张家口地区成人甲状腺疾患情况及人口学特征
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摘要
目的调查现阶段张家口地区成人甲状腺疾患情况及人口学特征,为制订卫生保健措施提供依据。方法以2015年1月1日—2017年12月31日在张家口市第一医院门诊、健康检查中心进行甲状腺疾病筛查的15 498例成年人群为研究对象,编制调查表,收集研究对象的临床诊断资料与人口学资料,采用相关软件对收集的资料进行汇总、统计分析。结果在15 498例研究对象中,临床诊断甲状腺疾病患者4 597例,总患病率为29.66%,其中甲状腺结节患病率占首位,其次是甲减、甲亢分别占第2、3位;在4 312例甲状腺结节患者中,实性结节患者2 410例(55.90%),囊性结节患者857例(19.87%),囊实性结节患者1 045例(24.23%)。2015—2017年,甲状腺疾病患病率分别为26.81%、28.22%、32.37%,呈逐年上升趋势(P<0.01)。女性甲状腺疾病总患病率明显高于男性,差异有统计学意义(P<0.01);不同年龄段、不同职业的甲状腺疾病患病率比较,差异均有统计学意义(均P<0.01),其中60～69岁年龄段患病率最高,医护人员患病率在不同职业类型中最高;海产品不同进食频率之间比较,差异有统计学意义(P<0.01),其中基本不食海产品人群患病率最高。结论张家口地区成人甲状腺疾病患病率逐年上升,在继续加强甲状腺疾病知识健康宣教、提倡健康生活的同时,还要特别关注女性、中老年人、医护人员等群体的身心健康状况,鼓励张家口地区居民定期进行甲状腺疾病筛查,实现早期防治,促进健康水平。
[Objective] To investigate the epidemic and demographic characteristics of thyroid diseases among adults in Zhangjiakou area at the present stage, provide a basis for the formulation of health care measures. [Methods] A total of 15 498 adults who received the thyroid disease screening in the outpatient service and physical examination center of the Zhangjiakou First Hospital from January 1, 2015 to December 31, 2017 were collected as the research objects. The questionnaire was designed to collect the clinical diagnostic data and demographic data of the research objects. The data were sum up and statistically analyzed by the related software.[Results]Among 15 498 subjects,4 597 were clinically diagnosed with thyroid diseases,and the total prevalence was 29.66%. The prevalence of thyroid nodules was the highest,followed by hypothyroidism and hyperthyroidism. Among 4 312 patients with thyroid nodules,2 410(55.90%)cases had solid nodules,857(19.87%) cases had cystic nodules,and 1 045(24.23%)cases had cystic mixing with solid nodules. From 2015-2017,the annual prevalence of thyroid diseases was respectively 26.81%,28.22% and 32.37%,showing a rising trend(P<0.01). The total prevalence of thyroid diseases in females was higher than that in males,and the difference was statistically significant(P<0.01). There were statistically significant differences in prevalence of thyroid diseases among different age group and different occupation group(both P<0.01),while the prevalence in 60-69 year-old age group was the highest,and the medical staff had the highest prevalence among different occupations. The difference was statistically significant among groups in different frequencies of seafood consumption(P<0.01),and the people who did not eat seafood had the highest prevalence.[Conclusion]The prevalence of thyroid diseases among adults in Zhangjiakou area increases year by year. It is necessary to continue to strengthen the health education of thyroid disease knowledge, advocate healthy life, pay special attention to physical and mental health of women, elderly and medical staff, and encourage residents in Zhangjiakou area to regularly screen for thyroid diseases to achieve early prevention and treatment and promote health level.
[Objective] To investigate the epidemic and demographic characteristics of thyroid diseases among adults in Zhangjiakou area at the present stage, provide a basis for the formulation of health care measures. [Methods] A total of 15 498 adults who received the thyroid disease screening in the outpatient service and physical examination center of the Zhangjiakou First Hospital from January 1, 2015 to December 31, 2017 were collected as the research objects. The questionnaire was designed to collect the clinical diagnostic data and demographic data of the research objects. The data were sum up and statistically analyzed by the related software.[Results]Among 15 498 subjects,4 597 were clinically diagnosed with thyroid diseases,and the total prevalence was 29.66%. The prevalence of thyroid nodules was the highest,followed by hypothyroidism and hyperthyroidism. Among 4 312 patients with thyroid nodules,2 410(55.90%)cases had solid nodules,857(19.87%) cases had cystic nodules,and 1 045(24.23%)cases had cystic mixing with solid nodules. From 2015-2017,the annual prevalence of thyroid diseases was respectively 26.81%,28.22% and 32.37%,showing a rising trend(P<0.01). The total prevalence of thyroid diseases in females was higher than that in males,and the difference was statistically significant(P<0.01). There were statistically significant differences in prevalence of thyroid diseases among different age group and different occupation group(both P<0.01),while the prevalence in 60-69 year-old age group was the highest,and the medical staff had the highest prevalence among different occupations. The difference was statistically significant among groups in different frequencies of seafood consumption(P<0.01),and the people who did not eat seafood had the highest prevalence.[Conclusion]The prevalence of thyroid diseases among adults in Zhangjiakou area increases year by year. It is necessary to continue to strengthen the health education of thyroid disease knowledge, advocate healthy life, pay special attention to physical and mental health of women, elderly and medical staff, and encourage residents in Zhangjiakou area to regularly screen for thyroid diseases to achieve early prevention and treatment and promote health level.
