体检人群甲状腺实质回声异常与甲状腺功能演变的关联研究  

Correlation between abnormal thyroid parenchymal echogenicity and thyroid function changes in health examination population

作　　者：靳育静 高鹰[1] 苏海燕[1] 尤俊方 孙绍梅[1] 张卿[1] Jin Yujing;Gao Ying;Su Haiyan;You Junfang;Sun Shaomei;Zhang Qing(Health Management Center,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院健康管理中心,天津300052

出　　处：《中华健康管理学杂志》2023年第12期899-903,共5页Chinese Journal of Health Management

基　　金：国家自然科学基金(72074167);天津市科技计划(22ZYCGSY00860);天津市卫生健康科技人才培育项目(KJ20178)。

摘　　要：目的探讨体检人群甲状腺实质回声异常与甲状腺功能演变之间的关系。方法本研究为队列研究,选取2017年1至12月在天津医科大学总医院健康管理中心完成甲状腺彩超和甲状腺功能检查且符合纳入、排除标准的受检者为研究对象,收集其年龄、性别、吸烟史、饮酒史、个人疾病史等资料以及甲状腺功能复检信息,随访期间发生甲状腺功能异常则随访截止,或至随访结束。评估甲状腺功能异常的累积发病率及发病密度。采用Cox回归模型分析甲状腺实质回声异常与甲状腺功能演变的关系。结果本研究共纳入6754例,年龄为(45.80±12.12)岁,女性占42.7%。平均随访时间1.82年,累积随访12263人年。随访期间新发甲状腺功能异常154例,累积发病率为2.28%(95%CI:1.94%~2.66%),发病密度为12.56/1000人年(95%CI:10.66/1000人年~14.69/1000人年)。多因素调整的Cox回归分析结果显示,甲状腺实质回声异常者发生单纯促甲状腺素异常风险与甲状腺功能异常风险均显著增加,HR(95%CI)分别为3.09(2.02~4.73)和2.92(1.96~4.33),均P<0.001。分层分析显示,除体重指数<18.5 kg/m^(2)、目前吸烟、目前饮酒外,其他分层因素显示甲状腺实质回声异常者发生甲状腺功能异常风险均明显增加。结论甲状腺实质回声异常是甲状腺功能异常演变的重要危险因素,应重视甲状腺功能的持续监测。Objective To explore the relationship between thyroid parenchymal echogenicity abnormalities and thyroid function evolution in health examination population.Methods It was a cohort study.According to the inclusion and exclusion criteria,participants were selected from individuals who underwent thyroid color ultrasound and thyroid function tests at the Health Management Center of Tianjin Medical University General Hospital from January to December 2017.Data including age,gender,smoking history,alcohol consumption history,personal medical history,and thyroid function re-examination information were collected.Follow-up was conducted until the occurrence of thyroid function abnormalities or until the end of the follow-up period.The cumulative incidence rate and incidence density of thyroid function abnormalities were evaluated.Cox regression analysis was used to analyze the relationship between thyroid parenchymal echogenicity abnormalities and thyroid function evolution.Results A total of 6754 participants were included in this study,with an average age of(45.80±12.12)years,and females accounted for 42.7%.The mean follow-up time was 1.82 years,with a cumulative follow-up duration of 12263 person-years.During the follow-up period,154 new cases of thyroid function abnormalities occurred,with a cumulative incidence rate of 2.28%(95%CI:1.94%-2.66%)and an incidence density of 12.56/1000 person-years(95%CI:10.66/1000-14.69/1000 person-years).The multivariate adjusted Cox regression analysis showed that individuals with thyroid parenchymal echogenicity abnormalities had a significantly increased risk of developing isolated thyroid stimulating hormone abnormalities and thyroid function abnormalities,with HR(95%CI)of 3.09(2.02-4.73)and 2.92(1.96-4.33),respectively,both P<0.001.Stratified analysis showed that,except for body mass index<18.5 kg/m^(2),current smoking,and current alcohol consumption,all other stratified factors showed a significant increase in the risk of thyroid function abnormalities in individuals with thyro

关 键 词：甲状腺 体格检查 甲状腺实质回声 甲状腺功能 

分 类 号：R581[医药卫生—内分泌]