目的 探讨高分辨率低剂量CT（HRLDCT）在无症状健康体检者筛查肺部疾病和肺外病变的应用价值。方法 回顾性分析于2011年1月—2021年12月在广州市第一人民医院行胸部HRLDCT检查的1 940例无症状健康体检者的影像学资料,由两位研究者分别评估和记录所有受检者的每一个阳性CT病征征象,分析各个阳性CT征象在总受检人群中的检出情况、各个阳性CT征象在性别、年龄分层中的分布情况,以及肺外阳性CT征象检出情况。比较肺癌和肺良性结节在不同性别、不同年龄段分布中的检出情况。结果 共有1 831例受检者存在阳性CT征象,总检出率为94.38%,共检出3 339个阳性CT征象。检出率最高的阳性CT征象是肺部良性结节（1 630例,84.02%）。在973例男性受检者中,检出肺癌22例（2.26%）,肺良性结节 815例（83.73%）;在967例女性受检者中,检出肺癌19例（1.96%）,肺良性结节815例（84.28%）,肺癌与肺良性结节在不同性别间的检出率比较差异无统计学意义（P=0.64,χ²=0.214）。肺部阳性CT征象的检出率随年龄的增长而升高,肺癌与肺良性结节最多见于51~60岁受检人群中,两者在51~60岁和61~70岁中的检出率比较差异有统计学意义（P=0.038,χ²=4.32）。此外,检出最多的肺外其他阳性CT征象为脂肪肝,共497例（25.62%）,其次是冠状动脉钙化173例（8.90%）。结论 HRLDCT在胸部的健康体检中可同时用于肺部疾病的筛查及发现肺外异常征象,具有较高的临床应用价值。

Objective To investigate the application value of high-resolution low-dose CT（HRLDCT）in screening for lung diseases and extra-pulmonary lesions in asymptomatic healthy individuals．Methods A retrospective analysis was performed on the images of 1 940 asymptomatic healthy individuals who underwent chest HRLDCT examination in our hospital from January 2011 to December 2021．Two investigators conducted independent evaluations and recordings of each positive CT sign in all individuals．An analysis of the detection rates of positive CT signs in the entire population,examining their distribution across various gender and age groups was involved in this study．The detection of positive CT signs outside the lung was also investigated．Additionally,the comparative analysis of lung cancer and benign pulmonary nodules detection across various genders and age cohorts were performed．Results A comprehensive count of 1831 individuals exhibited positive CT signs,resulting in an overall detection rate of 94．38%,with identifying a total of 3339 positive CT signs．The positive CT sign with the highest detection rate was benign pulmonary nodule（1 630 cases,84.02%）．In 973 male participants,22 cases of lung cancer were detected（2.26%）,and 815 cases of benign lung nodules were found（83.73%）．In 967 female participants,19 cases of lung cancer were detected（1.96%）,and 815 cases of benign lung nodules were identified（84.28%）．Statistical analysis revealed no significant difference in the detection rates of lung cancer and benign lung nodules between genders（P=0.64,χ²=0.214）．The prevalence of positive CT signs in the lungs demonstrates an upward trend with advancing age．Notably,individuals aged 51-60 exhibit a higher incidence of lung cancer and benign lung nodules．A statistically significant disparity in the detection rates of these conditions is observed between the 51-60 and 61-70 age cohorts（P=0.038,χ²=4.32）．In addition,the most frequently detected extrapulmonary positive CT findings were fatty liver,with a total of 497 cases（25.62%）,followed by coronary artery calcification with 173 cases（8.90%）．Conclusion sHRLDCT can be effectively employed in the screening of pulmonary conditions and identification of extra-pulmonary abnormalities during thoracic health assessments,demonstrating considerable clinical significance．

目的 了解农民工对入职体检结果异常的遵医行为状况及影响因素,为临床治疗、护理和健康教育提供相应的依据。方法 对106例在我院行入职体检且结果异常的农民工进行遵医行为的问卷调查,且对影响因素进行分析。结果 遵医行为好的有20例,一般的有38例,差的有48例;年龄、性别、文化程度、职业类型、疾病种类、经济收入对农民工的遵医行为均有影响(P＜0.01)。结论 农民工对入职体检结果异常的遵医行为不容乐观,建议国家或相关省市出台相关政策和法规,为农民工提供相应的健康保障;医疗机构要加大健康教育力度,提高农民工的健康意识和倡导健康行为,降低慢性病的发病率。

Objective To investigate migrant workers' medical compliance after receiving abnormal entry health examination results and relevant factors affecting compliance behavior, providing evidence to clinical treatment, nursing and health education. Methods 106 migrant workers who took part in entry health examination in our hospital and got abnormal results were accepted questionnaires and the relative factors were analyzed. Results 20 migrant workers had good compliance behavior, and 38 workers performed normally while 48 workers did bad. Age, gender, education, type of occupation, type of illness, and income all had influence on compliance behavior (P<0.01). Conclusion The recent condition of migrant workers' medical compliance on abnormal entry health examination results is not good. Therefore the country or province departments should carry out relative laws or policies, providing migrant workers with health support; Medical institutions should promote health education to improve migrant workers' health awareness and health behavior and reduce incidence of chronic diseases.