军事飞行员甲状腺结节影响因素分析

Influence factors analysis of thyroid nodules in military pilots

目的 分析军事飞行员甲状腺结节的患病情况及危险因素,为防治飞行员甲状腺疾病提供临床依据. 方法 回顾性分析在解放军第四五六医院健康体检和改装体检的629名飞行员甲状腺超声检查资料.分别按年龄、体质指数、空腹血糖水平分组,比较不同组间飞行员甲状腺结节的检出率.对可疑因素与甲状腺结节检出率的关系进行多因素Logistic回归分析. 结果 本组629名飞行员甲状腺结节检出率为19.24％,结节以直径不到1 cm的小结节（61.16％）、单发结节（63.64％）为主.甲状腺结节患病率随年龄增加而升高,差异有统计学意义（x2 =44.188,P＜0.01）.体质指数增高或空腹血糖升高者较正常者甲状腺结节患病率高,差异有统计学意义（x2=10.980、7.159,P＜0.01）.有负性生活事件者较无负性生活事件者患病率高,差异有统计学意义（x2 =5.862,P＜0.05）.有无饮酒史、吸烟史及不同飞行机种、飞行时间组飞行员相比,甲状腺结节患病率差异无统计学意义（P＞0.05）.多因素Logistic回归分析显示,年龄、空腹血糖、负性生活事件及体质指数是甲状腺结节的影响因素（B=0.565～0.723,P＜0.05）. 结论 甲状腺结节在飞行员中患病率较高,以单发的小结节为主.年龄、空腹血糖、负性生活事件及体质指数是飞行员甲状腺结节的影响因素.

Objective To analyze the prevalence and risk factors of thyroid nodules in military pilots,to provide basis for prevention and cure of the thyroid nodules on military pilots.Methods Retrospective analysis was on 629 pilots who were in the health examination or transition physical examination in the 456th hospital of PLA.They were grouped by age,body mass index and fasting plasma glucose （FPG） level to compare the difference of detection rate of thyroid nodules among groups.The relationship between suspicious factors and detection rate of thyroid disease was analyzed by Logistic regression analysis.Results The detection rate of thyroid nodules in the 629 pilots was 19.24%.The thyroid nodules were mainly with the diameter smaller than 1 cm （61.16%） and solitary nodule （63.64 %）.The prevalence of nodule was increased with the age and showed statistical significance among age groups （x2 =44.188,P〈0.01）.The pilots who had higher body mass index and fasting plasma glucose level showed the higher prevalence than those with the normal,and the difference had statistical significance （x2 =10.980,7.159,P〈0.01）.The pilots who were with negative events showed higher prevalence of nodule than those without,and the difference had statistical significance （x^2=5.862,P〈0.05）.The smoking history,drinking history,aircraft type and flight time were insignificantly influence the prevalence of nodule （P〉0.05）.The multiple factor Logistic regression analysis showed that age,fasting plasma glucose level,negative event influence,and body mass index were the influence factors of thyroid nodules （B=0.565-0.723,P〈0.05）.Conclusions The prevalence of thyroid nodules is high in pilots,and the small solitary nodule is the main representation.Age,fasting plasma glucose level,negative event influence,and body mass index are the influence factors of thyroid nodules.