摘要
目的甲状腺针吸细胞学(fine-needle aspiration cytology,FNAC)是诊断甲状腺疾病的直接、准确的检查方法。结合临床资料对FNAC确诊的甲状腺疾病进行不同年龄组分析,以提高对各年龄段患者甲状腺疾病特点的认识,以期对甲状腺疾病的临床诊治准确性作出一定的指导。方法回顾性分析北京大学第一医院内分泌科2006年8月—2010年1月期间经FNAC确诊的579例患者的甲状腺穿刺结果及临床资料,按年龄分为少年组(年龄<20岁)、青年组(20～39岁)、中年组(40～59岁)及老年组(年龄≥60岁)4组后,比较各组的临床特点。结果各组患者均以女性占优势,其中青年组两性差异最大(男女性别比为1∶20.3),而老年组两性差异相对较弱(男女性别比为1∶3.8)。少年组和老年组无临床症状及无甲状腺明显肿大者的比例高于另2组,临床表现更加隐匿。年龄小于20岁者甲状腺癌比例为13.3%,显著高于其他年龄组。老年组最常见的病理类型与其他3组不同,老年组最常见的病理类型为甲状腺肿,其他3组最常见的病理类型为桥本甲状腺炎。对桥本甲状腺炎患者细胞病理学亚型的分析显示,随年龄增加,嗜酸细胞亚型所占比例逐渐升高,淋巴细胞亚型所占比例则逐渐减少。结论甲状腺疾病不同年龄组的疾病分布谱及临床特点各有差异,结合这些临床特点对提高甲状腺疾病的诊断准确性,具有一定的临床指导意义。
Objective Fine-needle aspiration cytology(FNAC)is a kind of direct and accurate test for thyroid disease.The aim of this paper is to analyze the clinical features of thyroid disease confirmed by FNAC in patients at different age,and improve the understanding and clinical diagnosis and treatment of thyroid diseases.Methods FNAC results and clinical data of 579 patients with thyroid disease in Endocrinology Department Peaking University First Hospital from August 2006 to January 2010 were analyzed retrospectively.The patients according to their ages were divided into teenage(age<20 years),youth(20-39 years),middle age(40-59 years),and seniors(age≥60 years).The clinical features were compared among the four groups.Results Female patients accounted for main part in all groups,the difference in sex was especially obvious in the youth group(the ratio of male to female was 1∶20.3),not obvious in the senior group(the ratio of male to female is 1∶3.8).There were more patients who had no symptoms in teenage and seniors when compared with the other two groups that were with more obvious clinical manifestations.The incidence of thyroid carcinoma in the teenage group was the highest(13.3%)among the all four groups.The most common pathological type was goiter in seniors group;however,the most common pathological type was Hashimoto thyroiditis in the other three groups,the difference was obviously.The histologic subtype analysis for the patients with Hashimoto thyroiditis showed that the ratio of eosinophil subtype of Hashimoto thyroiditis increased and lymphocyte subtype of Hashimoto thyroiditis decreased with the age of patients increasing.Conclusion There are some differences in thyroid disease distribution and clinical feature among the different age groups.The analysis of the clinical significance will improve the accurate diagnosis of thyroid disease,which is of certain clinical significance.
作者
王薇
卢桂芝
高燕明
张晶
高莹
郭晓蕙
WANG Wei;LU Gui-zhi;GAO Yan-ming(Department of Endocrinology,the First Hospital of Peking University,Beijing 100034,China)
出处
《中华全科医学》
2019年第5期738-741,共4页
Chinese Journal of General Practice
基金
首都卫生发展科研专项项目(2018-2-4074)
