北京地区成人全血及血浆微量元素水平调查

目的 研究北京地区成人微量元素营养状况,探讨北京地区正常成人微量元素正常参考区间.方法 采集437名首都医科大学在校学生的血浆及全血标本,其中男233名,女204名,用原子吸收分光光度法检测铜(Cu)、锌(Zn)、钙(Ca)、镁(Mg)、铁(Fe)五种微量元素含量.结果 实验结果正常成人全血微量元素参考区间男、女间的差异有统计学意义.不同性别正常成人血浆标本微量元素Ca,Mg的参考区间差异无统计学意义,Cu,Zn,Fe男女间差异有统计学意义.而现有厂家提供的全血、血清参考区间未分男女,且与本次实验测定结果有一定差异.结论 微量元素异常可导致成人诱发多种临床常见疾病,因此应尽快建立不同地区成人全血、血浆或血清微量元素的参考区间.     

妊娠期女性全血微量元素结果分析及其参考区间建立

目的分析浙江省不同妊娠期女性全血微量元素结果,探讨并建立其参考区间。方法回顾性分析2015年1月至2016年9月杭州迪安医学检验中心共21 151份孕妇孕期常规体检的检测数据,按其妊娠时期的不同分为孕早、中、晚期组,同时将1 859例20~40岁的非妊娠健康体检女性作为对照组。统计不同孕期组受检者全血微量元素铜、锌、钙、镁、铁结果,并分析其与对照组的差异,必要时建立孕早、中、晚期组各元素的参考区间。结果铜元素孕早、中、晚期组与对照组,各孕期组之间结果差异有统计学意义(P0.05),且随妊娠时间出现生理性增高;与对照组比较,各孕期组锌元素均有不同程度的缺乏,孕早、中、晚期组缺乏率分别为5.6%、9.3%、5.0%;对照组铁元素与孕早期组的结果比较,差异无统计学意义(P=0.083),孕中、晚期组与对照组结果差异有统计学意义(P0.05)。厂家提供的参考区间不能满足临床需求。结论不同孕期孕妇微量元素存在不同程度的缺乏,备孕及孕期女性需要持续监测微量元素结果,必要时采取干预措施;对于铜元素宜分别建立各孕期参考区间作为补充依据;铁元素则建议以非妊娠期健康女性的数据建立参考区间作为补充依据。     

福建省泉州地区甲状腺抗体阴性孕妇不同孕期的甲状腺激素水平正常参考值的建立

目的建立福建省泉州地区甲状腺抗体阴性正常孕妇孕期前、中、后3个月间期甲状腺激素水平正常参考值范围。方法选取福建省泉州地区甲状腺抗体阴性孕4~39周妇女490例,应用电化学发光法检测其妊娠前、中、后3个月间期血清FT4、FT3、TSH、TPOAb水平,另选非孕期妇女51例作为对照,建立甲状腺抗体阴性妇女甲状腺激素水平正常参考值范围。结果不同孕期孕妇TPOAb中位数均在厂家提供参考区间内。其血清FT3、FT4水平在孕期前、中、后3个月呈逐渐降低(P<0.01);血清TSH水平自孕前期3个月至孕末期3个月呈逐渐升高(P<0.01);非孕期妇女甲状腺激素水平明显高于孕前期3个月水平(P<0.01),而低于孕中期和孕后期3个月水平(P<0.01)。在妊娠前、中、后3个月间期,泉州地区甲状腺抗体阴性正常孕妇FT3正常参考值范围分别为3.75~7.23、3.31~4.93和3.16~4.48 pmol/L;FT4分别为12.85~25.3、12.03~20.14和11.02~19.43 pmol/L;TSH分别为0.01~3.79、1.09~4.19和1.08~5.95 mU/L。结论通过本次测定,我们建立了泉州地区甲状腺抗体阴性甲状腺激素水平的孕期前、中、后3个月间期甲状腺激素正常参考值。     

天津市区正常妊娠妇女多种微量元素参考值的建立

[目的] 找出天津市区正常妊娠妇女在妊娠期体内铜、锌、钙、镁和铁5种微量元素含量的变化规律，建立正常妊娠妇女的5种微量元素参考值，并为群体保健工作提供科学参考依据，以便制订出指导干预措施，为确保提高母婴健康水平发挥应有作用。[方法] 采用微量法原子吸收分析技术，对天津市区1304名正常妊娠孕妇及100名非孕妇女进行铜、锌、钙、镁、铁5种微量元素的检测。[结果] 正常妊娠妇女血铜含量在孕早、中、晚期均高于非孕妇女（P〈0．001）；血锌和铁含垃在各孕周均低于非孕妇女（P〈0．001），血镁在孕中期时下降（P〈0．05），至孕晚期铁和镁略有升高；血钙含量在各孕周均低于非孕妇女（P〈0．001），在整个孕期变化不大。通过监测，得出天津市区正常妊娠妇女5种微量元素的参考值。[结论] 正常妊娠妇女与非孕妇女的微量元素含量有显著性差异，并在各个孕期有一定的变化规律。通过监测得到的天津市区5种微量元素的参考值可作为临床诊断的参考标准。     

