内科住院患者良恶性甲状腺结节检出情况及发病相关影响因素分析
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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.
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
[1] 魏培英,张乐星,韩志江,等.CT值对甲状腺良性单纯粗钙化结节诊断的价值[J].中华内分泌外科杂志,2018,12(1):43- 46.
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[12] 王新玲,艾合买提江·吐乎提,伊合巴兰·阿不都热合曼,等.乌鲁木齐某社区维吾尔族、汉族人群甲状腺结节和肥胖的相关性研究[J].中华疾病控制杂志,2017,21(10):1009-1013.
[13] 姜心桐,乔成栋,王龙.老年病房住院患者甲状腺结节患病情况的调查分析[J].临床合理用药,2016,9(2C):17-21.
[14] 常广,田京利,刘晓明,等.关于35 495名健康体检人员甲状腺结节检出情况分析[J].中华健康管理学杂志,2013,7(2):99-102.
[15] 杨昱,王志国,吴阳,等.南京市40岁以上人群甲状腺结节的流行病学调查[J].中华内分泌代谢杂志,2013,29(9):785-787.
[16] Kir S,Aydin Y,Coskun H.Relationship between metabolic syndrome and nodular thyroid diseases [J].Scand J Clin Lab Invest,2018,78(1-2)∶6-10.
[17] Mehran L,Amouzegar A,Rahimabad PK,et al.Thyroid function and metabolic syndrome:a population-based thyroid study [J].Horm Metab Res,2017,49(3)∶192-200.
[18] 王晓艳,王亚军,蒿花,等.甲状腺结节与代谢综合征相关组分的临床研究[J].西安交通大学学报(医学版),2017,38(1):151-153.
[2] 周健,赖旭峰,韩志江,等.多种CT征象对甲状腺良、恶性结节的预测价值[J].中华全科医师杂志,2018,17(1):44- 49.
[3] 阎玉芹.全球甲状腺结节及甲状腺癌的流行趋势及其原因分析[J].中华地方病学杂志,2013,32(3):239-240.
[4] Ukrainski MB,Pribitkin EA,Miller JL.Increasing incidence of thyroid nodules and thyroid cancer:does increased detection of a subclinical reservoir justify the associated anxiety and treatment?[J].Clin Ther,2016,38(4)∶976-985.
[5] 白萍萍,张连仲,马会民,等.健康体检人群甲状腺结节流行病学调查[J].中华健康管理学杂志,2015,9(1):76-78.
[6] 李萌辉,刘俊田.5196例健康体检者甲状腺良恶性结节筛查结果分析查[J].中华肿瘤杂志,2018,40(2):151-154.
[7] Pemayun TG.Current diagnosis and management of thyroid nodules [J].Acta Med Indones,2016,48(3)∶247-257.
[8] 朱桂全,何雨歆,兰小娇,等.外科视角解读2015 ATA 甲状腺结节及分化型甲状腺癌诊疗指南[J].肿瘤预防与治疗,2016,29(2):72-75.
[9] 于钏钏,王强.2008-2014年我国健康成人甲状腺结节流行特征及影响因素初步分析[J].环境与健康杂志,2016,33(5):440- 443.
[10] 沈李花,施荣香.上海外高桥地区体检人群甲状腺结节的发病特点[J].广东医学,2017,38(1):210-212.
[11] 廖敏,刘军,宁锐军,等.广西沿海产盐区人群甲状腺结节流行状况及相关因素分析[J].环境与健康杂志,2016,33(6):518-521.
[12] 王新玲,艾合买提江·吐乎提,伊合巴兰·阿不都热合曼,等.乌鲁木齐某社区维吾尔族、汉族人群甲状腺结节和肥胖的相关性研究[J].中华疾病控制杂志,2017,21(10):1009-1013.
[13] 姜心桐,乔成栋,王龙.老年病房住院患者甲状腺结节患病情况的调查分析[J].临床合理用药,2016,9(2C):17-21.
[14] 常广,田京利,刘晓明,等.关于35 495名健康体检人员甲状腺结节检出情况分析[J].中华健康管理学杂志,2013,7(2):99-102.
[15] 杨昱,王志国,吴阳,等.南京市40岁以上人群甲状腺结节的流行病学调查[J].中华内分泌代谢杂志,2013,29(9):785-787.
[16] Kir S,Aydin Y,Coskun H.Relationship between metabolic syndrome and nodular thyroid diseases [J].Scand J Clin Lab Invest,2018,78(1-2)∶6-10.
[17] Mehran L,Amouzegar A,Rahimabad PK,et al.Thyroid function and metabolic syndrome:a population-based thyroid study [J].Horm Metab Res,2017,49(3)∶192-200.
[18] 王晓艳,王亚军,蒿花,等.甲状腺结节与代谢综合征相关组分的临床研究[J].西安交通大学学报(医学版),2017,38(1):151-153.