西宁地区查体人群甲状腺结节发病特点的临床研究

发布时间：2018-01-03 07:26

本文关键词：西宁地区查体人群甲状腺结节发病特点的临床研究　出处：《苏州大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的了解西宁地区查体人群中甲状腺结节的检出情况,分析甲状腺结节数目、性质特点及其与甲状腺功能的关系。方法采用回顾性调查分析的研究方法对我院门诊查体人群的甲状腺超声结果进行了总结分析,并分性别、年龄段及不同BMI分组对甲状腺结节的检出率、结节的数目及性质进行比较,分析西宁地区甲状腺结节在查体人群中的患病特征;同时,比较超声正常组和有结节组甲状腺功能的变化,研究甲状腺结节的发生与甲状腺功能的关系。并采用多因素Logistic回归分析的方法,分析与甲状腺结节发生相关的独立危险因素。结果(1)本研究包含1673例查体对象,其年龄分布在21~96岁之间,平均年龄49.64±11.45岁;其中男性1227例(占73.3%),平均年龄49.66±11.54(21~96岁),女性446例(占26.7%),平均年龄49.59±11.20岁(22~83岁)。(2)本研究共检出甲状腺结节644例,检出率为38.5%。在644例甲状腺结节患者中单发结节327例占50.8%,多发结节317例占49.2%;实性结节315例占55.5%,囊实性162例占25.2%,囊性124例占19.3%。(3)查体人群中总体检出率为38.5%。其中男性共检出甲状腺结节416例,检出率为33.9%,女性共检出甲状腺结节228例,检出率为51.1%,女性略高于男性,两组间比较有统计学差异(?2=40.95,P0.001)。甲状腺结节的检出率在全体人群以及不同性别间,随年龄的增长逐渐增高(P值均0.001),而与BMI无相关性(?2=5.039,P=0.077)。(4)在甲状腺结节数目方面,多发结节所占比例女性较男性略高,两者有统计学差异(?2=10.62,P=0.001);随着年龄的增长,多发结节的比例逐渐增加(?2=29.69,P0.001);而在不同BMI分组中无明显差异(?2=1.163,P=0.762)。(5)在甲状腺结节性质的构成比方面,在不同年龄段分组中,甲状腺实性结节与年龄分组无关;而囊实性结节随着年龄的增长而增多,而囊性结节随着年龄的增加而减少(?2=34.84,P=0.006);在不同性别及不同BMI分组中均无明显差异(P=0.455,P=0.549)。(6)1673例研究对象中有1353例接受了甲状腺功能测定达80.9%,并依照TSH水平分为:TSH0.05u IU/m L18例占1.3%,TSH0.05~u IU/m L1115例占82.4%,TSH4.78~u IU/mL183例占13.5%,TSH≥10.0u IU/m L37例占2.7%。提示在本研究的查体人群中,甲状腺功能在正常范围达82.4%,亚临床甲状腺功能亢进的有1.3%,亚临床甲状腺功能减退的占13.5%,甲状腺功能减退的有2.7%。(7)将1353例接受甲状腺功能测定的查体对象,按照甲状腺超声检查结果分为无结节组和有结节组。结果显示,有结节组FT3、FT4水平较无结节组低,且有统计学差异(P=0.014,P=0.001),而TSH、TPOAb在两组间无差异(P=0.054,P=0.931)。(8)采用Logistic回归分析的方法显示,年龄、性别、BMI、总胆固醇(TC)、甘油三酯(TG)、尿酸(UA)、空腹血糖(FG)是甲状腺结节发生的独立危险因素(P0.001,P0.001,P=0.019,P=0.009,P0.001,P0.001,P=0.008),而与甲状腺功能(FT3、FT4、TSH)无明显相关。结论(1)在西宁地区查体人群中经甲状腺超声检查的甲状腺结节检出率为38.5%,女性高于男性,随着年龄的增长逐渐增高,以单发、实性结节为主。(2)在甲状腺结节数目方面,多发结节所占比例女性较男性略高,随着年龄的增长多发结节的比例逐渐增加。(3)在甲状腺结节性质的构成比方面,甲状腺实性结节比例与年龄分组无关,但囊实性结节比例随着年龄的增长而增多,而囊性结节比例随着年龄的增长而减少。(4)年龄、性别、BMI、总胆固醇、甘油三酯、尿酸、空腹血糖是甲状腺结节发生的独立危险因素。
[Abstract]:Objective to understand the prevalence of thyroid nodules in Xining check body in the crowd, the number of thyroid nodules were analyzed. The characteristics and its relationship with thyroid function. Using the method of thyroid ultrasound results survey analysis on outpatient Persons'Serum review are summarized, and the detection rate of sex, age and different BMI the grouping of thyroid nodules, compare the number and nature of nodules, analysis of prevalence characteristics of thyroid nodules in Xining area in the examination in the crowd; at the same time, the change of ultrasound in normal group and nodular thyroid function group, the relationship between thyroid function and thyroid nodules. The study method and Logistic regression analysis using multiple factors. Independent risk factors associated with the occurrence of thyroid nodules and analysis. Results (1) the study included 1673 cases of physical objects, the age distribution between 21~ at the age of 96, The average age of 49.64 + 11.45 years; there were 1227 males (73.3%), mean age 49.66 + 11.54 (21~96 years), 446 cases were female (26.7%), mean age 49.59 + 11.20 years (22~83 years). (2) in this study were detected in 644 cases of thyroid nodules, the detection rate of 38.5%. in 644 cases thyroid nodules solitary nodules in 327 cases accounted for 50.8%, 317 cases of multiple nodules accounted for 49.2%; solid nodules in 315 cases accounted for 55.5%, accounting for 25.2% of 162 cases of cystic, cystic in 124 cases of 19.3%. (3) subjects in the overall detection rate of 38.5%. in male were detected in 416 cases of thyroid nodules were detected. The rate is 33.9%, the female were detected in 228 cases of thyroid nodules, the detection rate was 51.1%, slightly higher than the male female, compared with a significant difference between the two groups (? 