儿童血铅与红细胞、网织红细胞多参数相关性研究

Research on the correlation between blood lead and red blood cell with reticulocyte multiple parameters in children

【目的】研究儿童血铅与红细胞、网织红细胞多参数的变化,探讨铅对儿童血液系统的影响。【方法】收集136例健康儿童和279例铅中毒患儿临床资料,用原子吸光谱仪检测儿童的血铅含量;采用Sysmex XE-2000型全自动血细胞分析仪检测网织红细胞等血常规参数。【结果】轻度中毒组,网织红细胞未成熟指数(IRF%)、高荧光度网织红细胞(HFR%)、中荧光度网织红细胞(MFR%)均高于对照组(P<0.05),而低荧光度网织红细胞(LFR%)低于对照组(P<0.05),而血红细胞(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、红细胞平均容积(MCV)、红细胞平均血红蛋白量(MCH)、红细胞平均血红蛋白浓度(MCHC),与对照组相比较差异无显著性(P>0.05)。中度铅中毒组,RET%、IRF%、HFR%、MFR%都高于对照组(P<0.05),而LFR%低于对照组(P<0.05),RBC、HGB、HCT都低于对照组(P<0.05)。【结论】铅中毒对儿童血液系统有很大的影响,网织红细胞参数变化较红细胞参数发生较早,观察网织红细胞多参数的变化能及早发现铅中毒对血液系统的影响。

[Objective] To investigate the correlation between red blood cell,reticulocyte multiple parameters and blood lead in children. [Methods] Blood lead levels were tested by atomic absorption spectrographic method. Blood cell and reticulocyte parameters were measured by automated hematology analyzer Sysmex XE-2000 in healthy and lead poisoning children. [Results] In slight lead poisoning group, reticululocyte（RET）, High fluorescence reticululocyte（HFR）, middle fluorescence reticululocyte（MFR ） were higher than those in healthy group（P〈0.01 ）,low fluorescence reticululocyte（LFR） was lower than that in normal group （P〈0. 01） ,There was no significaut difference in erythrocyte（RBC）,hemoglobin（HGB）,hematocrit （HCT）, mean corpuscular volume （MCV）, mean corpuscular hemoglobin （ MCH ） and mean corpuscular hemoglobin concentration（MCHC）. There was significant difference in RBC, HGB, HCT and RET,RIF, HFR, MFR,LFR between moderate lead poisming group and healthy group. [Conclusions] Reticuloeyte parameters can reflect the lead poisoning earlier than RBC parameters. Retieuloeyte parameters has important clinical value in diagnosing children ＇s lead poisoning.