Pediatric reference intervals for serum thyroxine, triiodothyronine, thyrotropin, and free thyroxine.
Pediatric reference intervals for serum thyroxine, triiodothyronine, thyrotropin, and free thyroxine.
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DOI：
10.1093/clinchem/45.7.1087
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发表时间：
1999-07
影响因子：
9.3
通讯作者：
David Zurakowski;James Di Canzio;J. A. Majzoub
中科院分区：
文献类型：
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作者：
David Zurakowski;James Di Canzio;J. A. Majzoub
甲状腺功能检查提供有关激素代谢和甲状腺功能障碍的信息。参考区间使临床医生能够评估甲状腺功能。已发表了几个甲状腺功能检查的儿科参考区间（1）（2）（3）（4）。实验室检查及其命名法已发表（5），美国甲状腺协会已将促甲状腺激素（TSH）列为甲状腺状态的最佳单一测量方法，因为其灵敏度高（6）。然而，从少数患者中获得的参考区间对于准确评估依赖于协变量（如年龄和性别）的检测结果并不可靠。IFCC推荐至少120名受试者用于非参数方法，其中进行了数据亚组（7）。Virtanen等人（8）提出，较小的样本量可能足以用于基于回归的参考区间。最近，人们对使用医院数据库提取大量患者数据用于临床研究非常感兴趣（9）（10）（11）（12）。医院数据库提供了足够数量的受试者来评估年龄和性别差异并建立基于年龄和性别的参考区间。测试结果可能会受到药物或治疗患者接受甲状腺疾病，改变甲状腺激素浓度的生理特征在新生儿期（13）（14）。因此，新生儿和患有甲状腺疾病或检查结果异常的患者应排除在用于建立参考区间的分析之外。在这里，我们报告的健康相关的参考区间血清甲状腺素（T4），三碘甲状腺原氨酸（T3），促甲状腺激素和游离T4被用作临床指南筛选可疑甲状腺功能障碍患者。这些儿科标准比以前发表的更准确，因为它们是年龄和性别特异性的，并且来自大量的儿童和青少年。
Thyroid function tests provide information about hormone metabolism and thyroid dysfunction. Reference intervals enable clinicians to evaluate thyroid function. Several pediatric reference intervals for thyroid function tests have been published(1)(2)(3)(4). Laboratory tests and their nomenclature have been published (5), and the American Thyroid Association has classified thyrotropin (TSH) as the best single measurement of thyroid status because of its high sensitivity (6). However, reference intervals that are derived from small numbers of patients are not reliable for accurately evaluating test results that are dependent on covariates such as age and sex. The IFCC has recommended a minimum of 120 subjects for nonparametric methods in which subgrouping of data is performed (7). Virtanen et al. (8) have proposed that a smaller sample size may be sufficient for regression-based reference intervals. Recently, there has been much interest in using hospital databases to extract large volumes of patient data for clinical research(9)(10)(11)(12). Hospital databases provide a sufficient number of subjects for evaluating age and sex differences and for establishing age- and sex-based reference intervals. Test results can be affected by medications or treatment received by patients for thyroid disease that alter the physiologic features of the thyroid hormone concentrations during the neonatal period (13)(14). Therefore, neonates and patients who have thyroid disease or demonstrate abnormal test results should be excluded from the analysis used to establish the reference intervals. Here we report health-related reference intervals for serum thyroxine (T4), triiodothyronine (T3), TSH, and free T4 to be used as clinical guidelines for screening patients with suspected thyroid dysfunction. These pediatric norms are more accurate than those previously published because they are age- and sex-specific and were derived from a large population of children and …