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KHO ST KCH THC TUYN GIP


CA NGI TRN 40 TUI BNG SIU M
Thanh Bnh **, Nguyn Th T Nga*, Nguyn nh Yn* , Nguyn Hi Thu**
** Trng i Hc Y Khoa Hu, * Trung Tm Bu c Tnh Qung Bnh
EVALUATION ON THYROID VOLUME OF
ADULTS OVER 40 YEARS OLD BY
ULTRASONOGRAPHY

thyroid volume in adults over 40 years old was


11,24 cm3 in male ( 50 years old ) and 9,29 cm3
in female ( 40 years old ).

Objective : to mesure normal size of thyroid gland of


normal adults over 40 years old by 2D echography
Sbjects & Methods ; A total of 470 adults without goiter
( over 40 years old and normal iodouria level and ) were
examine thyroid gland ultrasound with 7,5 MHZ sector.
The thyroid volume measured by Gutekunst R method :
Results : normal total thyroid gland size were :
- 10,90 1,88 cm3 ( male ) and 9,29 2,02 ( female ) in
aged of 50 - 59 years
- 11,24 3,16 cm3 ( male ) and 8,56 2,26 ( female ) in
aged of 50 - 59 years
- 10,28 3,38 cm3 ( male ) and 7,57 2,42 cm3
( female ) in aged of 60 - 69 years
- 9,31 3,47 cm3 ( male ) and 7,09 3,11 cm3 ( female )
in aged of 70 years
Volume of thyroid right lobe is larger than left lobe in the
adults over 40 years old ( p : 0,05 0,001 ).
The total thyroid volume was from 11,24 3,16 to 9,31
3,47cm3 in male and from, 9,29 2,02 to 7,09
3,11cm3 in female. The mean thyroid volume in mature
is 11,24 ( 50-59 years old male ) and 9,29 cm3 ( 40-49
years old female ) and the thyroid volume progessively
decreased from aged 50 - 59 in male and 4--49 in female
Correlations
Age thyroid volume decreased gradually according to
age and there were the negative correlation between
thyroid volume and age ( r = - 0,206 ,p < 0,01 in male
and, r = - 0,341, p < 0,01 in female ).
Height : thyroid volume relates to height and there was
positive correlation between heiht and volume ( r =
0,221 (p < 0,01) in male ) and r = 0,344 (p < 0,01)in
female )
Weight : thyroid volume tends to increase according to
weight. There were positive correlation between weight
and thyroi volume ( r = 0,426 (p < 0,01) in male and r =
0,365 (p < 0,01) in female )
BMI There were positive correlation between BMI and
thyroid volume in male ( r = r = 0,364 (p < 0,01) ) and
female r = 0,248 (p < 0,01) )
Body surface area ( BSA) : there were positive
correlation between thyroid volume and BSA ( r = 0,398
(p < 0,01) in male and r = 0,408 (p < 0,01) in female )
Conclusions :
There were positive correlation between the total thyroid
volume with height,weight,BMI and BSA, but negative
with age. The thyroid volume gradually decreased at
aged 50 - 59 in male and 40 - 49 in female. The mean

