红细胞参数的变化对铅中毒患儿的临床诊断意义

Clinical Diagnostic Value of Variation of Red Blood Cell Parameters in Children with Lead Poisoning

目的探讨红细胞参数的变化对慢性铅中毒患儿的临床诊断意义。方法根据临床诊断将375例儿童分为3组,其中正常对照组152例,高铅血症组131例,慢性铅中毒组92例。对比分析上述3组儿童的红细胞参数。结果 3组儿童红细胞计数(RBC)、血红蛋白浓度(Hb)、红细胞压积(Hct)、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)的均数不全相等;正常对照组的RBC、Hb、Hct显著高于高铅血症组(P<0.05),高铅血症组的RBC、Hb、Hct显著高于慢性铅中毒组(P<0.05);正常对照组与高铅血症组的MCV、MCH、MCHC相比差异无统计学意义(P>0.05),慢性铅中毒组的MCV、MCH、MCHC显著低于正常对照组与高铅血症组(P<0.05)。结论慢性铅中毒可以导致患儿的红细胞参数包括RBC、Hb、Hct、MCV、MCH、MCHC等不同程度降低,MCV、MCH、MCHC的测定有助于鉴别诊断高铅血症与慢性铅中毒。

Objective To explore the clinical diagnostic significance of variation of red blood cell parameters in children with chronic lead poisoning. Methods According to the clinical diagnoses, 375 children were divided into the normal group （n= 152）, the high blood lead level group （n= 131）, and the chronic lead poisoning group （n= 92）. And the blood cell parame- ters were compared among the three groups. Results There were significant differences in red blood cell counting （RBC）, hemoglobin concentration （Hb）, hematocrit （Hct）, mean corpuscular volume （MCV）, mean corpuscular hemoglobin （MCH）, and mean corpuscular hemoglobin concentration （MCHC） among the three groups. RBC, Hb, and Hct of the normal group were significantly higher than those of the high blood lead level group （P〈0.05）, while RBC, Hb, and Hct of the high blood lead level group were significantly higher than those of the chronic lead poisoning group （P 〈 0.05）. There was no statistically significant difference in MCV, MCH, and MCHC between the normal group and the high blood lead level group （ P 〉 0.05）, but MCV, MCH, and MCHC of the chronic lead poisoning group were significantly lower than those of the normal group and the high blood lead level group （P 〈 0.05）. Conclusions The red blood cell parameters, including RBC, Hb, Hct, MCV, MCH, and MCHC decrease differently as a result of chronic lead poisoning. Determination of MCV, MCH, and MCHC is conducive to differential diagnosis of high blood lead level and chronic lead poisoning.