论文部分内容阅读
目的探讨老年女性2型糖尿病合并甲状腺结节患者的超声特征。方法采用方便抽样法选择2011年1月至2013年12月自北京市2家医院和沈阳市2家医院住院治疗的200例老年女性2型糖尿病患者为研究对象,并纳入观察组(n=200)。按性别、年龄、体重匹配后,随机选择同期于上述4家医院体检的200例健康老年女性纳入对照组(n=200)。本研究遵循的程序均符合上述4家医院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书。2组老年女性年龄、体重比较,差异无统计学意义(P>0.05)。比较2组老年女性甲状腺结节发生情况及其超声特征。结果 1超声检查结果示,观察组老年女性甲状腺结节阳性率显著高于对照组老年女性,两组比较,差异有统计学意义(χ2=29.78,P<0.01)。2观察组老年女性甲状腺结节的形态、边界、内部回声、微小钙化灶和侧壁回声失落及后方衰减情况与对照组老年女性比较,差异均有统计学意义(χ2=8.82、20.21、12.71、17.48、15.55,P<0.01)。观察组良性结节患者的微小钙化灶发生率与恶性结节患者比较,差异有统计学意义(χ2=6.04,P=0.014),而形态、边界、内部回声、侧壁回声失落及后方衰减情况与恶性结节患者比较,差异无统计学意义(P>0.05)。对照组良性结节患者与恶性结节患者的甲状腺结节形态、边界、内部回声、微小钙化灶、侧壁回声失落及后方衰减的超声特征比较,差异均无统计学意义(P>0.05)。3超声检查诊断甲状腺结节的敏感度为98.11%,特异度为64.86%,总诊断符合率为89.5%,Kappa值为0.697(P<0.001)。结论彩色多普勒超声检查可作为临床评价老年女性2型糖尿病患者甲状腺结节的重要手段。
Objective To investigate the ultrasound features of elderly patients with type 2 diabetes and thyroid nodules. Methods A total of 200 elderly women with type 2 diabetes who were hospitalized in 2 hospitals in Beijing and Shenyang 2 hospitals from January 2011 to December 2013 were enrolled in the study group (n = 200) ). After matched by sex, age and weight, 200 healthy elderly women were randomly selected into the control group (n = 200) during the same period. The procedures followed in this study were in line with the ethical standards formulated by the human body testing committees of the four hospitals and approved by the committee. The informed consent of the subjects was obtained by grouping and sign informed consent of clinical research. There was no significant difference in age and weight between the two groups of elderly women (P> 0.05). The incidence of thyroid nodules in two groups of elderly women and their ultrasound features were compared. Results 1 Ultrasound examination showed that the positive rate of thyroid nodules in the elderly women in the observation group was significantly higher than that in the control group (χ2 = 29.78, P <0.01). There were significant differences in the morphology, border, internal echo, microcalcifications and side wall echo loss and posterior attenuation of thyroid nodules between the observation group and the control group (χ2 = 8.82,20.21,12.71, 17.48,15.55, P <0.01). The incidence of microcalcification in patients with benign nodules in the observation group was significantly different from that in patients with malignant nodules (χ2 = 6.04, P = 0.014), while morphological, borderline, internal echo, side wall echo loss and posterior attenuation Compared with malignant nodules, the difference was not statistically significant (P> 0.05). Thyroid nodule morphology, borderline, internal echo, microcalcifications, echo loss in the lateral wall and posterior attenuation in benign nodules and malignant nodules were not significantly different between the two groups (P> 0.05). The sensitivity, specificity and accuracy of ultrasonography in diagnosing thyroid nodules were 98.11%, 64.86% respectively. The overall diagnostic coincidence rate was 89.5%. The Kappa value was 0.697 (P <0.001). Conclusion Color Doppler ultrasonography can be used as an important method to evaluate thyroid nodules in elderly women with type 2 diabetes mellitus.