1.Mc ch :
Xc dnh th tch tuyn gip ca ngi ln trn
40 tui
2.i tng & Phng php :
470 ngi trn 40 tui c nng iode niu bnh
thng c kim tra bng siu m tuyn gip
vi u d 7,5 Mhz. Th tch tnh theo phng
php R Gutekunst
3. Kt qu :
. Th tch tuyn gip ca ngi trn 40 tui
- 10,90 1,88 cm3 ( nam ) v 9,29 2,02 ( n )
tui 50 - 59
- 11,24 3,16 cm3 ( nam ) v 8,56 2,26 ( n )
tui 50 - 59
- 10,28 3,38 cm3 ( nam ) v 7,57 2,42 cm3
( n ) tui 60 - 69
- 9,31 3,47 cm3 ( nam ) v 7,09 3,11 cm3 ( n
) tui 70
Th tch trung bnh (cm3) ton b tuyn gip
nam v n gii nh sau:
Th tch thu phi ln hn thu tri tt c cc
nhm tui ca c hai gii c ngha (tr cc
nhm tui trn 50 n )
Th tch tuyn gip ngi trn 40 dao ng t
11,24 3,16 n 9,31 3,47cm3 i vi nam
gii, 9,29 2,02 n 7,09 3,11cm3 i vi n
gii tu theo tui nh hay ln.
Th tch tuyn gip gim dn t tui 40-49
n v 50-59 nam.
Tng quan gia th tch tuyn gip vi cc yu
t tui v ch s nhn trc theo gii : Th tch
tuyn gip ngi trn 40 tui tng quan :
vi tui: r = - 0,206 (p < 0,01) i vi nam, r = 0,341 (p < 0,01) vi n.
vi chiu cao: r = 0,221 (p < 0,01) i vi nam, r
= 0,344 (p < 0,01)vi n.
vi cn nng: r = 0,426 (p < 0,01) i vi nam, r
= 0,365 (p < 0,01) vi n.
vi BMI: r = 0,364 (p < 0,01) i vi nam, r =
0,248 (p < 0,01) vi n.
vi din tch da: r = 0,398 (p < 0,01) i vi
nam, r = 0,408 (p < 0,01) vi n.
4. Kt lun .
Tuyn gip ca ngi ln bnh thng nh li
dn sau 40-50 tui i vi n v sau 50-60 tui
i vi nam.

TM TT

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I. T VN
Trong c th con ngi, tuyn gip l tuyn ni tit ln nht. Th tch v trng lng
ca tuyn tng dn t khi sinh ra cho n lc trng thnh (c th t 20-25ml, nng 20-30
gam v c lin quan vi tui, gii tnh, chiu cao, cn nng, din tch da... Sau tuyn gip
c khuynh hng nh li dn khi v gi . Tuy nhin, th tch tuyn bt u gim t tui
no, gi tr chun cn bao nhiu v c cn tng quan vi cc ch s nhn trc trn na
khng, th cha c ti liu no cp c th, gy kh khn trong vic chn on bu gip
nhng i tng ny
V vy, vic nh gi kch thc ca tuyn gip l iu ht sc quan trng trong vn
qun l cc bnh tuyn gip.
Hin nay, vic xc nh kch thc v cu trc tuyn gip theo cch thng thng vn
qua nhn s trn lm sng, ri phn loi theo tiu chun ca T chc Y t th gii (WHO),
phng php ny thng ch quan v c nhiu sai st nht nh .Siu m tuyn gip l mt
trong nhng k thut thm d hnh nh (cng vi x hnh, X quang, CT scan, MRI...) khch
quan v chnh xc hn. y l xt nghim an ton, khng xm nhp, t hoc hu nh v hi,
kinh t, c ng, d thc hin v cho kt qu nhanh vi chnh xc cao (c bit trong vic
pht hin bu gip nhn) .
Vit Nam hin vn cha c nhiu nghin cu bng siu m v kch thc v cu trc
tuyn gip ngi trn 40 tui. Vic nh gi th tch tuyn gip trn cc i tng ny cn
phi vay mn s liu tiu chun ca nc ngoi i chiu.
Mc ch:
1. Kho st kch thc bnh thng ca tuyn gip ngi trn 40 tui bng siu m
hai bnh din (2D).
2. Xc nh s tng quan gia th tch tuyn gip vi tui , chiu cao, cn nng, ch
s khi c th v din tch da theo gii cc i tng ny.
II. I TNG V PHNG PHP NGHIN CU
2.1. i tng nghin cu
2.1.1. i tng chn
- Ngi = 40 tui, c tr ti phng Hi Thnh - ng Hi (y l mt phng nm
vng ven bin, khng thiu it theo iu tra ca Chng trnh phng chng cc ri lon thiu
it Trung ng v tnh Qung Bnh nm 1999
- Khng c bu c ( 0 theo tiu chun ca WHO).
2.1.2. i tng loi tr
- c bu c (WHO), bnh tuyn gip tng iu tr ngoi khoa hay x tr, Siu m pht
hin nhn gip, b bnh nng km theo.
2.1.4. Thi gian nghin cu : T thng 7/2003 n thng 7/2004.
2.2. Phng php nghin cu
2.2.1. Thit k v chn mu
y l nghin cu m t ct ngang.
Chn mu theo phng php ngu nhin phn tng: Chia lm 4 nhm tui: 40-49, 50-59, 6069 v =70 tui. Mi nhm tui chn ngu nhin khong 80-120 ngi, nam n s lng
tng ng nhau.
2.2.2. Cc bc tin hnh
Bc 1: Chun b i tng nghin cu
Bc 2: Khm lm sng cc ch s nhn trc bao gm:
(1) Cn nng (kg):
(2) o chiu cao (cm):
(3) o din tch da
c tnh theo cng thc S = W0,425 x H0,725 x 71,84 x 10-4

