6096例健康体检教师人群甲状腺结节检出率及影响因素分析

Detection rate of thyroid nodules and analysis of influencing factors in 6096 cases of teacher population in healthy examination

目的:了解健康体检教师人群中甲状腺结节(thyroid nodule,TN)的检出率及影响因素。方法:回顾分析2018年10月—2021年6月在南京医科大学附属逸夫医院健康教师体检人群检查项目(包括性别、年龄、职业、身高、体重等),实验室检查(空腹血糖、血脂、肝功能、尿酸、C呼气检测等)及甲状腺彩超检查。应用Logistic多因素回归分析TN的影响因素。结果:(1)纳入研究的6096例体检者中,检查发现TN 2539例,总检出率为41.65%,其中男性TN检出率38.20%,女性TN检出率43.03%;单发结节检出率1340例(21.98%),多发结节检出率1199例(19.67%);对于TN根据TI-RADS分级,结果表明3级最多,占22.74%;年龄越大检出率越高,各年龄组之间TN检出率差异有统计学意义(P<0.05);此外TN检出部位分别是双侧叶(17.27%)>右侧叶(13.27%)>左侧叶(10.89%)>甲状腺峡部(0.21%);(2)女性教师人群以中教组检出率最高(49.44%),其中<30岁、30~39岁和≥60岁3组内不同教师类型检出率差异有统计学意义(P<0.05);(3)和非TN组相比,TN组高血压、空腹血糖异常,高脂血症、超重肥胖发生率较高,两组差异有统计学意义(P<0.05);(4)经Logistic多因素回归分析显示,女性是TN发病的独立危险因素(OR=1.913,P<0.05),与<30岁相比,40~49岁、50~59岁、≥60岁教师的TN发病风险较高(OR=1.402、2.923、4.637,均P<0.05),而与幼教组相比,高校教师的TN发病风险较低(OR=0.718,P<0.05)。结论:健康体检的教师人群中TN的检出率虽然偏高,但恶性度不高,超重肥胖、“三高”和TN密切相关,女性、年龄、中学教师是TN的危险因素,需综合关注上述指标,提高健康管理意识。

Objective:This study aims to investigate the detection rate and influencing factors of thyroid nodules(TN)among healthy teachers.Methods:The physical examination items(including gender,age,occupation,height,weight,etc.),laboratory examination(fasting blood glucose,blood lipid,liver function,uric acid,C breath test,etc.)and thyroid color ultrasound examination of health teachers in Sir Run Run Hospital Affiliated to Nanjing Medical University from October 2018 to June 2021 were retrospectively analyzed.Logistic regression was used to analyze the influencing factors of TN.Results:(1)Thyroid nodules were found in 2539 of 6096 patients,with a total detection rate of 41.65%,including 38.20%male and 43.03%female.There were 1340 single nodules(21.98%)and 1199 multiple nodules(19.67%).For TN classification according to TI-RADS,grade 3 was the most,accounting for 22.74%.The older the age,the higher the detection rate was,and there were significant differences in the detection rate of TN among different age groups(P<0.05).In addition,thyroid nodules were detected in bilateral lobe(17.27%)>right lobe(13.27%)>left lobe(10.89%)>thyroid isthmus(0.21%).(2)The detection rate of female teachers in the middle school group was the highest(49.44%),and there were significant differences in the detection rate of different types of teachers in the three age groups of<30 years old,30~39 years old and≥60 years old(P<0.05);(3)Compared with the non-TN group,the incidence of hypertension,abnormal fasting glucose,hyperlipidemia,overweight and obesity was higher in the TN group,and the differences were statistically significant between two groups(P<0.05).(4)Logistic multifactor regression analysis showed that female was an independent risk factor for TN(OR=1.913,P<0.05),and teachers aged 40-49,50-59 and≥60 had a higher risk of TN than those aged less than 30(OR=1.402,2.923,4.637,All P<0.05),and compared with preschool education group,college teachers had a lower risk of TN(OR=0.718,P<0.05).Conclusion:The detection rate of TN among teachers who underwent physical examination is high,but the malignancy is not high.Overweight,obesity and“three high”are closely related to TN.Female,age and middle school teachers are risk factors for TN,so comprehensive attention should be paid to the above indicators to improve health management awareness.