健康体检人群中甲状腺结节患病情况及相关因素分析

An Analysis of the Prevalence of Thyroid Nodules and Related Factors in Healthy Population

目的:观察四川省自贡市健康体检人群的甲状腺结节流行病学特点及影响因素,并分析甲状腺结节人群中医体质分布与焦虑、抑郁情绪的相关性。方法:对9 845例健康体检者进行甲状腺超声、促甲状腺激素、代谢相关指标、体质量指数进行数据统计;对1 881例彩超提示有甲状腺结节的受检者进行问卷调查,分析中医体质分布与焦虑、抑郁情绪的相关性。结果:甲状腺结节检出率男性低于女性,检出率随年龄增长而增加,差异有统计学意义(P<0.05);甲状腺结节组收缩压(t值=46.78)、舒张压(t值=29.38)、年龄(t值=372.24)、促甲状腺激素(t值=16.67)、血糖(t值=61.84)、三酰甘油(t值=13.49)、总胆固醇(t值=8.552)、高密度脂蛋白(t值=16.37)水平高于正常组,低密度脂蛋白(t值=17.32)、尿酸低于正常组(t值=86.32),差异具有统计学意义(P<0.05),两组体质量指数比较无统计学意义(P>0.05);多因素二分类Logistic回归分析显示性别(OR=1.346、P<0.05)、年龄(OR=1.028、P<0.05)、收缩压(OR=1.016、P<0.05)、舒张压(OR=1.014、P<0.05)、血糖(OR=1.061、P<0.05)是甲状腺结节患病的危险因素;甲状腺结节人群中痰湿质(16.53%)、气郁质(15.84%)、湿热质(15.68%)所占比例较高,不同性别的中医体质分布有统计学意义(P<0.05);PHQ-9抑郁症筛查量表评分,广泛性焦虑障碍量表(GAD-7)评分与湿热质、痰湿质、气郁质得分均存在正相关(P<0.05)。结论:甲状腺结节的检出率较高,女性多于男性,检出率随年龄增长而增多,性别、年龄、血压、血糖是甲状腺结节发病的危险因素。甲状腺结节人群中医体质分布在性别上有差异,占比最多的体质与焦虑、抑郁情绪具有明显相关性。

Objective: To observe the epidemiological characteristics and influencing factors of thyroid nodules among healthy people in Zigong area, Sichuan Province, and to analyze the correlation between TCM constitution distribution of thyroid nodules and anxiety and depression. Methods: Thyroid ultrasound, thyroid stimulating hormone, metabolic related indicators and body mass index were performed in 9,845 healthy subjects. Questionnaire survey was conducted in 1,881 patients with thyroid nodules, then the correlation between the distribution of TCM constitution and anxiety and depression was analyzed. Results: The detection rate of thyroid nodules in males was lower than that in females. The detection rate increased with age, and the difference was statistically significant(P<0.05). Systolic blood pressure(t value=46.78), diastolic blood pressure(t value=29.38), age(t value=372.24), thyroid stimulating hormone(t value=16.67), blood sugar(t value=61.84), triglyceride(t value=13.49), total cholesterol(t value=8.552), high density lipoprotein(t value=16.37) levels were higher than those of the normal group.(t=17.32), uric acid was lower than that of the normal group(t=86.32), and all the differences were statistically significant(P<0.05), and there was no significant difference in BMI between the two groups(P>0.05). Multivariate binary logistic regression analysis showed that sex(OR=1.346, P<0.05), age(OR=1.028,P<0.05), systolic blood pressure(OR=1.016, P<0.05), diastolic blood pressure(OR=1.014,P<0.05), blood sugar(OR=1.061,P<0.05) were risk factors for thyroid nodules. The proportion of phlegm-dampness constitution(16.53%), qi-depression constitution(15.84%) and dampness-heat constitution(15.68%) in thyroid nodules was higher, and the distribution of TCM constitution in different sex had statistical significance(P<0.05). The scores of PHQ-9 depression screening scale and GAD-7 were positively correlated with the scores of damp-heat, phlegm-dampness and qi-depression constitutions(P<0.05). Conclusion: The detection rate of thyroid nodules is higher in women than in men. The detection rate increases with age. Gender, age, blood pressure and blood sugar are risk factors for thyroid nodules. The distribution of TCM constitution in thyroid nodule population is different in gender, and the constitution with the largest proportion has obvious correlation with anxiety and depression.