四川遂宁地区学龄前儿童全血锌参考值范围调查

目的探讨四川遂宁地区学龄前儿童全血锌参考值范围。方法采用BH5300s原子吸收光谱法测定9 032例(男4 331例,女4 701例)在遂宁市中心医院进行锌含量检测的学龄前儿童(0~6岁),并对数据进行统计学分析处理。结果四川省遂宁地区学龄前儿童全血锌量元素的正常参考值范围是34.13~108.10μmol/L。结论本研究建立的学龄前儿童锌参考值范围与厂商提供的参考值范围有一定差距,但体现了本地区的实际学龄前儿童锌参考值范围,为本地学龄前儿童锌缺乏的临床诊断提供参考依据。     

810例末梢全血5种微量元素结果分析

目的 调查本地区婴幼儿、青少年及孕妇微量元素的含量，从而了解微量元素测定的必要性。方法 用原子吸收光谱法测定810例受试者末稍全血中铜、锌、钙、镁、铁的浓度，并将受试者按年龄分为5个阶段及孕妇组，以仪器厂方提供的不同年龄阶段5种元素含量的参考值作为对照进行统计。结果 孕妇及各年龄段的儿童，5种元素均有缺乏的现象，儿童尤以缺锌为主、铁次之，孕妇以缺铁多见、锌次之，也有钙和镁缺乏的现象。结论 （1）应建立本地区正常参考值。（2）多数儿童及孕妇都有微量元素缺乏的现象，建议儿童及孕妇进行微量元素普查，在医师指导下进行膳食营养调节。     

600例孕妇微量元素检测情况调查分析

目的了解目前重庆地区妊娠期妇女微量元素缺乏情况,为孕妇合理补充微量元素提供临床指导。方法采用原子吸收光谱法对孕妇全血进行铜、锌、钙、镁、铁5种微量元素检测,并对结果进行统计分析。结果妊娠期妇女铜、锌、钙、镁、铁5种微量元素缺乏率分别为1.67%、11.17%、27.5%、0.83%、38.67%。结论重庆地区妊娠期妇女铜、锌、钙、镁、铁5种微量元素以铁缺乏最为普遍,钙、锌次之。因此应加强妊娠期妇女铁、钙、锌的合理补充,以保证母体健康和胎儿正常身心发育。     

福建闽西地区儿童全血铜、锌、钙、镁、铁微量元素参考范围调查

目的 调查福建闽西地区儿童年龄特异性全血铜(Cu)、锌(Zn)、钙(Ca)、镁(Mg)、铁(Fe)微量元素正常参考范围.方法 利用BH5300S原子吸收光谱仪分析福建闽西地区1 702例1个月至11岁健康儿童的全血Cu、Zn、Ca、Mg、Fe微量元素浓度.结果 经统计得到福建闽西地区儿童年龄特异性全血Cu、Zn、Ca、Mg、Fe微量元素参考范围.分析全血微量元素与年龄的相关性,发现Cu和Fe元素与年龄呈负相关(P<0.05),Zn和Ca元素与年龄呈正相关(P<0.05),未发现全血Mg元素浓度与年龄相关性(P>0.05).经统计优化后,各元素参考范围年龄段划分减少.结论 全血Cu、Zn、Ca、Mg、Fe微量元素参考范围的建立可为儿童微量元素合理补充提供指导,特别为福建闽西地区儿童微量元素缺乏的实验室诊断和流行病学调查提供重要依据.     

