基于实验室信息系统建立甲状腺激素参考区间  

Establishing reference intervals of thyroid hormone based on a laboratory information system

作　　者：朱学彤 王凯瑾 周琪[2] 许建成[1] Zhu Xuetong;Wang Kaijin;Zhou Qi;Xu Jiancheng(Department of Laboratory Medicine,The First Hospital of Jilin University,Changchun 130021,China;Department of Pediatrics,The First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院检验科,长春130021 [2]吉林大学第一医院新生儿科,长春130021

出　　处：《中华内科杂志》2020年第2期129-133,共5页Chinese Journal of Internal Medicine

基　　金：吉林省卫生厅重点实验室科研课题(2017J071);吉林省教育厅"十三五"科学技术项目(JJKH20180214KJ)。

摘　　要：目的用实验室信息系统(LIS)中体检者的数据,探索间接法建立甲状腺激素参考区间的新方法。方法取2014年5月—2018年12月吉林大学第一医院LIS中体检中心数据,K-S检验分析正态性,BOX-COX将数据转成正态分布后用Turkey方法剔离群值。偏度系数-中位数-变异系数(LMS)法拟合连续百分位数曲线,决策树判定年龄划分截点,Z检验比较组间差异,非参数法计算P2.5、P97.5。结果纳入研究的体检者共计45742名。促甲状腺激素(TSH)参考区间不同年龄及性别间差异无统计学意义(Z<Z*),参考区间为0.60~4.41 mlU/L(20~79岁)。游离三碘甲状腺原氨酸(FT3)男性及35岁前女性随年龄下降,男性参考区间为4.47~6.44 pmol/L(20~44岁),4.19~6.21 pmol/L(45~64岁),3.90~5.85 pmol/L(65~79岁),女性为4.04~6.13 pmol/L(20~34岁),3.87~5.76 pmol/L(35~79岁)。游离甲状腺素(FT4)在20~49岁男性高于女性,男性参考区间为13.69~21.67 pmol/L,女性为12.99~20.83 pmol/L,50岁后不同性别及年龄间差异无统计学意义(Z<Z*),参考区间为12.98~21.21 pmol/L(50~59岁)。结论基于LIS数据建立的间接法参考区间简单可靠,适于临床实验室推广和应用。ObjectiveTo establish reference intervals(RIs)of thyroid hormone based on data from healthy subjects in laboratory information system(LIS)by indirect methods.MethodsData were selected from the physical examination center in LIS of the First Hospital of Jilin University from May 2014 to December 2018.The normal distribution of the original data was checked by the Kolmogorov-Smirnov test.Skewed data were transformed into normal distribution using BOX-COX techniques,and outliers were identified by the Turkey method.The continuous percentile curve was established by coefficient of skewness-median-coefficient of variation(LMS)methods.Cut-off value of age was determined by decision trees,and the differences between groups were verified by Z-tests.P2.5 and P97.5 in the RIs were analyzed by non-parametric methods.ResultsA total of 45742 subjects were included in the study.There were no differences in the RI for thyroid stimulating hormone(TSH)among age groups or between men and women(Z<Z*),and the RI was 0.60-4.41mIU/L(20-79 years old).However,the levels of free triiodothyronine(FT3)decreased with age in males and females under 35-year-old.The RIs for FT3 were 4.47-6.44pmol/L(20-44 years old),4.19-6.21pmol/L(45-64 years old)and 3.90-5.85pmol/L(65-79 years old)in males,and 4.04-6.13pmol/L(20-34 years old)and 3.87-5.76pmol/L(35-79 years old)in females,respectively.The levels of free thyroxine(FT4)in men were higher than those in women from 20 to 49 years old,and no gender and age differences could be viewed in subjects after 50 years old(Z<Z*).The RIs for FT4 were 13.69-21.76pmol/L(male,20-49 years old),12.99-20.83pmol/L(female,20-49 years old)and 12.98-21.21pmol/L(50~79 years old).ConclusionEstablishment of RIs of thyroid hormone based on the data from LIS is simple and reliable,which is suitable for clinical laboratory application.

关 键 词：甲状腺激素 参考区间 间接法 

分 类 号：R446[医药卫生—诊断学]