肢端肥大症患者合并甲状腺结节的相关危险因素分析  

Risk Factors Associated with Thyroid Nodules in Patients with Acromegaly

作　　者：杨涵 张明智[2] 魏嘉 陈进[3] 余叶蓉[1] 安振梅[1] 蔡博文[4] 姜曙[4] 魏懿[5] 谭惠文[1] 李建薇[1] YANG Han;ZHANG Ming-zhi;WEI Jia;CHEN Jin;YU Ye-rong;AN Zhen-mei;CAI Bo-wen;JIANG Shu;WEI Yi;TAN Hui-wen;LI Jian-wei(Department of Endocrinology and Metabolism,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Ultrasound,West China Hospital,Sichuan University,Chengdu610041,China;The Chinese Cochrane Center,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院内分泌代谢科,成都610041 [2]四川大学华西医院超声科,成都610041 [3]四川大学华西医院中国循证医学中心,成都610041 [4]四川大学华西医院神经外科,成都610041 [5]四川大学华西医院放射科,成都610041

出　　处：《四川大学学报（医学版）》2019年第3期433-437,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅项目(No.2018HH0065;No.2017SZ0063和No.2014SZ0170)资助

摘　　要：目的分析肢端肥大症合并甲状腺结节的相关危险因素。方法回顾性分析四川大学华西医院2009年5月至2018年1月,患肢端肥大症且进行了甲状腺彩超检查的患者。应用多重线性回归分析影响甲状腺体积和甲状腺结节大小的因素,多元logistic回归分析肢端肥大症患者合并甲状腺结节的相关危险因素。结果在240例肢端肥大症患者中,仅70例(29.17%)完成了甲状腺彩超检查。这70例中,合并甲状腺结节组56例,平均年龄(48.48±12.73)岁,女性37例,男性19例,中位病程8.0年;未合并甲状腺结节组14例,平均年龄(40.97±12.34)岁,女性7例,男性7例,中位病程3.0年,病程短于合并甲状腺结节组(P<0.05),年龄、性别比在两组间差异无统计学意义。回归分析表明,病程越长的肢端肥大症患者合并甲状腺结节的风险越高[比值比1.306,95%可信区间(1.010,1.688),P=0.035]。生长激素随机值与甲状腺体积呈线性相关(P<0.05)。未发现性别、年龄、生长激素水平等与肢端肥大症患者合并甲状腺结节相关。结论肢端肥大症病程长是合并甲状腺结节的独立危险因素。Objective To identify risk factors associated withthyroid nodular lesions in patients withacromegaly.Methods Clinical and thyroid ultrasonography data of patients with acromegaly diagnosed in the WestChina Hospital of Sichuan University from May 2009to January 2018were reviewed and analyzed.Multivariatelinear regression models were established to identify factors associated with thyroid volumes and size of thyroidnodules.Multivariate binary logistic regression models were established to determine risk factors associated withthyroid nodules in patients with acromegaly.Results Of the 240acromegaly patients,70received thyroidultrasonography and 56had thyroid nodules(56/70,80%).The patients with thyroid nodules had a longer medianduration of acromegaly than 14patients who without thyroid nodules(8.0years vs.3.0years,P<0.05),but had asimilar mean age and female to male ratio with the latter.The risk of thyroid nodules increased with the duration ofacromegaly〔odds ratio=1.306,95%confidence interval(1.010,1.688),P=0.042〕.The level of random growthhormone was linearly correlated with thyroid volumes.Gender,age,and serum growth hormone were not predictorsof thyroid nodulesin patients with acromegaly.Conclusion Duration of acromegaly is an independent predictor ofthyroid nodules.

关 键 词：肢端肥大症 垂体肿瘤 甲状腺结节 甲状腺癌 

分 类 号：R581[医药卫生—内分泌] R584.11[医药卫生—内科学]