北京地区儿童肾功能生化项目参考区间调查

目的调查北京地区健康儿童肾功能常规生化检测项目参考区间,建立儿童肾功能生化指标评价标准。方法采用Olympus2700全自动生化分析仪对548例3～14岁北京地区健康体检儿童血清进行尿素、肌酐、尿酸、胱抑素C、总蛋白和清蛋白项目的检测。应用SPSS软件对资料进行年龄、性别分组的正态性检验和比较,依据近期发布的卫生行业标准WS／T402-2012建立以上项目北京地区儿童参考区间。结果03～14岁男孩尿素参考区间为4．21±1．02mmol／L,女孩为3．91±1．67mmol／L。②儿童肌酐测定值存在年龄、性别差异,其中3～6岁儿童参考区间为35．43±7．80μmol／L;7～14岁男孩为44．37土12．21μmol／L,女孩为42．58±10．45μmol／L。③3～6岁儿童尿酸、总蛋白和清蛋白的参考区间分别为277．04±110．49μmol／L,69．34±6．78g／L和44．24±3．68g／L,7～14岁儿童尿酸、总蛋白和清蛋白的参考区间分别为305．24±120．52μmol／L,73．21士7．76g／L和45．22±3．86g／L。④3～14岁儿童胱抑素C测定值不存在年龄、性别差异,其参考区间为0．51～1．12mg／L。结论儿童肾功能常规生化检测项目的参考区间与成人存在差异,儿童医院实验室应建立使用儿童参考区间。儿童肾功能常规生化检测项目参考区间的建立要考虑年龄、性别差异。     

Platelet Parameters in Healthy and Pathological Pregnancy

Changes in platelet count (PLT) are very important during pregnancy. Many platelet disorders occur during pregnancy and a reduction in PLT is the most common hemostasis abnormality identified, and this has important implications for mother and foetus. Many of these disorders share clinical and laboratory features, making accurate diagnosis difficult. The aim of this study was to establish reference intervals of platelet parameters for some of the more important pathologies associated to pregnancy (pre‐eclampsia, gestational diabetes, autoimmune disorders, viral infections) using the automated hematology analyzer Sysmex XE‐2100 and to evaluate the difference between healthy and pathological pregnancy. We enrolled in our study 100 pregnant women in the third trimester of pregnancy. The parameters analyzed included PLT, platelet distribution width, and mean platelet volume (MPV). We found statistically significant difference in PLT in pre‐eclampsia, autoimmune disorders, and viral infections. Our results demonstrated also a statistically significant difference in MPV in pre‐eclampsia and gestational diabetes. Our results allow the clinicians to detect hematologic change by simple complete blood count useful for the management of the pathological pregnancies. In conclusion, the overall picture of platelet disorders is extremely variegated, leading to numerous diagnostic and therapeutic problems whose solutions require close collaboration between clinicians and laboratory specialists.     

儿童血小板参数参考范围的调查与分析

【目的】调查正常儿童血小板各项参数的参考范围,为临床诊断提供参考。【方法】采用日本SySmex XS-800i全自动五分类血细胞分析仪检测2102名年龄1-12岁正常儿童手指血常规,对检测结果中的血小板数量（PLT）、血小板平均体积（MPV）、血小板平均分布宽度（PDW）和血小板比容（PCT）进行统计分析。【结果】1～3岁儿童PLT和MPV参考范围分别是155-480×10^9／L和5．5～10．3fl,3～12岁儿童PLT和MPV参考范围分别是149～449×10^9／L和5．5～10．3fl;1～12岁儿童PDW和PCT参考范围分别是11．2～19．8f1和0．12％～0．36％;儿童血小板参数参考范围与性别无关,与年龄有关。【结论】不同年龄的正常儿童血小板参数范围存在着较大差异,应根据不同年龄段建立血小板参数参考范围。     