妊娠期妇女血清甲状腺功能指标参考值的建立

目的建立该地区血清特异的甲状腺指标参考值,提高该地区出生人口质量。方法收集符合《妊娠和产后甲状腺疾病诊治指南》提出的建立该单位或地区的妊娠期特异的血清甲状腺指标参考值的正常孕妇的血清标本共167例,其中妊娠早期47例,妊娠中期86例,妊娠晚期34例。用电化学发光的方法在罗氏cobas e601上测定各标本的促甲状腺素(TSH)和游离甲状腺素(FT4)的值,然后采用SPSS14.0软件对所得数据进行统计学分析,分别求出妊娠早期、妊娠中期和妊娠晚期TSH和FT4的中位数,建立妊娠期TSH和FT4参考值的95%可信区间,即得出该地区妊娠期妇女血清TSH和FT4的参考范围。结果首先在cobas e601上用电化学发光进行测定,然后再进行统计学分析得出该地区孕妇妊娠早期TSH的参考范围为0.05~2.90mIU/L,FT4的参考范围为12.5~18.3pmol/L;妊娠中期TSH的参考范围为0.2~3.63 mIU/L,FT4的参考范围为9.99~16.2pmol/L;妊娠晚期TSH的参考范围为0.17~4.90mIU/L,FT4的参考范围为9.34~13.9pmol/L。结论罗氏电化学发光测定邢台地区妊娠期正常孕妇血清特异的甲状腺指标参考值的建立,可以提高该地区妊娠期甲状腺功能异常的检出率,为优生优育和提高人口质量打下坚实的基础。     

上海市青浦地区儿童、青少年血清胱抑素C参考区间的建立

目的调查分析上海市青浦地区健康儿童、青少年血清胱抑素C(Cys C)水平,建立不同性别、不同年龄健康儿童、青少年Cys C的参考区间。方法采用分层整群随机抽样的方法,抽取上海市青浦地区433名儿童、青少年作为研究对象,对其进行健康体检和血清Cys C检测。采用两独立样本t检验比较不同特征个体的Cys C水平,以±1.96s建立血清Cys C的参考区间。结果 6~12岁、13~16岁2个组的Cys C参考值区间分别为0.39~1.41和0.40~1.50 mg/L;13~16岁组男孩参考区间为0.43~1.57 mg/L,女孩为0.41~1.39 mg/L。结论初步建立了上海市青浦地区儿童、青少年血清Cys C的参考区间,为评估其肾功能异常提供了依据。     

不同妊娠期妇女血微量元素水平变化分析

目的探讨不同妊娠期妇女血液微量元素变化情况。方法用原子吸收光谱分析法分别测定294例孕妇和47例健康妇女（对照组）Se、Mn、Fe、Cu、Zn水平。结果Se,与对照组（79．524&#177;10．55μg／L）比较,早孕组（72．16&#177;9．48μg／L）、中孕组（72．40&#177;11.58μg／L）,P〉0．05,晚孕组（56．76&#177;13．85μg／L）,P〈0．01;Mn,与对照组（15．00&#177;3．25μg／L）比较,早孕组（14．10&#177;3．73μg／L）、中孕组（15．57&#177;3．49μg／L）,P〉0．05,晚孕组（24．24&#177;5．43μg／L）,P〈0．01;Fe,与对照组（18．64&#177;3．76μmol／L）比较,早孕组（22．20&#177;4．68μmol／L）、晚孕组（12．68&#177;4．31μmol／L）,P〈0．01,中孕组（17．76&#177;6．13μmol／L）,P〉0．05;Cu,与对照组（16．28&#177;2．69μmol／L）比较,早孕组（23．28&#177;5．62μmol／L）、中孕组（25．48&#177;3．45μmol／L）、晚孕组（28．82&#177;4．36μmol／L）,P〈0．01;Zn,与对照组（12．83&#177;1．16μmol／L）比较,早孕组（10．85&#177;2．17μmol／L）、中孕组（9．71&#177;1.70μmol／L）、晚孕组（7．81&#177;1．36μmol／L）;P〈0．01。结论健康孕妇微量元素水平反映了微量元素之间协同、拮抗作用。随着妊娠期的推移,Fe的下降导致Mn的水平上升,Se的水平下降;而Cu的水平不断上升导致Zn水平不断下降,妊娠晚期各元素水平上升或下降尤为显著。     

Trace element reference values in serum determined by inductively coupled plasma atomic emission spectrometry.

Serum reference values for Ba, B, Cd, Cu, Fe, Mn, Li, Se, Sr, and Zn in 141 healthy Norwegians were determined. The trace element concentrations were determined by the inductively coupled plasma atomic emission spectrometry technique that we have recently validated. The reference intervals were established according to the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine. Also coverage intervals with coverage uncertainties were calculated according to the International Union of Pure and Applied Chemistry. The population studied consisted of 69 men and 72 women of the ages 21-87 years. The effects of gender, age, smoking, and oral contraceptives on serum levels of trace elements were investigated. Median concentrations of the different trace elements in (micromol/l) were as follows: Ba (0.44), B (1.50), Cd (0.004), Cu (17.1), Fe (21.4), Li (0.06), Mn (0.003), Se (1.26), Sr (0.17), and Zn (13.3). An increase in serum Ba and Sr was detected with age. These metals and Se were also significantly higher in women over 50 years of age in comparison to younger women. Women had higher serum Cu than men and those on oral contraceptives had higher serum Cu and Fe. Serum B tended to increase with age, while it was significantly reduced with smoking.     

