摘要
目的了解某中年至超高龄老年人群B超检查中甲状腺结节的检出情况，结节大小、数目等特点及结节与甲状腺功能的关系。方法采用分层整群随机抽样的横断面调查方法对本院干部门诊查体人群所做的甲状腺超声结果进行了总结分析，并分年龄段对结节的检出率、结节的大小、是否多发及超声检查下结节的性质进行比较，同时随机对部分人群进行了甲状腺功能的检查，以评价甲状腺结节的发生与甲状腺功能间的关系。结果（1）1721例查体对象，平均年龄71．4岁（40～108岁），结节总检出率高达76．6％，随年龄增大结节检出率逐渐增加，趋势性卡方检验结果有统计学意义（X^2=92．08，P〈0．01）；其中女性结节检出率87．4％，明显高于男性的75．5％（P=0．001）。（2）甲状腺结节患者中，单发结节比例为25．O％，多发结节比例为75．0％，且随年龄增大多发结节比例逐渐增加（X^2=78．55，P〈0．01）。（3）甲状腺结节患者中，小结节所占比例达68．2％，大结节所占比例为31．8％．且大结节所占比例随年龄增大逐渐增加（X^2=36．82，P〈0．01）。（4）根据超声检查所显示的结节内部回声特点，各年龄组均以实性结节为最多见，所占比例在全体人群达72．3％，其次为囊实性结节占26．6％，囊性结节最少见，仅占2．1％。结节性质在不同年龄组差别无统计学意义（X^2=14．22，P=0．076）。（5）部分查体对象（共884例）进行了甲状腺功能检查．并采用logistic回归分析的方法评价甲状腺结节与甲状腺功能的关系，其结果显示，TSH的降低与甲状腺结节的发生相关（P=0．005），TT3、TT4、FT3、FT4、RT3的高低及TGAb和（或）TPOAb是否阳性与甲状腺结节的发生无关（P〉0．05）。结论在中老年人群中经超声检查的甲状腺结节检出率较高。随着年龄的增加，甲状腺结节、多发结节和大结节的检出率均逐渐增加，并以实性结节为主。
Objective To investigate the prevalence and characteristics of thyroid nodule and its relationship with thyroid function in a group of middle-aged to elderly individuals. Methods A cross-sectional, stratified, and cluster random sampling study was performed in 1 721 subjects （ average age 71.4 years, from 40 to 108 years）. All subjects underwent ultrasound thyroid scan, and the prevalence of thyroid nodule and its size, quantity, property, and distribution were age-stratified and analyzed. The relationship between nodule existence and thyroid function was assessed in subjects who randomly accepted TSH, FT4 , and FT3 tests. Restflts The prevalence of thyroid nodule reached to 76.6%. The incidence of nodule increased with age （X2 = 92.08, P〈0.01 ）, and was more common in female （ 87.4% vs 75.5 %, P = 0.001 ）. In patients with thyroid nodule, the prevalence of solitary nodule was 25 %, compared with 75% of multiple nodules, which increased with age （X2 = 78.55, P〈0.01 ）. The prevalence of small nodule reached to 68.2%, compared with 31.8% of large nodules, which also increased with age （X2 = 36.82, P〈 0.01 ）. As to the property of nodule, solid nodule was the most common form （72.3%）, cyst-sdid nodule accounted for 26.6%, and detection rate of cyst nodule was only 2. 1%, and there was no significant difference among the different age groups （X^2 = 14.22, P = 0. 076 ）. 884 among the total subjects underwent thyroid function test, multiple logistic regression analysis demonstrated that the reduction of TSH was the only independent predicting factor of thyroid nodule （P = 0.005 ）. Conclusions The prevalence of thyroid nodules was considerably high according to the examing of uhrasonographic image, especially in the elderly. The incidence of thyroid nodule, especially multiple nodules or larger nodule, increased with age and solid nodule was the most common finding.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2014年第2期115-118,共4页
Chinese Journal of Endocrinology and Metabolism
