摘要
目的建立贵州地区不同年龄段儿童甲状腺功能指标——游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)和总甲状腺素(TT4)的参考区间,为早期诊断和治疗儿童甲状腺疾病提供参考依据。方法选取2019年1月至2019年12月在贵州省人民医院就诊的4d~17岁健康儿童1050名,按照不同年龄段分为6组,每组不少于120名。采用化学发光法检测血清甲状腺功能指标,比较不同性别、不同年龄组间甲状腺功能指标差异,同时依据美国临床实验室标准化协会(CLSI)EP28-A3C文件推荐的方法,以P2.5th作为下限、P97.5th作为上限建立儿童甲状腺功能指标参考区间。结果不同性别组间儿童甲状腺功能指标检测结果比较,差异无统计学意义(P>0.05);不同年龄组间儿童甲状腺功能指标检测结果比较,差异有统计学意义(P<0.05);本研究按不同年龄段建立的参考区间为:1组(4d~<1月):FT3(2.86~5.53pmol/L),FT4(9.44~22.17pmol/L),TSH(0.82~12.25m IU/L),TT3(1.24~1.97nmol/L),TT4(66.89~154.78nmol/L);2组(1~<12月):FT3(3.28~7.47pmol/L),FT4(9.36~19.89pmol/L),TSH(0.75~6.60m IU/L),TT3(1.23~2.34nmol/L),TT4(57.95~154.33nmol/L);3组(1~<5岁):FT3(3.98~7.19pmol/L),FT4(9.06~19.57pmol/L),TSH(0.73~5.71m IU/L),TT3(1.51~2.02nmol/L),TT4(62.90~148.51nmol/L);4组(5~<10岁):FT3(3.93~7.17pmol/L),FT4(10.15~18.58pmol/L),TSH(0.64~5.46m IU/L),TT3(1.48~1.97nmol/L),TT4(59.17~145.26nmol/L)。5组(10~<14岁):FT3(3.21~6.87pmol/L),FT4(10.14~18.68pmol/L),TSH(0.56~5.37m IU/L),TT3(1.40~1.81nmol/L),TT4(60.30~155.85nmol/L)。6组(14~<17岁):FT3(3.36~6.45pmol/L),FT4(10.33~18.59pmol/L),TSH(0.55~5.01m IU/L),TT3(1.44~1.71nmol/L),TT4(61.21~146.43nmol/L)。结论贵州地区儿童甲状腺功能指标的参考区间和厂家提供的有一定差异,本研究建立了贵州地区儿童甲状腺功能指标的参考区间,不仅真实体现各年龄段甲状腺功能指标的水平变化,还能减少因采用成人标准而造成的漏诊和误诊,为贵州地区儿童甲状腺疾病的诊断和治疗提供参考依据。
Objective To establish the reference intervals of thyroid function indicators of children in different age groups in Guizhou,including free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),total triiodothyronine(TT3)and total thyroxine(TT4),It provides reference for early diagnosis and treatment of thyroid diseases in children.Methods A total of 1050 healthy children aged from 4d to 17 years who visited guizhou people’s hospital from January 2019 to December 2019 were selected and divided into 6 groups according to different age groups,with no less than 120 children in each group.Serum thyroid function indicators were detected by chemiluminescence method to compare differences in thyroid function indicators between different genders and different age groups.Meanwhile,according to the method recommended by EP28-A3C document of American Association for Clinical Laboratory Standardization(CLSI),the reference interval of thyroid function indicators in children was established with P2.5th as the lower limit and P97.5th as the upper limit.Results Comparison of thyroid function test results among children of different genders showed no statistically significant difference(P>0.05);Comparison of thyroid function test results among children in different age groups showed statistically significant differences(P<0.05).The reference intervals established by different age groups in this study are:1 groups(4d~<1 month):FT3(2.86~5.53pmol/L),FT4(9.44~22.17pmol/L),TSH(0.82~12.25m IU/L),TT3(1.24~1.97nmol/L),TT4(66.89~154.78nmol/L).2 groups(1~<12 months):FT3(3.28~7.47pmol/L),FT4(9.36~19.89pmol/L),TSH(0.75~6.60m IU/L),TT3(1.23~2.34nmol/L),TT4(57.95~154.33nmol/L).3 groups(1~<5 years old):FT3(3.98~7.19pmol/L),FT4(9.06~19.57pmol/L),TSH(0.73~5.71m IU/L),TT3(1.51~2.02nmol/L),TT4(62.90~148.51nmol/L).4 groups(5~<10 years old):FT3(3.93~7.17pmol/L),FT4(10.15~18.58pmol/L),TSH(0.64~5.46m IU/L),TT3(1.48~1.97nmol/L),TT4(59.17~145.26nmol/L).5 groups(10~<14 years old):FT3(3.21~6.87pmol/L),FT4(10.14~18.68pmol/L),TSH(0.56~5.37m IU/L),TT3(1.40~1.81nmol/L),TT4(60.30~155.85nmol/L).6 groups(14~<17 years old):FT3(3.36~6.45pmol/L),FT4(10.33~18.59pmol/L),TSH(0.55~5.01m IU/L),TT3(1.44~1.71nmol/L),TT4(61.21~146.43nmol/L).Conclusion Guizhou province children thyroid function index of the reference range and manufacturers to provide a certain difference,this study established the guizhou province children thyroid function index of the reference range,not only real reflect the level changes of thyroid function indexes all ages,can also reduce missed diagnosis and misdiagnosis due to the adult standard,for guizhou area provided a reference for the diagnosis and treatment of thyroid disease in children.
作者
井沆
印倩
张俊
孙杰
井冰
凌晓午
JING Hang;YIN Qian;ZHANG Jun;SUN Jie;JING Bing;LING Xiao-wu(Department of Clinical laboratory,Guizhou Province People's Hospital,Guiyang,Guizhou 550002;Department of neonatology department,Guizhou Province People's Hospital,Guiyang,Guizhou 550002;Department of Emergency Pediatrics,Dengzhou Central Hospital,Dengzhou,Henan 474150)
出处
《智慧健康》
2021年第13期174-178,共5页
Smart Healthcare
基金
贵州省人民医院青年基金项目[GZSYQN[2017]08]。
关键词
儿童
甲状腺功能
参考区间
贵州
Children
Thyroid function
Reference interval
Guizhou
