社区卫生服务中心就诊患者甲状腺结节检出率和甲状腺功能调查分析

摘要

Objective To investigate the detection rate of thyroid nodules and thyroid function in community health service center patients.Methods The participants enrolled were 488 patients visited Tuanjiehu Community Health Service Center in Chaoyang District,Beijing,and undertook B-mode ultrasonography for the screening of thyroid nodules from March 2015 to June 2016.Two hundred and fifty-six of them also undertook thyroid function test.Results Among the 488 participants,316 were found with thyroid nodules,with a detection rate of 64,8%.There was no significant difference in the detection rate of thyroid nodules between male and female〔68.2%(45/66)vs.64.2%(271/422),x2=0.393,P=0.531〕;46.2%(146/488) were found with single thyroid nodule,53.8%(170/488) were found with multiple thyroid nodules.There was no significant difference in the amount distributions of thyroid nodules between male and female(x2=0.742,P=0.690);There was significant difference in the amount distributions of thyroid nodules among different age groups(x2=43.127,P<0.01),the middle-aged group and the elderly group had lower detection rate of no thyroid nodules than the young group,the elderly group had lower detection rate of no thyroid nodules than the middle-aged group(P<0.01);detection rate of single thyroid nodule showed no differences among different age groups(P>0.05);the elderly group had higher detection rate of multiple thyroid nodule than the young group and the middle-aged group(P<0.01).Of the 256 undertaking thyroid function test,90 had no thyroid nodules,76 had single thyroid nodule,and 90 had multiple thyroid nodules.There was no significant difference in T3,T4,FT3 and FT4 levels among the three groups by amount of thyroid nodules(P>0.05);there was significant difference in TSH levels among the three groups(P<0.05),concretely,the multiple thyroid nodules group had lower TSH level than the no thyroid nodules group and the single thyroid nodule group(P<0.05).Conclusion The detection rate of thyroid nodules in patients from Tuanjiehu Community Health Service Center is high,and it gradually increases with the ageing,especially multiple thyroid nodules,which should be paid attention in clinical practice.%目的 了解社区卫生服务中心门诊就诊患者甲状腺结节检出率及甲状腺功能情况.方法 选取2015年3月-2016年6月北京市朝阳区团结湖社区卫生服务中心就诊并接受过甲状腺B超检查的患者488例,检测有无甲状腺结节,其中256例接受甲状腺功能筛查.结果 488例患者中共检出甲状腺结节316例,检出率为64.8%,其中男45例,女271例,男性检出率为68.2%(45/66),女性检出率为64.2%(271/422).男性与女性甲状腺结节检出率比较,差异无统计学意义(x2=0.393,P=0.531).单发结节146例(46.2%),多发结节170例(53.8%).不同性别甲状腺结节检出情况比较,差异无统计学意义(x2=0.742,P=0.690).不同年龄组甲状腺结节检出情况比较,差异有统计学意义(x2=43.127,P<0.01);其中中年人组、老年人组无结节检出率较年轻人组降低,老年人组无结节检出率较中年人组降低(P<0.01);3组单发结节检出率比较,差异无统计学意义(P>0.05);老年人组多发结节检出率较年轻人组和中年人组升高(P<0.01).256例接受甲状腺功能检查的患者中,无结节组90例,单发结节组76例,多发结节组90例.3组三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平比较,差异均无统计学意义(P>0.05);3组促甲状腺激素(TSH)水平比较,差异有统计学意义(P<0.05);其中多发结节组TSH水平较无结节组和单发结节组降低(P<0.05).结论 北京市朝阳区团结湖社区卫生服务中心就诊患者甲状腺结节检出率较高,甲状腺结节检出率随着年龄的增大而逐渐增加,尤其是多发结节,在临床工作中应引起注意.