教师体检人群肺结节检出结果及影响因素分析

目的:分析教师人群肺结节检出结果和影响因素。方法:回顾性搜集我院体检中心3 068名教职工（包括离退休人员）胸部低剂量CT（low-dose computed tomography，LDCT）结果，和相关年龄、性别、生活史及部分检查资料进行整理分析，并建立体检后肺结节精准健康管理流程。结果:本次检出患有肺结节1 849例，总患病率60.27%，其中直径＜6 mm结节为89.89%,6~7 mm结节为6.81%，≥8 mm为3.30%;实性肺结节90.21%，亚实性结节9.79%；孤立性肺结节43.97%，多发性肺结节56.03%，其中高校教师组肺结节检出率达79.81%，男性为63.41%，吸烟者为93.37%,40岁以下为70.86%,每天运动＜60分钟为79.73%。其他方面以血脂异常和甲状腺疾病检出率较高。多因素Logistic回归分析显示，性别、吸烟、运动少和教师组别是肺结节发生的独立易感因素（OR=0.334、22.869、0.384、2.549，均P＜0.05)。结论:肺结节以＜6 mm、实性结节为主，正确认识肺结节，在体检中更应重视对运动少、青年女性、高校教师的筛查，加强长期规律随访。

Analysis on the result and influencing factors of pulmonary nodules in teachers' physical examination

Objective:To analyze the results and influencing factors of pulmonary nodules among teachers.Methods:The results of low-dose computed tomography (LDCT) were retrospectively collected from 3 068 staff (including retired staff) in the physical examination center of our hospital,and the relevant age,gender,life history and some examination data were collated and analyzed,and the precise health management process of pulmonary nodules after physical examination was established.Results:1 849 patients were diagnosed with pulmonary nodules,with a total prevalence of 60.27%,among which 89.89% were nodules<6 mm in diameter.6~7 mm nodules were 6.81%,≥8 mm 3.30%,solid pulmonary nodules 90.21%,subsolid nodules 9.79%.The detection rate of solitary pulmonary nodules was 43.97% and multiple pulmonary nodules 56.03%.Among them,the detection rate of pulmonary nodules was 79.81% in the college teachers group,63.41% in the male group,93.37% in smokers,70.86% in those under 40 years old,and 79.73% in those who had exercise less than 60 minutes per day.In other aspects,the detection rate of dyslipidemia and thyroid disease was higher.Multivariate Logistic regression analysis showed that gender,smoking,less exercise and teacher group were independent risk factors for pulmonary nodules (OR=0.334,22.869,0.384,2.549,all P＜0.05).Conclusion:Pulmonary nodules are mainly solid nodules<6 mm.To correctly understand pulmonary nodules,more attention should be paid to the screening of less exercise,young women and college teachers during physical examination,strengthen long-term regular follow-up.