中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2014年
2期
199-203
,共5页
目的：探讨首都医科大学附属北京妇产医院2~12周龄婴儿甲状腺激素水平的参考区间。方法选取2009年1月至2012年12月于北京市新生儿疾病筛查门诊就诊的2~12周龄的953例健康婴儿为研究对象。按照不同年龄段,将其分为2~4周龄组(n=416)、4~8周龄组(n=398)和8~12周龄组(n=139)。3组受试儿童的性别、胎龄、出生体质量等一般临床资料比较,差异无统计学意义(P>0.05)。应用化学发光法测定血清促甲状腺素(TSH)、三碘甲状腺原氨酸(TT3)、四碘甲状腺原氨酸(TT4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)的水平,各指标参考区间采用中位数及 P2.5、P25、P50、P75、P97.5表示,同时对不同性别、不同年龄组间的甲状腺激素水平,及婴儿与成年人甲状腺激素水平参考区间进行统计学分析(本研究遵循的程序符合首都医科大学附属北京妇产医院人体试验委员会制定的伦理学标准,征得该委员会批准,并征得受试对象监护人的知情同意,与之签署临床研究知情同意书)。结果 TSH、FT3、FT4、TT3、TT4水平男性与女性婴儿间比较,差异均无统计学意义(t=1.860,0.510,-0.360,0.920,1.370；P>0.05)。2~12周龄婴儿各激素水平与目前本院应用的成年人甲状腺激素水平参考区间进行比较,TSH、FT3、T3、T4水平高于成年人参考区间,且差异均有统计学意义(t=27.25,46.77,30.49,5.59；P<0.05),以TSH水平尤为突出,但FT4水平较成年人低。3组婴儿TSH水平无明显变化(F=0.345,P=0.708),但随着年龄增大,P97.5降低,95%CI呈缩小趋势；TT4、FT4水平随年龄增加呈下降趋势(F=12.57,P=0.000；F=21.17,P=0.000),TT3、FT3则呈升高趋势(F=14.75,P=0.000；F=3.699,P=0.025)。结论成年人的甲状腺激素水平参考区间不能广泛应用于婴幼儿,应建立儿童期各年龄段甲状腺激素水平参考区间,为儿童甲状腺疾病,特别是先天性甲状腺功能低下患儿的早期诊治提供参考。
目的：探討首都醫科大學附屬北京婦產醫院2~12週齡嬰兒甲狀腺激素水平的參攷區間。方法選取2009年1月至2012年12月于北京市新生兒疾病篩查門診就診的2~12週齡的953例健康嬰兒為研究對象。按照不同年齡段,將其分為2~4週齡組(n=416)、4~8週齡組(n=398)和8~12週齡組(n=139)。3組受試兒童的性彆、胎齡、齣生體質量等一般臨床資料比較,差異無統計學意義(P>0.05)。應用化學髮光法測定血清促甲狀腺素(TSH)、三碘甲狀腺原氨痠(TT3)、四碘甲狀腺原氨痠(TT4)、遊離三碘甲狀腺原氨痠(FT3)、遊離四碘甲狀腺原氨痠(FT4)的水平,各指標參攷區間採用中位數及 P2.5、P25、P50、P75、P97.5錶示,同時對不同性彆、不同年齡組間的甲狀腺激素水平,及嬰兒與成年人甲狀腺激素水平參攷區間進行統計學分析(本研究遵循的程序符閤首都醫科大學附屬北京婦產醫院人體試驗委員會製定的倫理學標準,徵得該委員會批準,併徵得受試對象鑑護人的知情同意,與之籤署臨床研究知情同意書)。結果 TSH、FT3、FT4、TT3、TT4水平男性與女性嬰兒間比較,差異均無統計學意義(t=1.860,0.510,-0.360,0.920,1.370；P>0.05)。2~12週齡嬰兒各激素水平與目前本院應用的成年人甲狀腺激素水平參攷區間進行比較,TSH、FT3、T3、T4水平高于成年人參攷區間,且差異均有統計學意義(t=27.25,46.77,30.49,5.59；P<0.05),以TSH水平尤為突齣,但FT4水平較成年人低。3組嬰兒TSH水平無明顯變化(F=0.345,P=0.708),但隨著年齡增大,P97.5降低,95%CI呈縮小趨勢；TT4、FT4水平隨年齡增加呈下降趨勢(F=12.57,P=0.000；F=21.17,P=0.000),TT3、FT3則呈升高趨勢(F=14.75,P=0.000；F=3.699,P=0.025)。結論成年人的甲狀腺激素水平參攷區間不能廣汎應用于嬰幼兒,應建立兒童期各年齡段甲狀腺激素水平參攷區間,為兒童甲狀腺疾病,特彆是先天性甲狀腺功能低下患兒的早期診治提供參攷。
목적：탐토수도의과대학부속북경부산의원2~12주령영인갑상선격소수평적삼고구간。방법선취2009년1월지2012년12월우북경시신생인질병사사문진취진적2~12주령적953례건강영인위연구대상。안조불동년령단,장기분위2~4주령조(n=416)、4~8주령조(n=398)화8~12주령조(n=139)。3조수시인동적성별、태령、출생체질량등일반림상자료비교,차이무통계학의의(P>0.05)。응용화학발광법측정혈청촉갑상선소(TSH)、삼전갑상선원안산(TT3)、사전갑상선원안산(TT4)、유리삼전갑상선원안산(FT3)、유리사전갑상선원안산(FT4)적수평,각지표삼고구간채용중위수급 P2.5、P25、P50、P75、P97.5표시,동시대불동성별、불동년령조간적갑상선격소수평,급영인여성년인갑상선격소수평삼고구간진행통계학분석(본연구준순적정서부합수도의과대학부속북경부산의원인체시험위원회제정적윤리학표준,정득해위원회비준,병정득수시대상감호인적지정동의,여지첨서림상연구지정동의서)。