本文選題：TSH　切入點：參考范圍　出處：《南昌大學(xué)》2014年碩士論文

【摘要】：目的：甲狀腺疾病是臨床上常見的疾病，促甲狀腺激素（TSH）是診斷甲狀腺疾病的關(guān)鍵，目前臨床上使用的TSH值參考范圍建立來源于無篩選人群，因此TSH參考范圍備受爭議。本研究目的為重新建立江西地區(qū)健康成年人TSH參考范圍，并分析影響TSH參考值范圍的因素。 方法：收集2012年7月-2013年9月來自江西省11個地級市共計1000名健康、未孕志愿者參加此次研究，進行了問卷調(diào)查，并分別測試了TSH、甲狀腺自身抗體[抗甲狀腺過氧化物酶抗體（TPOAb）和甲狀腺球蛋白抗體（TgAb）]，進行了甲狀腺觸診及超聲體檢。采用SPSS17.0軟件，統(tǒng)計正常參考范圍測定采用95%參考區(qū)間計算，用Kolmogorov-Smirnov進行正態(tài)性檢驗，各組間TSH差異比較采用t檢驗，評估性別、甲狀腺自身抗體及其他病史等因素對TSH值參考范圍的影響，年齡組之間及BMI組間兩兩比較采用LSD檢驗。 結(jié)果：排除了小于18歲、TPOAb陽性、甲狀腺腫大、近期服用含碘食物、甲狀腺疾病史以及家族史等因素后獲得463名志愿者。結(jié)果為：在正常人群中TSH值非正態(tài)分布，向右偏斜，，取對數(shù)后呈正態(tài)分布。在這個研究中年齡大于18歲健康的463名志愿者建立的新的參考范圍是0.59-4.95mIU/L。女性血清TSH參考范圍0.68-5.21mIU/L，男性0.55-4.76mIU/L，女性明顯高于男性，差異有統(tǒng)計學(xué)意義（P0.05）。甲狀腺抗體對TSH參考范圍有影響（P0.05）；而年齡、甲狀腺腫大、BMI及近期服用含碘食物對TSH參考范圍沒有影響（P0.05）。 結(jié)論：1、性別、甲狀腺抗體會影響TSH參考范圍的建立。 2、本研究的統(tǒng)計結(jié)果顯示TSH上限值及下限均升高，不同于廠商提供的參考范圍，各個地區(qū)及實驗室均應(yīng)建立本地區(qū)TSH參考范圍。
[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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R581;R445.1

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