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目的:分析甲状腺结节患者的临床及病理学特点,探讨甲状腺恶性结节的相关危险因素。方法:根据纳入及排除标准,选择在我院就诊的甲状腺结节283例。根据术后组织病理结果将其分为两组,良性组(良性结节)172例,恶性组(恶性结节)111例。单因素分析两组患者的年龄、性别、血清甲状腺球蛋白抗体(TgAb)、过氧化物酶抗体(TPOAb)、促甲状腺素(TSH)、游离甲状腺素(fT4)、游离三碘甲状腺原氨酸(fT3)水平、fT4/fT3的比值等结果,再用多因素Logistic回归分析筛选甲状腺恶性结节的危险因素。结果:单因素分析结果显示,年龄、TgAb、fT4(P<0.05)和fT4/fT3的比值(P<0.01)在两组间有显著的统计学差异。fT4/fT3的比值是恶性结节的危险因素(OR:2.065,95%CI:1.270-3.357);多因素logistic回归分析结果显示,年龄(OR:0.934,95%CI:0.911-0.957),TgAb(OR:2.069,95%CI:1.008-4.247)、fT4(OR:1.206,95%CI:1.038-1.401)水平是恶性结节的危险因素。结论:术前血清fT4/fT3的比值对鉴别甲状腺结节良恶性具有重要诊断价值,当fT4/fT3>3时增加了恶性结节的风险。患者年龄及血清学指标TgAb、fT4水平是甲状腺恶性结节的独立危险因素,可指导甲状腺良恶性结节的鉴别诊断。
Abstract：Objective:To analyze the clinical and pathological characteristics of thyroid nodules in ooder to explore the related risk factors of malignant thyroid nodules.Methods:A total of 283 eligible patients with thyroid nodules that were treated in our hospital during January 2015 and December 2017 enrolled and divided into benign group(benign thyroid nodule group,n=172)and malignant group(malignant thyroid nodule,n=111)based on postoperative histopathological results.The age,sex,serum thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb),thyroid stimulating hormone(TSH),free thyroxine(fT4),free three iodine thyroxine(fT3)and fT4/fT3 ratio were subjected to univariate analysis,and the risk factors of malignant thyroid nodule were screened by multivariate logistic regression analysis.Results:Univariate analysis showed that age,TgAb,fT4(P<0.05)and fT4/fT3(P<0.01)were significantly different between the two groups.The fT4/fT3 ratio was a risk factor of malignant nodules(OR:2.065,95%CI:1.270-3.357).Multivariate logistic regression analysis indicated that the risk factors of malignant thyroid nodule were age(OR:0.934,95%CI:0.911-0.957),TgAb(OR:2.069,95% CI:1.008-4.247)and fT4(OR:1.206,95% CI:1.038-1.401).Conclusion:The fT4/fT3 ratio has important diagnostic value in differentiation of benign and malignant thyroid nodules.A fT4/fT3 ratio that is higher than 3 may indicate high risk of malignancy.The age,TgAb and fT4 are independent risk factors for malignant thyroid nodule,which is of great value in differentiation of benign and malignant thyroid nodules.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20180925.001
中图分类号:R653
引用信息:
[1]赵跃,王宁,刘春蓉,等.术前fT4/fT3比值与甲状腺功能检查在甲状腺结节良恶性鉴别诊断中的临床研究[J].海南医学院学报,2018,24(20):1833-1837.DOI:10.13210/j.cnki.jhmu.20180925.001.
基金信息:
国家自然科学基金项目(81302577)~~
2018-09-28
2018-09-28
2018-09-28