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S l din tch da (m2), W l trng lng c th (kg) v H l chiu cao c th (cm)
(4) o ch s khi c th (BMI):
Bc 3: Khm tuyn gip nh gi theo WHO (1993)
Bc 4: Siu m tuyn gip, s dng my siu m Aloka (Nht Bn) vi u d Linear 7.5
MHz. Siu m kiu B hai bnh din (2D).
- Tnh th tch thu gip: Theo Gutekunst R vi V= a X b X c X p/ 6
V l th tch mt thu (cm3), a l chiu cao (di) mi thu (cm),
b l chiu
rng (ngang) mi thu (cm), c l chiu dy (su) mi thu (cm)
Th tch tuyn gip ton phn = V Thu tri + V Thu phi
Tnh V tuyn gip trung bnh ca tng thu, ton b tuyn v gii hn trn
X l s liu : chng trnh EPI INFO 6.04 v EXCEL 2000 h tr.
III. KT QU NGHIN CU
Chng ti kho st c 470 i tng trn 40 tui, Kt qu nh sau:
Bng 1. Phn b i tng nghin cu theo tui v gii
Nhm tui
Nam
N
Chung
T l %
40 - 49
44
59
103
21,9
50 - 59
49
62
111
23,6
60 - 69
65
67
132
28,1
47
77
124
26,4
70
Tng cng
205
265
470
100,0
Khng c s khc bit gia nam v n cc nhm tui (p > 0,05).
1. Kt qu siu m tuyn gip
1. Th tch tuyn gip ca ngi bnh thng
Bng 2: Th tch tng thu gip theo nhm tui ca nam gii
Nhm tui
Th tch thu gip ca nam (cm3)
p
Thu phi
Thu tri
Chnh
40 - 49
0,75
< 0,01
5,83 1,06
5,08 1,00
50 - 59
0,85
< 0,05
6,04 1,70
5,19 1,66
60 - 69
0,72
< 0,05
5,50 1,82
4,78 1,74
0,81
< 0,05
70
5,06 1,86
4,25 1,89
Th tch thu phi ln hn thu tri tt c cc nhm tui c ngha thng k (p <
0.05), chnh lch trung bnh l 0,78cm3 (p < 0,001).
Bng 3: Th tch tng thu gip theo nhm tui ca n gii
Nhm tui
Th tch thu gip ca n (cm3)
p
Thu phi
Thu tri
Chnh
40 - 49
0,45
< 0.05
4,87 1,10
4,42 1,15
50 - 59
0,28
> 0,05
4,42 1,28
4,14 1,25
60 - 69
0,47
> 0,05
4,02 1,28
3,55 1,33
0,37
> 0,05
70
3,73 1,76
3,36 1,47
Th tch trung bnh thu phi ln hn thu tri c ngha nhm tui 40-49 (p < 0,05).
chnh lch trung bnh gia thu phi v thu tri l 0,39cm3 (p < 0,01).
2. Th tch tuyn gip ton phn
Bng 4: Th tch tuyn gip ton phn ca nam v n
Th tch t/gip
Th tch t/gip ca
Chnh
p
Nhm tui
ca nam (cm3)
n (cm3)
40 - 49
1,61
< 0,01
10,90 1,88
9,29 2,02
50 - 59
2,68
< 0,01
11,24 3,16
8,56 2,26

