南京市26 788名体检人群甲状腺结节检出率及影响因素分析

doi:10.12183/j.scjpm.2021.1354

摘要/Abstract

摘要： 目的通过对大样本健康体检人群进行甲状腺超声检查,分析甲状腺结节的检出率及其危险因素,以期对甲状腺癌的早期防范提供线索。方法收集2018年1月至2020年5月于南京某医院体检中心行甲状腺超声检查的体检者临床资料,采用单、多因素方法进行分析。结果 26 788例体检者中检出甲状腺结节6 965例,总体检出率为26.0%,其中男性检出率为21.7%,女性检出率为41. 4%,女性检出率明显高于男性（χ²=919.785,P<0.01）。随着年龄的增长甲状腺结节检出率显著增加（P<0.01）。多因素Logistic回归分析显示女性（OR=3.075）、年龄越大（OR=1.066）、空腹血糖异常（OR=1.136）、血压异常（OR=1.151）为罹患甲状腺结节的影响因素。结论女性、高龄、血糖异常、血压异常是甲状腺结节的危险因素,甲状腺结节的发病可能与代谢异常有关,对代谢异常人群早期筛查可尽早发现甲状腺结节并采取防治措施。

关键词: 甲状腺, 甲状腺结节, 危险因素, 体检, 筛查

中图分类号:

R195

仝瑞祥, 何忠华, 王阳春, 陈婷婷, 方琴, 冯锋. 南京市26 788名体检人群甲状腺结节检出率及影响因素分析[J]. 华南预防医学, 2021, 47(10): 1354-1357.

参考文献

[1] Liu Y, Lin Z, Sheng C, et al.The prevalence of thyroid nodules in northwest China and its correlation with metabolic parameters and uric acid[J]. Oncotarget, 2017, 8(25):41555-41562.
[2] 李莉,郭峰丽,杨旭.健康体检人群甲状腺结节检出情况及发病影响因素研究[J].华南预防医学, 2021, 47(2): 158-161.
[3] 万学红,卢雪峰.诊断学[M]. 8版,北京:人民卫生出版社,2013:605-613.
[4] Angell TE,Maurer R, Wang Z, et al.A cohort analysis of clinical and ultrasound variables predicting cancer risk in 20,001 consecutive thyroid nodules[J]. J Clin Endocrinol Metab, 2019, 104(11): 5665-5672.
[5] Hyun MK, Kim JH, Kwon JW.Incidence of thyroid cancer and medical cost among patients with newly diagnosed thyroid nodules in Korea: A retrospective cohort study using nationwide data[J]. J Canc Res Ther, 2019, 15(3):676-680.
[6] 霍立双,刘丰雨,高琛,等.我国大陆地区甲状腺结节患病率Meta分析[J].河北医科大学学报,2017,38(2):138-141,205.
[7] Faria CC, Peixoto MS, Carvalho DP, et al.The emerging role of estrogens in thyroid redox homeostasis and cagenesis[J]. Oxid Med Cell Longev, 2019, 2019:1-13.
[8] Zheng L, Yan W, Kong Y, et al.An epidemiological study of risk factors of thyroid nodule and goiter in Chinese women[J]. Int J Clin Exp Med ,2015,8(7):11379-11387.
[9] Moon JH, Hyun MK, Lee JY, et al.Prevalence of thyroid nodules and their associated clinical parameters: A large-scale, multicenter-based health checkup study[J].Korean J Intern Med,2018,33(4):753-762.
[10] 井高静, 傅松波, 焦彩虹,等.甘肃陇南地区农村人群不同性别甲状腺结节患病状况调查[J].河北医科大学学报,2020,41(2):128-131,137.
[11] Jiang H, Tian Y, Yan W, et al.The prevalence of thyroid nodules and an analysis of related lifestyle factors in Beijing communities[J]. Int J Environ Res Public Health, 2016, 13(4):442.
[12] 高芳凤, 郑伍桂, 车春,等.健康体检人群甲状腺结节相关因素研究[J].华南预防医学, 2019, 45(6): 536-539.
[13] Kwong N, Medici M, Angell TE, et al.The influence of patient age on thyroid nodule formation, multinodularity, and thyroid cancer risk[J].J Clin Endocrinol,2015,100(12):4434-4440.
[14] Liu J, Wang C, Tang X, et al.Correlation analysis of metabolic syndrome and its components with thyroid nodules[J]. Diabetes Metab Syndr Obes,2019,12:1617-1623.
[15] 王晨鸽, 刘靖芳, 汤旭磊,等.甘肃地区代谢综合征发病及与甲状腺结节的关系[J].中国老年学杂志, 2018, 38(22):53-56.
[16] 徐海凤, 赵猛.2型糖尿病患者甲状腺结节的危险因素分析[J].临床荟萃,2020, 35(3):242-244.
[17] Mayers RA, Andrea SM, Alejandro PR, et al.Association between metabolic syndrome and euthyroid nodular goiter: A case-control study[J]. Colomb Medica, 2019,50(4):239-251.
[18] Shin J, Kim MH, Yoon KH, et al.Relationship between metabolic syndrome and thyroid nodules in healthy Koreans[J]. Korean J Intern Med, 2016, 31(1):98-105.
[19] Anil C, Kut A, Atesagaoglu B, et al.Metformin decreases thyroid volume and nodule size in subjects with insulin resistance: A preliminary study[J]. Med Princ Pract, 2015, 25(3):233-236.
[20] 蒋苏梅,赵雅萍.妊娠期高血压疾病对孕期甲状腺功能的影响[J].医学临床研究,2020,37(7):1039-1041,1044.
[21] 王学强,吴凯,忻莹.血清促甲状腺激素等指标在甲状腺结节影像、临床诊断中的参考价值[J].浙江医学教育,2019,18(3):56-59.