目的 探讨甲状腺结节不同风险级别与代谢指标间的关系。方法 选择584例空军特色医学中心体检并行甲状腺超声检查、身高体重检测、血糖、血脂、血尿酸及甲状腺功能检测者进入研究,检测数据导入甲状腺风险评估平台,按评估情况分为三组:无结节组、低风险组、中高风险组。比较不同风险级别各组以上指标的差异。结果 无结节组与低风险组相比甲状腺素(TT4)有统计学差异(H=4.936,P＜0.05),年龄、血尿酸、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)有显著统计学差异(H=10.29,18.415,44.446,17.655,20.171,P＜0.01);无结节组与中高风险组FT3有统计学差异(H=4.534,P＜0.05);低风险组与中高风险组各项指标间均无统计学差异。结论 不同风险级别甲状腺结节体检者血尿酸、甲状腺功能检测有差异,有助于对结节人群进行分级管理,及早干预。
Abstract
Objective To evaluate thyroid nodules, wechat platform was used to study the relationship between different risk levels and metabolic indexes.Methods 584 subjects were selected to check thyroid ultrasound, height and weight, blood glucose, blood lipid, blood uric acid and thyroid function. The test data is imported into the thyroid risk assessment platform. 584 subjects were divided into three groups according to the assessment:non nodule group, low risk group, high risk group. Doctors collect the results of thyroid ultrasound and thyroid function examination from doctor’s client-side, check the risk assessment report, supervise the subjects.Results There was statistical difference in TT4 between non nodule group and low risk group(H=4.936,P＜0.05).Age,serum uric acid,FT3,FT4 and TSH has significant statistical differences in two group(H=10.29,18.415,44.446,17.655,20.171,P＜0.01). There was statistical difference in FT3 between non nodule group and high risk group(H=4.534,P＜0.05). All tests had no significant difference between the low-risk group and the high-risk group.Conclusions On different thyroid nodules risk levels,there were differences in serum uric acid and thyroid function,graded management of thyroid nodule population and early intervention was helpful.
关键词
甲状腺结节 /
风险评估 /
代谢
Key words
thyroid nodule /
risk assessment /
metabolism
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参考文献
[1] 中华医学会内分泌学分会,中华医学会外科学分会内分泌学组,中国抗癌协会头颈肿瘤专业委员会,中华医学会核医学分会.甲状腺结节和分化型甲状腺癌诊治指南[J].中华内分泌代谢杂志,2012,28(10):779-797.
[2] 张 波,徐景竹,吴 琼.2015年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读:超声部分[J].中国癌症杂志,2016,26(1):19-24.
[3] 孙团起,吴 毅.我国甲状腺结节的诊治现状与展望[J].中国普外基础与临床杂志,2014,21(9):1053-1055.
[4] Boelaert K, Horacek J, Holder R L,et al.Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration[J].J Clin Endocrinol Metab,2006,91(11):4295-4301.
[5] Polyzos S A,Kita M,Efstathiadou,et al.Serum thyrotropin concentration as a biochemical predictor of thyroid malignancy in patients presenting with thyroid nodules[J].J Cancer Res Clin Oncol,2008,134(9):953-960.
[6] Jin J,Machekano R,Mchenry C R.The utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease[J].Am J Surg,2010,199:294-297.
[7] 曾 泉,刘 杰,朱 江,等.术前血清促甲状腺素水平预测正常功能甲状腺结节性质的作用分析[J].临床耳鼻咽喉头颈外科杂志,2014,28(24):1931-1933.
[8] 闫慧娴,谷伟军,杨国庆,等. 血清促甲状腺激素与甲状腺乳头状微小癌相关性研究[J].中华内分泌代谢杂志,2014,30(8):669-672.
[9] 柳 林,卢洪文,冯 剑,等.健康体检者7097名甲状腺结节检出情况与临床特点[J].中华临床医师杂志(电子版),2014,8(14):2663-2667.
[10] 李 伟.职工体检甲状腺结节调查及3年随访分析[J].实用糖尿病杂志,2014,10(5):48-49.
[11] Sponziello M L, Bruno R, Durante C,et al.Growth factor receptors gene expression and Akt phosphorylation in benign human thyroid nodules are unaffected by chronic thyrotropin suppression[J].Horm Metab Res,2011,43(1):22-25.
[12] 王晓艳,王亚军,蒿 花,等.甲状腺结节与代谢综合征相关组分的临床研究[J].西安交通大学学报(医学版),2017,38(1):151-153.
[13] 冷 松,刘 颖,赵 辉,等.代谢综合征及其组分与甲状腺结节相关性的研究[J].中华健康管理学杂志,2011,5(4),211-214.
[14] 张春玉,曾洪利,刘 颖,等.甲状腺结节与代谢综合征及其组分的相关性分析[J].中华内分泌代谢杂志,2012,28(2):132-135.
[15] 张艳町,吴 霞,牛久欣,等.深州市健康体检人群甲状腺结节患病率及相关因素分析[J].河北医药,2014 ,36(22):3482-3483.
[16] 席 燕,王月香.老年高血压患者促甲状腺激素水平及临床意义[J].中国老年学杂志,2013,33(6):1425-1426.
[17] 田晓玲,李彩艳,林凤平,等.代谢综合征患者甲状腺结节患病情况分析[J].中国临床保健杂志,2015,18(3):264-266.
[18] Bétry C,Challan-Belval M A,Bernard A,et al.Increased TSH in obesity:Evidence for a BMI-dependent association with leptin[J].Diabetes Metab,2015,41(3):248-251.
[19] Rezzónico J,Rezzónico M,Pusiol E,et al.Metformin treatment for small benign thyroid nodules in patients with insulin resistance[J].Metab Syndr Relat Disord,2011,9(1):69-75.
[20] 王 博,刘 珺,张玄娥,等.糖代谢异常与甲状腺结节相关性研究[J].中国全科医学,2015,18(30): 3648-3652.
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