2=40.95, P0.001). The detection rate of thyroid nodules in all groups and between different genders, increased gradually with the increase of age (P = 0.001), and no correlation with BMI (2=5.039, P=0.? 077). (4) in the number of thyroid nodules, nodules in the proportion of women is slightly higher than that of men, both have statistical difference (? 2=10.62, P=0.001); with the increase of age, multiple nodules increased (? 2=29.69, P0.001); and there is no obvious difference in different groups (BMI 2=1.163?, P=0.762). (5) in the form of thyroid nodules than that in different age groups in thyroid nodules and age groups; and cystic nodules with age increasing, while the cystic nodules decreased with increasing age (? 2=34.84, P=0.006) were; no significant differences in different gender and different BMI groups (P=0.455, P=0.549). (6) of 1673 subjects in 1353 cases underwent thyroid function test was 80.9%, and in accordance with the level of TSH is divided into: TSH0.05u IU/m L18 TSH0.05~u IU/m L1115 patients accounted for 1.3%, accounted for 82.4% of TSH4.78~u cases, IU/mL183 cases accounted for 13.5% TSH = 10.0u IU/m, L37 2.7%. cases hint in the subjects of this study, the thyroid function was 82.4% in the normal range, subclinical hyperthyroidism 1.3%, subclinical hypothyroidism accounted for 13.5%, hypothyroidism with 2.7%. (7) of the 1353 patients received thyroid function test check the body of the object, in accordance with the thyroid ultrasound examination were divided into non nodule group and nodule group. The results showed that the nodule group FT3, FT4 levels were no nodules was low, and there is significant difference (P=0.014, P=0.001), and TSH, TPOAb did not differ between the two groups (P=0.054, P=0.931) (8) method. The Logistic regression analysis showed that age, gender, BMI, total cholesterol (TC), triglyceride (TG), uric acid (UA), fasting blood glucose (FG) were independent risk factors of thyroid nodules occurred (P0.001, P0.001, P=0.019, P=0.009, P0.001, P0.001, P=0.008), and thyroid function (FT3 FT4, TSH. No obvious correlation). Conclusion (1) in the Xining area Persons'Serum by thyroid ultrasound in thyroid nodule detection rate was 38.5%. The female is higher than male, with age gradually increased, with single, solid nodules. (2) in the number of thyroid nodules, nodules in the proportion of women slightly higher than men, with age of multiple nodules gradually increase the proportion. (3) in which the ratio of thyroid nodules, thyroid nodules and the proportion of age independent, but cystic nodules in proportion with age increased, while the proportion of cystic nodules decreases with age. (4) the age, gender, BMI, total cholesterol, triglyceride, uric acid, fasting blood glucose were independent risk factors of thyroid nodules.

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R581

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