摘要
目的利用临床实验室信息系统(LIS)中体检者“大数据”,使用间接法探讨不同性别和年龄对甲状腺激素水平的影响,建立适合的甲状腺激素数据分组方案及参考区间。方法回顾性分析2018年1月至2020年12月郑州大学第三附属医院共17174例含甲状腺功能检测数据的健康体检者信息,采用独立样本K-S检验分析正态性,BOX-COX将数据转成近似正态分布后用Tukey法剔离群值。采用Kruskal-Wallis H秩和检验比较不同年龄组组间差异。采用非参数法建立不同性别及年龄的TSH、FT4、FT3的P_(2.5)、P_(97.5)医学参考区间及90%的置信区间,探讨不同年龄、性别组的数据分布及差异的显著性,并与行业标准及试剂说明书推荐的参考区间比较。结果男性以64岁、女性以50岁为年龄分组界限,男性总体TSH水平为0.66~5.08 mIU/L、女性18~49岁和≥50岁TSH水平分别为0.69~5.95 mIU/L、0.75~6.49 mIU/L,女性TSH水平高于男性(P<0.001)。男性总体FT4水平为11.3~17.8 pmol/L,女性18~49岁和≥50岁FT4水平分别是10.6~17.0 pmol/L、10.8~17.2 pmol/L。男性18~64岁和≥64岁FT3水平分别是3.90~6.45 pmol/L、3.76~6.41 pmol/L,女性总体FT3水平为3.81~6.45 pmol/L。与试剂说明书推荐的参考区间相比,实验室建立的FT4参考区间与之有统计学差异,TSH、FT3参考区间与之无统计学差异;与行业标准推荐的参考区间相比,实验室建立的TSH、FT4和FT3的参考区间均与之无统计学差异。结论性别和年龄影响TSH、FT4和FT3水平。实验室应在适宜分组的前提下,基于实验室数据建立适合自己的甲状腺激素参考区间。
Objective To establish reference intervals(RIS) of thyroid hormone based on laboratory data in Laboratory Information System(LIS) by indirect methods,and to explore the influence of different gender and age on thyroid hormone level,to further establish a suitable grouping scheme for thyroid hormone reference intervals.Methods An observation study was conducted.17 174 subjects were collected from routine physical examination database of the Third Affiliated Hospital of Zhengzhou University between January 2018 to December 2020.The normality of the original data was checked by the Kolmogorov-Smirnov test.BOX-COX techniques was used to transforme skewed data into normal distribution,and outliers were identified and excluded by Tukey method.and the differences between groups were analyzed by Z-tests.P_(2.5),P_(97.5) and 90% confidence intervals(CI) for lower and upper limits in the RIs were analyzed by non-parametric methods.To explore the distribution and differences of TSH,FT4 and FT3 levels by different gender and age.Results Males were divided into two groups by age 65 and females were divided by age 50,respectively.The distribution of TSH in male was 0.66-5.08 mIU/L,the distribution of TSH in female of 18-49 group and ≥50 group were 0.69-5.95mIU/L,0.75-6.49 mIU/L.The distribution of FT4 in male was 11.3-17.8 pmol/L,the distribution of FT4 in female of 18-49 group and ≥50 group were 10.6-17.0pmol/L,10.8-17.2 pmol/L.The distribution of FT3 in male of 18-64 group and ≥65 group were 3.90-6.45pmol/L,3.76-6.41pmol/L,the distribution of FT3 in female was 3.81-6.45pmol/L.There are no significant differences of TSH,FT3 among “rough” RIS,manufacture recommended RIS and medical standard.There is significant difference of FT4 between “rough” RIS and manufacture recommended RIS,but there is no significant difference of FT4 between “rough” RIS and medical standard.Conclusion Gender and age affect the serum FT3,FT4 and TSH levels significantly.Each laboratory should establish its own reference intervals of th
作者
李伟
赵瑞
祁朝阳
刘丽莎
张琳琳
袁恩武
LI Wei;ZHAO Rui;QI Zhao-yang;LIU Li-sha;ZHANG Lin-lin;YUAN En-wu(Department of Clinical Laboratory,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《医药论坛杂志》
2023年第12期17-23,共7页
Journal of Medical Forum
关键词
促甲状腺激素
参考区间
性别
间接法
年龄
Thyroid hormone
Reference intervals
Indirect methods
Gender
Age
