| 摘要: |
| 目的 评估不同环境下的海军军人自身免疫性甲状腺疾病的患病情况，以便前移防控措施。方法 回顾性分析2020年6月至9月在海军军医大学（第二军医大学）第一附属医院体检中心进行健康体检的2 198例海军官兵体检数据。按驻地不同，将官兵分为城市组（驻扎在沿海城市的官兵）和舰船组（驻扎在舰船的官兵），比较两组海军官兵的血清三碘甲腺原氨酸（T3）、甲状腺素（T4）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）水平及甲状腺超声结果，并采用多因素logistic回归分析探讨甲状腺功能、甲状腺抗体水平及甲状腺超声结果的影响因素。结果 城市组1 095例，年龄为34（29，41）岁，男663例（60.55%）、女432例（39.45%）；舰船组1 103例，年龄为33（28，38）岁，男1 014例（91.93%）、女89例（8.07%）。两组的性别及年龄差异均有统计学意义（P均<0.01）。城市组甲状腺抗体水平异常111例（10.14%，111/1 095），亚临床甲状腺功能亢进（简称"亚甲亢"）9例（0.82%，9/1 095），亚临床甲状腺功能减退（简称"亚甲减"）85例（7.76%，85/1 095），超声检查有甲状腺结节363例（45.72%，363/794）；舰船组甲状腺抗体水平异常84例（7.62%，84/1 103），亚甲亢5例（0.45%，5/1 103），亚甲减38例（3.45%，38/1 103），超声检查有甲状腺结节258例（33.64%，258/767）。多因素logistic回归分析结果显示，性别与甲状腺抗体水平异常有关（P<0.01），驻地和甲状腺抗体水平是TSH的影响因素（P均<0.01），性别、年龄及甲状腺抗体水平与甲状腺结节的发生有关（P均<0.01）。结论 驻地在沿海城市的海军官兵甲状腺抗体水平异常率及亚甲减、甲状腺结节患病率较高，有必要对其给予更多关注。女性海军官兵更需前移防控措施，而且甲状腺抗体水平升高的女性海军官兵随年龄的增大需对结节的良恶性进一步评估。 |
| 关键词: 海军 自身免疫性甲状腺疾病 亚临床甲状腺功能异常 健康管理 |
| DOI：10.16781/j.CN31-2187/R.20210128 |
| 投稿时间：2021-02-06修订日期：2021-08-26 |
| 基金项目:海军军医大学（第二军医大学）第一附属医院军事医学专项（2018JS011），海军军医大学（第二军医大学）教学成果立项培育项目（JPY2020A21）. |
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| Autoimmune thyroid diseases in naval soldiers under different environments: a survey of current status |
| ZHAN Lu1,ZHUANG Wei2,YAN Gui-ling3,WANG Zhi-ping4,HU Wei1* |
(1. Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. No. 31690 Troop of PLA, Jilin 132500, Jilin, China;
3. Department of General Surgery, Naval Hospital of PLA Eastern Theater Command, Zhoushan 316000, Zhejiang, China;
4. Physical Examination Center, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To evaluate the incidence of autoimmune thyroid diseases in naval soldiers under different environments, so as to take early prevention and control measures. Methods The data of 2 198 naval officers and soldiers who underwent physical examination in the Physical Examination Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jun. to Sep. 2020 were retrospectively analyzed. The officers and soldiers were divided into urban groups (stationed in coastal cities) and ship groups (stationed in ships) according to their stations. The levels of serum triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and thyroid ultrasound results were compared. Multivariate logistic regression was used to analyze the influencing factors of thyroid function, thyroid antibody level and thyroid ultrasound results. Results There were 1 095 cases in the urban group, with a median age of 34 (29, 41) years, including 663 males (60.55%) and 432 females (39.45%), and 1 103 cases in the ship group, with a median age of 33 (28, 38) years, including 1 014 males (91.93%) and 89 females (8.07%). There were significant differences in gender and age between the 2 groups (P<0.01). In the urban group, there were 111 cases (10.14%, 111/1 095) of abnormal thyroid antibodies, 9 cases (0.82%, 9/1 095) of subclinical hyperthyroidism, 85 cases (7.76%, 85/1 095) of subclinical hypothyroidism and 363 cases (45.72%, 363/794) of thyroid nodules. In the ship group, there were 84 cases (7.62%, 84/1 103) of abnormal thyroid antibodies, 5 cases (0.45%, 5/1 103) of subclinical hyperthyroidism, 38 cases (3.45%, 38/1 103) of subclinical hypothyroidism and 258 cases (33.64%, 258/767) of thyroid nodules. Multivariate logistic regression analysis showed that the gender was correlated with abnormal thyroid antibody level (P<0.01), station and thyroid antibody level were the influencing factors of TSH (both P<0.01), and gender, age and thyroid antibody level were related to the incidence of thyroid nodules (all P<0.01). Conclusion The naval officers and soldiers stationed in coastal cities have higher incidence of abnormal thyroid antibody, subclinical hypothyroidism and thyroid nodules. For female naval officers and soldiers, prevention and control measures should be taken earlier, and the benign or malignant of the nodules in female naval officers and soldiers with elevated thyroid antibodies need to be further evaluated with the increase of age. |
| Key words: navy autoimmune thyroid disease subclinical thyroid dysfunction health management |
