江西地区成年人促甲状腺激素正常参考值范围建立及影响因素分析

发布时间：2018-04-03 01:17

本文选题：TSH　切入点：参考范围　出处：《南昌大学》2014年硕士论文

【摘要】：目的：甲状腺疾病是临床上常见的疾病，促甲状腺激素（TSH）是诊断甲状腺疾病的关键，目前临床上使用的TSH值参考范围建立来源于无筛选人群，因此TSH参考范围备受争议。本研究目的为重新建立江西地区健康成年人TSH参考范围，并分析影响TSH参考值范围的因素。方法：收集2012年7月-2013年9月来自江西省11个地级市共计1000名健康、未孕志愿者参加此次研究，进行了问卷调查，并分别测试了TSH、甲状腺自身抗体[抗甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）]，进行了甲状腺触诊及超声体检。采用SPSS17.0软件，统计正常参考范围测定采用95%参考区间计算，用Kolmogorov-Smirnov进行正态性检验，各组间TSH差异比较采用t检验，评估性别、甲状腺自身抗体及其他病史等因素对TSH值参考范围的影响，年龄组之间及BMI组间两两比较采用LSD检验。结果：排除了小于18岁、TPOAb阳性、甲状腺肿大、近期服用含碘食物、甲状腺疾病史以及家族史等因素后获得463名志愿者。结果为：在正常人群中TSH值非正态分布，向右偏斜，，取对数后呈正态分布。在这个研究中年龄大于18岁健康的463名志愿者建立的新的参考范围是0.59-4.95mIU/L。女性血清TSH参考范围0.68-5.21mIU/L，男性0.55-4.76mIU/L，女性明显高于男性，差异有统计学意义（P0.05）。甲状腺抗体对TSH参考范围有影响（P0.05）；而年龄、甲状腺肿大、BMI及近期服用含碘食物对TSH参考范围没有影响（P0.05）。结论：1、性别、甲状腺抗体会影响TSH参考范围的建立。 2、本研究的统计结果显示TSH上限值及下限均升高，不同于厂商提供的参考范围，各个地区及实验室均应建立本地区TSH参考范围。
[Abstract]:Objective: thyroid disease is a common disease in clinic, thyroid stimulating hormone (TSH) is the key to diagnosis of thyroid disease. The reference range of TSH used in clinic is established from non-screening population, so the reference range of TSH is controversial.The purpose of this study was to re-establish the reference range of TSH for healthy adults in Jiangxi province and analyze the factors affecting the range of reference values of TSH.Methods: a total of 1000 healthy volunteers from 11 prefectural cities in Jiangxi Province from July 2012 to September 2013 were enrolled in the study.The thyroid autoantibodies (TSH), thyroid autoantibodies (TPOAbs) and thyroglobulin antibodies (TgAbs) were tested, and thyroid palpation and ultrasound examination were performed.Using SPSS17.0 software, the normal reference range was calculated by 95% reference interval, the normal distribution was tested by Kolmogorov-Smirnov, the difference of TSH was compared by t test, and the sex was evaluated.The effect of thyroid autoantibodies and other factors on the reference range of TSH value was evaluated by LSD test.Results: 463 volunteers were obtained after exclusion of TPOAb positive, thyroid enlargement, recent intake of iodine food, history of thyroid disease and family history, etc.The results were as follows: in normal population, the TSH value was non-normal distribution and skewed to the right, and the logarithm showed normal distribution.In the study, 463 healthy volunteers aged 18 years and older established a new reference range of 0.59-4.95 m IUP / L.The reference range of serum TSH in women was 0.68-5.21mIUP / L, and that in males was 0.55-4.76mIUP / L, which was significantly higher in females than in males (P 0.05).Thyroid antibody had an effect on the reference range of TSH, but age, goiter and iodine diet had no effect on the reference range of TSH.Conclusion: 1, sex, thyroid antibody may influence the establishment of TSH reference range.2. The statistical results of this study show that the upper and lower limits of TSH are increased, which is different from the reference range provided by manufacturers. The reference range of TSH should be established in all regions and laboratories.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581;R445.1

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