引文
[1]胡婉钰,曾志斌,张红.湖南省碘营养状况及碘盐与甲状腺疾病关系的流行病学调查[J].中华实用诊断与治疗杂志,2018,32(5):440-444.
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[4]葛明华,徐栋,杨安奎,等.甲状腺良性结节、微小癌及颈部转移性淋巴结热消融治疗专家共识(2018版)[J].中国肿瘤,2018,27(10):768-773.
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[8]REINERS C,WEGSCHEIDER K,SCHICHA H,et a1.Prevalence of thyroid disorders in the working population of Germany:ultrasonography screening in 96,278 unselected employees[J].Thyroid,2004,14(11):926-932.
[9]MARTAYAN A,SANCHEZ-METE L,BALDELLI R,et al.Gene variants associated to malignant thyroid disease in familial adenomatous polyposis:a novel APC germline mutation[J].J Endocrinol Invest,2010,33(9):603-606.
[10]BADIHIAN S,JALALPOUR P,MIRDAMADI M,et al.Quality of Life,Anxiety and Depression in Patients with Differentiated Thyroid Cancer under Short Term Hypothyroidism Induced by Levothyroxine Withdrawal[J].Klin Onkol,2016,29(6):439-444.
[11]何立群,杨洁妮,胡孟钧,等.细针吸取细胞学联合免疫组织化学标记物在甲状腺结节鉴别诊断中的意义[J].中国医师进修杂志,2013,36(14):28-30.
[12]赵薛飞,董红军,张劼楠,等.沿海地区居民甲状腺结节患病状况及相关因素分析[J].浙江预防医学,2015,27(2):120-123.
[13]郝志华,王俊明,陈春彦,等.体检人群甲状腺结节的检出情况及相关因素分析[J].中国慢性病预防与控制,2012,20(3):307-310.
[14]刘婷婷,滕卫平.中国国民碘营养现状与甲状腺疾病[J].中华内科杂志,2017,56(1):62-64.
[15]邢再玲,王临虹.2014年北京市某三家医院护士甲状腺疾病调查研究[J].中国预防医学杂志,2016,17(8):601-604.
[16]范勇,郑嫦娟,康丽玫.手术室护士甲状腺疾病患病情况的调查分析[J].广东医学院学报,2012,30(4):454-456.
[2]冯宝香,陈慧欣,王雪,等.吉林省成人甲状腺疾病超声检查流行病学研究[J].中国地方病防治杂志,2016,31(7):745-746.
[3]程千鹏,洛佩,吕肖锋.甲状腺功能减退症的病因和对机体影响的研究进展[J].医学综述,2018,24(9):1766-1770.
[4]葛明华,徐栋,杨安奎,等.甲状腺良性结节、微小癌及颈部转移性淋巴结热消融治疗专家共识(2018版)[J].中国肿瘤,2018,27(10):768-773.
[5]留芳,李晓红,任艳鑫,等.2539例甲状腺疾病构成分析[J].中国病案,2012,13(11):77-79.
[6]RIOS A,RODRIQUEZ JM,NAVAS D,et al.Family Screening in Familial Papillary Carcinoma:The Early Detection of Thyroid Disease[J].Ann Surg Oncol,2016,23(8):2564-2570.
[7]CERESINI G,MARINA M,LAURETANI F,et al.Relationship Between Circulating Thyroid-Stimulating Hormone,Free Thyroxine,and Free Triiodothyronine Concentrations and 9-Year Mortality in Euthyroid Elderly Adults[J].J Am Geriatr Soc,2016,64(3):553-560.
[8]REINERS C,WEGSCHEIDER K,SCHICHA H,et a1.Prevalence of thyroid disorders in the working population of Germany:ultrasonography screening in 96,278 unselected employees[J].Thyroid,2004,14(11):926-932.
[9]MARTAYAN A,SANCHEZ-METE L,BALDELLI R,et al.Gene variants associated to malignant thyroid disease in familial adenomatous polyposis:a novel APC germline mutation[J].J Endocrinol Invest,2010,33(9):603-606.
[10]BADIHIAN S,JALALPOUR P,MIRDAMADI M,et al.Quality of Life,Anxiety and Depression in Patients with Differentiated Thyroid Cancer under Short Term Hypothyroidism Induced by Levothyroxine Withdrawal[J].Klin Onkol,2016,29(6):439-444.
[11]何立群,杨洁妮,胡孟钧,等.细针吸取细胞学联合免疫组织化学标记物在甲状腺结节鉴别诊断中的意义[J].中国医师进修杂志,2013,36(14):28-30.
[12]赵薛飞,董红军,张劼楠,等.沿海地区居民甲状腺结节患病状况及相关因素分析[J].浙江预防医学,2015,27(2):120-123.
[13]郝志华,王俊明,陈春彦,等.体检人群甲状腺结节的检出情况及相关因素分析[J].中国慢性病预防与控制,2012,20(3):307-310.
[14]刘婷婷,滕卫平.中国国民碘营养现状与甲状腺疾病[J].中华内科杂志,2017,56(1):62-64.
[15]邢再玲,王临虹.2014年北京市某三家医院护士甲状腺疾病调查研究[J].中国预防医学杂志,2016,17(8):601-604.
[16]范勇,郑嫦娟,康丽玫.手术室护士甲状腺疾病患病情况的调查分析[J].广东医学院学报,2012,30(4):454-456.