4
60 - 69
2,71
< 0,01
10,28 3,38
7,57 2,42
2,22
< 0,01
70
9,31 3,47
7,09 3,11
Chung
2,36
< 0,01
10,44 3,13
8,08 2,65
Th tch tuyn gip ton phn ca nam ln hn ca n mi nhm tui (c ngha
thng k vi p < 0,01), chnh lch trung bnh l 2,36cm3.
Th tch tuyn gip trung bnh ca nam trn 40 tui l 10,44 3,13cm3 ln hn ca
n trn 40 tui l 8,08 2,65cm3 (p < 0,01).
Th tch tuyn gip c xu hng nh dn t nhm tui 50-59 nam v 40-49 n.

Th

tc
h
tuy
n
gi
p
(c
m3
)

12

11.24

10.90

10

10.28

9.29

9.31

8.56
7.57

7.09

Nam
N

4
2
0
40-49

50-59

60-69

= 70

Nhmtu
i
Biu 1. Th tch tuyn gip ton phn theo nhm tui ca nam v n
3 . Tng quan gia th tch tuyn gip vi tui v cc ch s nhn trc theo gii
1. Tng quan gia th tch tuyn gip vi tui
2.

Thtch (cm3)

T ng quan gia thtch v i tu


i namgi i
y =-0.0596x +14.005

20

R =0.0423

15
10
5
0
0

20

40

Tu
i

60

80

100

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Biu 3.2. Tng quan gia th tch tuyn gip vi tui nam

Thtch (cm3)

T ng quan gia thtch v i tu


i ngi i
y =-0.0678x +12.174
2
R =0.1161

20
15
10
5
0
0

20

40

Tu
i

60

80

100

Biu 3.3. Tng quan gia th tch tuyn gip vi tui n


Bng 5: Tng quan th tch vi cc tui theo gii
tui
40
50
60
70
H s
Nam
- 0,206
- 0,231
- 0,186
- 0,093
tng quan
(p < 0,01)
(p < 0,01)
(p > 0,05)
(p > 0,05)
r
N
- 0,341
- 0,244
- 0,090
- 0,033
(p < 0,01)
(p < 0,01)
(p > 0,05)
(p > 0,05)
C s tng quan nghch gia th tch tuyn gip v tui c nam ln n trn 40 tui, nht l
tui trn 50 i vi nam (h s tng quan r = - 0,231 l ln nht vi p < 0,01) v trn
40 tui i vi n (r = - 0,341 l ln nht vi p < 0,01).
2. Tng quan gia th tch tuyn gip vi chiu cao
C s tng quan thun va phi gia th tch tuyn gip v chiu cao vi r = 0,344 (p <
0,01) n, tng quan thp vi r = 0,221 (p < 0,01) nam.Khng c s khc bit v th tch
tuyn gip gia nam v n a s cc nhm chiu cao.
3. Tng quan gia th tch tuyn gip vi cn nng
C s tng quan thun va phi gia th tch tuyn gip v cn nng vi r = 0,426 (p < 0,01)
nam, r = 0,365 (p < 0,01) n.Khng c s khc bit v th tch tuyn gip gia nam v n
a s cc nhm cn nng.
3.3.3.4. Tng quan gia th tch tuyn gip vi ch s khi c th (BMI)
C s tng quan thun va phi gia th tch tuyn gip v BMI vi r = 0,364 (p < 0,01)
nam, tng quan t n vi r = 0,248 (p < 0,01). Khng c s khc bit v th tch tuyn gip
gia nam v n a s cc nhm BMI.

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T ng quan gia thtch v i BMI namgi i
Thtch (cm3)

20
15
10
y =0.441x +0.9334

R =0.1326

0
10

15

20

BMI

25

30

35

Biu 3.4. Tng quan gia th tch tuyn gip vi BMI nam gii
5. Tng quan gia th tch tuyn gip vi din tch da (BSA)
C s tng quan thun va phi gia th tch tuyn gip v BSA vi r = 0,398 (p < 0,01)
nam, r = 0,408 (p < 0,01) n. Khng c s khc bit v th tch tuyn gip gia nam v n
cc nhm din tch da.