妊娠期女性血浆抗凝血酶Ⅲ和D-二聚体参考区间的建立

目的建立该实验室不同孕期健康孕妇血浆抗凝血酶Ⅲ(AT-Ⅲ)和D-二聚体(D-D)参考区间。方法选取该院2 850例不同孕期健康孕妇及同期260例非妊娠期健康女性,采用法国STA-R Evolution全自动血凝仪及配套试剂,检测所有研究对象的AT-Ⅲ活性及D-D浓度,参照美国临床和实验室标准化协会(CLSI)C28-A3文件,建立该实验室各指标的参考区间。结果非妊娠健康女性血浆AT-Ⅲ及D-D参考区间分别为84.7%~123.3%,≤0.52μg/mL。≤13孕周、13~27孕周、27孕周的孕妇血浆AT-Ⅲ的参考区间分别为81.8%~115.8%、77.7%~112.1%、68.1%~113.1%。≤13孕周、13~20孕周、20~27孕周、27孕周的孕妇血浆DD的参考区间分别为:≤0.75、≤1.04、≤2.14、≤3.24μg/mL。结论建立该实验室健康孕妇不同孕期血浆AT-Ⅲ及D-D的参考区间,有助于临床评价妊娠期女性凝血、抗凝及纤溶功能。     

Element concentrations in urine of patients suffering from chronic arsenic poisoning

In order to know the element levels in the urine of patients with chronic arsenic poisoning caused by arsenic assimilated from burning coal via air and food, we investigated various elements in the urine of 16 patients with this disease and 16 controls living in the same county in Guizhou Province of China. Concentrations of 25 elements (Al, As, Ba, Be, Bi, Ca, Cd, Cr, Cu, Fe, Ga, Mg, Mn, Mo, Ni, P, Pb, Rb, Sb, Se, Sn, Sr, Ti, V and Zn) were determined by an inductively coupled plasma mass spectrometer or an inductively coupled plasma atomic emission spectrometer. The average concentrations of Cu, Ga and Sn as well as As in the patients were significantly higher, and those of Cr, Rb, Sr and Ti in the patients were significantly lower than the control values. Al, Ba, Mn, Ni and Se were under detection limit in the patients, though they could be detected in the controls. There were no positive correlations between the concentration of As and the concentrations of other elements, including Cu, Ga and Sn in the patients. The results of this study suggest that As from burning coal might influence the urinary excretion of some elements.     

Trace elements in human clinical specimens: evaluation of literature data to identify reference values

Reference values are proposed for the concentrations of As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Pb, Se, and Zn in whole blood, blood serum, urine, milk, liver, and hair from adult human subjects. For F, I, and Ni, it was not possible to evaluate reference intervals for all the specimens mentioned above. For several elements, including Al, B, Br, Cs, Li, Rb, U, and V, the present status of the literature does not provide an adequate basis for formulating baseline concentrations; therefore, results from selected investigations are listed for information only. For elements such as Cu, Fe, and Zn, which are known to be homeostatically controlled, the concentrations in whole blood and blood serum follow a gaussian-like frequency distribution, and we could consider both median and mean values for evaluation. On the other hand, elements whose concentrations in tissues and body fluids are influenced by dietary availability (e.g., As and Se) or environmental factors (e.g., Cd, Hg, and Pb) show wide scatter. In these cases, the median appeared to be a better indicator of the central tendency than the mean, when different populations are involved. These points are illustrated.     

电感耦合等离子质谱法检测儿童末梢血多种元素

目的建立同时检测儿童末梢血多种元素的电感耦合等离子质谱(ICP-MS)法。方法采用ICP-MS法检测湖南地区474例健康儿童(6个月至12岁)末梢血标本钙、镁、铁、铜、锌、铅6种元素水平,并建立各元素的参考区间。结果健康儿童末梢血钙、镁、铁、铜、锌、铅水平均呈偏态分布,且男女儿童末梢血各元素水平比较,差异均无统计学意义(P0.05);该地区健康儿童末梢血钙、镁、铁、铜、锌、铅参考区间分别为57.30~81.40 mg/L、30.40~44.80 mg/L、361.20~531.40 mg/L、848.10~1 469.20μg/L、2.68~6.54mg/L和0.00~100.00μg/L。结论成功建立了同时检测儿童末梢血钙、镁、铁、铜、锌、铅6种元素的ICP-MS法,以及各元素的参考区间。     

