自身免疫性甲状腺疾病诊断中的应用[J].检验医学,2012,27(3):195-198.
[6]RIVOLTA G,CERUTTI R,COLOMBO R,et al.Prevalence of subclinical hypothyroidism in a population living in the Milan metropolitan area[J].J Endocrinol Invest,1999,22(9):693-697.
[7]COOPER D S,BIONDI B.Subclinical thyroid disease[J].Lancet,2012,379(9821):1142-1154.
[8]向玉桂.老年甲状腺功能减退23例误诊分析[J].检验医学与临床,2012,9(5):633-633.
[9]CARACCIO N,FERRANNINI E,MONZANI F.Lipoprtein pro-file in subclinical hypothyroidism:response to levothyroxine replacement,a randomized placebo-controlled study[J].JClin Endocrinol Metab,2002,87(4):1533-1538.
[10]RODONDI N,DEN ELZEN W P,BAUER D C,et al.Subclinical hypothyroidism and the risk of coronary heart disease and mortality[J].JAMA,2010,304(12):1365-1374.
[11]CAPPOLA A R,FRIED L P,ARNOLD A M,et al.Thyroid status,cardiovascular risk,and mortality in older adults[J].JAMA,2006,295(9):1033-1041.
[12]WATERHOUSE D F,MCLAUGHLIN A M,WALSH CD,et al.An examination of the relationship between normal range thyrotropin and cardiovascular risk parameters:a study in healthy women[J].Thyroid,2007,17(3):243-248.
[13]LAI Y,WANG J,JIANG F,et al.The relationship between serum thyrotropin and components of metabolic syndrome[J].Endocr J,2011,58(1):23-30.
[14]BASTEMIR M,AKIN F,ALKIS E,et al.Obesity is associated with increased serum TSH level,ndependent of thyroid function[J].Swiss Med Wkly,2007,137(29/30):431-434.
[15]邵金凤,吴淑琼.甲状腺功能减退症患者替代治疗前后血脂、血尿酸变化及临床意义[J].湖北中医药大学学报,2010,12(3):58-60.
[16]白耀.甲状腺病变-基础和临床[M].北京:科学技术文献出版社,2003:102.
[2]冯志伟,李胜亮,孙利忠,等.甲状腺功能检测异常954例结果分析[J].临床军医杂志,2014,42(11):1202-1203.
[3]张志利,彭国英,李树堂.太原地区健康体检人群甲状腺功能紊乱患病情况调查[J].中华内分泌代谢杂志,2002,18(6):446-448.
[4]袁帅,江璐,朱力,等.上海地区6 112例健康体检者血清甲状腺激素和甲状腺自身抗体检测结果分析[J].检验医学,2015,30(3):219-223.
[5]李跃松,朱亚妮,殷政芳,等.血清甲状腺过氧化物酶抗体在自身免疫性甲状腺疾病诊断中的应用[J].检验医学,2012,27(3):195-198.
[6]RIVOLTA G,CERUTTI R,COLOMBO R,et al.Prevalence of subclinical hypothyroidism in a population living in the Milan metropolitan area[J].J Endocrinol Invest,1999,22(9):693-697.
[7]COOPER D S,BIONDI B.Subclinical thyroid disease[J].Lancet,2012,379(9821):1142-1154.
[8]向玉桂.老年甲状腺功能减退23例误诊分析[J].检验医学与临床,2012,9(5):633-633.
[9]CARACCIO N,FERRANNINI E,MONZANI F.Lipoprtein pro-file in subclinical hypothyroidism:response to levothyroxine replacement,a randomized placebo-controlled study[J].JClin Endocrinol Metab,2002,87(4):1533-1538.
[10]RODONDI N,DEN ELZEN W P,BAUER D C,et al.Subclinical hypothyroidism and the risk of coronary heart disease and mortality[J].JAMA,2010,304(12):1365-1374.
[11]CAPPOLA A R,FRIED L P,ARNOLD A M,et al.Thyroid status,cardiovascular risk,and mortality in older adults[J].JAMA,2006,295(9):1033-1041.
[12]WATERHOUSE D F,MCLAUGHLIN A M,WALSH CD,et al.An examination of the relationship between normal range thyrotropin and cardiovascular risk parameters:a study in healthy women[J].Thyroid,2007,17(3):243-248.
[13]LAI Y,WANG J,JIANG F,et al.The relationship between serum thyrotropin and components of metabolic syndrome[J].Endocr J,2011,58(1):23-30.
[14]BASTEMIR M,AKIN F,ALKIS E,et al.Obesity is associated with increased serum TSH level,ndependent of thyroid function[J].Swiss Med Wkly,2007,137(29/30):431-434.
[15]邵金凤,吴淑琼.甲状腺功能减退症患者替代治疗前后血脂、血尿酸变化及临床意义[J].湖北中医药大学学报,2010,12(3):58-60.
[16]白耀.甲状腺病变-基础和临床[M].北京:科学技术文献出版社,2003:102.