滨海地区甲状腺结节患病率调查及相关因素分析
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摘要
目的调查分析山东潍坊滨海地区甲状腺结节的患病率及相关因素。方法对2014年3月～2016年12月我院体检中心2318例体检者的资料进行分析。采用SPSS20.0软件对实验数据进行统计,采用卡方检验进行组间比较,采用卡方趋势检验进行相关趋势比较、分析检出情况,采用Logistic回归分析年龄、性别、尿碘水平与结节检出率的关系。结果①本组体检人群甲状腺结节检出者866例(37.36%);年龄(43.64±10.01)岁,其中女299例(35.01%),男567例(38.73%),女性检出率低于男性。甲状腺结节检出率随年龄增长呈增高趋势(P<0.05)。②检出的全部结节中,单发结节412例(47.58%),年龄22～77(41.93±8.66)岁;多发结节454例(52.42%),年龄24～80(45.19±10.88)岁;男性单发结节检出率为18.65%,女性单发结节检出率为16.27%,差异无显著性(P>0.05);男性多发结节检出率为20.08%,女性多发结节检出率为18.73%,差异无显著性(P>0.05)。小结节、中结节和大结节的检出率男性分别为87.65%,10.58%,1.76%,女性分别为85.95%,10.37%,3.68%.③检出甲状腺结节者的尿碘水平为(175.69±13.51)μg/L。④不同性别结节大小的检出率比较,差异无显著性(P>0.05)。Logistic回归分析显示年龄与甲状腺结节发生呈正相关关系,OR(95%CI)为1.075(1.064-1.087),性别、尿碘水平与甲状腺结节无相关关系。结论山东潍坊滨海地区甲状腺结节的患病率与年龄呈正相关,与尿碘水平、性别无相关关系。
Objective To investigate the prevalence and the influencing factors of thyroid nodules(NT)in healthy population in Binhai district of Weifang city,Shandong Province.Methods Two thousand three hundred and eighteen physical examinees from March 2014 to March 2016 in Binhai People's Hospital Physical Examination Center of Shandong Province were included into this study,analyzed the detection of thyroid nodule by chisquare test,chi square trend test,and used Logistic regression analysis to study the relationship of age,gender,urine iodine and the detection rate of nodules.Urine iodine was tested by fast urine iodine quantitative analysis.Results ①According to our data,866 adults were found to have TN accounting for 37.36%(866/2318),(43.64±10.01) years old,including female 299(35.01%) and male 567(38.73%).The detection rate of thyroid nodules in female was lower than that in male,and increased with age(χ~2=103.70 in male,χ~2=70.19 in female,all P<0.001).②412 adults were found to have solitary nodule accounting for 47.58%,the age(41.93±8.66) years old,and 454 adults have multiple nodules accounting for 52.42%,the age(45.19±10.88) years old;The detection rate of solitary nodule was higher in male than female(18.65% vs.16.27%,χ~2=2.76,P=0.0965),the same as multiple nodules(20.08% vs.18.73%,χ~2=1.31,P=0.2522).The detection rate of small,moderate and large nodules were 87.65%,10.58%,1.76% in male respectively,and 85.95%,10.37%,3.68% in female respectively.③Urinary iodine levels of physical examinees found to have TN was 175.69±13.51μg/L.④The rank sum test of two independent samples showed that there was no significant difference in the size of nodules between the gender(U=3.03,P=0.2192).Multiple Logistic regression analysis showed that risk of thyroid nodules related to the age with OR(95% CI) 1.075(1.064-1.087),while there was no relationship among thyroid nodules and urinary iodine level and gender.Conclusion The detection rate of thyroid nodules was positively correlated with age in Binhai district of Weifang city,Shandong Province,and was no correlation with urinary iodine level and gender.
