健康体检者7097名甲状腺结节检出情况与临床特点

目的分析潍坊地区健康体检者甲状腺结节的检出情况,了解本地区甲状腺结节的患病率与甲状腺结节的临床特点。方法采用分层整群随机抽样的横断面调查方法对2010年1月至2012年12月在我院健康体检并行甲状腺超声检查的7 097名体检者的甲状腺结节检出情况进行分析,比较不同年龄、不同性别结节检出率、结节大小、结节数目之间的差异;对超声检出结节者全部进行甲状腺功能检查。结果 7 097名体检者中有2 458名检出甲状腺结节,总检出率为34.63%,随着年龄增长而增加,趋势性卡方检验结果有统计学意义(男χ2=834.17,女χ2=625.85,均P=0.001);男、女性检出率分别为31.4%、40.74%,女性明显高于男性,女性检出年龄早于男性。单发结节检出率随着年龄的增长而减少,多发结节检出率随着年龄的增长而增加(χ2=71.55,P=0.016),单发结节检出率男性多于女性(56.87%vs.43.26%,χ2=91.857,P=0.01),多发结节反之(43.18%vs.58.47%,χ2=248.65,P=0.01);小结节、中等结节和大结节的检出率男性分别为78.91%、17.22%、4.32%;女性分别为70.13%、20.59%、10.09%。本组体检者共检出甲状腺癌11例,恶性结节占所检出结节的0.45%。用Logistic回归分析的方法评价甲状腺结节与甲状腺功能的关系显示,年龄、性别进入回归方程(P=0.023,0.001),TSH、FT3、FT4水平和TGAb、TPOAb是否阳性与甲状腺结节的发生无相关性(P>0.05)。结论应用高分辨率超声使甲状腺结节检出率明显增高,甲状腺结节已成为健康体检人群常见、多发的疾病之一,随着年龄增加,甲状腺结节的检出率明显增加。

Detection of thyroid nodule and its characteristics in 7 097 health check-up people

Objective To investigate the prevalence and characteristics of thyroid nodule（TN） in healthy adults of WeiFang district of Shandong Province. Methods A cross-sectional, stratified and cluster random sampling study was performed from January 2010 to December 2012. All the subjects were underwent high frequency probe and color Doppler ultrasonography to TN screening, and the prevalence of TN and its size, quantity, property, distribution were age-stratified and analyzed. The relationship between nodule existence and thyroid function was assessed in subjects who aeeepted TSH, FT3, FT4, TGAb, TPOAb tests. Results According to our data, 7 097 adults were included and analysised. 2 458 were found to have TN accounting for 34.63% of all employees. TN incidence were 31.4% and 40.74% in male and female respectively, TN incidence increased with age （x^2=834.17 in male,x^2=625.85 in female, all P=0.001）, and was more common in female （40.2% in female vs. 23.6% in male）. In subjects with thyroid nodule, the solitary nodule was 49.27%, which decreased with age, compared with 50.73% of multiple nodules, which increased with age （x^2=71.55, P=0.016）. The detection rate of solitary nodule was higher in male than female （56.87% vs. 43.26%, 2,2591.857, P=0.01） while the detection rate of multiple nodules was lower in male than female （43.18% vs. 58.47%, 2,2=248.65, P=0.01）. The detection rate of small, moderate and large nodules in male were 78.91%, 17.22%, 4.32% respectively, and 70.13%, 20.59%, 10.09% in female respectively. 11 cases of TN were proved to be thyroid carcinoma, accounting for 1.15% of all subjects examined.Multiple logistic regression analysis demonstrated that age and gender were independent predicting factors of TN（P=0.023, 0.001）, while there was no relationship among the thyroid function and TN（P〉0.05）. Conclusion The prevalence of TN was considerably high according to the examining of ultrasonographic image, and increased with age indicating the necessity of carrying out TN s