作者：李冬霞，卫文婷，韩桂玲，罗雪，樊佳佳，李得民，贾明月，陈钢，张纾难

单位：

1.北京中医药大学研究生院2.中日友好医院呼吸中心中医肺病科国家呼吸医学中心中国医学科学院呼吸病学研究院国家呼吸系统疾病临床医学研究中心世界卫生组织戒烟与呼吸疾病预防合作中心3.昌平区中医医院4.中国人民大学后勤集团5.中日友好医院体检中心

Units：

Graduate School of Beijing University of Chinese Medicine;Department of Traditional Chinese Medicine for Pulmonary Diseases of Respiratory Medicine Center/National Center for Respiratory Medicine/Institute of Respiratory Medicine of Chinese Academy of Medical Sciences/National Clinical Research Center for Respiratory Diseases/Collaborating Centre for WHO Tobacco Cessation and Respiratory Diseases Prevention,China-Japan Friendship Hospital;Beijing Changping District Traditional Chinese Medicine Hospital;Logistics Group of Renmin University of China;Physical Examination Center, China-Japan Friendship Hospital;

关键词：

多发性肺结节; 孤立性肺结节; 北京; 流行病学; 影响因素分析;

Keywords：

Multiple pulmonary nodules;Solitary pulmonary nodules;Beijing;Epidemiology;Root cause analysis;

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.319

Funds：

国家自然科学基金资助项目（82104760）； 中日友好医院“菁英计划”人才培育工程（ZRJY2021-GG06）； 国家区域（专科）中医诊疗中心建设（中医肺病）项目（2019-zx-004）；

摘要：

目的 分析北京市某三甲医院体检人群肺结节检出情况及其影响因素。方法 选取2020年12月至2021年5月在中日友好医院体检中心进行健康体检者10 277例为研究对象。收集体检者一般资料、血清肿瘤标志物、影像学检查结果，将CT检查报告提示有肺结节者纳入肺结节组，未提示有肺结节者纳入无肺结节组。体检者发生肺结节的影响因素分析采用多因素Logistic回归分析。结果 10 277例体检者中，检出肺结节5 363例（52.18%）。肺结节组女性占比、收缩压、舒张压、血压升高者占比、有高血压史者占比、有高脂血症史者占比、有糖尿病史者占比、有冠心病史者占比、甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原153(CA153)、总前列腺特异抗原（TPSA）、胃泌素释放肽前体（Pro-GRP）、鳞状上皮细胞癌抗原（SCC）、神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片段抗原21-1(CYFRA21-1)高于无肺结节组，年龄大于无肺结节组，糖类抗原125(CA125)低于无肺结节组（P<0.05）。肺结节检出率随体检者年龄的增长而升高（P<0.05）。男、女性体检者肺结节检出率均随年龄的增长而升高（P<0.05）。多因素Logistic回归分析结果显示，性别、年龄是体检者发生肺结节的影响因素（P<0.05）。结论体检人群肺结节检出率高达52.18%，女性和年龄增长是体检人群发生肺结节的危险因素。

Abstract：

Objective To analyze the detection and influencing factors of pulmonary nodules in physical examination population of a tertiary A hospital in Beijing. Methods A total of 10 277 subjects who underwent physical examination in the Physical Examination Center of China-Japan Friendship Hospital from December 2020 to May 2021 were selected as the research objects. The general data, serum tumor markers and imaging examination results of the physical examination participants were collected. The subjects with pulmonary nodules suggested by CT examination report were included in the pulmonary nodules group, and the subjects without pulmonary nodules were included in the non-pulmonary nodules group. Multivariate Logistic regression analysis was used to analyze the influencing factors of pulmonary nodules in physical examiners. Results Among 10 277 physical examiners, 5 363（52.18%） pulmonary nodules were detected. The proportion of women, systolic pressure, diastolic blood pressure, the proportion of subjects with elevated blood pressure, history of hypertension, history of hyperlipidemia, history of diabetes and history of coronary heart disease, alpha fetoprotein（AFP）, carcinoembryonic antigen（CEA）, carbohydrate antigen 153（CA153）, total prostate specific antigen（TPSA）, gastrin releasing peptide precursor（Pro-GRP）, squamous cell carcinoma antigen（SCC）, neuron-specific enolase（NSE）, cyto-keratin 19 fragment antigen 21-1（CYFRA21-1） in the lung nodule group were higher than those in the non-lung nodule group, the age was older than that in the non-lung nodule group, and carbohydrate antigen 125（CA125） was lower than that in the non-lung nodule group（P < 0.05）. The detection rate of pulmonary nodules increased with age（P < 0.05）. The detection rate of pulmonary nodules increased with age in both male and female subjects（P < 0.05）. The results of multivariate Logistic regression analysis showed that gender and age were the influencing factors of pulmonary nodules in physical examiners（P < 0.05）. Conclusion The detection rate of pulmonary nodules in the physical examination population is 52.18%. Women and age are the risk factors for pulmonary nodules in the physical examination population.

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