健康儿童血清无机磷水平探讨

目的探讨健康儿童血清无机磷水平,建立儿童血清无机磷的参考范围.方法随机抽取120例健康儿童和30例健康成年人,利用直接紫外法检测血清无机磷.结果本文探讨的健康儿童各年龄组血清无机磷参考范围为0～1岁1.81～2.25mmol/L、1～3岁1.63～1.97mmol/L、3～14岁1.55～1.83mmol/L,儿童血清无机磷水平与成人有显著性差异.结论健康儿童血清无机磷水平高于健康成人,但随年龄的增大,血清无机磷水平有下降趋势.男女儿童血清无机磷无显著差异.     

健康儿童血清无机磷水平探讨

目的　探讨健康儿童血清无机磷水平 ,建立儿童血清无机磷的参考范围 .方法　随机抽取 12 0例健康儿童和 30例健康成年人 ,利用直接紫外法检测血清无机磷 .结果　本文探讨的健康儿童各年龄组血清无机磷参考范围为 0～ 1岁 1.81～ 2 .2 5mmol/L、1～ 3岁 1.6 3～ 1.97mmol/L、3～ 14岁 1.5 5～ 1.83mmol/L ,儿童血清无机磷水平与成人有显著性差异 .结论　健康儿童血清无机磷水平高于健康成人 ,但随年龄的增大 ,血清无机磷水平有下降趋势 .男女儿童血清无机磷无显著差异     

三亚地区1-7岁健康儿童天冬氨酸转移酶参考区间的建立与比较研究

目的建立和比较三亚地区1-7岁健康儿童天冬氨酸转移酶(aspartateaminotransferase,AST)正常参考值及不同年龄段儿童AST水平与现有临床标准的差异,更好地为临床诊断和治疗服务。方法对2017年1月至2018年12月在三亚市妇幼保健院儿保科接诊的1610名1-7岁健康体检儿童的AST血清检测结果进行回顾性分析,且对不同年龄段儿童AST水平进行统计并与成人及本实验室现有参考范围进行比较。结果三亚地区1610名1-7岁健康儿童血清AST均值为32.93U/L,最小值为7.63U/L,最大值88.03U/L,根据统计学计算得到95%的置信区间为15.09U/L-50.77U/L,高于本实验室现有参考标准8.0U/L-40U/L;男、女儿童血清AST水平无显著性差异(P0.05);1岁儿童与其他年龄段儿童血清AST水平有显著性差异(P0.05),而且随着年龄的增长AST水平呈逐渐下降趋势。结论三亚地区健康儿童的AST参考区间高于成人,同一地区不同年龄段的儿童血清AST的水平有所差异,建议不同的地区有必要对不同年龄段的儿童制定相应的AST参考区间。     

2143例0～12岁儿童血清碱性磷酸酶结果探讨

目的探讨2143例0～12岁儿童血清碱性磷酸酶（ALP）的结果。方法应用SIEMENS Dimension RxL Max全自动生化分析仪检测2143例来本院体检的0～12岁儿童血清ALP,对所得的数据进行统计学处理。结果儿童血清ALP值在3～岁、9～岁和10～岁组男女性别间差异有统计学意义（P〈0.05）,其余组男女性别间差异均无统计学意义。儿童血清ALP值在1～岁、10～岁、11～12岁年龄组间差异有统计学意义（P〈0.05）,而其他年龄组之间差异无统计学意义（P〉0.05）。结论 0～12岁儿童血清ALP水平显著高于成人。儿童时期血清ALP水平与其年龄和性别相关,应根据不同性别、年龄的儿童相应的发育情况给予不同的参考范围。     

儿童血清TBIL、DBIL参考区间确定

目的 收集整理1-14岁健康儿童血清总胆红素(TBIL)、直接胆红素(DBIL)测定结果,建立符合当地实际情况适合儿童使用的血清TBIL、DBIL参考区间.方法 随机选择2007～2008年在我院体检中心进行入托、入学及健康体检的1～14岁健康儿男、女儿童,作为实验组.同时随机选择2007～2008年在我院体检中心进行健康体检的健康男、女成人,作为对照组.比较男女儿童之间是否存在显著性差异,再比较实验组与对照组是否存在显著性差异.通过百分位数法,确定1～14岁儿童血清TBIL、DBIL参考区间.结果 男童、女童之间差异均无显著性(P＞0.05),但与成人对照组之间差异均存在显著性(P＜0.01).1～14岁儿童血清TBIL、DBIL参考区间分别为2.2-15.4μmol/L、0.7-5.5μmol/L.结论 1～14岁儿童参考区间明显低于文献报道成人参考区间,应对现用的参考区间进行调整,增加儿童有别于成人的参考区间,提高对儿童疾病诊断的灵敏度.     

