甲状腺结节超声表现与尿碘含量的相关性研究

Relationship between ultrasonographic features of thyroid nodule and urinary iodine

目的探讨甲状腺结节患病率及甲状腺结节超声表现与尿碘含量的关系。方法对参与黑龙江省甲状腺疾病普查的2 648位居民进行问卷调查,记录基本信息(姓名、性别、年龄、家族史、既往史、碘盐摄入量),常规二维超声检查甲状腺,检测受检者的尿碘含量,排除甲状腺术后患者、甲状腺疾病药物(优甲乐)服用者、6个月内碘造影剂使用者及肾功能异常者,最终有2 363例入组研究,根据检查结果将受检者分为结节组与正常对照组,并根据尿碘含量、结节数量、钙化程度进一步分组对照。将所得数据及相关的临床资料进行统计分析。结果甲状腺结节的发病率与尿碘含量有关(P<0.05),甲状腺结节组的尿碘中位数高于正常组(结节组193.56μg/L,正常组139.14μg/L);与尿碘含量100~200μg/L比较,尿碘含量的降低或升高,甲状腺单发结节发病率上升(16.1%~32.7%),甲状腺多发结节发病率下降,结节数量与尿碘含量有关(P<0.05);甲状腺结节钙化组的尿碘中位数高于无钙化组(钙化组186.43μg/L,无钙化组142.85μg/L),差异有统计学意义(P<0.05)。相对于尿碘含量100~200μg/L而言,尿碘含量<100μg/L时,结节发生钙化的风险高;尿碘含量>300μg/L时,单结节发病风险高。结节钙化及结节数量在不同尿碘含量之间有鉴别意义(P<0.05)。结论甲状腺超声检查结合实验室尿碘含量监测可简便、快捷地预测甲状腺结节发病风险及评估甲状腺结节发生钙化的风险,为临床治疗甲状腺结节制定最佳方案提供依据,为减缓甲状腺结节恶性变病程提供新思路。

Objective To investigate the urinary iodine content and prevalence of thyroid nodule and the relationship between the ultrasonographic of thyroid nodule. Methods Two thousand six hundred and forty-eight cases of clinical data of census and thyroid ultrasound examination from November 2014 to January 2015 in heilongjiang province was analyzed. Patients with thyroid surgery,thyroid disease,drug users,six months iodine contrast media users and abnormal renal function were excluded,according to the test results 2 363 patients were divided into nodular group and normal control group,and further nodules group divided according to quantity and calcified of nodules,respectively. Urine iodine content of each group was detected,each set of data and related clinical data were statistically analyzed. Results Thyroid nodule was associated with urinary iodine content(P〈0. 05）,the median urinary iodine of thyroid nodule group was higher than normal group(nodule group 193. 56 μg/L,the normal group 139. 14 μg/L）. Relative to the urinary iodine content in 100-200 μg/L,with the increase of urinary iodine or not,thyroid single nodule detection rate rase（16. 1%-32. 7%）,multiple thyroid nodules detection rate decreased,single nodule associated with urinary iodine content(P〈0. 05）. The median urinary iodine of thyroid nodule calcification group was higher than without calcification group（186. 43 μg/L calcification group,without calcification group142. 85 μg/L）,the difference was statistically significant(P〈0. 05）. Relative to the urinary iodine content in 100-200 μg/L,urine iodine content 100 μg/L,nodular calcification had high risk. Urinary iodine content 〉300 μg/L,single nodule had high risk. There were differences between urinary iodine content(P〈0. 05）. Conclusion By thyroid nodule ultrasonic manifestations and combined with urinary iodine content can be simple,rapid assessment of thyroid nodules and predicting risk of calcification in thyroid nodules disease risk,for the best solution to provide the reference for clinical treatment of thyroid nodule,provide new way to reduce the malignant thyroid nodule.