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目的了解体检人群甲状腺结节(TN)的检出情况及相关因素,探讨甲状腺彩超检查的重点人群及是否应将其列为常规体检项目。方法选择2010年1-12月在河北省人民医院体检中心进行甲状腺超声检查的13664例体检者作为研究对象,并进行血脂、血糖、血压等检测。其中8596例体检者同时进行甲状腺外科触诊检查。甲状腺超声检测发现TN的236例体检者进行甲状腺功能检查。结果体检人群TN检出率为47.43%。外科触诊检出TN的体检者经甲状腺超声均检出TN。随着结节直径的增大,外科检出率逐渐升高,直径1cm以上的TN外科检出率>50%。TN如不伴甲状腺增大对血清中总三碘甲状腺原胺酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原胺酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平无影响。甲状腺超声检查异常的各组抗甲状腺过氧化物酶抗体(TPO)均高于正常组,差异有统计学意义(P<0.05)。与未检出TN的体检者比较,检出TN的体检者收缩压、空腹血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均升高,差异有统计学意义(P<0.01)。结论 TN在体检人群中的检出率不低,但多数为良性结节,对甲状腺功能无明显影响,重点人群和有条件的地方应推荐做甲状腺超声检查。
Objective To understand the detection of thyroid nodules (TN) in physical examination population and its related factors, and to explore whether the key population of thyroid ultrasound examination should be classified as routine medical examination. Methods From January to December 2010, 13664 subjects undergoing thyroid ultrasonography at the People’s Hospital of Hebei Province People’s Medical Center were selected for the study. Blood lipids, blood glucose and blood pressure were measured. Among them, 8596 cases were examined by palpation of thyroid surgery at the same time. Thyroid ultrasound examination revealed 236 cases of TN in thyroid function tests. Results The positive rate of TN in physical examination group was 47.43%. Surgical palpation detected TN of the subjects were detected by thyroid ultrasound TN. With the increase of nodule diameter, surgical detection rate gradually increased, more than 1cm diameter of the TN surgical detection rate> 50%. TN had no significant effect on the levels of total TTX, TT4, FT3, FT4, thyrotropin (TPH), thyroid stimulating hormone TSH) level no effect. Thyroid ultrasound abnormalities in each group of anti-thyroid peroxidase antibody (TPO) were higher than the normal group, the difference was statistically significant (P <0.05). Compared with those without TN, systolic blood pressure, fasting blood glucose, total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol were all significantly increased in TN subjects (P <0.01) . Conclusion The detection rate of TN in the physical examination population is not low, but most of them are benign nodules, which have no obvious effect on the thyroid function. Thyroid ultrasound examination should be recommended in the key population and the places where there are conditions.