【摘要】：目的:分析山西地區(qū)的常住居民中甲狀腺結(jié)節(jié)的患病情況,探討甲狀腺結(jié)節(jié)的發(fā)生與血脂異常的關(guān)系,了解可能引起甲狀腺結(jié)節(jié)發(fā)生的相關(guān)危險(xiǎn)因素,為血脂異�；颊咧屑谞钕俳Y(jié)節(jié)性疾病的篩查提供理論依據(jù)。方法:使用多階段分層整群隨機(jī)抽樣的方法,隨機(jī)抽取山西地區(qū)18周歲以上的居民做抽樣調(diào)查。在城市人群中隨機(jī)抽取1395例居民,在農(nóng)村人群中隨機(jī)抽取1261例居民,共2656例。所有同意參加的調(diào)查對(duì)象簽知情同意書,并填寫調(diào)查問(wèn)卷,包括性別、年齡、身高、體重、既往史、口服藥物情況等;采集調(diào)查對(duì)象的空腹靜脈血,化驗(yàn)空腹血脂,行甲狀腺超聲。收集數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.納入總樣本量2656例,甲狀腺結(jié)節(jié)的檢出人數(shù)為305例,總患病率為11.48%;其中男性樣本量為1363例,男性中甲狀腺結(jié)節(jié)的檢出人數(shù)為134例,其患病率為9.83%;女性樣本量為1293例,女性中甲狀腺結(jié)節(jié)的檢出人數(shù)為171例,其患病率為13.23%,女性甲狀腺結(jié)節(jié)的患病率較男性甲狀腺結(jié)節(jié)的患病率高,差異有統(tǒng)計(jì)學(xué)意義(χ2=7.519,P=0.006)。2.按年齡分組,60歲以下各年齡組女性結(jié)節(jié)患病率均高于男性,在40歲年齡組男女結(jié)節(jié)患病率的差異有統(tǒng)計(jì)學(xué)意義(χ2=8.575,P=0.003),余年齡組男女結(jié)節(jié)患病率的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.男性、女性甲狀腺結(jié)節(jié)的患病率都會(huì)隨著年齡的增長(zhǎng)而增高,增高趨勢(shì)有統(tǒng)計(jì)學(xué)意義(總體:χ2=65.88,P0.001;男性:χ2=52.87,P0.001;女性:χ2=19.28,P0.001)。4.受檢人群分別按甘油三酯(Triglyceride,TG)、總膽固醇(Total Cholesterol,TC)、低密度脂蛋白(Low-density lipoprotein,LDL)、高密度脂蛋白(High-density lipoprotein,HDL)分組分析甲狀腺結(jié)節(jié)的患病率,LDL異常組甲狀腺結(jié)節(jié)患病率高于LDL正常組,差異有統(tǒng)計(jì)學(xué)意義(χ2=3.91,P=0.048),TG、TC、HDL異常組與正常組甲狀腺結(jié)節(jié)的患病率差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。5.按有無(wú)甲狀腺結(jié)節(jié)的發(fā)生分組,結(jié)節(jié)組TC水平高于非結(jié)節(jié)組,差異有統(tǒng)計(jì)學(xué)意義(t=2.111,P=0.035);結(jié)節(jié)組與非結(jié)節(jié)組的TG、LDL、HDL水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。6.應(yīng)用Logistic回歸分析,經(jīng)性別、年齡校正后,總膽固醇水平的增高可能是甲狀腺結(jié)節(jié)發(fā)生的危險(xiǎn)因素(OR=1.070,95%可信區(qū)間為1.009~1.135)。結(jié)論:1.山西地區(qū)女性甲狀腺結(jié)節(jié)的患病率高于男性,并且甲狀腺結(jié)節(jié)的患病率有隨著年齡的增長(zhǎng)而增高的趨勢(shì)。2.甲狀腺結(jié)節(jié)的發(fā)生可能與血清低密度脂蛋白、總膽固醇水平相關(guān)。3.總膽固醇水平的增高可能是甲狀腺結(jié)節(jié)發(fā)生的危險(xiǎn)因素。
[Abstract]:Objective: to analyze the prevalence of thyroid nodules in residents of Shanxi Province, to explore the relationship between thyroid nodules and dyslipidemia, and to understand the risk factors that may lead to the occurrence of thyroid nodules. To provide theoretical basis for screening thyroid nodular diseases in patients with dyslipidemia. Methods: multistage stratified cluster random sampling was used to select randomly the residents over 18 years old in Shanxi area. 1395 residents were randomly selected from urban population and 2656 from rural population. All agreed participants signed informed consent forms and completed questionnaires, including gender, age, height, weight, past history, oral medication, etc. Fasting venous blood was collected, fasting blood lipid was tested and thyroid ultrasound was performed. Collect data for statistical analysis. Results: 1. The total sample size was 2656, the total prevalence rate of thyroid nodules was 11.48, the number of male samples was 1363, the number of male thyroid nodules was 134, the prevalence rate of thyroid nodules was 9.83. The prevalence of thyroid nodule in female was 13.23. The prevalence of thyroid nodule in female was higher than that in male (蠂 ~ 2 / 7.519, 蠂 ~ 2 = 7.519, 蠂 ~ 2 = 7.519, 蠂 ~ 2 = 7.519, P < 0.05). P0. 006). According to the age group, the nodule prevalence rate of female under 60 years old was higher than that of male group, and there was significant difference between male and female nodule prevalence rate in 40 years old group (蠂 2 = 8.575 P0. 003). There was no significant difference in nodule prevalence between men and women in the remaining age group (P0.05). The prevalence rate of thyroid nodules in males and females increased with age (overall: 蠂 2: 65.88%, P 0.001; males: 蠂 2, 52.87, P 0.001; female: 蠂 2, 19.28, P 0.001). The prevalence of thyroid nodules was analyzed by triglyceride (Triglyceride,TG), total cholesterol (Total Cholesterol,TC), low density lipoprotein (Low-density lipoprotein,LDL) and high density lipoprotein (High-density lipoprotein,HDL). The prevalence rate of thyroid nodules in abnormal LDL group was higher than that in normal LDL group (蠂 2 / 3.91 P 0.048). There was no significant difference in thyroid nodule prevalence between abnormal TG,TC,HDL group and normal group (P0.05). According to the occurrence of thyroid nodule, the TC level of nodule group was higher than that of non-nodule group, the difference was statistically significant (t = 2.111), and there was no significant difference in TG,LDL,HDL level between nodule group and non-nodule group (P0.05). By using Logistic regression analysis, the increase of total cholesterol level after sex and age correction may be the risk factor of thyroid nodule (OR=1.070,95% confidence interval 1.009 鹵1.135). Conclusion: 1. The prevalence of thyroid nodules in women in Shanxi area is higher than that in men, and the prevalence rate of thyroid nodules increases with age. 2. 2. Thyroid nodules may be associated with serum low density lipoprotein (LDL) and total cholesterol levels. Increased total cholesterol may be a risk factor for thyroid nodules.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R581

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