Distribution Characteristics Of Thyroid Function In Outpatient Department Of A Third-class Hospital And Analysis Of The Factors Affecting Therapeutic Effect

Objective: The blood test results of thyroid function in outpatients of the second hospital of hebei medical university were statistically analyzed to explore the distribution characteristics of patients with thyroid disfunction and further guide the standardized diagnosis and treatment of patients with thyroid function abnormalities in outpatients.The related factors affecting the return of thyroid function to normal were analyzed retrospectively,in an attempt to find out the influencing factors for conservative treatment of thyroid dysfunction and to assist the clinical prediction of drug treatment for thyroid diseases.Materials and Methods: In this study,Collect the general data of outpatients and thyroid function indicators such as FT3,FT4,TSH,TPOAb and TGAb from June 2014 to December 2018 in various departments of the Second Hospital of Hebei Medical University.A total of 138865 blood samples were collected.The age ranges from 10 to 100 years.According to the standard of normal thyroid function provided by reagent data,the patients were divided into normal group,hyperthyroidism group,hypothyroidism group,subclinical hyperthyroidism group and subclinical hypothyroidism group.Instrument: Siemens Automatic Chemical Analyzer(IMMULITE2000-xpi);statistical method:WPS Office 2019 software was used for data entry and SPSS 24.0 statistical software was adopted for statistical processing.Measurement data were presented as mean+standard deviation(x±S)indicate.X2 test was used to compare the percentage.Respectively,“FT4 standard time”,“TSH standard time”,“Thyroid function tests standard time”as the dependent variable,With“sex,age,medication before the FT4,TRAb,TgAb,TPOAb levels”as the independent variable line multiple linear regression analysis,P<0.05 was considered with statistically significance.Result:1.A total of 138865 out-patients underwent thyroid function examination in our hospital.The top 3 outpatients were endocrinology 54 684(39.38%),reproduction 16841(12.13%),nuclear medicine 11857(8.54%);The latter three were 376 in respiratory department,accounting for 0.27%,287 in traditional Chinese medicine,accounting for 0.21%,and 41 in oncology department,accounting for 0.03%.2.The abnormal rate of thyroid function in different departments of our hospital is different.According to the ranking of abnormal detection rate,the top three are oncology department,the abnormal rate is 85.37%,nuclear medicine department,69.97%,extraglandular department,61.32%.In the last three places,the abnormal rate of neurology was 13.58 %,the abnormal rate of obstetrics was 12.83 %,and the abnormal rate of reproduction was 9.71 %.3.Subclinical hypothyroidism was the most common thyroid disease in our hospital,accounting for 14.51%,followed by subclinical hyperthyroidism(11.1%),hyperthyroidism(9.6%)and hypothyroidism(1.6%).The number of patients undergoing thyroid function examination in our hospital's outpatient department increased year by year,but the diagnostic rate of thyroid disease in our hospital decreased year by year.4.The sex ratio of hyperthyroidism group was 1:3,which was significantly different from that of normal control group(P < 0.05);the sex ratio of subclinical hypothyroidism group was about 1:4.7,which was significantly different from that of normal control group(P < 0.05);the number of female patients in subclinical hyperthyroidism group and hypothyroidism group was more than that of male patients,but compared with normal control group,There was no significant difference between the sexes.5.The age distribution of different thyroid diseases is different,hyperthyroidism and subclinical hypothyroidism are concentrated in 15-44 years old,the most in 30-44 years old;hypothyroidism and subclinical hyperthyroidism are concentrated in 30-59 years old,the most in 45-59 years old;except the age differences between subclinical hyperthyroidism group and hypothyroidism group are not significant(P > 0.05),there are significant differences among other groups(P < 0.05).6.The follow-up rate of hyperthyroidism and hypothyroidism was 39.9% and 47.5% respectively.The follow-up rate of hyperthyroidism was significantly lower than that of hypothyroidism(P < 0.05).7.3291 patients with hyperthyroidism who were initially diagnosed and regularly followed up in the endocrinological outpatient department of our hospital were selected.The independent variables were "FT3 recovery time","FT4 recovery time","TSH recovery time".The independent variables were "gender,age,initial FT4,TSH,TPOAb,and TGAb".The recovery time of FT3,FT4 and TSH were all correlated with the level of FT4 before treatment(P < 0.05),while the other five factors were not correlated with the recovery time(P > 0.05).8.480 patients with hypothyroidism who were first diagnosed and regularly followed up in the Endocrinology Department of our hospital were selected.The independent variables were "FT3 recovery time","FT4 recovery time","TSH recovery time".The independent variables were "gender,age,initial FT4,TSH,TPOAb,TRAb and TGAb".The results showed that thyroid function was recovered by multiple linear regression analysis.The time required for three items,FT3,FT4 and TSH to reach the standard was not correlated with the appeal index(P > 0.05).Conclusion:1.The number of out-patient thyroid function examinations in our hospital has increased year by year,but the detection rate of abnormalities has decreased.The departments of thyroid function examinations are mainly concentrated in endocrinology,reproduction,nuclear medicine and extraglandular medicine.Some departments,such as oncology,have a high rate of thyroid function abnormalities,while the number of patients who improve thyroid function examinations is less.2.The proportion of female patients with hyperthyroidism and subclinical hypothyroidism was higher than that of male patients,and the average age of patients with hypothyroidism was higher than that of hyperthyroidism.3.The follow-up rates of patients with hyperthyroidism and hypothyroidism were 39.9% and 47.5% respectively.Nearly two-thirds of patients with hyperthyroidism in our hospital lost.4.The normal time of TSH in hyperthyroidism and hypothyroidism was longer than that in FT3 and FT4,and the difference was statistically significant.Initial FT4 level was the influencing factor of recovery time of FT3,FT4 and TSH in patients with hyperthyroidism after conservative treatment,but not related to patients' gender,age,TSH,TPOAb and TGAb before treatment;FT3,FT4 and TSH recovery time in patients with hypothyroidism after treatment were not related to patients' gender,age,FT4,TSH,TPOAb and TGAb.