吉林省城乡居民甲状腺结节流行情况及影响因素

发布时间：2018-03-17 02:36

本文选题：甲状腺结节　切入点：流行病学　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对吉林省城乡居民流行病学调查了解吉林省城乡甲状腺结节患病率、流行特点,并了解甲状腺结节患病影响因素。方法:采用分层整群随机抽样方法选取吉林省18岁以上常住城乡居民进行横断面研究。最终有2484例纳入本研究,其中城镇居民1163例,占46.8%,农村居民1321例,占53.2%。对调查对象进行问卷调查、体格检查、实验室生化指标检查和甲状腺超声检查。原始数据由两人分别应用Epidata软件录入,第三人负责核对、导出数据。最终数据应用SPSS 17.0软件进行统计学分析。结果:1、吉林省城乡居民甲状腺结节总体患病人数为608例,总体粗患病率为24.5%,标化患病率为27.0%;2、结节患病率随着年龄增长而增加,趋势检验具有统计学意义(P0.001),OR:1.035(1.023-1.045);3、女性结节标化患病率为29.6%,男性结节标化患病率为23.9%,女性结节患病率大于男性(P0.01),OR:2.416(1.850-3.155);4、结节组与非结节组相比,结节组左、右叶的左右径、前后径、上下径及峡部前后径比非结节组大(P0.05);5、甲状腺结节以实性低回声、小于1cm的单发结节为主,甲状腺结节总体钙化率为23.7%;6、不同文化程度结节患病率差异具有统计学意义(P0.001),组间比较未上学组比高中/中专组和大专/大学组结节患病率高(P0.05);小学组比高中/中专组和大专/大学组结节患病率高(P0.05);7、不同职业结节患病率差异有统计学意义(P0.001),组间比较家务组结节患病率高于其他各职业组(P0.05);8、不同进食盐量与结节患病率无关(P0.05);9、女性吸烟组结节患病率大于非吸烟组(P0.05);10、不同BMI组结节患病率不同(P0.001),且随着BMI等级增加结节患病率增加,趋势检验亦具有统计学意义(P0.001);11、随着腰围的增加,结节患病率增加(P0.01),OR:1.022(1.004-1.041);12、随着糖代谢水平降低,结节患病率增加,趋势检验具有统计学意义(P0.001),且随着空腹血糖水平增加,结节患病率增加(P0.001),OR:1.144(1.014-1.290);13、不同尿碘浓度组结节患病率不同(P0.05),组间比较碘过量组结节患病率均小于其它三组(P0.05);不同尿碘水平之间单发、多发结节患病率不同,差异具有统计学意义(P0.05),碘缺乏组以多发结节为主,其它组以单发结节为主,随着尿碘水平增加,多发结节患病率下降;14、TPOAb阳性组结节患病率大于阴性组(P0.05);15、随着收缩压升高,结节患病率升高(P0.05),OR:1.016(1.007-1.024);16、多因素回归分析结果显示女性(OR:2.416,95%CI:1.850-3.155,P0.001)、年龄(OR:0.034,95%CI:1.023-1.045,P0.001)、甲状腺疾病家族史(OR:1.560,95%CI:1.070-2.275,P=0.021)、FBG(OR:1.144,95%CI:1.014-1.290,P=0.028)、收缩压(OR:1.016,95%CI:1.007-1.024,P0.001)、腰围(OR:1.022,95%CI:1.004-1.041,P=0.018)是甲状腺结节患病的独立危险因素。结论:1、吉林省城乡居民甲状腺结节总体标化患病率为27.0%,其中女性结节标化患病率为29.6%,男性结节标化患病率为23.9%,女性结节患病率大于男性;2、女性、年龄增大、空腹血糖升高、收缩压增加、腰围增大、甲状腺疾病家族史是甲状腺结节独立危险因素;3、甲状腺结节数量以单发结节为主,结节大小以小于1cm为主,回声以实性低回声为主,甲状腺结节总体钙化率为23.7%。
[Abstract]:Objective: through the investigation of urban and rural residents in Jilin province and Jilin province to understand the epidemiology of thyroid nodule prevalence, epidemiological characteristics, and to understand the prevalence and influencing factors of thyroid nodules. Methods: using stratified random sampling methods in Jilin Province over the age of 18 permanent residents in the cross-sectional study. The final 2484 were enrolled in the study, including urban residents in 1163 cases, accounted for 46.8% of rural residents in 1321 cases, accounting for 53.2%. of the survey questionnaire, physical examination, laboratory examination and biochemical indexes of thyroid ultrasonography. The original data from two respectively using Epidata software, third people responsible for checking, final data export data. SPSS 17 software was used for statistical analysis. Results: 1 urban and rural residents in Jilin Province, the overall prevalence of thyroid nodules in 608 cases, the overall prevalence was 24.5%, the standardized prevalence rate was 27%; 2, the prevalence rate of nodules with With the increase of age, with statistically significant trend test (P0.001), OR:1.035 (1.023-1.045); 3, female nodule standardized prevalence rate was 29.6%, male nodule standardized prevalence rate was 23.9%, the prevalence rate of male is larger than female nodules (P0.01), OR:2.416 (1.850-3.155); 4, nodules were compared with non nodule group left, right lobe nodule group, the diameter, anteroposterior diameter, vertical diameter and isthmus diameter before and after non nodule group (P0.05); 5, thyroid nodules