儿童总免疫球蛋白E和特异性免疫球蛋白E临床可报告范围建立的研究

目的 建立儿童荧光酶联免疫分析法检测总免疫球蛋白E(tIgE)和特异性免疫球蛋白E(sIgE)的临床可报告范围。方法 收集儿童tIgE和sIgE血清样本12例,参考中国合格评定国家认可委员会(CNAS)和美国临床实验室标准化协会(CLSI)相关文件,在荧光免疫分析仪上进行tIgE和sIgE的分析测量范围(AMR)验证试验,建立其临床可报告范围(CRR)。结果 tIgE的AMR为3～4 788kU/L,最大允许稀释倍数为50倍,CRR为3～239 400kU/L。sIgE的AMR为0.01～92.97kUA/L,不能进行稀释,CRR为0.01～92.97kUA/L。结论 儿童tIgE和sIgE临床可报告范围的建立,对于高值病例的动态监测和病例间比较有重要意义,tIgE能够满足临床需求。     

3310例妊娠期血清甘胆酸水平回顾性分析

本文回顾分析3310例妊娠期血清甘胆酸(CG)水平,建立不同孕期CG参考范围,探讨CG增高结合临床及血清总胆汁酸(TBA)的测定结果进行分析、诊治,现报告如下。1 1对象和方法1.1对象均为2011.1～2012.1本院妇产科门诊和住院孕妇,既往无肝胆疾病史。对3310例孕妇进行血清CG测定,平均年龄(26.6±2.2)岁;对792例血清CG含量高于参考范围的孕妇进行血清TBA含量测定,平均年龄(27.5±3.1)岁。     

儿童肾功能三项参考区间确定

目的 收集整理1-14岁健康儿童血清尿素(Urea)、肌酐(Cr)、尿酸(UA)测定结果,建立符合当地实际情况适合儿童使用的血清Urea、Cr、UA参考区间.方法 随机选择2006～2008年在我院体检中心进行入托、入学及健康体检的1～14岁健康儿童,作为实验组,分为男童组和女童组.同时随机选择2007～2008年在我院体检中心进行健康体检的健康成人,作为对照组,同样分为男性组和女性组.先比较男女儿童之间是否存在显著性差异,再比较实验组与对照组是否存在显著性差异.通过百分位数法,确定1～14岁儿童血清Urea、Cr、UA参考区间.结果 男童、女童之间差异均无显著性(P＞0.05),但与成人对照组之间差异均有显著性(P＜0.01).1～14岁儿童血清Urea、Cr、UA参考区间分别为1.8～6.3mmol/L、16-73umol/L和134-413umol/L.结论 1～14岁儿童参考区间明显低于文献报道参考区间.     

心肌梗死患者高密度脂蛋白含量测定

本 文对 39例AMI患者和 85例健康体检者血清HDL C含量进行了检测分析 ,结果报道如下。1　资料与方法1.1　标本来源对照组 :85例健康体检者 ,其中男性 5 4例 ,女性 31例 ,年龄范围在 4 2～ 6 4岁 ,平均年龄 5 1岁。实验组 :39例AMI患者为本院住院病人均经临床和本实验室检测结果确诊患者。男性 2 7例 ,女性 12例 ,年龄范围在 4 1～ 70岁 ,平均年龄 5 3岁。1.2　仪器和方法日立 7170A全自动生化分析仪。HDL C试剂盒由日本协和株式会社提供 (此试剂盒均在有效期内使用 )。实验方法采用二点终点法。2　结　果39例AMI患者血清HDL C测定…     

广州成人血清总蛋白、白蛋白及A/G比值参考值调查

目的建立广州地区健康成人血清总蛋白、白蛋白及A/G比值的参考范围.方法对广州地区2897名健康成人的血清总蛋白(TP)、白蛋白(ALB)进行检测,计算A/G比值,对结果进行统计分析.结果①TP参考范围为(69.17～84.41)g/L,不存在性别差异(p＞0.05).男性ALB、A/G明显高于女性(p＜0.001);男性参考范围为:ALB(44.26～55.16)g/L、A/G(1.33～2.39);女性参考范围为:ALB(42.49～53.23)g/L、A/G(1.20～2.18).②男女各年龄阶段TP、ALB、A/G的参考范围也存在不同程度差异.结论①广州成年人TP、ALB、A/G的参考范围在性别、年龄组间是不同的.②旧的参考范围已不适用于当今人群,各地、各实验室应测定一批健康成人的标本,统计出本实验室的参考范围.若存在性别差异,应分别制定两性的参考范围.若存在年龄组间差异,还应进一步制定两性内各个年龄组的参考范围.     

