摘要
目的建立上海地区儿童甲状腺功能检测指标——促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)的参考区间。方法选取2014年8月至2015年7月于上海地区9家医院就诊的4 d^17岁健康儿童720名,按年龄分为6组,每组120名。血液收集后离心,血清-20℃冷冻保存,使用贝克曼库尔特Uni Cel Dx I 800免疫分析系统进行测定。依据美国临床实验室标准化协会(CLSI)C28-A3文件及国际临床化学和检验医学联合会(IFCC)的相关要求制定参考区间的合理方法和可靠依据,以非参数法确定TSH、FT3和FT4的95%参考区间(百分位数范围为2.5%~9 7.5%,可信区间为9 0%)。结果各组按年龄段划分参考区间为:A组(4 d~<1个月),TSH 0.53~18.91μIU/m L,FT3 2.42~5.67 pmol/L,FT4 11.85~33.81 pmol/L;B组(1~<12个月),TSH0.7 5~5.7 5μI U/m L,F T3 4.2 1~8.1 6 p m o l/L,F T4 9.4 0~1 9.5 4 p m o l/L;C组(1~<5岁),T S H0.6 3~6.2 0μI U/m L,F T3 3.5 4~6.9 0 p m o l/L,F T4 9.3 2~1 8.4 0 p m o l/L;D组(5~<1 0岁),T S H0.58~5.39μIU/m L,FT3 3.97~7.83 pmol/L,FT4 10.65~19.23 pmol/L;E组(10~<14岁),TSH0.3 9~5.3 6μI U/m L,F T3 4.2 7~8.5 5 p m o l/L,F T4 9.8 0~1 9.6 4 p m o l/L。F组(1 4~1 7岁),T S H0.48~5.06μIU/m L,FT3 3.14~6.15 pmol/L,FT4 9.57~18.27 pmol/L。A组新生儿与相邻的B组参考区间分布比较,差异有统计学意义(Z>3);各组内不同性别间TSH、FT3、FT4水平比较,差异无统计学意义(P>0.05)。结论建立了上海地区4 d^17岁健康儿童按年龄分组TSH、FT3和FT4的参考区间。利用以上参考区间能够解释儿童甲状腺功能的检测结果,有助于诊断、治疗和监测甲状腺功能减低症、甲状腺功能亢进症、甲状腺炎、甲状腺肿及甲状腺肿瘤等疾病。
Objective To establish the reference intervals of thyroid stimulating hormone(TSH),freetriiodothyronine(FT3) and free thyroxine(FT4) for children in Shanghai. Methods A total of 720 healthychildren of 4 d to 17 years old from 9 hospitals in Shanghai were enrolled from August 2014 to July 2015. Thesechildren were classified into 6 groups according to ages and 120 cases were in each group. After centrifugation,serum specimens were frozen at -20 ℃. The levels of TSH,FT3 and FT4 were determined by Beckman Coulter DxI800 automated immunoassay system. The reference intervals of TSH,FT3 and FT4 were established according to theClinical and Laboratory Standards Institute(CLSI) C28-A3 and the International Federation of Clinical Chemistryand Laboratory Medicine(IFCC) guidelines. Nonparametric methods were used to establish the 2.5th and 97.5th percentiles for reference intervals and 90% confidence interval. Results The ages of Group A-F were 4 d -<1 month,1-<12 months,1-<5 years,5-<10 years,10-<14 years and 14-17 years,respectively. The reference intervals ofGroup A were TSH 0.53-18.91 μIU/mL,FT3 2.42-5.67 pmol/L and FT4 11.85-33.81 pmol/L. The reference intervalsof Group B were TSH 0.75-5.75 μIU/mL,FT3 4.21-8.16 pmol/L and FT4 9.40-19.54 pmol/L. The reference intervalsof Group C were TSH 0.63-6.20 μIU/mL,FT3 3.54-6.90 pmol/L and FT4 9.32-18.40 pmol/L. The reference intervalsof Group D were TSH 0.58-5.39 μIU/mL,FT3 3.97-7.83 pmol/L and FT4 10.65-19.23 pmol/L. The reference intervalsof Group E were TSH 0.39-5.36 μIU/mL,FT3 4.27-8.55 pmol/L and FT4 9.80-19.64 pmol/L. The reference intervalsof Group F were TSH 0.48-5.06 μIU/mL,FT3 3.14-6.15 pmol/L and FT4 9.57-18.27 pmol/L. There was statisticalsignificance for reference interval distribution between Group A and B(Z>3). The TSH,FT3 and FT4 referenceintervals for sex in all age groups showed no statistical significance(P>0.05). Conclusions The reference intervalsof TSH,FT3 and FT4 are established for healthy children of 4 d to 17 years old in Shanghai. The reference intervalsabove can explain the results of thyroid function,which can improve the diagnosis,treatment and monitoring ofhypothyroidism,hyperthyroidism,thyroiditis,goiter and thyroid neoplasm for children.
作者
李怀远
蒋黎敏
钱悦平
傅启华
李冬
LI Huaiyuan;JIANG Limin;QIAN Yueping;FU Qihua;LI Dong(Department of Clinical Laboratory,Tongji Hospital,Tongji University,Shanghai 200065,China;Department of Clinical Laboratory,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Diagnostics Division,Beckman Coulter Commerial Enterprise(China) Co.,Ltd.,Shanghai 200335,China)
出处
《检验医学》
CAS
2016年第12期1045-1049,共5页
Laboratory Medicine
基金
上海申康医院发展中心医院临床辅助科室能力建设项目(SHDC22014018)
