健康人群中甲状腺结节患病情况调查-乔令艳

　48　8　Vol.48　No.8　　　　　　　　　　　(　　)JOURNALOFSHANDONGUNIVERSITY(HEALTHSCIENCES)　　　　　20108　Aug.2010　:2010-03-19:(1982-),,,。:,,,,,。E-mail:[e-mail]　:1671-7554(2010)08-0005-03乔令艳1,宋心红2,林海燕2,高聆3,赵家军1(1.;2.;3.,250021):目的　了解健康查体人群中甲状腺结节的患病率及结节特征。方法　对4687例既往无甲状腺疾病史的健康查体人员的甲状腺高分辨率超声检查报告、临床资料进行汇总、统计分析。并对其中经过血清促甲状腺激素测定的526例,按照甲状腺超声检查报告分为甲状腺结节组和超声正常组,比较两组血清促甲状腺激素水平。结果　超声检查结果表明,整个调查人群中,甲状腺结节阳性率为30.12%,女性患病率明显高于男性(34.13%vs27.33%,P0.01)。结节患病率随年龄增长呈增加趋势,Spearman等级相关分析表明,年龄与结节患病率呈正相关(P0.01)。随年龄增长,多发结节所占比例增加,但结节数目与性别无关。甲状腺结节以直径不到1cm的小结节为主(65.79%),结节的性质以实性为主,占56.94%,混合性比例为27.12%,囊性比例为15.93%。结节组和超声正常组血清促甲状腺素水平无明显差异(P0.05)。结论　甲状腺结节在人群中患病率较高,以单发的小结节、实性结节为主,女性高于男性,结节患病率随年龄增长而增加。:甲状腺结节;健康人群;回顾性研究:R581　　　:APrevalenceofthyroidnodulesinahealthypopulationQIAOLing-yan1,SONGXin-hong2,LINHai-yan2,GAOLing3,ZHAOJia-jun1(1.DepartmentofEndocrinology;2.TheHealthExaminationCenter;3.DepartmentofCentralLaboratory,ShandongProvincialHospitalAffiliatedtoShandongUniversity,Jinan250021,China)Abstract:Objective　Toassesstheincidenceandfeaturesofthyroidnodulesinphysicalexaminations.Methods　Atotalof4687adultswithoutahistoryofthyroiddiseasewereenrolledinthestudy.Thyroidultrasonographywasper-formedinallsubjectsandserumthyrotropin(TSH)wasevaluatedin526ofthemwhoweresubdividedintotwogroupsaccordingtothepresenceorabsenceofthyroidnodules.SerumTSHwascomparedbetweenthesetwogroups.Results　Theprevalenceofthyroidnoduleswas30.12%inthestudiedpopulationandincreasedwithage.Thyroidnodulesweresignificantlymorecommoninfemalesthanmales(34.13%vs27.33%,P0.01).Spearmanrankcorrelationa-nalysisindicatedapositivecorrelationbetweenageandtheoccurrenceofthyroidnodules(P0.01).Multiplenodulesweremoreprominentinelderlypeople,butnoobviousdifferencewasobservedinthenumberofthyroidnodulesbe-tweenmenandwomen.Mostnodulesweresmallerthan1cm(65.79%)andtheecho-structureofnoduleswassolidin56.94%,mixedin27.12%andcysticin15.93%ofthecases.TherewasalsonosignificantdifferenceinserumTSHbetweengroupswithandwithoutthyroidnodules(P0.05).Conclusion　Theprevalenceofthyroidnodulesishighinhealthyadultsandincreaseswithage.Mostnodulesweresmall,solitaryandsolidinthestudiedpopulation.Keywords:Thyroidnodules;Healthypopulation;Retrospectivestudy　　。,,1%5%;,50%;B19%～67%[1]。,、、　6　　　　　　　　　　(　　)488　。,[2-3],,,。,4687,。1　资料与方法1.1　　20041200812,B5029,、342,4687。1.2　　、。,、,。4687526(TSH),(n=3275)(n=1412),TSH,TSH。1.3　　SPSS16.0,x±s,;TSH,;Spearman,P0.05。2　结　果2.1　　4687,17～93,(53.89±12.44),2759,19～92,(53.99±12.32),1928,17～93,(53.77±12.62)。,1。