标题：40岁及以上健康体检人群肺结节检出结果及影响因素分析

      作者：林家莉 1，梁秋瑜 1，黄小知 2，潘柳先 2，覃琰 2，李建立 2，蒋紫琼 2，李卫 2    广西医学科学院·广西壮族自治区人民医院健康管理研究所 1、健康管理中心 2，广西 南宁 530000

      卷次： 2024年35卷12期

      【摘要】 目的 探索40岁及以上健康体检人群肺结节的流行现状并探讨其相关影响因素，为预防早期肺癌提供科学依据。方法 选取2022年度于广西壮族自治区人民医院体检的40岁及以上体检者共2 365例，其中肺结节组1 596例，无肺结节组769例。比较两组体检者体格检查和生化相关指标的差异，通过多因素 Logistic回归分析肺结节相关的影响因素；采用限制性立方样条分析(RCS)进一步探讨影响因素与肺结节之间的剂量反应关系。结果 调查人群肺结节总检出率为 67.48%，其中女性检出率为 69.03%，明显高于男性的 63.34%，差异具有统计学意义(P<0.05)；肺结节组体检者的年龄、糖化血红蛋白、尿素氮、高血压既往史和甲胎蛋白(AFP)均高于非肺结节组，而CA125则相反，差异均具有统计学意义(P<0.05)；经多因素Logistic回归分析结果显示，性别、年龄和AFP均是体检者发生肺结节的影响因素(P<0.05)；经RCS分析结果显示，年龄与肺结节患病风险呈非线性关系(Poverall<0.001，Pnonliearity<0.001)，而血清AFP浓度与之呈线性相关(Poverall=0.031, Pnonliearity=0.832)。结论 该人群的肺结节检出率约67.48%，女性、年龄增长和血清AFP浓度是体检人群肺结节患病的危险因素。
      【关键词】 肺结节；低剂量CT；流行病学；影响因素
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2024）12—1749—04

Examination results and influencing factors of pulmonary nodules in people aged 40 years and above.
LIN Jia-li 1,LIANG Qiu-yu 1, HUANG Xiao-zhi 2, PAN Liu-xian 2, QIN Yan 2, LI Jian-li 2, JIANG Zi-qiong 2, LI Wei 2. Institute ofHealth Management 1, Health Management Center 2, Guangxi Zhuang Autonomous Region People's Hospital, GuangxiAcademy of Medical Sciences, Nanning 530000, Guangxi, CHINA
【Abstract】 Objective To explore the prevalence and influencing factors of pulmonary nodules in healthcheck-up population aged 40 years and above, and to provide a scientific basis for the prevention of early lung cancer.Methods A total of 2 365 subjects undergoing physical examination aged 40 years and above in Guangxi Zhuang Au-tonomous Region People's Hospital in 2022 were selected, including 1 596 subjects in the pulmonary nodule group and769 subjects in the non-pulmonary nodule group. The differences in physical examination and biochemical indicators be-tween the two groups were compared, and the influencing factors related to pulmonary nodules were analyzed by multi-variate Logistic regression. Restricted cubic spline (RCS) analysis was used to further explore the dose-response relation-ship between the influencing factors and pulmonary nodules. Results The total detection rate of pulmonary nodules was67.48%, and the detection rate in females was significantly higher than that of males (69.03% vs 63.34%, P<0.05). Theage, glycosylated hemoglobin, blood urea nitrogen, history of hypertension, and alpha-fetoprotein (AFP) in the pulmonarynodule group were significantly higher than those in the non-pulmonary nodule group, while CA125 was just the opposite,with statistically significant differences (all P<0.05). Multivariate Logistic regression analysis showed that gender, age,and AFP were the influencing factors of pulmonary nodules in the pulmonary nodule group (P<0.05). RCS results showedthat there was a nonlinear relationship between age and the risk of pulmonary nodules (Poverall<0.001, Pnonliearity<0.001).However, serum AFP concentration was linearly associated with the risk of lung nodules (Poverall=0.031, Pnonliearity=0.832).Conclusion We found that the detection rate of pulmonary nodules in healthy people was about 67.48%. Female, age,and serumAFP concentration are associated with increased risk of pulmonary nodules.
      【Key words】 Pulmonary nodules; Low-dose computed tomography; Epidemiology; Influencing factors