T ng quan gia thtch v i din tch da ngi i


Thtch (cm3)

20

y =8.3644x - 3.5719
2
R =0.1661

15
10
5
0
1.0

1.1 1.2

1.3

1.4 1.5 1.6 1.7


Din tch da (m2)

1.8 1.9

2.0

Biu 3.5. Tng quan gia th tch tuyn gip vi din tch da n gii
IV. BN LUN
1. Th tch tng thu gip
V quan im Thu phi ln hn thu tri tuyn gip
Muller L.C v CS (1988) siu m gip 1080 i tng t 7-20 tui, sng ti vng Speyer
v Neckargemund thuc CHLB c ghi nhn thu phi ln hn thu tri, vi chnh l
0.8cm3 mi la tui . Nygaard B v cng s (1993) siu m tuyn gip cho 391 ph n an
Mch ghi nhn thu phi ln hn thu tri vi chnh lch trung bnh l 1,37cm3 .
Schorman L v cng s (1995) siu m gip cng ghi nhn thu phi ln hn thu tri .
Mai Trng Khoa, Lng Linh H (2002) siu m gip ghi nhn t 8-14 tui th tch thu phi
chnh lch khng r rt so vi thu tri (p > 0,05), nhng t 15 tui tr ln th tch thu phi
ln hn thu tri (p < 0,05).

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Nguyn Hi Thu v CS (2002) siu m gip 677 i tng tui 15-23 cng ghi nhn thu
phi ln hn thu tri tuyn gip trong cc tui trn (p < 0,05 - 0,001) V quan im th
tch hai thu khng khc bit nhau
Phm Vn Choang, Hong Kim c, Nguyn B S (1996) siu m tuyn gip bng u d
5.0MHz cho 580 tr 7-14 tui, thy thu phi ln hn thu tri khng c ngha thng k (p
> 0,05)
Kt qu nghin cu ca chng ti 421 ngi trn 40 tui (191 nam v 230 n) cho thy th
tch thu phi ln hn thu tri tuyn gip c hai gii, vi chnh trung bnh 0,78cm3
nam (p < 0,001) v 0,39cm3 n (p < 0,01). Kt qu ny ph hp vi a s cc kt qu
nghin cu trc ca cc tc gi trong v ngoi nc, l thu phi ln hn thu tri tuyn
gip.
T kt qu nghin cu ny, chng ti rt ra kt lun l khng nn o kch thc ca mt thu
suy on ra th tch ton phn, m cn phi o kch thc ca tng thu mt ri cng li
th chnh xc hn.
2. Th tch tuyn gip ton phn
2.1. Th tch tuyn gip v gii tnh
Berghout A v CS (1987) Trng i hc Amsterdam (H Lan) siu m cho 50 ngi
tui t 20-70 (gm 50 nam v 50 n), o c th tch tuyn gip trung bnh nam l 12,7
4,4cm3 ln hn n l 8,7 3,9cm3 vi p = 0,0014 .
Muller L.C v cng s (1988) i hc Heidelbeig (CHLB c) siu m tuyn gip cho
tr 7-20 tui ghi nhn di 10 tui th tch tuyn gip khng khc bit gia nam v n nhng
tui dy th th tch tuyn gip ca n hi ln hn nam .
Gomez J.M v cng s (2000) nghin cu 268 ngi (134 nam, 134 n) khng mc bnh
tuyn gip, thy th tch tuyn gip ca nam 9,19ml ln hn ca n 6,19ml (p = 0,001) .
Rago T v cng s (2001) khi siu m cho 482 ngi th thy th tch tuyn gip ca nam
12,9 3,6ml ln hn ca n 9,2 ,9ml (p < 0,0001)[78].
Mai Trng Khoa, Phan S An (2002) siu m tuyn gip 140 ngi bnh thng (gm 60
nam, 80 n) ghi nhn th tch thu phi, thu tri v chung hai thu ca nam gii u ln hn
ca n gii (p < 0,05) .
Mai Trng Khoa, Lng Linh H (2002) nhn thy th tch tuyn gip ngi bnh thng 816 tui ca nam v n chnh lch cha r rt (p > 0,05), nhng t 17 tui tr ln th tch
tuyn gip ca nam ln hn ca n (p < 0,05) .
Kt qu nghin cu ca chng ti 421 i tng (gm 191 nam, 230 n) cho thy th tch
tuyn gip trung bnh ca nam gii l 10,44 3,13cm3 ln hn ca n gii 8,08 2,65cm3
(p < 0,01) v tng nhm tui th th tch tuyn gip ca nam cng u ln hn ca n c
ngha thng k (p < 0,01).
2.2. Th tch tuyn gip v tui theo gii
Theo y vn v mt sinh l v gii phu, th tch v trng lng tuyn gip tng dn theo tui
k t khi sinh ra, t gi tr ln nht la tui trng thnh, sau tuyn s nh li dn sau
tui 50 .
Nygaard B v cng s (1993) an Mch siu m tuyn gip cc la tui 15, 30, 45 v 60
tui, ghi nhn th tch tuyn gip ln lt l 12, 18, 18, v 18cm3
Tajtakova M v cng s (2003) siu m cho 347 ph n tui sinh (160 ngi tui 20-29 v
187 ngi tui 30-40), ghi nhn th tch tuyn gip n 20-29 tui l 8,78ml, nh hn n
30-40 tui l 10,66ml (p < 0,01) .
Mai Trng Khoa, Lng Linh H (2002) o th tch tuyn gip ngi bnh thng 8-80 tui
nhn thy th tch tuyn gip ca nam v n c xu hng tng dn theo tui v t gi tr cc
i la tui 25-30, sau gim dn khi tui tng ln .

