胎儿血象变化趋势研究

Study on change pattern of fetal peripheral blood cells.

[目的]分析胎儿不同胎龄的血象10项指标水平,探讨胎儿期血象的变化趋势.[方法]B超引导下抽取450例胎龄19～37周胎儿的脐静脉血,检测血象10项指标.计算各孕周段正常值,分析各指标变化趋势与胎龄的相关关系.[结果]①胎儿的RBC、HGB、HCT、WBC、NEUT均与胎龄呈正相关关系(r分别为0.574、0.364、0.407、0.364、0.494,P均＜0.001).②MCH、MCV、LYMP均与胎龄呈负相关关系(r分别为0).385、-0.495、-0.458,P均＜0.001).③妊娠中期起,胎儿的血小板(platelet,PLT)数量已达成人水平,PIT与胎龄无相关关系(r=0.041,P＞0.05).④妊娠中期的胎儿淋巴细胞占优势,其比值随胎龄的增长而下降,足月时低于50%;而中性粒细胞比值的变化趋势与淋巴细胞相反,随胎龄的增长而上升,足月时超过50%.[结论]胎儿的红细胞系及白细胞系的发育与胎龄密切相关,血小板生成水平则达到成人水平;白细胞系中性粒细胞比值与淋巴细胞比值的变化趋势呈相反走势.

【Objective】 To analyze ten parameters of the peripheral blood cells of fetus at different fetal are and study the change patterns of fetal peripheral blood cells. 【Methods】 The umbilical cord blood of 450 fetuses between nineteen to thirty-seven weeks of fetal age was collected. The ten parameters of fetal peripheral blood cells were detected. The change patterns of fetal peripheral blood cells and their relation to fetal age were studied. 【Results】 There was positive correlation between fetal age and fetal red blood cell （r=0.574, P〈0.001 ）, hemoglobin （r=0.364, P〈0.001）, hematocrit （r=0.407, P〈0.001）, white blood cell （r=0.364, P〈0.001） and neutrophil（r=0.491, P〈0.001）. There was negative correlation between fetal age and mean corpuscular hemoglobin, mean corpuscular volume and lymphocyte. The correlation coefficient value were -0.385, 0.495 and -0.458, respectively （P〈0.001）. The ratioof neutrophil increased with fetal age at the second and third trimester and was greater than fifty percent at the end of gestation. While the ratio of lymphocyte decreased with fetal age and was less than 50% at the end of gestation. No correlation was found between platelet and fetal age （r=0.041, P〉0.05）. 【Conclusions】 The development of red blood cells and white blood cells of fetus was correlated to fetal age. The platelet number of fetus had reached the level of adult. The ratio of neutrophil of fetus increased with fetal age at the second and third trimester, while the ratio of lymphocyte of fetus decreased with fetal age.