1　()()()()3037427930～3926020346340～49845482132750～59871630150160～6938632671270～3602456052759　1928　46872.2　、　4687,1412,30.12%。754,27.33%;658,34.13%。(χ2=24.929,P0.01)。,、2。2,,,30,8.11%,9.52%,,70～,40.00%,47.76%。,Spearman,,(P0.01)。,40～4960～69(P0.05)。2　、()()()(%)()()(%)P303738.114249.520.82530～392605420.772034924.140.38740～4984517320.4748214429.880.000＊＊50～5987123526.9863019130.320.15760～6938614537.5632615346.930.012＊70～36014440.0024511747.760.0592759　75427.331928　65834.130.000＊＊　　＊P0.05,＊＊P0.01vs2.3　、　1412,924(65.44%),17～92,(51.6±11.5);488(34.56%),22～93,(56.3±12.7)。3275,19～92,(40.8±12.1)。,(P0.01)。,,,.7　　　　　(χ2=51.78,P0.01)。,。3。3　(%)()()307(100)0(0)730～3980(78.23)23(21.77)10340～49248(77.67)69(22.33)31750～59267(62.68)159(37.32)42660～69179(60.07)119(39.93)29870～143(54.79)118(45.21)261924(65.44)488(34.56)1412　　　1412754,502,252;658,422,236,、(χ2=1.27,P=0.26)。2.4　、　3,(1.0cm)、(1.0～2.0cm)、(2.0cm)。,。、4。,1cm。(χ2=2.72,P=0.252)。,56.94%,,27.12%,15.93%。,(χ2=0.215,P=0.898)。4　、[n(%)]62(8.22)187(24.80)505(66.98)432(57.29)205(27.19)117(15.52)67(10.18)167(25.38)424(64.43)372(56.54)178(27.05)108(16.41)129(9.14)354(25.07)929(65.79)804(56.94)383(27.12)225(15.93)2.5　　TSH526,399,127。,TSH,,5。、,TSH(P0.05)。5　TSH(mU/L,x±s)n3992.25±0.202.38±0.172.30±0.16　2622.17±0.222.40±0.192.25±0.20　1372.30±0.422.32±0.262.37±0.301272.42±0.302.50±0.212.43±0.223　讨　论,、、、、,。Framingham,,4.2%[4]。Parham[5]2523,2.5%。,。[6]15.7%,[7]33.9%。4687,30.12%,1cm(65.79%),[8]、Bartolotta[9]。,,(34.13%vs27.33%),[2-3,10]。,(65.44%),,。TSH,,TSH,[6,11]。,,,,。B,。、、。,,。,(下转第12页)　12　　　　　　　　　(　　)488　。:[1],,.[J].,2008,88(33):305-310.[2]HanQuan-bin,LiMa-lin,LiSheng-hong,etal.Ent-kauranediterpenoidsfromIsodonrubescensvarlushanen-sis[J].ChemPharmBull(Tokyo),2003,51(7):790-793.[3]ChenJun-hui,WangShao-bin,ChenDong-yang,etal.Theinhibitoryeffectoforidoninonthegrowthoffifteenhumancancercelllines[J].ChineseJournalofClinicaloncology,2007,4(1):16-20.[4],,,.PI3K/AKTHeLa[J].:,2007,28(5):506-510.[5]HanJian,YeMin,QiaoXue,etal.InductionofapoptosisandG2/McellcyclearrestbyoridonininhumangastriccancerBGC-823cell[J].JournalofChinesePharmaceu-ticalSciences,2007,16(5):307-314.[6],,,.[J].,2008,19(15):1124-1126.[7]TakahashiH,AokiN,NakamuraS,etal.Cornifiedcellenvelopeformationisdistinctfromapoptosisinepidermalkeratinocytes[J].JDermatolSol,2000,23(1):161-169.[8]KristensenBW,NoerH,GramsbergenJB,etal.Col-chicineinducesapoptosisinorganotypichippocampalslicecultures[J].BrainRescarch,2003,964(2):264-278.[9],,,.MB49[J].,2008,39(8):1219-1222.[10]CohenGM.Caspase:theexecutionersofapopt