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Xut pht kt qu trn tuyn gip ph n c kch thc b hn nam gii. V vy khng th c
s o chung ca nam v n, Chnh v vy th tch tuyn gip cn lu theo gii. Tht vy kt
qu nghin cu ca chng ti ghi nhn ngc li :
Th tch tuyn gip bt u nh li t tui 40 - 50 tui. V vy c s tng quan nghch th
tch gip vi vi tui: r = -0,206 (p < 0,01) nam v r = -0,341 (p < 0,01) n. Th tch
tuyn gip trung bnh t gi tr ln nht l 11,24 3,16cm3 nam gii tui 50-59 sau
gim dn, cn n t gi tr ln nht l 9,29 2,02cm3 tui 40-49 sau th gim
dn.
Bng 4.1: Th tch tuyn gip trung bnh cc nhm tui ca nam v n
Nhm tui
40 - 49
50 - 59
60 - 69
Nam
10,90 1,88
11,24 3,16
10,28 3,38
Th tch
3
(cm )
N
9,29 2,02
8,56 2,26
7,57 2,42

70
9,31 3,47
7,09 3,11

2.3. Th tch tuyn gip v chiu cao theo gii


Muller L.C v cng s (1988) nghin cu trn cc i tng kho mnh 7-20 tui cho thy c
mi tng quan thun cht ch gia th tch tuyn gip vi chiu cao
Gomez J.M, Maravall F.J, Gomez A, Guma A, Soler J (2000) nghin cu 268 ngi ln cho
thy th tch tuyn gip tng quan thun vi chiu cao c th, h s tng quan r = 0,44 (p =
0,0001) .
Nguyn Hi Thu v cng s (2002) ghi nhn c s tng quan thun gia th tch tuyn gip
v chiu cao vi r = 0,26457 nam v r = 0,16278 n .
Kt qu ca chng ti cng cho thy th tch tuyn gip tng quan thun vi chiu cao c
th, vi r = 0,221 (p < 0,01) nam v r = 0,334 (p < 0,01) n. .
2.4. Th tch tuyn gip v cn nng theo gii
Berghout A, Wiersinga W.M, Smits N.J, Touber J.L (1987) Trng i hc Amsterdam
(H Lan) siu m cho 50 ngi trng thnh (25 nam, 25 n) cho thy t l th tch tuyn
gip / trng lng c th nam l 0,16 0,05 ml/kg, n l 0,13 0,06 ml/kg v khng lin h
gii tnh
Muller L.C v cng s (1988) nghin cu thy c mi tng quan cht ch gia th tch tuyn
gip vi cn nng .
Gomez J.M, Maravall F.J, Gomez A, Guma A, Soler J (2000) nghin cu 268 ngi ln cho
thy th tch tuyn gip tng quan thun vi trng lng c th, h s r = 0,39 (p = 0,0001) .
Nguyn Hi Thu v cng s (2002) ghi nhn c s tng quan thun gia th tch tuyn gip
vi cn nng 15-23 tui vi r = 0,34684 nam v r = 0,31640 n .
Kt qu nghin cu ca chng ti ghi nhn c s tng quan thun va phi gia th tch
tuyn gip v cn nng theo gii vi r = 0,426 (p < 0,01) nam, r = 0,365 (p < 0,01) n.
2.5. Th tch tuyn gip v ch s khi c th (BMI) theo gii.
Gomez J.M, Maravall F.J, Gomez A, Guma A, Soler J (2000) nghin cu 268 i tng cho
