唐山地区健康新生儿凝血结果正常参考范围的探讨

INVESTIGATE ON REFERENCE INTERVALS OF PT,APTT AND FIB OF HEALTHY NEWBORN IN TANGSHAN AREA

目的 建立唐山地区新生儿血浆凝血酶原时间（PT）,活化部分凝血活酶时间（APTT）和纤维蛋白原（FIB）的生物参考区间。方法 按照美国临床和实验室标准协会（CLSI）C28-A2推荐方法,选取2010年5月—2013年5月健康新生儿1 102例,按照性别不同分为男（584例）、女（518例）二组;根据不同民族分男（汉族548例,少数民族36例）、女（汉族495例,少数民族23例）二组,采用法国STAGO全自动血凝仪测定其PT,APTT,FIB,对检测结果进行比较分析。结果 经正态性检验,新生儿PT,APTT,FIB测定值均呈正态分布。经Z检验发现不同性别新生儿APTT分布差异有统计学意义（tAPTT=6.693,P〈0.05）,不同民族新生儿PT,APTT,FIB分布差异无统计学意义（t男=0.058~0.317,t女=0.049~0.317,P〉0.05）。各项指标的参考区间（P2.5~P97.5）如下：新生儿PT参考范围11.1~14.9s;APTT参考范围（男）29.9~62.6s,（女）30.6~63.4s;FIB的参考范围1.51~3.46 g/L。结论 初步建立唐山地区新生儿PT,APTT,FIB的生物参考区间,提高新生儿出血性疾病、凝血功能障碍、血液病诊治的准确性。

Objective To establish the biological reference intervals of plasma prothrombin time（PT）,activated partial thromboplastin time（APTT）and fibrinogen（FIB）of healthy newborn in Tangshan region in order to provide evidences for clinic.Methods According to the indirect sampling technique in Clinical and Laboratory Standards Institute（CLSI）C28-A2,the plasma samples of 1102 healthy newborn determined by STA-R system were collected.All subjects were divided into 2 groups（male 584;female 518）according to gender,and divided into 2 groups（Han nationality male 548;national minority male 36,Han nationality female 495;national minority female 23）according to nationality.Results There were obvious significance on APTT in different gender groups by Z-test（tAPTT=6.693,P〈0.05）,but the reference intervals of PT and FIB should be combined.There were not obvious significance of PT,APTT,FIB in different nationality groups（t男 =0.058~0.317;t女 = 0.049~0.317,P〉0.05）.The indicators（P2.5~P97.5）were showed as follows：PT11.1~14.9s;APTT29.9~62.6s（male）,30.6~63.4s（female）;FIB1.51~3.46g/L.Conclusion It is necessary to establish the biological reference intervals of PT,APTT and FIB for treatment and clinical diagnosis of newborn hemorrhagic disease.