中国老年健康人群血常规检测结果多中心调查

A multi-center survey of blood routine examination in apparently healthy elderly population in China

目的根据全国多地区临床中心调查结果,分析我国表观健康老年人群全血常规检测相关参数分布特点,探讨血常规指标水平随年龄变化的特点,了解中国老年人血常规检测常用项目的分布水平。方法 2018年4-7月,纳入全国10家临床中心医院年龄≥60岁表观健康老年人共7 613名,其中60~69岁3 808名,70~79岁2 222名、≥80岁1 133名,采用日本Sysmex公司自动化全血细胞分析仪对纳入对象进行全血细胞分析及血细胞涂片显微镜检查,采用秩和检验、单因素方差分析和独立样本t检验比较各年龄段的结果以及不同性别间的差异,以各指标调查值的P2.5~P97.5为人群分布水平。结果 (1)老年人群随年龄增加,红细胞计数、血红蛋白、红细胞比容降低,平均红细胞体积增加(P<0.05)。各年龄段贫血比例男性高于女性(χ2=108.074,P<0.001):60~69岁男性为1.47%(31/2 102),女性为1.00%(17/1 706);70~79岁,男性为2.18%(30/1 376),女性为1.65%(14/846);年龄≥80岁男性为7.06%(55/779),女性为6.21%(22/354)。(2)白细胞总数未见随年龄变化特征;随着年龄增加,白细胞分类计数可见中性粒细胞增加,淋巴细胞减少,单核细胞增加(P均<0.05)。(3)随着年龄的增加,血小板计数下降(P<0.05)。获得≥60岁老年表观健康人群血常规检测常用项目的分布水平,部分项目如红细胞计数、血红蛋白、红细胞比容、平均红细胞体积、中性粒细胞百分数、淋巴细胞百分数、单核细胞百分数和血小板计数与国家行业标准发布的中国成年人血细胞分析参考区间存在一定的差异。结论血常规检测指标有一定的随年龄变化特点,而老年表观健康人群血常规检测常用项目的分布水平与成年人参考区间存在一定的差异,老年人群在疾病诊治和慢病管理时需关注此特点,建立中国老年人群的血常规参考区间将有利于临床诊断和治疗。

Objective To analyze the distribution levels of complete blood count parameters of apparently healthy elderly population in China,and explore the correlation between blood count parameters and age based on data derived from 7613 participants.Method A total of 7613 apparent healthy elderly people aged over 60 years were recruited from 10 clinical centers across China between April to July 2018.There were 3808 participants aged between 60 and 69 years,2222 aged between 70 and 79 years,and 1133 aged≥80 years.Blood routine examination was performed using automated complete blood analyzer of Sysmex company and blood smear microscopic examination were conducted by experienced clinical laboratory technician.Rank sum test,one-way ANOVA and t test were used to compare the results of different age groups(60-69,70-79,≥80 years)and the differences between genders.The 2.5 percentiles and 97.5 percentiles of each parameter were taken as the distribution levels of the population.Results(1)Red blood cell count(RBC),hemoglobin(Hb),hematocrit(Hct)reduced and mean corpuscular volume(MCV)increased with increasing age(P<0.05).The count of red blood cells and hemoglobin levels decreased slightly in women than men(P<0.05).The proportion of anemia in men is higher than in women in all age groups(1.47%(31/2102)vs 1.00%(17/1706)in 60-69 years old,2.18%(30/1376)vs 1.65%(14/846)in 70-79 years,7.06%(55/779)vs 6.21%(22/354)in age≥80 years group;χ2=108.074,P<0.001).(2)The white blood cell count was similar among various age groups.Neutrophil and monocyte percentage increased(P<0.05),and lymphocytes decreased with increasing age(P<0.05).(3)Platelets count(PLT)decreased with aging(P<0.01).There is a certain difference in the distribution level of common items such as RBC,Hb,Hct,MCV,neutrophil percentage,lymphocyte percentage,monocyte percentage,and PLT count between elderly apparent healthy people(over 60 years)and the reference interval for blood cell analysis of Chinese adults issued by national industry standards.Conclusion There are some differences between the distribution levels of apparent elderly healthy people(over 60 years)and the reference intervals commonly used in our country.More attentions should be paid to these differences in the diagnosis and treatment of disease and chronic disease management.Further studies are needed to determine the reference intervals of healthy elderly population in China,which would be helpful to clinical diagnosis and treatment in this population.