健康老年人血清甲状腺激素5项参考范围的建立

Establishment of reference range of thyroid hormones in the healthy elderly

目的：建立健康老年人甲状腺激素的参考值范围,为诊断、治疗、筛查老年人甲状腺疾病及相关研究提供依据及参考。方法：将660例健康志愿者按年龄分为中老年组（50~69岁）483例和高龄组（≥70岁）177例,采用化学发光法测定志愿者血清三碘甲状腺原氨酸（TT3）、甲状腺素（TT4）、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）,并进行统计分析。结果：高龄组与中老年组比较,血清FT3和TT3显著降低（P〈0.01,P〈0.05）,血清FT4和TSH显著升高（P〈0.01,P〈0.05）,血清TT4有升高趋势,但没有统计学差异（P〉0.05）。健康老年人FT3水平与年龄呈负相关（P〈0.01）,FT4、TT4、TSH水平与年龄呈正相关（P〈0.01,P〈0.05）,TT3与年龄无明显相关（P〉0.05）。中老年组参考范围：FT3 3.61~5.88pmol/L、TT3 1.16~2.25nmol/L、FT4 7.03~13.03pmol/L、TT4 76.54~153.54nmol/L、TSH 0~4.47m IU/L;高龄组参考范围：FT3 3.35~5.51pmol/L、TT3 0.97~2.28nmol/L、FT4 7.04~13.80pmol/L、TT4 75.90~161.74nmol/L、TSH 0~4.97m IU/L。结论 ：初步建立了老年人甲状腺激素5项的参考范围,为临床医生对50岁以上人群的甲状腺功能评判提供了参考。

Objective：To set up the reference ranges of thyroid hormones in the healthy elderly to provide reference criteria for diagnosis,treatment and monitoring or screening of thyroid disease in aged people. Methods：The 660 healthy volunteers were divided into 2 groups by age：middle and old aged people group （50-69years of age,n=483）and advanced age group （≥70 years of age,n=177）.The levels of serum total tri- iodomethane （TT3） ,total thyroxine （TT4） ,free triiodothyronine （FF3） ,free thyroxine （FT4）and thyroid-stimulating hormone（TSH）were determined by chemistry luminescence technique.Statistical analysis was made by the soft- ware SPSS 19.0.Results：Compared with middle and old aged people group,the levels of serum FT3 and TT3 were lower （P〈0.01,P〈0.05）and the levels of serum FT4 and TSH were higher （P〈0.01,P〈0.05）in advanced age group.Although Tr4 seems higher in advanced age group than the other,there was no significant differ- ences （P〉0.05）.The level of serum FT3 was negatively correlated with age （P〈0.01）.And the levels of serum FT4,TT4,TSH showed positive relationships with age（P〈0.01,P〈O.O5）.There were no relationships between the level of serum Tr3 and age （P〉0.05）.The reference range in middle and old aged people group：FT3 3.61- 5.88pmol/L,TT3 1.16-2.25nmol/L,FT4 7.03-13.03pmol/L,TF4 76.54-153.54nmol/L,TSH 0-4.47mlU/L.The ref- erence range in advanced age group ： FF3 3.35-5.5 lpmol/L,Tr3 0.97 -2.28nmol/L, FT4 7.04 -13.80pmol/L,TT4 75.90-161.74nmol/L,TSH 0-4.97mlU/L.Conclusion：The reference ranges of serum thyroid hormones in the healthy elderly are established ,which supply good reference value for clinicians to evaluate thyroid function.