결과 TSH、FT3、FT4、TT3、TT4수평남성여녀성영인간비교,차이균무통계학의의(t=1.860,0.510,-0.360,0.920,1.370；P>0.05)。2~12주령영인각격소수평여목전본원응용적성년인갑상선격소수평삼고구간진행비교,TSH、FT3、T3、T4수평고우성년인삼고구간,차차이균유통계학의의(t=27.25,46.77,30.49,5.59；P<0.05),이TSH수평우위돌출,단FT4수평교성년인저。3조영인TSH수평무명현변화(F=0.345,P=0.708),단수착년령증대,P97.5강저,95%CI정축소추세；TT4、FT4수평수년령증가정하강추세(F=12.57,P=0.000；F=21.17,P=0.000),TT3、FT3칙정승고추세(F=14.75,P=0.000；F=3.699,P=0.025)。결론성년인적갑상선격소수평삼고구간불능엄범응용우영유인,응건립인동기각년령단갑상선격소수평삼고구간,위인동갑상선질병,특별시선천성갑상선공능저하환인적조기진치제공삼고。
Objective To investigate reference intervals of thyroid hormone levels of infants between the age of 2-12 weeks.Methods From January 2009 to December 2012,a total of 953 infants between the age of 2-12 weeks who had clinic servers at Beijing Newborn Screening Center were recruited into this study. They were divided into three groups according to different age periods,2-4 weeks group (n=416 ), 4-8 weeks group(n=398),and 8-12 weeks group(n=139).Levels of the serum triiodothyronine (TT3), thyroxine (TT4 ),free triiodothyronine (FT3 ),free thyroxine (FT4 )and thyroid-stimulating hormone (TSH)were measured by chemiluminescence method.Median and P2.5,P25,P50,P75,P97.5 were calculated for levels of thyroid hormones.All markers were analyzed between gender,age and so on among three groups.Furthermore,the differences of thyroid hormones between infants and adults were also conducted.The study protocol was approved by the Ethical Review Board of Investigation in Beij ing Obstetrics and Gynecology Hospital,Capital Medical University.Informed consent was obtained from all participates′parents.Results There had no significant difference among three groups of TSH (F=0.345, P=0.708),and there had significant differences among three groups of FT3,FT4,TT3 and TT4 (F=3.699,P=0.025;F=21.170,P=0.000;F=14.750,P=0.000;F=12.570,P=0.000).There had no significant differences between boys and girls on the levels of TSH,FT3,FT4,TT3 and TT4 (t=1.860, 0.510,-0.360,0.920,1.370;P>0.05).Thyroid hormone levels (TSH,FT3,TT3,TT4)of children at the age of 2-12 weeks were higher than those of adults,with significant differences (t=27.25,46.77, 30.49,5.59,P=0.000).Conclusions The reference intervals of adults are not universally applicable to infants.It is important to establish the reference intervals of thyroid hormone levels of infants.
