1456例军事飞行人员甲状腺结节影响因素分析及健康促进和管理策略

Analysis of influencing factors and health promotion and management strategies for thyroid nodules in 1 456 military pilots

目的 了解军事飞行人员中甲状腺结节检出情况并分析相关影响因素,为制定健康管理策略提供参考。方法 以2019年1月至2021年12月在桂林康复疗养中心参加特勤体检鉴定的飞行人员1 456人为研究对象,按照甲状腺彩超检查情况将该人群分为甲状腺结节组与无甲状腺结节组,分析检出率及其影响因素。结果 进行特勤体检1 456人,均为男性,甲状腺结节327例,检出率为22.46%;飞行人员甲状腺结节检出率呈现上升趋势,不同年份比较差异有统计学意义(χ2=19.586,P<0.001);多因素Logistic回归分析显示,飞行时间>4 000 h(OR=1.347,P=0.003)、机种为高性能战机(OR=1.511,P=0.005)、空腹血糖异常(OR=3.638,P=0.004)和既往有甲状腺疾病史(OR=2.543,P=0.004)是甲状腺结节的危险因素。结节组与无结节组代谢性指标比较,结节组FT3和FT4明显低于无结节组,差异有统计学意义(P<0.05),其他指标比较差异无统计学意义(P>0.05)。结论 飞行人员甲状腺结节检出率有上升趋势,应引起重视,同时飞行时间长、高性能战机、空腹血糖异常和既往患有甲状腺疾病等可能使甲状腺结节检出风险增高,且FT3和FT4水平降低可能与甲状腺结节存在一定相关性。在健康促进和维护中,应对甲状腺结节高危人群加强筛查并推行积极的健康干预和管理措施,定期跟踪随访,科学管理,减少因甲状腺相关疾病导致停飞和限制飞行。

Objective To understand the detection of thyroid nodules in military pilots and analyze relevant influencing factors,in order to provide reference for formulating health management strategies.Methods A total of 1456 pilots who participated in special service medical examination and appraisal at Guilin Rehabilitation and Recuperation Center from January 2019 to December 2021 were selected as the study subjects.According to the results of thyroid ultrasound examination,the population was divided into a thyroid nodule group and a non thyroid nodule group,and the detection rate and influencing factors were analyzed.Results 1456 people underwent special medical examinations,all of whom were males.There were 327 cases of thyroid nodules,with a detection rate of 22.46%;The detection rate of thyroid nodules in flight personnel showed an upward trend,and there was a statistically significant difference between different years(χ2=19.586,P<0.001);Multivariate Logistic regression analysis showed that flight time>4000 h(OR=1.347,P=0.003),high performance aircraft(OR=1.511,P=0.005),abnormal fasting blood sugar(OR=3.638,P=0.004),and a history of thyroid disease(OR=2.543,P=0.004)were risk factors for thyroid nodules.Compared with the non nodule group,the metabolic indicators of the nodule group showed significantly lower FT3 and FT4,with a statistically significant difference(P<0.05).There was no statistically significant difference in other indicators compared(P>0.05).Conclusion The detection rate of thyroid nodules in pilots has an upward trend,which should be paid attention to.At the same time,long flight time,high-performance fighter aircraft,abnormal fasting blood sugar and previous thyroid disease may increase the risk of thyroid nodules detection,and the reduction of FT3 and FT4 levels may be related to thyroid nodules.In health promotion and maintenance,screening should be strengthened for high-risk groups with thyroid nodules,and proactive health interventions and management measures should be implemented.Regular follow-up and scientific management should be carried out to reduce grounded and restricted flights caused by thyroid related diseases.