基于干式化学法建立深圳地区3月龄至18岁健康儿童青少年心肌酶谱参考区间值

Investigation of myocardial enzymes reference intervals in pediatric population based on dry chemical system

目的 建立深圳地区3月龄至18岁健康人群干式化学法血清乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）和天冬氨酸氨基转移酶（AST）的参考区问值。方法 根据儿童青少年生长发育规律分为3月龄至3岁、～6岁、～12岁和～18岁组。标本来源为健康体检常规检测后的剩余血标本。采用美国强生公司VITROS350干式化学分析仪检测血清LDH、CK、CK-MB和AST水平，比较不同年龄组和不同性别问的差异，并建立4项指标在3月龄至18岁不同年龄组中的参考区间值。薯囊2345名儿童青少年合格标本进入本文分析，男1346名，女999名。3月龄至3岁组187名，～6岁组918名，～12岁组916名，～18岁组324名。①～6岁组CK，～12岁组CK、AST，～18岁组CK、AST、CK-MB男、女童问检测结果差异均有统计学意义（P均〈0．05），均为男童高于女童，其他指标男、女童问检测结果差异均无统计学意义（P均〉0．05）。4项指标在不同年龄组问检测结果差异均有统计学意义（P均〈0．05），两两比较3月龄至3岁组与～18岁组CK、3月龄至3岁组与～6岁组CK-MB、3月龄至3岁组与～6岁组AST检测结果差异无统计学意义（P均〉0．05），其他各组问两两比较均有统计学意义（P均〈0．05）。②4项指标检测结果均与年龄呈负相关。⑧LDH参考区问值（U·L^-1）：3月龄至3岁504～896，3～12岁491～790，12～18岁342～716。CK参考区间值（U·L^-1）：3月龄至12岁50～226，12～18岁男童47～256，12～18岁女童34～235。CK—MB参考区问值（u·L^-1）：3月龄至6岁18～44，6～12岁7～35，12～18岁7～28。AST参考区问值（U·L^-1）：3月龄至3岁23～60，3～12岁24～47，12～18岁17～47。结论 干式化学法建立的深圳地区3月龄至18岁健康儿童青少年心肌酶谱的参考区问值有其独特性，均与年龄呈负相关，与国内外报道和厂家说明书有差异。

Objective To establish the reference intervals of lactate dehydrogenase( LDH),creatine kinase( CK),creatine kinase MB( CK-MB) and aspartate aminotransferase( AST) based on dry chemical system in healthy pediatric population aged from 3 months to 18 years in Shenzhen. M ethods Healthy pediatric population aged from 3 months to 18 years were divided into four groups by age according to the rule of growth and development: 3 months to 3 years,- 6 years,- 12 years and- 18 years age groups. The serum samples were from the remaining specimens of routine physical examination after routine testing. Serum LDH,CK,CK-MB and AST were detected by the VITROS 350 system,and the differences between different age groups and different genders were compared and the reference intervals of 4 items among healthy children and adolescents aged from 3 months to 18 years were established. Results A total of 2 345 qualified specimens from children and adolescents were recruited,including 1346 males and 999 females,with 187,918,916 and 324 subjects for 3 months to 3 years,- 6 years,- 12 years and- 18 years age groups.1 The reference intervals of LDH showed no significant difference between boys and girls( P > 0. 05),but the CK of- 6 years boys,CK,AST of- 12 years boys,CK,AST,CK-MB of- 18 years old boys were significantly higher than those in girls( P < 0. 05). 2 The 4 items showed significant differences in different age groups( P < 0. 05),but the CK showed no significant difference between 3 months to 3 years group and- 18 years group,the CK-MB showed no significant difference between 3 months to 3 years group and- 6 years group,the AST showed no significant difference between- 6 years group and- 12 years group( P > 0. 05). The reference intervals of serum LDH( U·L- 1) : 3 months to 3 years 504- 896,3- 12 years 491- 790,12- 18 years 342- 716; reference intervals of CK( U·L- 1) : 3 months to 12 years 50- 226,12- 18 years 47- 256( male),34- 235( female); reference intervals of CK-MB( U·L- 1) : 3 months to 6 years 18- 44,6- 12 years 7- 35,12- 18 years 7- 35;reference intervals of AST( U·L- 1) : 3 months to 3 years 23- 60,3- 12 years 24- 27,12- 18 years 17- 47 U·L- 1. 3The reference intervals of 4 items overall decrease with age. Conclusion Dry chemical system of minor myocardial enzymes reference intervals are unique and significantly associated with the change of age.