Establishment and Validation of Reference Range of Thyroid Function among Healthy 11~16 Year-old Teenagers in Xi'an
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国家科技期刊平台
NETL
NSTL
维普
万方数据
目的 分析西安地区 11~16岁健康青少年血清甲状腺功能特征并确立其指标参考范围,为临床诊疗提供理论依据.方法 将空军军医大学第一附属医院(西京医院)2020 年 1 月~2022 年 12 月满足纳入标准的 1 378 例 11~16岁健康青少年作为研究对象,其中男性628例,女性750例.按不同年龄将研究对象分为三组:组1:11~<13岁433例;组2:13~<15岁425例;组3:15~≤16岁520例.分析11~16岁不同性别及不同年龄段血清甲状腺功能指标差异,建立各组参考范围,并选择 99 例符合纳入标准的 11~16 岁正常青少年进行验证.结果 不同性别之间促甲状腺激素[TSH,2.56(1.80,3.63)μIU/ml vs 2.43(1.68,3.48)μIU/ml]及总甲状腺素[TT4,97.84(85.34,111.00)nmol/L vs 98.20(87.16,111.23)nmol/L]比较,差异无统计学意义(Z =-1.881,-0.638,均P>0.05);游离甲状腺素[FT4,16.93(15.49,18.60)pmol/L vs 16.26(14.80,17.83)pmol/L]、游离三碘甲状腺原氨酸[FT3,6.21(5.66,6.80)pmol/L vs 5.59(4.98,6.19)pmol/L]、总三碘甲状腺原氨酸[TT3,2.24(1.96,2.55)pmol/L vs 2.04(1.78,2.34)nmol/L]比较,差异具有统计学意义(Z =-5.368,-11.994,-6.417,均P<0.01);不同年龄段之间的甲状腺功能各项指标间差异具有统计学意义(Z=10.649~261.003,均P<0.05).该研究建立了不同年龄段、不同性别的甲状腺功能各项指标的参考范围,经 99 例标本验证血清甲状腺功能指标均在所建立的参考区间范围内.结论 青少年机体各种激素分泌变化较大,甲状腺激素分泌受多种因素影响,不能完全依赖成人或厂家提供的参考范围诊断及治疗青少年甲状腺疾病,建立西安市11~16岁青少年甲状腺功能指标参考范围,为临床医生诊疗提供数据支持.
Objective To analyze serum characteristics and determine the reference range for thyroid function among healthy 11~16 year-old teenagers in Xi'an in order to offer a theoretical basis for clinical diagnosis and therapy.Methods A sum of 1 378 healthy 11~16 year-old teenagers who met the inclusion criteria from the First Affiliated Hospital of the Air Force Medical University(Xijing Hospital)between January 2020 and December 2022 were selected as research subjects,including 628 males and 750 females.They were divided into three groups based on age:Group 1:11~<13 year-olds(433 cases),Group 2:13~<15 year-olds(425 cases),and Group 3:15~≤16 year-olds(520 cases).Differences in serum thyroid function indices among different genders and age groups were analyzed,the reference ranges for these indices were established,and 99 healthy 11-16 year-old teenagers who met the inclusion criteria were chosen for verification.Results There were no significant differences between different genders in thyroid stimulating hormone[TSH,2.56(1.80,3.63)μIU/ml vs 2.43(1.68,3.48)μIU/ml]and total thyroxine[TT4,97.84(85.34,111.00)nmol/L vs 98.20(87.16,111.23)nmol/L],the differences were statistically significant(Z=-1.881,-0.638,all P>0.05).Meanwhile,the differences in free thyroxine[FT4,16.93(15.49,18.60)pmol/L vs 16.26(14.80,17.83)pmol/L],free triiodothyronine[FT3,6.21(5.66,6.80)pmol/L vs 5.59(4.98,6.19)pmol/L],and total triiodothyronine[TT3,2.24(1.96,2.55)nmol/L vs 2.04(1.78,2.34)nmol/L]between different genders were significant(Z=-5.368,-11.994,-6.417 all P<0.01).The differences in thyroid function indices were significant among different age groups(Z=10.649~261.003,all P<0.05).The reference ranges for thyroid function indices across different age groups and genders were established,in which thyroid function indicators were verified to be within the established reference range by 99 samples.Conclusion Teenage hormone secretion varies greatly,and the secretion of thyroid hormones is influenced by various factors.Thus,the diagnosis and treatment of teenage thyroid diseases cannot fully rely on the reference ranges provided by adults or manufacturers.This study established the reference range of the thyroid function indices of 11~16 year-old teenagers in Xi'an,offering clinical doctors'diagnosis and treatment data support.