hypoechoic nodules, less than 1cm, the overall rate of thyroid nodule calcification in 23.7%; 6, the difference was statistical significance in different culture the degree of nodules (P0.001), comparison between groups did not go to school group was higher than high school / secondary school and college / University (P0.05); group of nodules in primary school group was higher than high school / secondary school and college / University (P0.05); group of nodules in 7 different occupation nodule prevalence rate difference was statistically significant (P0. 001), comparison between groups of housework prevalence rate is higher than that in other groups were occupation group (P0.05); 8, different amount of salt intake and the prevalence rate of independent nodules (P0.05); 9, female smoking group nodule prevalence of more than non smoking group (P0.05); 10, the prevalence rate of different nodules of different BMI group (P0.001). And with the BMI level increased nodule prevalence increased, trend test was also statistically significant (P0.001); 11, with increases in waist circumference, nodule prevalence increased (P0.01), OR:1.022 (1.004-1.041); 12, with the level of glucose metabolism decreased, nodule prevalence increased, statistically significant trend test (P0.001), and with the the fasting blood glucose level increased, nodule prevalence increased (P0.001), OR:1.144 (1.014-1.290); 13, the prevalence rate of different nodules of different urinary iodine concentration group (P0.05), comparison between groups in high iodine group nodules prevalence rates were less than the other three groups (P0.05); single between different level of urine iodine nodules prevalence rate Different, the difference was statistically significant (P0.05), iodine deficiency group with multiple nodules, nodules in other groups, with the increase in urinary iodine level, decreased the rate of prevalence of multiple nodules; 14, TPOAb positive group nodule prevalence of more than negative group (P0.05); 15, with systolic pressure increased, the prevalence rate of nodules increased (P0.05), OR:1.016 (1.007-1.024); 16, multivariate regression analysis showed that female (OR:2.416,95%CI:1.850-3.155, P0.001), age (OR:0.034,95%CI:1.023-1.045, P0.001), family history of thyroid disease (OR:1.560,95% CI:1.070-2.275, P=0.021), FBG (OR:1.144,95%CI:1.014-1.290, P=0.028), systolic blood pressure (OR:1.016,95%CI:1.007-1.024, P0.001), waist circumference (OR:1.022,95%CI:1.004-1.041, P=0.018) is an independent risk factor for the prevalence of thyroid nodules. Conclusion: 1, urban and rural residents in Jilin province thyroid nodules overall standardized prevalence rate was 27%, in which the female nodules standardized patients Male nodular disease rate was 29.6%, the standardized prevalence rate was 23.9%, the prevalence rate of male is larger than female nodules; 2, female, age, fasting blood glucose, systolic blood pressure increased, increased waist circumference, family history of thyroid disease are independent risk factors of thyroid nodules; 3, the number of thyroid nodules in solitary nodules, nodule size less than 1cm, echo constant low echo, calcification of thyroid nodules the overall rate of 23.7%.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R581

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