肢端肥大症患者合并甲状腺结节的相关危险因素分析

  目的  分析肢端肥大症合并甲状腺结节的相关危险因素。  方法  回顾性分析四川大学华西医院2009年5月至2018年1月，患肢端肥大症且进行了甲状腺彩超检查的患者。应用多重线性回归分析影响甲状腺体积和甲状腺结节大小的因素，多元logistic回归分析肢端肥大症患者合并甲状腺结节的相关危险因素。  结果  在240例肢端肥大症患者中，仅70例（29.17%）完成了甲状腺彩超检查。这70例中，合并甲状腺结节组56例，平均年龄（48.48±12.73）岁，女性37例，男性19例，中位病程8.0年；未合并甲状腺结节组14例，平均年龄（40.97±12.34）岁，女性7例，男性7例，中位病程3.0年，病程短于合并甲状腺结节组（P<0.05），年龄、性别比在两组间差异无统计学意义。回归分析表明，病程越长的肢端肥大症患者合并甲状腺结节的风险越高比值比1.306，95%可信区间（1.010，1.688），P=0.035]。生长激素随机值与甲状腺体积呈线性相关（P<0.05）。未发现性别、年龄、生长激素水平等与肢端肥大症患者合并甲状腺结节相关。  结论  肢端肥大症病程长是合并甲状腺结节的独立危险因素。

Risk Factors Associated with Thyroid Nodules in Patients with Acromegaly

  Objective  To identify risk factors associated with thyroid nodular lesions in patients with acromegaly.  Methods  Clinical and thyroid ultrasonography data of patients with acromegaly diagnosed in the West China Hospital of Sichuan University from May 2009 to January 2018 were reviewed and analyzed. Multivariate linear regression models were established to identify factors associated with thyroid volumes and size of thyroid nodules. Multivariate binary logistic regression models were established to determine risk factors associated with thyroid nodules in patients with acromegaly.  Results  Of the 240 acromegaly patients, 70 received thyroid ultrasonography and 56 had thyroid nodules (56/70, 80%). The patients with thyroid nodules had a longer median duration of acromegaly than 14 patients who without thyroid nodules (8.0 years vs. 3.0 years, P＜0.05), but had a similar mean age and female to male ratio with the latter. The risk of thyroid nodules increased with the duration of acromegalyodds ratio=1.306, 95% confidence interval (1.010, 1.688), P=0.042]. The level of random growth hormone was linearly correlated with thyroid volumes. Gender, age, and serum growth hormone were not predictors of thyroid nodules in patients with acromegaly.  Conclusion  Duration of acromegaly is an independent predictor of thyroid nodules.