中老年甲状腺结节528例临床分析

CLINICAL ANALYSIS OF THYROID NODULE IN 528 CASES OF MIDDLE AND OLD-AGED PEOPLE

目的分析中老年人甲状腺结节病变的特点。方法回顾分析我院45～79岁健康体检的甲状腺结节患者528例的临床资料，根据年龄段分为二组：中年组年龄45～59岁，共196例；老年组年龄60～79岁，共332例。全部行甲状腺彩色超声检查。电化学发光法检测甲状腺功能及甲状腺抗体。结果中老年甲状腺结节以单发、直径〈1．0cm为主。甲状腺功能正常者271例；原发性临床甲减患者51例；原发性亚临床甲减患者206例。其中，老年组女性亚临床甲减发生率较中年组女性明显升高，差异有统计学意义（P〈0．05）；老年组亚临床甲减总发生率高迭42．47％，较中年组明显升高（P〈0．05）。原发性甲减患者甲状腺自身抗体阳性率高达47．86％。结论与中年人群相比，老年人群具有更高的甲状腺结节发生率且易合并原发性甲减；原发性甲减患者甲状腺自身抗体阳性率明显升高。

Objective To analyze the characteristics of the lesion of thyroid nodule in elderly and middle- aged people. Methods A total of 528 eases, aged 45 to 79, were enrolled in this study. They were divided into two groups according to the age.. group was 196 cases in middle - aged group of 45 - 59 years old, 332 cases in elderly group aged 60 -79. Thyroid in every case was screened by chromatic color ultrasound. Fasting venous blood were collected for detecting serum thyroid stimulating hormone （TSH）, free thyroxine（FT4）, free triiodothyronine（FT3）, thyroid peroxidase antibody（TPO - Ab） and thyroglobulin antibody （TG - Ab） with electrochemiluminescence assay. Results Thyroid nodules with single, diameter 〈1.0 cm was more in middle- aged and elderly people. There were 271 cases with euthyroidism, 51 cases with primary clinical hypothyroidism and 206 cases with primary subclinical hypothyroidism. The detection rate of subclinical hypothyroidism was 54. 72% in old women, which was significantly higher than that in middle- aged women （P〈0.05）. The overall detection rate rate of subclinical hypothyroidism was 42.47% in old people, which was significantly higher than that in middle- aged people （P〈0.05）. Thyroid autoanti- body positivity rate was 47.86% in patients with primary hypothyroidism. Conclusions Old people have a higher detection rate of primary hypothyroidism and thyroid nodule than middle - aged peoffle. Patients with hypothyroidism and subclinical hypothyroidism tend to be thyroid autoantibody positive.