| 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 |
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| 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] |
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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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