[1]张 艳,李鸿钏,刘 翔,等.甲状腺疾病应用参考变化因子评估连续监测甲状腺功能指标结果的价值[J].现代检验医学杂志,2019,34(05):135-138.[doi:10.3969/j.issn.1671-7414.2019.05.034]
　ZHANG Yan,LI Hong-chuan,LIU Xiang,et al.Value of Using Reference Change Factor to Evaluate the Results of Continuous Monitoring of Thyroid Function Indicators in Thyroid Diseases[J].Journal of Modern Laboratory Medicine,2019,34(05):135-138.[doi:10.3969/j.issn.1671-7414.2019.05.034]
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甲状腺疾病应用参考变化因子评估连续监测甲状腺功能指标结果的价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年05期
页码:
135-138
栏目:
检验与临床
出版日期:
2019-10-29

文章信息/Info

Title:
Value of Using Reference Change Factor to Evaluate the Results of Continuous Monitoring of Thyroid Function Indicators in Thyroid Diseases
文章编号:
1671-7414(2019)05-135-04
作者:
张 艳1; 李鸿钏1; 刘 翔1; 黄亨建2
(1.成都市郫都区中医医院检验科,成都 611730; 2.四川大学华西医院实验医学科,成都 610041)
Author(s):
ZHANG Yan1; LI Hong-chuan1; LIU Xiang1; HUANG Heng-jian2
(1.Department of Clinical Laboratory,Traditional Chinese Medicine Hospital of Pidu District,Chengdu 611730,China; 2.Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)
关键词:
参考变化因子;  参考变化值;  甲状腺功能监测
分类号:
R582; R392.11
DOI:
10.3969/j.issn.1671-7414.2019.05.034
文献标志码:
A
摘要:
目的 通过对甲状腺功能检测项目的参考变化因子(reference change factor,RCF)和参考变化值(reference change value,RCV)的应用研究,为临床解读连续多次甲状腺功能检测结果提供更科学的依据。方法 选取郫都区中医医院2018年11～12月甲状腺功能检测指标(TSH,T3,T4,FT3,FT4)的实验室分析变异(analytical variance,CVA)和个体内生物学变异(intraindividual biological variation,CVI)数据,根据公式RCV=Z*21/2*(CV2A+CVI2)1/2,RCFup=exp[Z*21/2*(CVA2+CVI2)1/2/100],RCFdown=1/RCFup,计算在99%(单、双侧)概率下各指标的RCV值和RCF值,并分析在连续结果解读中的运用价值。结果 在99%概率下,各检测指标的个体指数(Individual Index,II),单侧RCV,双侧RCV,单侧RCFup,双侧RCFup,单侧RCFdown和双侧RCFdown分别为TSH:0.78,63.87%,70.73%,1.71%,2.03%,0.58%和0.49%; T3:0.56,24.26%,26.87%,1.23%,1.31%,0.82%和0.76%; T4:0.45,17.84%,19.75%,1.16%,1.22%,0.86%和0.82%; FT3:0.45,27.10%,30.01%,1.26%,1.35%,0.80%和0.74%; FT4:0.47,20.78%,23.01%,1.19%,1.26%,0.84%和0.79%。TSH,T3,T4,FT3和FT4的个体指数均较小,运用参考范围来评价检测结果存在一定的局限性,应结合RCV和RCF来判断结果变化的临床意义。结论 RCV适用两次检测结果之间的分析,评价多个连续结果时使用RCF,可作为临床决策的工具,以便对甲状腺病人状态做出正确判断。
Abstract:
Objective To provide a more scientific basis for clinical interpretation of the results of multiple consecutive thyroid function tests,through the application research of reference change factor(RCF)and reference change value(RCV)of thyroid function test items.MethodsUnder 99%(single and bilateral)probability,using the laboratory analytical variance(analytical variance,CVA)and the intraindividual biological variation(intraindividual biological variation,CVI)data of thyroid function test indexes(TSH,T3,T4,FT3,FT4)in Pidu District Hospital of Traditional Chinese Medicine from November 2018 to December 2018,RCV=Z*21/2*(CVA2+CVI2)1/2,RCFup=exp[Z*21/2*(CVA2+CVI2)1/2/100],RCFdown=1/RCFup,RCV value and RCF value of each detection index were calculated,and the application value in the interpretation of continuous results was analyzed.Results Under99% probability,Individual Index(II),Unilateral RCV,bilateral RCV,unilateral RCFup,bilateral RCFup,unilateral RCFdown and bilateral RCFdown were:TSH:0.78,63.87%,70.73%,1.71%,2.03%,0.58% and 0.49%.T3:0.56,24.26%,26.87%,1.23%,1.31%,0.82% and 0.76%.T4:0.45,17.84%,19.75%,1.16%,1.22%,0.86% and 0.82%.FT3:0.45,27.10%,30.01%,1.26%,1.35%,0.80% and 0.74%.FT4:0.47,20.78%,23.01%,1.19%,1.26%,0.84% and 0.79% respectively.The individual indexes of TSH,T3,T4,FT3 and FT4 were all small,so there were certain limitations in using the reference range to evaluate the test results,and the clinical significance of the changesshould be judged by combining RCV and RCF.Conclusion RCVis only suitable for the analysis between two test results.The use of RCF in evaluating multiple consecutive outcomes can be used as a tool for clinical decision-making in order to make a correct judgement of the state of thyroid patients.

参考文献/References:

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备注/Memo

备注/Memo:
作者简介:张艳(1982-),女,本科,主管检验师,从事临床免疫学方面的研究,E-mail:114612396@qq.com。
更新日期/Last Update: 2019-10-20