北京地区儿童血清金属元素钙、镁、锌、铁和铜参考区间的建立

Establishment of reference ranges of metallic elements Ca,Mg,Fe,Zn and Cu in serum of children in Beijing

目的建立北京地区健康儿童血清金属元素钙(Ca)、镁(Mg)、铁(Fe)、锌(Zn)和铜(Cu)的参考区间,为预防儿童金属元素缺乏、过量及合理补充提供科学依据。方法选取2019年1月至12月于首都儿科研究所附属儿童医院保健科健康体检的6510例0.5~10岁儿童为研究对象,采用电感耦合等离子色谱法(ICP^MS)测定儿童血清Ca、Mg、Fe、Zn和Cu金属元素的水平,按年龄分组比较并采用百分位数法(P2.5~P97.5)建立各年龄组儿童金属元素的参考区间。结果各年龄组儿童血清Ca、Mg、Fe、Zn、Cu 5种元素的水平均有显著性差异(F/χ^2值分别为53.157、207.366、50.664、57.522、136.913,均P<0.01),其参考区间(mg/L)分别为:0.5~<1岁组83.25~109.5、17.60~25.45、322.00~1561.10、500.95~1122.90、616.00~1547.05;1~<2岁组82.00~108.81、16.60~24.60、381.88~1715.50、519.75~1116.13、714.63~1606.13;2~<3岁组81.40~107.03、16.40~23.93、513.75~1794.75、517.75~1121.75、737.75~1543.75;3~<4岁组80.38~106.00、16.16~23.52、470.70~1815.85、519.10~1163.45、763.33~1644.25;4~<5岁组78.99~106.21、16.10~23.70、466.70~1775.55、529.90~1091.80、717.65~1591.65;5~<6岁组80.41~107.60、16.11~23.50、488.80~1760.95、531.25~1120.95、728.45~1564.95;6~<7岁组80.40~106.09、15.85~23.45、463.00~1919.90、555.53~1154.43、690.10~1557.28;7~<10岁组80.00~106.20、16.06~23.00、549.65~1794.45、529.75~1158.40、669.55~1488.35。结论北京地区儿童血清Ca、Mg、Fe、Zn、Cu水平存在年龄差异,各地区在确定金属元素参考值范围时应综合考虑年龄、地域等因素。

Objective To establish reference ranges of metallic elements calcium(Ca),magnesium(Mg),ferrum(Fe),zinc(Zn)and cuprum(Cu)in serum of healthy children in Beijing city,so as to provide scientific basis for preventing deficiency,overdose and reasonable supplement in daily intake.Methods A total of 6510 healthy children aged 0.5~10 years who received regular physical examination in Department of Child Health,The Affiliated Children’s Hospital,Capital Institute of Pediatrics,Beijing from January to December 2019 were enrolled in this study.The serum levels of Ca,Mg,Fe,Zn and Cu were detected in inductively coupled plasma^mass spectrometer(ICP^MS)method,and the levels were compared among different age groups.The reference intervals of the metallic elements in serum of the children in different age groups were established by percentile method(P2.5~P97.5).Results There were significant differences in serum levels of Ca,Mg,Fe,Zn and Cu among different age groups(F/χ^2=53.157,207.366,50.664,57.522 and 136.913 respectively,all P<0.01).The normal reference intervals of serum levels of Ca,Mg,Fe,Zn and Cu(mg/L)in different age groups were as follows respectively:83.25~109.5,17.60~25.45,322.00~1561.10,500.95~1122.90 and 616.00~1547.05 in 0.5~<1 year old group;82.00~108.81,16.60~24.60,381.88~1715.50,519.75~1116.13 and 714.63~1606.13 in 1~<2 years old group;81.40~107.03,16.40~23.93,513.75~1794.75,517.75~1121.75 and 737.75~1543.75 in 2~<3 years old group;80.38~106.00,16.16~23.52,470.70~1815.85,519.10~1163.45,763.33~1644.25 in 3~<4 years old group;78.99~106.21,16.10~23.70,466.70~1775.55,529.90~1091.80 and 717.65~1591.65 in 4~<5 years old group;80.41~107.60,16.11~23.50,488.80~1760.95,531.25~1120.95 and 728.45~1564.95 in 5~<6 years old group;80.40~106.09,15.85~23.45,463.00~1919.90,555.53~1154.43 and 690.10~1557.28 in 6~<7 years old group;80.00~106.20,16.06~23.00,549.65~1794.45,529.75~1158.40 and 669.55~1488.35 in 7~<10 years old group.Conclusion There are age differences in serum levels of Ca,Mg,Fe,Zn and Cu of the children in Beijing.Age and regional factors should be taken into account when determining the reference ranges of metallic elements in different regions.