间接法建立长春地区儿童静脉血血细胞分析参考区间

Establishing reference intervals for venous blood cell analysis in children of Changchun by indirect method

目的运用间接法建立长春地区健康儿童静脉血血细胞分析参考区间。方法收集2013年1月至2020年12月该院实验室信息系统(LIS)中1个月至18岁健康儿童静脉血血细胞分析检测结果。采用Kolmogorov-Sminov检验分析数据正态性;采用箱式图与茎叶图法剔除离群值;采用Kruskal-Wallis H检验和Mann-Whitney U检验分别比较各年龄段及性别间差异;采用非参数法计算P_(2.5)、P_(97.5)作为参考区间上下限。结果剔除离群值后共纳入2961例研究对象,所有血细胞分析项目均有年龄差异。除中性粒细胞绝对值外,其余血细胞分析项目在部分年龄段有性别差异。白细胞计数、单核细胞绝对值、嗜酸性粒细胞绝对值、嗜碱性粒细胞绝对值、血小板计数随年龄增长呈较缓下降趋势。中性粒细胞绝对值在1个月至<3岁明显上升,6岁后趋于平缓。淋巴细胞绝对值在1个月至<8岁明显下降,8岁后缓慢下降。红细胞计数、血红蛋白、血细胞比容随年龄增长明显上升,且红细胞计数在1~18岁、血红蛋白在8~18岁、血细胞比容在13~18岁均呈现性别差异,男性均高于女性。平均红细胞体积、平均红细胞血红蛋白含量随年龄增长呈较缓上升趋势。结论该研究使用间接法建立了儿童静脉血血细胞分析参考区间。间接法简单易行,为实验室参考区间的建立提供了适宜途径。

Objective To establish the reference intervals for venous blood cell analysis in children of Changchun by indirect method.Methods The data were extracted from the healthy children aged from 1 month to 18 years old in the the laboratory information system(LIS)of the First Hospital of Jilin University from January 2013 to December 2020.Kolmogorov-Sminov test was used to detect the normality of data.The outliers were identified and eliminated by Box Plots and Stem-and-Leaf Plots.Kruskal-Wallis H test and Mann-Whitney U test were applied for determination of age and sex partition.P_(2.5) and P_(97.5)percentiles were calculated as the upper and lower limits of the reference interval by non-parametric method.Results A total of 2961 healthy children were enrolled in the study.All items showed significant difference among different age groups.The significant differences between different sexes showed in some age groups except NEUT#.WBC,MO#,EO#,BASO#and PLT showed slow decreasing trend with age.NEUT#increased significantly from 1 month to<3 years old,and leveled off after 6 years old.LYMPH#decreased obviously from 1 month to<8 years old,and decreased slowly after 8 years old.RBC,Hb and HCT showed an obvious upward trend with age,and RBC,Hb and HCT showed significant sex differences from 1 to 18 years old,from 8 to 18 years old and from 13 to 18 years old respectively,which were higher in men than in women.MCV and MCH increased slowly with age.Conclusion This study confirms the feasibility and reliability of the indirect method to establish the reference intervals for venous blood cell analysis in children,which is applicable to a wild range of clinical laboratories,and provides a more appropriate way to establish or verify the reference intervals.