孕中晚期胎儿血细胞成分的研究

Study on components of blood cells in healthy human fetus from middle to late time of gestation

目的 建立孕周为19-37周各胎龄段的正常胎儿脐血血细胞成分的参考值范围，了解胎儿血细胞的生成情况，为产前和早产儿血液学疾病的诊断提供依据。方法 采用Coulter GENS system2型全自动血液分析仪检测182例胎儿血常规12项参数，并用显微镜人工镜检分类。结果 从19-37周WBC从3．58×10^9／L增加到5．76×10^9／L，随孕周的增加WBC是逐渐增加的，WBC分类结果显示以淋巴细胞为主，中性粒细胞较少，随孕周的增加，淋巴细胞逐渐减少，中性粒细胞逐渐增加，有核红细胞随孕周的增加而逐渐减少，单核细胞、嗜酸性粒细胞、嗜碱性粒细胞随孕周的变化不明显；RBC、HGB、HCT随着孕周的增加而逐渐增加，而MCV则是随着孕周的增加而逐渐减少，MCH、MCHC在各胎龄段之间的差异无统计学意义；PLT在各胎龄段之间的变化不明显，基本维持在210×10^9／L的水平，PDW、MPV、PCT在各胎龄段之间差异亦无统计学意义。结论 胎儿脐血血细胞成分处在一个动态的变化过程中，建立不同胎龄段胎儿脐血中血细胞成分的参考值范围有助于产前和早产儿疾病的诊断。

Objective To establish normal range of components of cord blood cells in healthy fetuses from 19 to 37 weeks＇gestation and to provide proof for diagnosis of hematological disorders in prenatal fetuses and premature infants. Methods Twelve hematological parameters were determined in 182 fetuses using Coulter GENS system 2 full automated blood cell counter, and the blood ceils were classified by microscope. Results The number of white blood cell （WBC） was increased gradually from 3.58×10^9/L to 5. 76×10^9/L with the gestational weeks increasing from 19 to 37 weeks. The differential counts indicated that the lymphocytes represented the main population. The number of lymphocytes and normoblast was decreased gradually and that of neutrophils was increased gradually. The numbers of monocytes, eosinophils and basophils remained stable as the increasing of gestational weeks. The red blood cell （RBC）, hemoglobin （HGB） and hematocrit （HCT） were increased gradually but mean corpuscular volume （MCV） was decreased. The differences between mean corpuscular hemoglobin （MCH）, plateiet volume distribution width （PDW） , mean platelet volume （MPV） , plateletcrit （PCT） and mean corpuscular hemoglobin concentration （MCHC） were not significant among different fetuses＇ages. Conclusion The components of cord blood cells in healthy fetuses are dynamic and the establishment normal range of components of cord blood cells in healthy fetuses is helpful to diagnose the disorders in prenatal fetuses and premature infants.