新疆地区维吾尔族和汉族血液淋巴细胞免疫表型参考值范围的调查

为了建立新疆维吾尔族和汉族健康成人血液淋巴细胞免疫表型分析参考值,并比较两民族在族别,性别等方面上是否存在差异,用单克隆抗体对75例维吾尔族和104例汉族健康成人外周血进行标记,用流式细胞术进行采集分析,读取数据并对比结果,应用SPSS11.0软件进行统计学分析。结果表明:新疆地区20-50岁的维吾尔族和汉族健康成人外周血淋巴细胞亚群参考值范围:总T细胞分别为(67.85±8.97)%和(69.98±10.14)%;辅助性T细胞分别为(36.86±5.74)%和(40.07±6.10)%;抑制性T细胞分别为(26.67±6.15)%和(27.16±6.29)%;CD4/CD8比值分别为(1.46±0.47)和(1.56±0.47);NK细胞分别为(16.91±9.89)%和(12.81±7.34)%;B细胞分别为(10.09±3.33)%和(11.78±3.81)%;CD3+/HLA-DR+分别为(10.05±2.95)%和(11.27±4.98)%;CD25+细胞分别为(1.76±5.26)%和(4·10±4.30)%。两民族在辅助性T细胞水平、NK细胞、B细胞及CD25+细胞上的差异有统计学意义;维吾尔族健康人群的男性与女性在辅助性T细胞及CD4/CD8比值水平上的差异有统计学意义,而汉族男女性T细胞亚群的差别则见于抑制性T细胞和NK细胞水平;维吾尔族与汉族男性在辅助性T细胞及CD4/CD8比值上的差异有统计学意义,前者略低于后者;维吾尔族女性NK细胞显著高于汉族(P<0.01),而CD25+细胞水平较低(P<0.01)。结论:族别和性别因素可影响健康人淋巴细胞表型分布,本研究建立了新疆维吾尔族和汉族健康成人血液淋巴细胞免疫表型分布参考值,并查明两民族在族别、性别方面的差异。     

维族与汉族强直性脊柱炎患者炎性指标的差异性分析

目的初步探讨维族与汉族强直性脊柱炎患者炎性指标间的差异性。方法对49例维族和87例汉族强直性脊柱炎患者进行外周血炎性指标检测。结果分析显示维族和汉族AS患者性别构成存在统计学差异(x2=8.36,P=0.0038),维族患者男性比率(93.88%)明显高于汉族(73.56%),而不同年龄段性别构成均无统计学差异(x2维族=0.65,P=0.7214;x2汉族=3.38,P=0.1836);维族与汉族儿童青少年(20.41%,10.34%)和青壮年(67.35%,80.46%)患者比率均无统计学差异(x2=2.64,P=0.1041;x2=2.93,P=0.0868);血清超敏C反应蛋白(hsCRP)和CRP存在统计学显著性差异(thsCRP=2.36,P=0.0193;tCRP=4.08,P=0.0001),均表现为维族患者检测水平明显高于汉族,ASO检测水平在正常值范围内表现出维族患者高于汉族(t=8.13,P=0.0000)。白细胞计数(WBC)在正常值范围内民族间无差异(t=0.97,P=0.3323),而单核细胞水平(#MONO)维族患者明显高于汉族(t=2.23,P=0.0255),且其单核细胞升高...     

福州地区 0~3岁健康儿童外周血红细胞膜六项脂肪酸指标参考区间调查

目的　对福州地区 0～ 3岁健康儿童外周血红细胞膜中脂肪酸含量 6项指标的参考区间进行调查。方法　选取 2019年 3月～ 2020年 2月来福州儿童医院体检的 0~3岁健康儿童 60例,分别检测 omega-6多不饱和脂肪酸（ PUFA）总量（简称 omega-6）（包括亚油酸、γ -亚麻酸、二十碳二烯酸、二十碳三烯酸、花生四烯酸和二十二碳四烯酸）, omega-3 PUFA总量（简称 omega-3）（包括 α -亚麻酸、二十碳五烯酸、二十二碳五烯酸和二十二碳六烯酸）,单不饱和脂肪酸（ MUFA）总量（包括十六碳一烯酸、十八碳一烯酸、二十碳一烯酸和二十四一烯酸）,饱和脂肪酸（ SFA）总量（包括十四烷酸、十六烷酸、十八烷酸、二十烷酸、二十二烷酸和二十四烷酸）, omega-6/omega-3比值和 omega-3指数（即二十碳五烯酸与二十二碳六烯酸总和）共 6项目,含量以百分比（ %）为单位,用于初步调查生物参考区间,均采用 x±1.96s表示。结果　6项指标不同性别、不同年龄差异均无统计学意义 (P>0.05),初步建立 omega-6（25.43%~34.09%）,omega-3（7.03%~16.68%）,MUFA(14.02%~18.70%),SFA（38.95%~46.35%）,omega-6/omega-3（1.26~4.61）和 omega-3指数（ 4.62%~13.08%）六项指标参考区间。结论　种族、地域、性别、年龄及饮食结构的差异会影响六项目的参考区间,其不仅客观反映了人体内脂肪酸的分布状况,而且为 0~3岁健康儿童临床检测的结果提供参照;并为儿童补充 omega-3 PUFA提供科学依据,更为进一步建立中国健康人群 PUFA的参考区间打下基础。     

