西藏地区2～14岁藏族儿童血常规和血清铁参考值的建立

发布时间：2018-05-24 06:43

本文选题：血常规 + 血清铁　；参考：《中国循证儿科杂志》2017年03期

【摘要】：目的建立西藏地区藏族2~14岁儿童血常规和血清铁参考值。方法在西藏拉萨市选取西藏自治区人民医院妇幼保健院(我院)儿童保健科作为学龄前儿童数据采集现场,选取西藏自治区江孜县和隆子县3所小学作为学龄儿童数据采集现场,藏族儿童是指父母均为藏族、且世代居住在藏区;行体格检查时采集的儿童的静脉血,统一在我院临床检验科行血常规和血清铁检测,检验值直接从相关仪器导出用于本文分析。依据检测指标分布特点,采用百分位数法(P2.5~P97.5)或x±1.96 s确定其双侧参考值范围,采用LMS program软件(版本:1.35),拟合血常规和血清铁依年龄变化的百分位数曲线。结果 2016年1月1日至12月31日2~14岁3 881(藏族3 137和汉族744)名健康儿童进入本文分析。学龄前儿童血标本3 253份,学龄儿童血标本628份。2~6岁组分别为546、1 878、475、270和111例,7~14岁组36~101例,藏、汉族儿童不同年龄段性别差异均无统计学意义(P均0.05)。较平原地区RBC、Hb和PLT参考值范围整体右移,运铁蛋白饱和度(UIBC)、血清总铁结合力(TIBC)参考值范围更宽;WBC参考值范围左移,中性粒细胞计数(NEUT#)、淋巴细胞计数(LYMPH#)、单核细胞计数(MONO#)和嗜酸性粒细胞百分比(EO%)参考值范围更宽,嗜碱性粒细胞百分比(BASO%)参考值范围稍小。就绝对计数来看,NEUT#参考值范围左移,LYMPH#、MONO#、嗜酸性粒细胞计数(EO#)和BASO#参考值范围更窄。Hb、RBC比容(HCT)、平均PLT容积(MPV)、RBC平均Hb量、浓度和体积(MCH、MCHC和MCV)和RBC分布宽度(RDW-SD)随年龄呈上升趋势,PLT、淋巴细胞百分比(LYMPH%)和BASO%随年龄呈下降趋势,中性粒细胞百分比(NEUT%),PLT比容(PCT)随年龄增长先升后降。除TIBC、MCH和PCT外,余指标在藏族与汉族儿童中差异均有统计学意义。其中,汉族儿童WBC、RBC、血清铁、Hb、HCT、PLT和MCV水平高于藏族儿童;藏族儿童MCHC、RDW-CV、PLT分布宽度(PDW)、UIBC、MPV和RDW-SD水平高于汉族儿童。结论与平原地区比较,西藏高海拔地区血常规和血清铁参考值随儿童年龄的变化趋势与平原在区基本一致,RBC、Hb和PLT等参考值范围整体右移且范围更宽,WBC及其分属参考值范围左移且范围更宽,西藏高海拔地区血常规和血清铁应以当地参考值作为参照。
[Abstract]:Objective to establish the blood routine test and serum iron reference value of Tibetan children aged 14 years old in Tibet. Methods in Lhasa, Tibet, the Department of Child Health of the people's Hospital of Tibet Autonomous region was selected as the data collection site for preschool children. Three primary schools in Jiangzi County and Longzi County, Tibet Autonomous region, were selected as data collection sites for school-age children. Tibetan children refer to children whose parents are both Tibetans and who have lived in Tibetan areas for generations. Blood routine examination and serum iron detection were carried out in our clinical laboratory. The test values were derived directly from relevant instruments for analysis in this paper. According to the distribution characteristics of the test indexes, the range of bilateral reference values was determined by percentile method (P2.5P97.5) or x 卤1.96s. The LMS program software (version 1. 35) was used to fit the blood routine and the percentile curves of serum iron changes with age. Results from January 1 to December 31, 2016, 214 years old 3 881 (Tibetan 3137 and Han 744) healthy children were included in this analysis. There were 3 253 blood samples of preschool children, and 6 28 blood samples of school age children. The number of blood samples in 6 years old group was 5466 ~ 1 878475270 and 36 ~ 101 cases in 714 years old group respectively. There was no significant difference in sex between Tibetan and Han nationality children in different age groups (P < 0.05). Compared with plain area, the whole reference range of HB and PLT moved to the right, the saturation of ferritin and the range of TIBC of serum total iron binding ability moved to the left, and the whole range of reference values of RBCs and PLT moved to the right, and the range of reference values of TIBC was shifted to the left. The reference range of neutrophil count, lymphocyte count, monocyte count and eosinophilic granulocyte percentage is wider, and basophilic granulocyte percentage is slightly smaller. In terms of absolute count, the range of reference values of Neutron # is shifted to the left in #MONO#A (eosinophil count) and BASO#. The range of reference values is narrower. The specific volume of BASO# is HCTX, and the average PLT volume is higher than that of PLT. The concentration and volume of MCHC and MCV) and the distribution width of RBC (RDW-SD) showed an upward trend with age. The percentage of lymphocyte (LYMPH) and BASO% decreased with age. The percentage of neutrophils increased first and then decreased with age. With the exception of TIBCU MCH and PCT, there were significant differences in the other indexes between Tibetan and Han children. The levels of MCV and MCV in serum of Han children were higher than those of Tibetan children, and the distribution width of RDW-CVPLT in Tibetan children was higher than that of Han children. Conclusion compared with plain area, The variation trend of blood routine and serum iron reference values with the age of children in high altitude areas of Tibet is basically consistent with that of the plain areas. The whole range of reference values such as RBCs HB and PLT moves to the right and the range of reference values is wider and the range of reference values moves to the left and the range is wider. Blood routine and serum iron should be taken as reference value in high altitude area of Tibet.
【作者单位】：西藏自治区人民医院妇幼保健院儿童保健科;复旦大学附属儿科医院临床流行病学研究室;西藏自治区人民医院妇幼保健院检验中心;复旦大学附属儿科医院免疫科;
【分类号】：R179

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