摘要
目的:了解内科住院患者甲状腺良恶性结节检出情况、分布特征及发病相关影响因素。方法:回顾性选择2013年1月至2017年12月重庆市第六人民医院内科住院患者1 058例作为研究对象,对甲状腺超声检查及相关临床资料汇总分析,计算甲状腺结节和甲状腺癌的检出率,分析内科住院患者甲状腺结节发病的影响因素。结果:甲状腺结节阳性检出率为58.41%、甲状腺癌的检出率为1.51%。男性检出率明显低于女性(52.46%vs 64.83%;χ~2=16.648,P<0.001);而不同性别住院患者甲状腺癌的检出率之间差异无统计学意义(1.46%vs 1.57%;χ~2=0.023,P=0.897)。<40岁、40~49岁、50~59岁、60~69岁、70~79岁、≥80岁6个年龄段甲状腺结节检出率分别为37.93%、45.98%、61.92%、66.17%、68.99%、69.14%,随着年龄的增长,甲状腺结节的检出率增长明显(χ~2_(趋势)=43.638,P<0.001);不同年龄段甲状腺癌的检出率之间差异无统计学意义(χ~2=3.220,P=0.666)。多因素Logistic回归分析显示:女性(OR=1.749)、年龄增加(OR=1.036)和空腹血糖(FPG)升高(OR=1.012)是甲状腺结节发病的独立危险因素(P<0.05)。结论:内科住院患者的甲状腺结节的检出率较高,性别和年龄是影响甲状腺结节检出率分布特征的重要因素。对于女性、年龄较大的老年住院患者伴有空腹血糖(FPG)等,应当普遍行甲状腺超声筛查,以便于早期发现和早期诊断甲状腺结节及甲状腺癌。
Objective: To investigate the detection, distribution and influencing factors of thyroid benign and malignant nodules in medical inpatients. Methods: A total of 1 058 medical inpatients at our hospital from January 2013 to December 2017 was retrospectively selected. Thyroid ultrasound and related clinical data were collected and analyzed. The detection rates of thyroid nodules and thyroid cancer were calculated, and the influencing factors of incidence of thyroid nodules in medical inpatients were analyzed. Results: The positive detection rate of thyroid nodules was 58.41%, and the detection rate of thyroid cancer was 1.51%. The detection rate of thyroid nodules in males was significantly lower than that in females(52.46% vs 64.83%; χ~2=16.648, P<0.001), and there was no significant difference in the detection rate of thyroid cancer between the two sexes(1.46% vs 1.57%; χ~2=0.023, P=0.897). The detection rates of thyroid nodules in 6 age groups(<40, 40~49, 50~59, 60~69, 70~79, ≥80) were 37.93%, 45.98%, 61.92%, 66.17%, 68.99% and 69.14% respectively. With the increase of age, the detection rate of thyroid nodules increased significantly(χ~2_(tred)=43.638, P<0.001), and there was no statistically significant difference in the detection rate of thyroid cancer among ages(χ~2=3.220, P=0.666). Multiple factor Logistic regression analysis showed that female(OR=1.749), increase of age(OR=1.036), elevation of fasting blood glucose(FPG)(OR=1.012) were independent risk factors(P<0.05) of the incidence of thyroid nodules. Conclusion: The detection rate of thyroid nodules is high in medical inpatients. Gender and age are important factors affecting the distribution of thyroid nodules. For female and elderly inpatients with FPG, thyroid screening by ultrasound should be widely used to facilitate the early detection and diagnosis of thyroid nodules and thyroid cancer.
引文
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