宝鸡地区甲状腺功能五项指标生物参考区间的调查

目的：调查宝鸡地区甲状腺功能五项指标（TSH,T3,T4,FT3和 FT4）的生物参考区间,为准确筛查及诊断甲状腺疾病提供依据。方法参照美国临床实验室标准化委员会（NCCLS）C28-A2文件中涉及到的有关参考区间定义,调查,验证的描述,采用罗氏Cobas E601电化学发光免疫分析仪及其配套试剂、标准品、质控品,对4820名健康人群的甲状腺功能五项指标进行检测,检测结果按性别差异进行统计学分析处理,确定各项指标的参考区间。并与第三版全国临床检验操作规程作比较。结果该地区甲状腺功能五项指标95％正常参考区间分别为男性：TSH 0.20～4.28 mIU／L,T31.22～2.46 nmol／L,T464.64～149.00 nmol／L,FT33.00～6.04 pmol／L和 FT411.93～22.21 pmol／L;女性：TSH 0.20～4.52 mIU／L,T31.24～2.44 nmol／L,T467.60～142.40 nmol／L,FT32.96～5.76 pmol／L和 FT411.86～21.54 pmol／L。男性TSH,FT3,FT4水平与女性相比较,差异具有统计学意义（t值分别为3.962,7.570,5.132,P 值分别为0.042,0.026,0.033）。男性T3,T4水平与女性相比较,差异无统计学意义（t值分别为0.000,1.151,P 值分别为1.000,0.120）。该地区结果与第三版全国临床检验操作规程相比较,男性 T3,T4,FT3和 FT4差异有统计学显著性意义（t值分别为9.755,4.349,114.7,79.82;P值分别为0.000,0.003,0.000,0.000）,女性 TSH,T3,FT3和 FT4差异亦有统计学显著性意义（t值分别为5.304,9.548,128.9,72.99;P值分别为0.002,0.000,0.000,0.000）。结论该地区罗氏 Cobas E601电化学发光免疫分析仪甲状腺功能五项指标生物参考区间的调查为临床诊疗工作提供了更准确的参考数据。     

呼伦贝尔地区蒙古族及汉族健康儿童静脉血血细胞参数参考区间的调查分析

目的确立内蒙古呼伦贝尔地区蒙古族、汉族健康儿童静脉血血细胞参数参考区间。方法使用日本Sysmex公司的XE-5000全自动血细胞分析仪检测698名7~13岁蒙古族、汉族健康儿童静脉血血细胞参数,按性别、民族进行统计分析,并与《全国临床检验操作规程(第4版)》及参考文献中其他民族的相同项目进行比较。结果呼伦贝尔地区蒙古族与汉族男童、女童血细胞参数差异均有统计学意义(P0.05);同民族不同性别健康儿童的大部分参数比较,差异有统计学意义(P0.05)。结论儿童血细胞参数随地域、民族、性别等不同而变化,确立不同地区、民族、性别健康儿童血细胞参数参考区间十分必要。     