thy th tch tuyn gip tng quan thun vi BMI vi h s r = 0,13 (p = 0,02). Rago T,
Chiovato L, Aghini Lombardi F, Grasso L, Pinchera A, Vitti P (2001) khi siu m cho 482
ngi th thy th tch tuyn gip tng quan vi din tch da, chiu cao v cn nng nhng
khng tng quan vi ch s khi m v nc c th . Nguyn Hi Thu v cng s (2002)
nhn thy c s tng quan gia th tch tuyn gip v BMI vi h s tng quan r = 0,24839
nam v r = 0,23065 n
Kt qu nghin cu ca chng ti cho thy: C s tng quan thun va phi gia th tch
tuyn gip v BMI vi r = 0,364 (p < 0,01) nam, r = 0,248 (p < 0,01) n. Khng c s
khc bit v th tch tuyn gip gia nam v n a s cc nhm BMI.
2.6. Th tch tuyn gip v din tch da (BSA) theo gii

9
Muller L.C v cng s (1988) nghin cu trn 1080 hc sinh kho mnh 7-20 tui cho thy s
lin quan gia th tch tuyn gip vi din tch da l tng quan cht ch nht . Gomez J.M,
Maravall F.J, Gomez A, Guma A, Soler J (2000) nghin cu 268 ngi ln cho thy th tch
tuyn gip tng quan thun vi din tch da vi h s r = 0,48 (p = 0,0001) . Delange F
(1997), Gim c U hi Quc t Phng chng cc ri lon do thiu it (ICCIDD), trng
nhm nghin cu Thyromobil cng chng minh th tch tuyn gip tng quan cht ch vi
din tch da v khuyn co rng cc nc chm pht trin th nn dng din tch da thay cho
tui tnh tng quan vi th tch tuyn gip .
Nguyn Hi Thu v cng s (2002) ghi nhn c s tng quan thun gia th tch tuyn gip
vi din tch da ngi 15 - 23 tui vi r = 0,31973 nam v r = 0,29664 n .
Kt qu nghin cu ca chng ti ghi nhn c s tng quan thun gia th tch tuyn gip
v din tch da c hai gii, vi r = 0,398 (p < 0,01) nam, r = 0,408 (p < 0,01) n.
Tm li : ngi trn 40 tui th tch tuyn gip thay i , vi tr trung bnh t 1,24 3,16
n 9,31 3,47cm3 i vi nam, 9,29 2,02 n 7,09 3,11cm3 i vi n gii n.
2.7. Ngoi yu t tui tc v gii tnh th khi tnh th tch tuyn gip cn tham kho thm cc
ch s nhn trc c tng quan sau:
Vtg/Chiu cao
Vtg/Cn nng
Vtg/BSA
Vtg/BMI
3
3
3
2
(cm /m)
(cm /kg)
(cm /m )
(cm3/v BMI)
Nam
6,49 1,92
0,19 0,05
6,62 1,87
0,48 0,14
N
5,39 1,72
0,17 0,05
5,78 1,78
0,38 0,12
IV. KT LUN
Qua siu m tuyn gip ca 470 ngi trn 40 tui sng vng khng thiu it chng ti i
n mt s kt lun sau:
1. Th tch tuyn gip trung bnh ( cm3) ca ngi trn 40 tui ca nam v n nh sau:
- 10,90 1,88 cm3 ( nam ) v 9,29 2,02 ( n ) tui 50 - 59
- 11,24 3,16 cm3 ( nam ) v 8,56 2,26 ( n ) tui 50 - 59
- 10,28 3,38 cm3 ( nam ) v 7,57 2,42 cm3 ( n ) tui 60 - 69
- 9,31 3,47 cm3 ( nam ) v 7,09 3,11 cm3 ( n ) tui 70

