承德市体检人群甲状腺结节患病情况及危险因素研究

发布时间：2018-09-07 21:07

【摘要】：目的:通过对承德市体检人群甲状腺结节患病情况的横断面研究,了解承德市体检人群甲状腺结节患病率情况;在此基础上自行编制具有承德特色的甲状腺结节相关因素调查问卷,用于体检人群甲状腺结节患病危险因素的病例对照研究,了解其患甲状腺结节的危险因素,为制定承德市甲状腺结节防治措施、临床医护人员进行健康宣教提供理论指导和科学依据。方法:本课题采用以体检人群为基础的横断面调查及病例对照研究方法,收集2015年1月~2016年1月在承德市某三甲医院健康体检中心查体的18~90岁体检者的血液生化检查、B型超声检查、体格检查及身体测量等检测项目的结果,描述性分析承德市体检人群中甲状腺结节患病率及其它疾病的检出情况;同时在体检人群中选取符合诊断标准的200例新发甲状腺结节阳性者作为病例组,按照同期、年龄(±3岁)选取无甲状腺结节的200例体检者作为对照组,应用自编的《甲状腺结节相关因素调查问卷》对两组人群生活饮食、社会心理及疾病家族史等影响因素进行问卷调查,数据整理后,进行单因素及多因素非条件logistic回归分析,进一步探讨承德市体检人群甲状腺结节患病的相关危险因素。结果:1承德市体检人群甲状腺结节横断面研究结果:6000例健康体检居民中,有效的统计数据资料为5462例(男性3218例、女性2244例)。甲状腺结节总患病率为40.72%,其中女性人群甲状腺结节患病率为42.47%,男性人群甲状腺结节患病率为39.53%,女性甲状腺结节患病率高于男性,差异有统计学意义(χ2=4.64,P=0.031)。甲状腺结节患病率与年龄的增长成正相关趋势,60岁年龄段人群结节患病率最高,达到64.19%。多因素分析发现年龄(OR=1.032,P=0.000)、体重指数(OR=1.021,P=0.042)、空腹血糖(OR=2.101,P=0.037)是体检人群中甲状腺结节患病率较高的独立影响因素。2承德市体检人群甲状腺结节危险因素病例对照研究结果:经单因素及多因素非条件Logistic回归分析后,甲状腺疾病家族史(OR=5.17,P=0.010)、长期熬夜(OR=4.87,P=0.010)、经常生气(OR=3.32,P=0.000)及食用碘盐(OR=3.13,P=0.000)可能为体检人群患甲状腺结节的危险因素;家庭生活关系和谐(OR=-1.07,P=0.000)、积极的自我看法(OR=-0.44,P=0.016)可能为体检人群患甲状腺结节的保护因素。结论:1承德市体检人群甲状腺结节总患病率为40.72%。其中,女性甲状腺结节患病率氋于男性,且患病率随年龄增长而逐渐升高,60岁年龄段人群结节患病率高达64.19%,提示:应对我市居民甲状腺结节的流行现况引起更多关注。2甲状腺结节受多种影响因素的综合作用,建议居民及高危人群应该从膳食、生活方式、改善社会心理环境等多方面采取预防控制措施,对年龄60岁及有甲状腺疾病家族史的高危人群,应重点进行监测,以期预防疾病的发生。
[Abstract]:Objective: to investigate the prevalence rate of thyroid nodules in healthy people in Chengde city by cross-sectional study. On the basis of this, the questionnaire of thyroid nodule related factors with Chengde characteristic was compiled, which was used in the case-control study of thyroid nodule risk factors in physical examination population to find out the risk factors of thyroid nodule. In order to make the prevention and cure measures of thyroid nodule in Chengde City, and provide the theory guidance and scientific basis for the health education of the clinical medical staff. Methods: a cross-sectional investigation and a case-control study based on physical examination were used in this study. From January 2015 to January 2016, the results of the blood biochemical examination, physical examination and physical measurement of 180-year-old people who were examined in the health examination center of a third Class A Hospital in Chengde City were collected, such as B-mode ultrasound examination, physical examination and physical measurement, etc. The prevalence of thyroid nodules and the detection of other diseases were analyzed in Chengde City, and 200 newly diagnosed thyroid nodule positive patients were selected as the case group according to the same period. The age (卤3 years) of 200 healthy persons without thyroid nodule were selected as control group. The self-designed questionnaire of thyroid nodule related factors was used to investigate the influencing factors such as diet, social psychology and family history of disease in the two groups. Univariate and multivariate non-conditional logistic regression analysis was carried out to further explore the risk factors of thyroid nodule in healthy population in Chengde city. Results the results of the cross-sectional study of thyroid nodules in the population in Chengde City showed that the effective statistical data were 5462 cases (3218 males and 2244 females) out of 6 000 healthy residents. The total prevalence rate of thyroid nodules was 40.72%. The prevalence rate of thyroid nodules was 42.47 in female population and 39.53 in male population. The prevalence rate of thyroid nodule in female was higher than that in male (蠂 ~ 2 = 4.64) (蠂 ~ 2 = 4.64). The incidence of thyroid nodule was positively correlated with the increase of age. The prevalence rate of thyroid nodule was the highest in the age group of 60 years old, reaching 64.19%. Multivariate analysis found that age (OR=1.032,P=0.000), body mass index (OR=1.021,P=0.042) and fasting blood glucose (OR=2.101,P=0.037) were independent factors influencing the prevalence of thyroid nodules. After univariate and multivariate unconditioned Logistic regression analysis, Family history of thyroid disease (OR=5.17,P=0.010), long stay up (OR=4.87,P=0.010), frequent anger (OR=3.32,P=0.000) and iodized salt (OR=3.13,P=0.000) may be the risk factors of thyroid nodule in healthy people. Harmonious family life (OR=-1.07,P=0.000) and positive self-perception (OR=-0.44,P=0.016) may be the protective factors for thyroid nodules. Conclusion the total prevalence rate of thyroid nodules in the population in Chengde City is 40.72. Among them, the prevalence of thyroid nodules in females was higher than that in males. The prevalence rate of thyroid nodules increased gradually with the increase of age, and the prevalence rate of thyroid nodules was 64.19, which suggested that more attention should be paid to the prevalence of thyroid nodules in the residents of our city. It is suggested that the residents and high risk groups should take preventive and control measures from the aspects of diet, lifestyle, and improvement of social and psychological environment, and should focus on monitoring the high risk population aged 60 years and having a family history of thyroid diseases. In order to prevent the occurrence of disease.
【学位授予单位】：承德医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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