血小板膜糖蛋白CD62P和CD63的检测方法及其在糖尿病患者中的表达

血小板a-颗粒膜蛋白(CD62P)和溶酶体膜蛋白(CD63)是血小板活化标志物,但血小板膜蛋白极不稳定,易活化,造成实验结果不可靠,为此应采用统-标准的检测方法.为探讨该目的并了解糖尿病患者血小板的活化情况,实验中采用全血单克隆抗体直接免疫荧光标记法和流式细胞术,对正常人及37例成人糖尿病患者进行了研究.正常人无固定组在标记后30,60,90和120分钟时,CD62P和CD63阳性率(%)分别为7.57±2.33,20.50±5.70,28.70±5.67,36.52±6.13及0.89±0.36,1.11±0.84,2.35±2.02,5.43±3.66,其相应点的平均荧光强度各自为1.57±0.13,1.88±0.08,2.00±0.09,2.38±0.22及3.91±0.11,4.07±0.16,4.38±0.14,4.44±0.19,二项均随检测时间推移逐渐升高,其中阳性率增高更加显著.而正常人多聚甲醛固定组CD62P和CD63在相同各时间点的阳性率和平均荧光强度基本相同,未出现明显变化.此外,37例成人糖尿病患者CD62P和CD63的阳性率分别为(14.11±6.68)%及(2.71±1.74)%,比相对正常对照组显著升高(P＜0.001,P＜0.05).由此可见,血小板CD62P和CD63非常敏感,在体外易受激活,采血后需立即标记,全部操作应在30分钟内完成,而多聚甲醛固定可抑制活化并稳定血小板标记复合物,使上机检测时间延长至2小时而对结果无影响.成人糖尿病患者心血管系统合并症可能与血小板活化有关.     

石家庄地区部分健康成人血清尿酸参考值调查分析

目的确定石家庄地区健康成人不同性别、不同年龄组的血清尿酸参考值范围。方法将1721例自20～60岁每间隔10岁男、女各分为一组,60岁以上者分为男、女两组,每组至少120例 将〈50岁的各年龄组视为青壮年,〉50岁年龄组视为中老年。均采用罗氏全自动生化分析仪检测血清尿酸浓度。结果本调查研究中男、女血清尿酸浓度均呈正态分布,经统计学分析表明,同年龄组男性和女性血清尿酸浓度比较差异有统计学意义（P〈0.001） 男性、女性青壮年组与中老年组血清尿酸浓度比较差异亦有统计学意义（P〈0.001）。男性除20～29年龄组外,各年龄组均数与男性总体均数之间比较差异无统计学意义（t=2.082,P=0.039 t=0.570,P=0.5790 t=0.156,P=0.876 t=-1.976,P=0.050 t=0.793,P=0.429） 女性除20～29年龄组外,各年龄组均数与总体均数比较差异均有统计学意义（t=-2.065,P=0.002 t=-3.188,P=0.002 t=2.859,P=0.005 t=4.514,P〈0.001）。结论血清尿酸浓度水平与年龄、性别有关,石家庄地区健康成人血清尿酸值有逐渐上升趋势,与现用正常参考值区间有一定差别,各实验室有必要建立自己的血清尿酸正常参考值区间并以此作为诊断的标准。     

Human platelet antigen allele frequencies and new mutations on platelet glycoprotein genes in the Chinese Han population

Background and Objectives: The frequencies of human platelet antigens (HPAs) vary between different populations. In this study, we determined the HPA allele frequencies in the Chinese Han population and identified situation of incompatibility possibly leading to alloimmunisation. Methods: A total of 750 volunteer blood donors of the Chinese Han population were genotyped for HPA‐1 to ‐17w systems. HPA genotyping was determined by polymerase chain reaction sequence‐based typing. Results: Among the 17 HPA systems, the allele frequency is different from other populations. We noted the absence of HPA‐7bw to HPA‐14bw, HPA‐16bw and HPA‐17bw alleles in the population. The estimated incompatibility probabilities regarding platelet antigens 1 to 6w and 15 systems after transfusion of random donor platelet were from 0·004 to 0·373. Thirteen glycoprotein alleles were observed in the population. In addition, we identified 16 novel mutations on the glycoprotein genes separated from HPA polymorphisms, including GP1BA (517‐525delAAC), ITGA2B (2722C>T and IVS26+85T>C), ITGA2 (1521C>T, 2474T>G and IVS20+10 G>C), ITGB3 (1476G>A, IVS10+19C>A, 1813G>A, IVS11+21G>A, IVS11+152A>G and IVS11‐104T>C), GP1BB (IVS1‐79G>A, IVS1‐27C>T and 129G>A) and CD109 (2139A>G). Five of them could lead to amino acid deletion, substitution or premature stop codon in corresponding glycoprotein. Conclusions: There was a high degree of polymorphism of the membrane glycoprotein genes related to human platelet alloantigen‐1 to ‐17w systems in the Chinese Han population. These data could have some impact on the diagnosis, prevention and treatment of alloimmune thrombocytopenia.     

