老年女性2型糖尿病患者甲状腺结节超声特征的临床分析  

Clinical evaluation of sonographic features of thyroid nodules in elderly women with type 2diabetes

作　　者：仉立辉 宫建[2] 杨朋[3] 朴哲[4] 纪忠杰 李宁 杨传家[7] 汪立杰[8] 王东侠 刘臻[7] 季金杰[10] 徐锦华 

机构地区：[1]北京市中西医结合医院超声室,100039 [2]沈阳药科大学生命科学与生物制药学院临床药学教研室,110016 [3]沈阳市第四人民医院干诊科,100031 [4]北京市石景山医院麻醉科,100043 [5]辽宁省丹东市中医院放射科,118000 [6]北京普仁医院普外科,100001 [7]中国医科大学附属盛京医院胰腺甲状腺外科,沈阳110004 [8]中国医科大学附属第四医院心内科,沈阳110032 [9]北京市丰台中西医结合医院,100072 [10]北京中医药大学东直门医院东区医学影像科,101100

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第1期35-39,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金项目(81072182)~~

摘　　要：目的探讨老年女性2型糖尿病合并甲状腺结节患者的超声特征。方法采用方便抽样法选择2011年1月至2013年12月自北京市2家医院和沈阳市2家医院住院治疗的200例老年女性2型糖尿病患者为研究对象,并纳入观察组(n=200)。按性别、年龄、体重匹配后,随机选择同期于上述4家医院体检的200例健康老年女性纳入对照组(n=200)。本研究遵循的程序均符合上述4家医院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书。2组老年女性年龄、体重比较,差异无统计学意义(P>0.05)。比较2组老年女性甲状腺结节发生情况及其超声特征。结果 1超声检查结果示,观察组老年女性甲状腺结节阳性率显著高于对照组老年女性,两组比较,差异有统计学意义(χ2=29.78,P<0.01)。2观察组老年女性甲状腺结节的形态、边界、内部回声、微小钙化灶和侧壁回声失落及后方衰减情况与对照组老年女性比较,差异均有统计学意义(χ2=8.82、20.21、12.71、17.48、15.55,P<0.01)。观察组良性结节患者的微小钙化灶发生率与恶性结节患者比较,差异有统计学意义(χ2=6.04,P=0.014),而形态、边界、内部回声、侧壁回声失落及后方衰减情况与恶性结节患者比较,差异无统计学意义(P>0.05)。对照组良性结节患者与恶性结节患者的甲状腺结节形态、边界、内部回声、微小钙化灶、侧壁回声失落及后方衰减的超声特征比较,差异均无统计学意义(P>0.05)。3超声检查诊断甲状腺结节的敏感度为98.11%,特异度为64.86%,总诊断符合率为89.5%,Kappa值为0.697(P<0.001)。结论彩色多普勒超声检查可作为临床评价老年女性2型糖尿病患者甲状腺结节的重要手段。Objective To evaluate the sonographic features of thyroid nodules in elderly female patients with type 2diabetes.Methods From January 2011 to December 2013,a total of 200 elderly female patients with type 2diabetes were carried out by convenience sampling from 2hospitals in Beijing and 2hospitals in Shenyang as observation group（n=200）.According to gender,age and weight matching,a total of 200 healthy elderly female were included from the same hospitals at the same time as control group（n=200）.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the four hospitals above.Informed consent was obtained from each participant.There were no significant differences in age,weight between two groups（P〈0.05）.Incidence rate of thyroid nodules and sonographic features were compared between two groups.Results 1 Color Doppler ultrasound results showed that the prevalence of thyroid nodules in elderly female of the observation group was significantly higher than that of control group.There was a significant difference between two groups（χ2=29.78,P〈0.01）.2There were significant differences in the morphology,boundary,internal echo, micro-calcification,side wall echo loss and rear attenuation of thyroid nodules between two groups（χ2=8.82,20.21,12.71,17.48,15.55;P〈0.01）.There were significant differences in the micro-calcification between the benign nodule patients and malignant nodules patients in observation group（χ2=6.04,P=0.014）,meanwhile no significant differences were found in the morphology,boundary,internal echo,side wall echo loss and rear attenuation between them in observation group（P〈0.05）.There were no significant differences in the morphology,boundary,internal echo,micro-calcification,side wall echo loss and rear attenuation between benign nodule patients and malignant nodules patients in control group（P〈0.05）.3 Compared with the thyroid nodules of pathological diagnosis,the sensitivity,specificity,total coincidence rate and Kappa v

关 键 词：糖尿病 2型 甲状腺结节 超声检查 多普勒 彩色 女性 老年人 

分 类 号：R587.1[医药卫生—内分泌] R581[医药卫生—内科学] R445.1[医药卫生—临床医学]