Objective To investigate the prevalence and the influencing factors of thyroid nodules(NT)in healthy population in Binhai district of Weifang city,Shandong Province.Methods Two thousand three hundred and eighteen physical examinees from March 2014 to March 2016 in Binhai People's Hospital Physical Examination Center of Shandong Province were included into this study,analyzed the detection of thyroid nodule by chisquare test,chi square trend test,and used Logistic regression analysis to study the relationship of age,gender,urine iodine and the detection rate of nodules.Urine iodine was tested by fast urine iodine quantitative analysis.Results ①According to our data,866 adults were found to have TN accounting for 37.36%(866/2318),(43.64±10.01) years old,including female 299(35.01%) and male 567(38.73%).The detection rate of thyroid nodules in female was lower than that in male,and increased with age(χ~2=103.70 in male,χ~2=70.19 in female,all P<0.001).②412 adults were found to have solitary nodule accounting for 47.58%,the age(41.93±8.66) years old,and 454 adults have multiple nodules accounting for 52.42%,the age(45.19±10.88) years old;The detection rate of solitary nodule was higher in male than female(18.65% vs.16.27%,χ~2=2.76,P=0.0965),the same as multiple nodules(20.08% vs.18.73%,χ~2=1.31,P=0.2522).The detection rate of small,moderate and large nodules were 87.65%,10.58%,1.76% in male respectively,and 85.95%,10.37%,3.68% in female respectively.③Urinary iodine levels of physical examinees found to have TN was 175.69±13.51μg/L.④The rank sum test of two independent samples showed that there was no significant difference in the size of nodules between the gender(U=3.03,P=0.2192).Multiple Logistic regression analysis showed that risk of thyroid nodules related to the age with OR(95% CI) 1.075(1.064-1.087),while there was no relationship among thyroid nodules and urinary iodine level and gender.Conclusion The detection rate of thyroid nodules was positively correlated with age in Binhai district of Weifang city,Shandong Province,and was no correlation with urinary iodine level and gender.
引文
[1]中华医学会内分泌学分会,中华医学会外科学分会内分泌学组,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南[J].中华核医学与分子影像学杂志,2013,33(2):99~115.
[2]柳林,卢洪文,冯剑,等.健康体检者7097名甲状腺结节检出情况与临床特点[J].中华临床医师杂志(电子版),2014,8(14):90~94.
[3]Moon WJ,Kwag HJ,Na DG.Are there any specific ultrasound findings of nodular hyperplasia("leave me alone"lesion)to differentiate it from follicular adenoma[J].Acta Radiologica,2009,50(4):383~388.
[4]Cooper DS,Doherty GM,Haugen BR,et al.The American Thyroid Association Guidelines Task Force.Revised management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2009,19:1167~214.
[5]Brito JP,Gionfriddo MR,Al Nofal A,et al.The accuracy of thyroid nodule ultrasound to predict thyroid cancer:systematic review and meta-analysis[J].J Clin Endocrinol Metab,2014,99(4):1253~1263.
[6]Tang Y,Gao GL,Li GS.The research of characteristics of thyroid nodules disease in Weihai city[J].Chi Prac Med,2010,5(31):54~55.
[7]张春玉,曾洪利,刘颖,等.甲状腺结节与代谢综合征及其组分的相关性分析[J].中华内分泌代谢杂志,2012,28(2):132~135.
[8]徐厚兰,危静,兰满.11 268名健康体检人群甲状腺结节发生的流行状况调查分析[J].疾病监测,2014,29(12):987~989.
[9]常广,田京利,刘晓明,等.关于35495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.
[10]Moon JH,Hyun MK,Lee JY,et al.Prevalence of thyroid nodules and their associated clinical parameters:a large-scale,multicenterbased health checkup study[J].Korean J of Intern Med,2018,33(4):753~762.
[11]Furlanetto TW,Peccin S,Ma DOS,et al.Prevalence of thyroid nodules in 40 years-old or old women[J].Rev Assoc Med Bras,2000,46(4):331~334.
[12]Fang G,Ding G,Lou X,et al.Incidence of thyroid diseases in Zhejiang Province,China,after 15 years of salt iodization[J].J Trace Elem Med Biol,2016,36(3):57~64.
