吉林省2~14岁汉族儿童血清碱性磷酸酶参考区间的建立

Establishment of reference intervals of serum alkaline phosphatase for Han children aged 2-14 years in Jilin province

目的建立吉林省2~14岁汉族儿童血清碱性磷酸酶（ALP）的参考区间。方法使用日立7600-210全自动生化分析仪检测1 690名健康儿童（男835名,女855名）血清ALP。Dixon法弃离群值后,绘制分布图以判断资料是否服从正态分布。One-way ANOVA比较各地区不同组间差异及确定是否需性别、年龄分组。非参数方法计算参考值的2.5百分位数、50百分位数和97.5百分位数,计算其90%置信区间。结果吉林省2~11岁儿童ALP值无性别差异,12岁后逐渐出现性别差异。ALP水平在2~4岁儿童略低,5~10岁儿童升高并相对稳定。12~14岁女孩ALP水平逐渐下降,而同年龄段男孩依然上升并保持在较高水平。年龄、性别合并后的参考区间包括2~4岁、5~10岁、11岁、12岁（男）、13~14岁（男）、12岁（女）、13岁（女）及14岁（女）。结论建立各地区儿童年龄、性别相关的血清ALP参考区间对正确评估儿童发育及分析疾病状况具有重要意义。

Objective To establish the reference intervals of serum alkaline phosphatase （ALP） for Han children aged 2-14 years old in Jilin province. Methods A total of 1 690 healthy children （835 males and 855 females） were detected serum ALP level by the Hitachi 7600-210 automatic biochemical analyzer. After excluding the outlier data by using Dixon method, the distribution chart was drawn for judging the data whether conforming to the normal distribution. The one-way ANOVA was used to compare the differences among different groups in various areas and whether needing to grouping by gender and age. The 2.5,50,97.5 per- centiles of ALP were calculated by non-parametric method and 90% confidence intervals were calculated by R language 3.1. Results The serum ALP values had no statistically significant difference between genders among children aged 2--11 years old in Jilin province. The gender difference was gradually appeared over 12 years old. The ALP level was slightly lower in the children aged 2 4 years old,which in the children aged 5--10 years old was increased and relatively stable. The ALP level in the girls aged 12--14 years old was gradually decreased,while which in the boys with the same age was still increased and maintained the higher level. The combined reference intervals of serum ALP included 2-- 4 years old, 5 -- 10 years old, 11 years old, 12 years old （boys）, 13 - 14 years old （boys） ,12 years old （girls） ,13 years old （girls） and 14 years old （girls）. Conclusion The establishment of serum ALP reference interval has an important significance for correctly evaluating the child development and analyzing the disease status.