Th tch thu phi ln hn thu tri tt c cc nhm tui ca c hai gii c ngha (tr cc
nhm tui trn 50 n )
Th tch tuyn gip ngi trn 40 dao ng t 11,24 3,16 n 9,31 3,47cm3 i vi
nam gii, 9,29 2,02 n 7,09 3,11cm3 i vi n gii tu theo tui nh hay ln.
Th tch tuyn gip gim dn t tui 40-49 n v 50-59 nam.
2. 1. Th tch tuyn gip tng quan nghch
vi tui: r = - 0,206 (p < 0,01) i vi nam, r = - 0,341 (p < 0,01) i vi n.
2.2. Th tch tuyn gip tng quan thun
vi chiu cao : r = 0,221 (p < 0,01) i vi nam, r = 0,344 (p < 0,01) i vi n.vi cn nng : r = 0,426 (p < 0,01) i vi nam, r = 0,365 (p < 0,01) i vi n.
vi BMI: r = 0,364 (p < 0,01) i vi nam, r = 0,248 (p < 0,01) i vi n.
vi din tch da: r = 0,398 (p < 0,01) i vi nam, r = 0,408 (p < 0,01) i vi n.
Kch thc tuyn gip ca ngi ln bnh thng nh li dn sau 40-50 tui i vi n v sau
50-60 tui i vi nam.
TI LIU THAM KHO
1/ Phm Vn Choang. ( 2000 ) Kt qu siu m tuyn gip trong 3 nm 1993-1995 ti Vin
Ni tit. K yu ton vn Cng trnh Nghin cu Khoa hc Ni tit v Chuyn ha. Nh Xut
bn Y hc 5.2000. Trang 23-26.
2/ Nguyn Hi Thy.( 2000 ) Siu m tuyn gip . Chn on v iu tr bnh tuyn gip Nh
xut bn Y hc H Ni.Tr. 79-99
3/ Fobble. F (1995), Thyroid gland - Color Duplex sonography - Principles and clinical

10
applications - Thieme.
4/ Gomez J.M, Maravall F.J, Gomez N, Guma, Soler J (2000), Determinants of thyroid
volume as measured by ultrasonography in healthy adults randomly selected, Clin Endocrinol
(Oxf), 53(5), pp 629-34.
5/ Muller L. C, Troger J, Khabirpour F, Pockler C (1998), Normal values of thyroid gland
volume: Ultrasound measurements in schoolchildren 7 to 20 years of age , Deutsch Med
Wocheschr 2; 113(48), p 1872-5.
6/ Nygaard B. , Peter Gideon, Harriet Dige Petersen (1993). Thyroid volume and
morphology and urinary iodine excretion in Danish municipality, Acta Endocrinologica. 1993.
129: 505-510.
7/ Palmer P.E.S (1995), Manual of Diagnostic Ultrasonography, WHO Geneve, 1-41, p 302305.
8/ Parker T (1995), Thyroid. Textbook of Ultrasonography, Mosby, p 351-359.
9/ Zimmermann M, Saad A. ( 2000) Thyroid ultrasound compared with world Heath
Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions
of mild and severe iodine deficiency, Eur. J Endocrinol, 143(6) pp 727-31
10/ Berlin X. , J Tramalloni, C. Swagier.( 1999 ) Rgion cervicale. cho Doppler vasculaire et
viscrale. Masson (1999).
11/ Paulette J.( 1993) Manuel dultrasonographie generale de ladulte. (1993).
12/ Rouanet. J.P, Daclin P.Y. ( 2001 ) . IRM et Thyroide, 2eme dition. Elsevier

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