广州地区1688例正常儿童静脉血血小板参数参考范围调查

目的建立广州地区正常儿童静脉血血小板5项参数即PLT、MPV、PCT、PDW、P-LCR的正常参考范围。方法应用日本东亚公司的sysmex2100全自动血细胞分析仪采用仪器自动吸样的方式对居住在广州地区的1 688名正常儿童的静脉血血小板五项参数进行检测分析,并与国内部分报道结果进行比较。结果血小板五项参数的参考范围中PLT和PCT存在性别差异（P〈0.05）,男性参考范围为：PLT（174.66~406.30）×1012/L、PCT 0.156%~0.384%;女性参考范围为：PLT（125.49~425.05）×1012/L、PCT 0.134%~0.386%。其余指标参考范围为：MPV 6.9~12.1 fl,PDW 8.54%~17.98%、P-LCR 12.46%~40.54%。结论广州地区儿童女性PLT和PCT均值均低于男性,同性别各年龄阶段的指标也部分存在差异,4~8岁年龄段的血小板数为最高。     

Platelet microparticles and soluble P selectin in peripheral artery disease: Relationship to extent of disease and platelet activation markers

Background. There is increased platelet activation in many cardiovascular diseases. This observation may explain the presence of increased levels of platelet microparticles (PMP) in these diseases. However, whether or not levels of PMPs inter‐relate with other markers of platelet activation, such as soluble P‐selectin, or with disease severity, is unknown. We therefore hypothesized raised PMP levels in stable peripheral artery disease (PAD) intermittent claudication (IC), with an additional increase in severe PAD critical limb ischaemia (CLI). Furthermore, we tested the hypothesis that PMP levels are correlated with other markers of platelet activation, such as soluble P‐selectin, membrane bound P‐selectin (CD62P) and CD63.

Methods. Patients with PAD were recruited from the vascular outpatient and inpatient facilities at a teaching hospital. Age‐ and sex‐matched controls were also recruited from healthy volunteers. Venous blood was obtained from 23 patients with severe disease (CLI), 36 with moderate disease (IC), and from 30 healthy controls. The percentage of platelets positive for CD62P and CD63, as well as the numbers of PMPs were defined by flow cytometry. Plasma soluble P selectin was measured by enzyme‐linked immunosorbent assay (ELISA).

Results. PMPs were increased relative to healthy controls in patients with IC, with a further increase in CLI (P<0.001). Soluble P selectin and CD62+ve platelets were raised in both patient groups, but there was no difference amongst the two patient groups. CD63+ve cells were raised only in CLI compared to healthy controls. In multivariate analysis, only PMP and soluble P selectin independently predicted disease severity, and the two markers correlated modestly (r?=?0.345, P<0.001).

Conclusion. Increased PMP and soluble P selectin are both related to the severity of symptomatic PAD. However, it is uncertain if this relationship is a cause or effect of atherosclerosis. This finding may have clinical implications as PMPs have the potential to influence the progression of atheroma as well as promote thrombosis.     

新疆汉族人群血小板抗原1—5、15系统基因多态性分析

目的调查研究与血小板输注无效关系密切的人类血小板抗原(human platelet antigen,HPA)1—5及15系统基因在新疆汉族人群中的遗传多态性。方法采用聚合酶链-序列特异性引物(PCR-SSP)法对101例无血缘关系的新疆汉族血样进行HPA基因分型。结果新疆汉族HPA-1a、2a、3a、4a、5a、15a基因频率分别是0.9851、0.9208、0.5446、1、0.9505、0.4653,HPA-1b、2b、3b、4b、5b、15b基因频率分别是0.0149、0.0792、0.4554、0、0.0495、0.5347,新疆汉族HPA基因频率与维吾尔族人群相比,HPA-1a、1b基因频率差异具有统计学意义(P<0.05)。结论HPA-1、2、3、5、15系统均具有多态性,HPA-3、15系统具有高度多态性。