马利,李淑琪.基于TI-RADS分类的桥本甲状腺炎合并结节危险因素分析[J].中南民族大学学报自然科学版,2022,41(1):32-37
基于TI-RADS分类的桥本甲状腺炎合并结节危险因素分析
Analysis on TI-RADS-based risk factors of Hashimoto's thyroiditis with thyroid nodules
  
DOI:10.12130/znmdzk.20220106
中文关键词: 桥本甲状腺炎  甲状腺结节  TI-RADS  危险因素
英文关键词: Hashimoto's thyroiditis  thyroid nodule  TI-RADS  risk factors
基金项目:陈如泉全国名老中医药专家传承工作室基金资助项目[国中医药人教函〔2018〕134号]
作者单位
马利 湖北中医药大学 信息工程学院武汉430074 
李淑琪 湖北中医药大学 信息工程学院武汉430074 
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中文摘要:
      目的:基于甲状腺影像报告和数据系统(TI-RADS)分类探讨桥本甲状腺炎(HT)合并结节的恶变危险因素,辅助临床诊断,同时为早期防治和患者的自我健康管理提供依据.方法:回顾性分析了2016年1月至2018年12月某省级三甲医院内分泌科就诊的所有HT合并结节患者基本资料、超声检查及实验室检查结果.基于TI-RADS结果将研究患者的恶变风险分为低、中、高三组,应用累积逐步logistic回归分析桥本氏甲状腺炎(HT)合并结节的恶变危险因素.结果:502例HT合并结节患者中,TI-RADS结节恶性风险等级判定的有346例,低、中、高风险检出率分别为23.99%、58.09%、17.92%.单因素分析结果显示,结节数量、结节直径、游离三碘甲状腺原氨酸(FT4)、游离甲状腺素(FT3)、促甲状腺激素(TSH)水平对恶变风险有显著性影响(P<0.05).累积logistic逐步回归结果表明结节直径(OR=1.582,CI:1.036—2.414,P<0.05)、TSH降低(OR=2.088,CI:1.021—4.268,P<0.05)、FT3增高(OR=3.070,CI:0.960—9.815,P<0.05)是危险因素.结论:HT合并结节患者的结节直径越大,FT3水平升高,TSH水平降低,发生恶变的潜在风险越高.
英文摘要:
      Objective: Based on the classification of Thyroid Imaging Report and Data System (TI-RADS), the risk of malignant transformation of Hashimoto's thyroiditis (HT)complicated with nodules was investigated to assist clinical diagnosis and provide the basis for the early prevention,treatment and self-management of patients'health. Methods: The basic data, ultrasound examination and laboratory examination results of all patients with HT complicated with nodules who were admitted to the endocrinology department of a provincial 3A hospital from January 2016 to December 2018 were retrospectively analyzed. Based on the results of TI-RADS, the patients were divided into three groups: low, medium and high degree, and cumulative stepwise logistic regression was used to analyze the risk factors of malignant transformation for HT with nodules. Results: Among the 502 patients with HT complicated with nodules, 346 cases were determined by TI-RADS to have the malignant risk, and the detection rates of low, medium and high degree were 23.99%, 58.09% and 17.92%, respectively. Univariate analysis showed that the number of nodules, the diameter of nodules and the levels of FT4, FT3 and TSH had significant effects on the malignant transformation (P<0.05). The results of cumulative logistic stepwise regression showed that the diameter of nodules (OR=1.582,CI:1.036–2.414, P<0.05), the decrease of TSH (OR=2.088,CI:1.021–4.268, P<0.05) and the increase of FT3 (OR=3.070,CI:0.960–9.815, P<0.05) were the risk factors. Conclusion: The larger the diameter of nodules, the higher the FT3 level and the lower the TSH level is, the higher the potential risk of malignant transformation will be.
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