目的了解宁夏南部山区甲状腺结节和甲状腺功能异常的患病现况。方法采用人口比例抽样法抽取泾源县18岁以上人群10639人,采用高分辨率超声进行甲状腺检查,抽空腹血检测促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(F'I'3)水平。采用卡方检验和Spearman秩相关分析进行统计分析。结果宁夏南部山区甲状腺结节患病率为29.08%,标化率为27.17%,女性(32.68%)高于男性(24.88%)(x2=76.0292,P〈0.001),年龄与甲状腺结节患病率呈正相关(r=0.272,P〈0.001)。甲状腺功能异常、亚临床甲减、亚临床甲亢、甲减、甲亢的患病率分别为17.39%、13.00%、0.42%、0.96%、3.01%。TSH异常组的甲状腺结节患病率高于正常组(39.44%比27.24%,X2=95.6240,P〈0.001)。甲状腺结节组和正常组之间TSH、FT3、FT4水平比较,差异有统计学意义(Z=-9.144,P〈0.00l;Z=-6.140,P〈0.001;Z=-1.997,P=0.046)。结论宁夏南部山区甲状腺结节和甲状腺功能异常患病率高,甲状腺结节和甲状腺功能异常的关系需要开展进一步研究,应重视山区人群甲状腺结节的早期筛查与诊断。
Objective To investigate the prevalence of thyroid nodules and thyroid dysfunction in southern mountainouss areas of Ningxia. Methods A cross-sectional study was conducted among a representative sample of 10 639 adults in Jingyuan county with a population proportionate sampling method. High-resolution ultrasound was used to examine the thyroid and fasting blood specimens were collected inthe morning for measurement of TSH, FT4, FT3. Chi-square test and spearman rank correlation analysis were used for statistical analysis. Results The prevalence of thyroid nodules was 29.08%, the sex- and age- adjusted rate was 27.17%. The prevalence of thyroid nodules was higher in women than in men (32.68% vs. 24.88%, X2=76.029 2, P〈O.O01) and age was positively associated with thyroid nodules (r= 0.272, P〈0.001). The rate of thyroid dysfunction, subclinical hypothyroidism, subclinical hyperthyroidism, hypothyroidism, hyperthyroidism were 17.39%, 13.00%, 0.42%, 0.96%, 3.01%, respectively. The prevalence of thyroid nodules was higher in abnormal TSH group than in normal TSH group (39.44% vs. 27.24%, X~=95.624 O, P〈0.001). The level of THS, FT3, FT4 in thyroid nodules group differed from control group (Z=-9.144, P〈0.001; Z=-6.140, P〈0.001; Z=-1.997, P=0.046). Conclusion The prevalence of thyroid nodules and thyroid dysfunction were higher in southern mountainous areas of Ningxia. The relationship between thyroid nodules and thyroid function needs further research. We should pay attention to the early screening and diagnosis of thyroid nodules in mountainous areas.