正常孕妇血常规参考值范围的序贯性测定

目的：了解正常妊娠妇女常用血常规指标的变化,建立其参考值范围。方法：分别在早孕（孕10～14周）、中孕（孕20～24周）、晚孕（孕30～34周）及产后（产后12周）四个时期序贯性测定120例正常妊娠妇女血常规指标：红细胞（RBC）、血红蛋白（HB）、红细胞压积（HCT）、血小板（PLT）、白细胞（WBC）,并建立参考值范围。同期选取53例健康体检非孕者为对照。结果：RBC、HCT早、中、晚孕相对于正常对照均降低（P〈O．01）。HB在孕期降低,中、晚孕降低较明显,相对于正常对照差异有统计学意义（P〈0．01）。PLT早、中孕降低不明显（P〉0．05）,到晚孕期相对于正常对照降低差异有统计学意义（P〈0．05）。WBC在妊娠四期相对于正常对照均升高（P〈O．01）。结论：血常规各项指标随孕期发展均产生不同程度的变化,从该序惯性研究中得出了正常妊娠妇女的5个血常规指标水平的参考值范围,该参考值范围可以用于评估正常妊娠妇女的孕期健康水平。     

Reference intervals for vitamins B1, B2, E, D, retinol, beta-carotene, and folate in blood: usefulness of dietary selection criteria

Reference intervals for normal concentrations in blood of vitamins B1, B2, E, D, retinol, beta-carotene, and folic acid were determined from a selected sample of people attending a Health Examination Center or being examined in occupational health services in France. This reference sample consisted of 362 men and women, ages 18 to 44 years, selected according to the main variation factors known for the vitamins studied: consumption of tobacco and alcohol, ponderal index (relating height and weight), use of drugs and oral contraceptives, and past history of surgical or medical treatment. Reference intervals were determined for each sex. Vitamin B1 (erythrocyte transketolase activity), plasma retinol, and folic acid values in whole blood are significantly higher in men than in women (p less than 0.001), but vitamin B2 (activation of erythrocyte glutathione reductase) and plasma beta-carotene values are significantly higher in women (p less than 0.001 and less than 0.01 respectively). Dietary intake of vitamins produced no significant displacement of the reference values. For each vitamin we discuss the other major sources of variation factors and the usual values reported in the literature.     

Variation of trace element concentrations in patients undergoing hemodialysis in the north of Spain

Background: Trace elements are essential substances for the proper physiological and biochemical functioning of the organism. Hemodialysis patients are potentially at risk of deficiency or excess of these elements. The application of inductively coupled plasma mass spectrometry (ICP-MS) allows the simultaneous quantification of very small amounts of multiple trace elements. The aim was to measure the serum concentration of copper (Cu), zinc (Zn), selenium (Se), and nickel (Ni), and the whole blood concentration of arsenic (As), lead (Pb), and manganese (Mn), in patients undergoing hemodialysis as well as in controls.

Methods: The study was carried out in 57 hemodialysis patients compared with 57 controls with normal renal function. Serum and whole blood samples from the dialysis group were collected before and after hemodialysis sessions and Cu, Zn, Se, Ni, As, Pb and Mn levels were determined using ICP-MS.

Results: Hemodialysis patients showed significantly lower blood levels of Cu, Zn and Se than controls (p?p?p?p?Conclusion: Hemodialysis patients are at increased risk of trace elements deficiency (especially for Zn and Se) or excess (Ni) in respect to healthy subjects. Monitoring of blood levels and supplementation of some trace elements may be indicated in patients undergoing hemodialysis.     

Concentrations of trace elements in sweat during sauna bathing

Trace elements in sweat during sauna bathing were assessed. Sweat collected by the whole body method was compared with that collected by the arm bag method. The sweat samples were collected from ten healthy male adults aged 22-26 years, by heat exposure in dry sauna bathing (60 degrees C, 30 minutes). Concentrations of major (Na, Cl, K, Ca, P and Mg) and trace (Zn, Cu, Fe, Ni, Cr and Mn) elements in sweat tended to be lower in the arm bag method than in the whole body method. It was found that Ca, Mg, Fe and Mn concentrations in the arm bag method were significantly lower than those in the whole body method. The amount of trace elements in sweat measured by the arm bag method was less than that by the whole body method; significant differences were observed in Fe and Mn amounts. These observations suggest that excretion of trace elements by sweating induces trace element decrease. Therefore, athletes and workers who work in a hot environment and sweat much habitually should ingest adequate amounts of trace elements.