健康老年人静脉全血细胞计数参考范围调查

Investigation on the reference range of venous whole blood cell counts in healthy elder people

目的调查健康老年人血细胞分析参数的参考范围。方法使用Sysmex XT-1800血液分析仪对395名健康老年人(男197名、女198名,年龄≥65岁)和188名对照者(年龄<65岁)进行全血细胞计数。项目包括白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均血红蛋白浓度(MCHC)、红细胞分布宽度(RDW)、血小板计数(PLT)、平均血小板体积(MPV)。结果健康老年组男性WBC、RBC、Hb、HCT、MCH、MCHC均高于女性(P<0.05、P<0.001),PLT低于女性(P<0.001),MCV、RDW、MPV男、女之间差异无统计学意义(P>0.05)。各项目参考范围分别为WBC:男性(4.10～9.81)×109/L,女性(4.14～8.94)×109/L;RBC:男性(3.68～5.13)×1012/L,女性(3.52～5.12)×109/L;Hb:男性119～161 g/L,女性113～147 g/L;HCT:男性34.0%～46.0%,女性33.0%～47.0%;MCV:84.0～99.3 fL;MCH:男性29.1～34.7 pg,女性27.7～33.7 pg;MCHC:男性334～366 g/L,女性328～360 g/L;RDW:12.0%～14.9%;PLT:男性(102～257)×109/L,女性(123～337)×109/L;MPV:7.7～12.1 fL。健康老年组男性RBC、Hb、HCT、MCH、MCHC、PLT和MPV参考范围与对照组男性比较差异有统计意义(P<0.05),而女性MCV、MCH、MCHC和MPV参考范围与对照组女性比较差异有统计意义(P<0.05)。健康老年组年龄与WBC、MCV、RDW呈正相关(r值分别为0.106、0.208、0.115,P均<0.05),与RBC、Hb、HCT、MCHC呈负相关(r值分别为-0.207、-0.200、-0.139、-0.238,P均<0.001),与MCH、PLT、MPV无相关性。结论健康老年人WBC高于一般成年人,红细胞参数中除RDW与年龄呈正相关外,多数参数均呈负相关。老年男性PLT出现数量减少、MPV增大等情况,均与现行的参考范围有明显差异。应针对老年人的特殊情况设定其相应的参考范围。

Objective To investigate a reference range of blood cell counts in healthy elder people.Methods An automated hematological analyzer（Sysmex XT-1800） was used to determine the parameters of venous whole blood cell counts,including white blood cell（WBC）,red blood cell（RBC）,hemoglobin（Hb）,hematocrit（HCT）,mean corpuscular volume（MCV）,mean corpuscular hemoglobin（MCH）,mean corpuscular hemoglobin concentration（MCHC）,red cell distribution width（RDW）,platelet（PLT） and mean platelet volume（MPV）.A total of 395 healthy elder people（197 males and 198 females ≥65 years old） and 188 controls 65 years old were enrolled.Results The WBC,RBC,Hb,HCT,MCH and MCHC in elder males were higher than those in elder females（P0.05,P0.001）.PLT in elder males was lower than that in elder females（P0.001）.The MCV,RDW and MPV had no statistical significance between males and females（P0.05）.The reference ranges of WBC were（4.10-9.81）×109/L in males and（4.14-8.94）×109/L in females,RBC：（3.68-5.13）×1012/L in males and（3.52-5.12）×109/L in females,Hb： 119-161 g/L in males and 113-147 g/L in females,HCT： 34.0%-46.0% in males and 33.0%-47.0% in females,MCV： 84.0-99.3 fL,MCH： 29.1-34.7 pg in males and 27.7-33.7 pg in females,MCHC： 334-366 g/L in males and 328-360 g/L in females,RDW： 12.0%-14.9%,PLT：（102-257）×109/L in males and（123-337）×109/L in females and MPV： 7.7-12.1 fL.The reference ranges of RBC,Hb,HCT,MCH,MCHC,PLT and MPV in elder males had statistical significance with the males in the control group（P0.05）.In elder females,the reference ranges of MCV,MCH,MCHC and MPV had statistical significance with the females in the control group（P0.05）.The age of elder people had the positive correlation with WBC,MCV and RDW（r=0.106,0.208 and 0.115,P0.05）,had the negative correlation with RBC,Hb,HCT and MCHC（r=-0.207,-0.200,-0.139 and-0.238,P0.001）,and had no correlation with MCH,PLT and MPV.Conclusions The WBC in the elder people is higher than that in the controls.Excluding RDW with positive correlation,the other parameters have negative correlations with age increasing.PLT in elder males decreases,and MPV increases.They are different with the current reference ranges.It is important to establish the reference range of venous whole blood cell counts in healthy elder people.