东莞市东南片区3～6岁儿童甲状腺功能指标参考范围的建立

Establishment of reference range of thyroid function in 3-6 years old children in southeast district of Dongguan city

目的建立东莞市东南片区3～6岁儿童甲状腺功能指标的参考范围,为该年龄阶段儿童甲状腺功能异常提供科学诊断依据。方法选取2017年8月至2018年7月到该院进行入幼或入学体检,且出生后一直在该地区生活的3～6岁健康儿童290例作为研究对象,采集空腹静脉血3～4mL后分离血清,采用电化学发光免疫分析法检测血清总三碘甲腺原氨酸(TT3)、血清总甲状腺素(TT4)、血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺素(TSH),依照美国临床和实验室标准化协会(CLSI)EP28-A3c文件的相关要求,以95%可信区间(P_(2.5)～P_(97.5))统计方法确定TT3、TT4、FT3、FT4、TSH参考范围。结果经统计分析,3～6岁儿童TT3为1.60～2.95nmol/L,TT4为78.60～165.50nmol/L,FT3为4.00～7.60pmol/L,FT4为13.30～23.10pmol/L,TSH为0.82～3.53μIU/mL;不同性别儿童甲状腺功能指标参考范围比较,差异无统计学意义(P>0.05);新建立的参考范围与厂家提供的参考范围比较有较大差别。结论利用新建立的儿童甲状腺功能指标参考范围能更准确解释该地区3～6岁儿童甲状腺功能的检测结果,有助于该年龄阶段儿童甲状腺疾病的诊断、治疗和监测。

Objective To establish a reference range for thyroid function in children aged 3to 6years in the southeast of Dongguan city,and to provide a scientific diagnosis basis for thyroid function in children of this age group.Methods A total of 290children aged 3to 6years old who had been in kindergarten or physical examination in our hospital from August 2017to July 2018were selected,who had been living in the region since birth.A total of 3to 4mL of fasting venous blood of these children was collected.The serum levels of total triiodothyronine(TT3),serum total thyroxine(TT4),serum free triiodothyronine(FT3),serum free thyroxine(FT4)and thyrotropin(TSH)were measured by Roche Cobas E601electrochemiluminescence immunoassay.The reference ranges of TT3,T4,FT3,FT4and TSH were determined in accordance with the relevant requirements of the American Society for Clinical and Laboratory Standards(CLSI)EP28-A3c,with 95%CI(P2.5-P97.5)confidence interval statistical method.Results After statistical analysis,the reference range of thyroid function and function for children 3to 6years old in the region was established.TT3was 1.60-2.95 nmol/L,TT4was 78.60-165.50nmol/L,FT3was 4.00-7.60pmol/L,FT4was 13.30-23.10pmol/L and TSH was 0.82-3.53μIU/mL.Reference range of different gender had no statistically significance(P>0.05).The newly established reference range was quite different from the reference range provided by the manufacturer.Conclusion Using the newly established reference parameters for children′s thyroid function can more accurately explain the detection of thyroid function in children of 3-6years old in this region,which is helpful for the diagnosis,treatment and monitoring of thyroid disease.