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目的:分析探讨桥本甲状腺炎（hashimotos thyroiditis，HT）合并甲状腺结节的超声表现及恶性结节的相关因素。方法:回顾性分析2020年1月至12月于河南科技大学第一附属医院行甲状腺超声检查的82例HT合并甲状腺结节患者的资料，依据穿刺细胞学检测结果分为良性组53例，其中男8例，女45例，年龄（48.94±3.12）岁；恶性组29例，其中男5例，女24例，年龄（47.77±3.51）岁。比较两组患者超声表现特征，并分析患者结节病理性质的影响因素。结果:良性组患者有家族史以及超声影像中结节边界不清晰、形态不规则、微钙化、血流杂乱、纵横比≥1、实性结节及实性成分低回声率均低于恶性组，差异均有统计学意义（n χ2=15.418、22.287、17.784、21.116、13.982、25.588、4.179、13.234，均n P＜0.05）；多因素分析显示结节边界不清晰［n OR（95%置信区间）：3.432（1.193～9.869），n P=0.023］、形态不规则［n OR（95%置信区间）：7.463（2.043～27.264），n P=0.003］、血流杂乱［n OR（95%置信区间）：5.140（1.051～25.144），n P=0.044］、纵横比≥1［n OR（95%置信区间）：13.210（1.909～91.425），n P=0.009］及实性成分低回声［n OR（95%置信区间）：10.773（1.924～60.331），n P=0.007］均为HT合并恶性结节的独立危险因素。n 结论:超声检查对HT合并甲状腺结节患者的结节性质的鉴别有一定价值，恶性结节家族史、结节边界不清晰、形态不规则、血流杂乱、纵横比≥1、实性结节及实性成分低回声均为HT合并恶性结节的独立危险因素。“,”Objective:To analyze and explore the ultrasound findings of Hashimoto\'s thyroiditis (HT) combined with thyroid nodules and the related factors of malignant nodules.Methods:The data of 82 patients with HT and thyroid nodules undergoing thyroid ultrasonography in The First Affiliated Hospital of Henan University of Science and Technology between January and December 2020 were retrospectively analyzed. According to the results of fine-needle aspiration cytology, the patients were divided into a benign group and a malignant group. The benign group had 53 cases, including 8 males and 45 females, with an age of (48.94±3.12). The malignant group had 29 cases, including 5 males and 24 females, with an age of (47.77±3.51). The ultrasound findings were compared between the two groups. The influencing factors of nodular pathological properties were analyzed.Results:The proportions of the cases with family history and unclear nodule boundaries, irregular morphology, micro-calcification, disordered blood flow, aspect ratio ≥ 1, hypoecho of solid nodules and solid components of ultrasound findings in the benign group were lower than those in the malignant group (n χ2=15.418, 22.287, 17.784, 21.116, 13.982, 25.588, 4.179, and 13.234, all n P＜0.05). Multivariate analysis showed that unclear nodule boundaries [n OR (95% confidence interval): 3.432 (1.193-9.869), n P=0.023], irregular morphology [n OR (95% confidence interval): 7.463 (2.043-27.264), n P=0.003], disordered blood flow [n OR (95% confidence interval): 5.140 (1.051-25.144), n P=0.044], aspect ratio ≥ 1 [n OR (95% confidence interval): 13.210 (1.909-91.425), n P=0.009], and hypoecho of solid components [n OR (95% confidence interval): 10.773 (1.924-60.331), n P=0.007] were all the independent risk factors of HT combined with malignant nodules.n Conclusions:Ultrasound examination is of certain differential value for the properties of nodules in patients with HT combined with thyroid nodules. Family history of malignant nodules, unclear nodule boundaries, irregular morphology, disordered blood flow, aspect ratio ≥ 1, and hypoecho of solid nodules and solid components are all independent risk factors of HT combined with malignant nodules.