碘适宜地区学龄儿童甲状腺功能指标正常参考值的建立

Establishment of reference values for analysis of thyroid function in school-age children in iodine-adequate nutrition areas

目的建立碘适宜地区学龄儿童甲状腺功能指标的正常参考值范围。方法以碘适宜地区（尿碘中位数处于100～200μg／L）的128名8。10岁健康儿童（男62名、女66名）作为调查对象，采用美国贝克曼公司的Access2免疫分析系统化学发光法测定甲状腺功能相关指标[总三碘甲腺原氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺球蛋白（Tg）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）]。结果儿童甲状腺功能指标的正常参考值范围（95％参考区间）：TT3为1．63～3．36nmol／L、TT4为110．65～186．67nmoll/L、FT3为4．65～7．25pmol／L、FT4为9．75～15．59pmol／L、TSH为1．10～5．54mU／L、Tg为3．75～36．27μg／L，不同性别间上述各项指标比较差异无统计学意义（P均〉0．05），儿童与文献已报告的成人甲状腺功能各指标有明显的差异。结论儿童甲状腺功能指标正常参考值范围不同于成人，建立儿童甲状腺功能指标正常参考值对于儿童甲状腺疾病的诊断和碘营养评估很有必要。

Objective To establish reference values for thyroid hormone in school-age children in iodine- adequate nutrition areas. Methods Totally 128 8 - 10-year-old healthy children （male： 62, female： 66） were screened rigorously in iodine-adequate nutrition areas （median of urinary iodine： 100 - 200 μg/L）. The values of total triiodothyronine （TT3）, total thyroxine （TT4）, free triiodothyronine （FT3）, free thyroxine （FT4）, thyrotropin fiSH）, thyroglobulin （Tg）, thyroid peroxidase antibody （TPOAb）, and thyroglobulin antibody （TgA） in serum were determined through the Access 2 Immunoassay System （Beckman-Coulter, USA） using a chemiluminescence detection systerm Results Normal reference ranges for thyroid function indicators in children （95% confidence limit） of TT3, TT4, FT3, FF4, TSH, and Tg were 1.63 - 3.36 nmol/L, 110.65 - 186.67 nmol/L, 4.65 - 7.25 pmol/L, 9.75 - 15.59 pmol/L, 1.10 - 5.54 mU/L, and 3.75 - 36.27 μg/L respectively. There was no significant difference in hormone levels between boys and girls （P 〉 0.05）. The thyroid function indices were substantially different between children and adults. Conclusions Normal reference range of thyroid function index of children is different from that of adults. It is necessary to establish the reference range of thyroid function indices for children in order to diagnose thyroid diseases and monitor iodine nutrition.