摘要
目的探讨首都医科大学附属北京妇产医院2～12周龄婴儿甲状腺激素水平的参考区间。方法选取2009年1月至2012年12月于北京市新生儿疾病筛查门诊就诊的2～12周龄的953例健康婴儿为研究对象。按照不同年龄段,将其分为2～4周龄组(n=416)、4～8周龄组(n=398)和8～12周龄组(n=139)。3组受试儿童的性别、胎龄、出生体质量等一般临床资料比较,差异无统计学意义(P>0.05)。应用化学发光法测定血清促甲状腺素(TSH)、三碘甲状腺原氨酸(TT3)、四碘甲状腺原氨酸(TT4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)的水平,各指标参考区间采用中位数及P2.5、P25、P50、P75、P97.5表示,同时对不同性别、不同年龄组间的甲状腺激素水平,及婴儿与成年人甲状腺激素水平参考区间进行统计学分析(本研究遵循的程序符合首都医科大学附属北京妇产医院人体试验委员会制定的伦理学标准,征得该委员会批准,并征得受试对象监护人的知情同意,与之签署临床研究知情同意书)。结果 TSH、FT3、FT4、TT3、TT4水平男性与女性婴儿间比较,差异均无统计学意义(t=1.860,0.510,-0.360,0.920,1.370;P>0.05)。2～12周龄婴儿各激素水平与目前本院应用的成年人甲状腺激素水平参考区间进行比较,TSH、FT3、T3、T4水平高于成年人参考区间,且差异均有统计学意义(t=27.25,46.77,30.49,5.59;P<0.05),以TSH水平尤为突出,但FT4水平较成年人低。3组婴儿TSH水平无明显变化(F=0.345,P=0.708),但随着年龄增大,P97.5降低,95%CI呈缩小趋势;TT4、FT4水平随年龄增加呈下降趋势(F=12.57,P=0.000;F=21.17,P=0.000),TT3、FT3则呈升高趋势(F=14.75,P=0.000;F=3.699,P=0.025)。结论成年人的甲状腺激素水平参考区间不能广泛应用于婴幼儿,应建立儿童期各年龄段甲状腺激素水平参考区间,为儿童甲状腺疾病,特别是先天性甲状腺功能低下患儿的早期诊治提供参考。
Objective To investigate reference intervals of thyroid hormone levels of infants between the age of 2-12 weeks.Methods From January 2009 to December 2012,a total of 953 infants between the age of 2-12 weeks who had clinic servers at Beijing Newborn Screening Center were recruited into this study. They were divided into three groups according to different age periods,2-4 weeks group （n=416 ）, 4-8 weeks group（n=398）,and 8-12 weeks group（n=139）.Levels of the serum triiodothyronine （TT3）, thyroxine （TT4 ）,free triiodothyronine （FT3 ）,free thyroxine （FT4 ）and thyroid-stimulating hormone （TSH）were measured by chemiluminescence method.Median and P2.5,P25,P50,P75,P97.5 were calculated for levels of thyroid hormones.All markers were analyzed between gender,age and so on among three groups.Furthermore,the differences of thyroid hormones between infants and adults were also conducted.The study protocol was approved by the Ethical Review Board of Investigation in Beij ing Obstetrics and Gynecology Hospital,Capital Medical University.Informed consent was obtained from all participates′parents.Results There had no significant difference among three groups of TSH （F=0.345, P=0.708）,and there had significant differences among three groups of FT3,FT4,TT3 and TT4 （F=3.699,P=0.025;F=21.170,P=0.000;F=14.750,P=0.000;F=12.570,P=0.000）.There had no significant differences between boys and girls on the levels of TSH,FT3,FT4,TT3 and TT4 （t=1.860, 0.510,-0.360,0.920,1.370;P〉0.05）.Thyroid hormone levels （TSH,FT3,TT3,TT4）of children at the age of 2-12 weeks were higher than those of adults,with significant differences （t=27.25,46.77,＆amp;nbsp;30.49,5.59,P=0.000）.Conclusions The reference intervals of adults are not universally applicable to infants.It is important to establish the reference intervals of thyroid hormone levels of infants.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2014年第2期69-73,共5页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
2012年首都医科大学附属北京妇产医院院内科研基金(2012-21)~~
关键词
甲状腺激素类
置信区间
化学发光测定法
婴儿
Thyroid hormones
Confidence intervals
Chemiluminescent measurements
Infant