[13]Weng W,Dong M,Zhan J,et al.A PRISMA-compliant systematic review and meta-analysis of the relationship between thyroid disease and different levels of iodine intake in mainland China[J].Medicine,2017,96(25):e7279.
[14]Haugen BR,Alexander EK,Bible KC,et al.2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1~133.
[15]Mitchell AL,Gandhi A,Scott-Coombes D.Management of thyroid cancer:United Kingdom National Multidisciplinary Guidelines[J].JLaryngol Otol,2016,130(S2):S150~S160.
[16]Subekti I.Manajemen non-bedah pada nodul tiroid[C].In:Pemayun TGD,Nugroho KH,Minuljo TT,et al.Thyroid workshop.Annual scientific meeting of indonesian society of endocrinology in conjunction with semarang endocrine metabolic meeting.Semarang:PERKE-NI,2016:15~22.
[17]Buscemi S,Massenti FM,Vasto S,et al.Association of obesity and diabetes with thyroid nodules[J].Endocrine,2017(S1):1~9.
[2]柳林,卢洪文,冯剑,等.健康体检者7097名甲状腺结节检出情况与临床特点[J].中华临床医师杂志(电子版),2014,8(14):90~94.
[3]Moon WJ,Kwag HJ,Na DG.Are there any specific ultrasound findings of nodular hyperplasia("leave me alone"lesion)to differentiate it from follicular adenoma[J].Acta Radiologica,2009,50(4):383~388.
[4]Cooper DS,Doherty GM,Haugen BR,et al.The American Thyroid Association Guidelines Task Force.Revised management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2009,19:1167~214.
[5]Brito JP,Gionfriddo MR,Al Nofal A,et al.The accuracy of thyroid nodule ultrasound to predict thyroid cancer:systematic review and meta-analysis[J].J Clin Endocrinol Metab,2014,99(4):1253~1263.
[6]Tang Y,Gao GL,Li GS.The research of characteristics of thyroid nodules disease in Weihai city[J].Chi Prac Med,2010,5(31):54~55.
[7]张春玉,曾洪利,刘颖,等.甲状腺结节与代谢综合征及其组分的相关性分析[J].中华内分泌代谢杂志,2012,28(2):132~135.
[8]徐厚兰,危静,兰满.11 268名健康体检人群甲状腺结节发生的流行状况调查分析[J].疾病监测,2014,29(12):987~989.
[9]常广,田京利,刘晓明,等.关于35495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.
[10]Moon JH,Hyun MK,Lee JY,et al.Prevalence of thyroid nodules and their associated clinical parameters:a large-scale,multicenterbased health checkup study[J].Korean J of Intern Med,2018,33(4):753~762.
[11]Furlanetto TW,Peccin S,Ma DOS,et al.Prevalence of thyroid nodules in 40 years-old or old women[J].Rev Assoc Med Bras,2000,46(4):331~334.
[12]Fang G,Ding G,Lou X,et al.Incidence of thyroid diseases in Zhejiang Province,China,after 15 years of salt iodization[J].J Trace Elem Med Biol,2016,36(3):57~64.
[13]Weng W,Dong M,Zhan J,et al.A PRISMA-compliant systematic review and meta-analysis of the relationship between thyroid disease and different levels of iodine intake in mainland China[J].Medicine,2017,96(25):e7279.
[14]Haugen BR,Alexander EK,Bible KC,et al.2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1~133.
[15]Mitchell AL,Gandhi A,Scott-Coombes D.Management of thyroid cancer:United Kingdom National Multidisciplinary Guidelines[J].JLaryngol Otol,2016,130(S2):S150~S160.
[16]Subekti I.Manajemen non-bedah pada nodul tiroid[C].In:Pemayun TGD,Nugroho KH,Minuljo TT,et al.Thyroid workshop.Annual scientific meeting of indonesian society of endocrinology in conjunction with semarang endocrine metabolic meeting.Semarang:PERKE-NI,2016:15~22.
[17]Buscemi S,Massenti FM,Vasto S,et al.Association of obesity and diabetes with thyroid nodules[J].Endocrine,2017(S1):1~9.