Serum immunoglobulin levels in healthy children and adults

Serum levels of IgM, IgG and IgA were determined in 270 healthy children, 4–12 years old, and in thirty healthy adults by the radial immunodiffusion method of Mancini. There were nine 1-year age groups of thirty children each (fifteen boys and fifteen girls); the adult group consisted of fifteen males and fifteen females.

The difference in values between adults and children was statistically significant. The IgG and IgA concentrations showed a gradual rise with increasing age; the IgM concentration remained constant at a distinctly lower level than that in adults. The IgA level was about the same in both sexes. Girls had significantly higher IgM and IgG levels than boys. A consistent seasonal influence on the three serum immunoglobulin concentrations could not be demonstrated. A very wide variation in serum levels of each immunoglobulin in each age group was found. Very low values were by no means exceptional. The consequence of this finding for the diagnosis of immunological incompetency is discussed.

     

Influence of strain characteristics and immunity on the epidemiology of Campylobacter infections in Thailand.

To determine how strain differences and immunity affect the clinical expression of Campylobacter infections, we conducted a study of acute diarrheal disease in Thailand in which specimens from children with Campylobacter infections were cultured weekly for up to 12 weeks to determine the serotype-specific length of time of convalescent-phase excretion and rate of reinfection. Levels of immunoglobulin G to cell-surface antigens of C. jejuni were determined in another population of healthy children who were closely related by age and location to the children in the diarrheal disease study. Campylobacter species were initially isolated from 18% of 586 children under 5 years old with diarrhea; most isolates in Thailand belonged to serotypes commonly found in developed countries. C. coli was significantly less often associated with symptomatic infections and with bloody diarrhea than C. jejuni (P less than 0.001 and P = 0.045, respectively). The peak age of isolation and the peak level of immunoglobulin G to Campylobacter species occurred before 2 years of age. The mean duration of convalescent-phase excretion was 14 +/- 2 (standard error of the mean) days for children less than 1 year old and 8 +/- 2 days for children 1 to 5 years old (P = 0.02, t test). Infection with another Campylobacter serotype was found in 34% of 105 children during the 12-week follow-up period. The rate of reinfection in these children was 15% (range, 8 to 22%) each week. Hyperendemic exposure to Campylobacter species in Thailand confers immunity to infection that is associated with an early peak in specific serum antibodies and an age-related decrease in the case-to-infection ratio and duration of convalescent-phase excretion but does not prevent asymptomatic infections.     

常住北京市城区少儿血清维生素A和25-羟基维生素D水平分析

目的:检测北京市城区少儿冬季血清维生素A(VA)和25-羟基维生素D(25-OH VD)水平,分析营养状况。方法:2012年12月至2013年2月本院儿童保健门诊体检的0-14岁少儿292例,按年龄分为0-1岁、2-3岁、4-6岁和7-14岁四组,完成问卷调查和体格检查后,采用高效液相色谱法测定每例少儿血清VA水平,采用高效液相质谱串联法测定每例少儿血清25-OH VD水平,分析各年龄组VA、25-OH VD水平差异及每组低水平VA、25-OH VD检出率。结果:(1)292例少儿血清VA平均水平为(1.09±0.29)μmol/L,不同年龄组VA水平有显著性差异(F=10.96,P0.01),以0-1岁组最低(0.9±0.31)μmol/L;所有受检少儿低水平VA检出率为43.84%(128/292),不同年龄组低水平VA检出率有显著性差异(χ2=34.74,P0.01),0-1岁组检出率最高(76.32%)。(2)292例少儿血清25-OH VD平均水平(22.12±8.51)ng/ml,不同年龄组水平有显著性差异(F=7.56,P0.01),7-14岁组最低(18.34±6.34)ng/ml;所有受检者中低水平25-OH VD检出率为80.17%(233/292),不同年龄组低水平25-OH VD检出率有显著性差异(χ2=13.79,P0.05),4-6岁组最高(87.05%)。结论:冬季,常住北京市城区0-1岁幼儿的VA最低,7-14岁的25-OH VD最低,值得关注。     

Factors influencing serum immunoglobulin E levels in Greek children

Serum levels of immunoglobulin E (IgE) were determined by enzyme immunoassay in 414 Greek infants and children of both sexes, 1 month to 14 years old. The children were admitted to the "Aghia Sophia" Teaching Hospital for Children (Athens, Greece) for surgical corrections of minor anatomic abnormalities, but they were otherwise healthy. Statistical analysis was performed through multiple regression after logarithmic transformation of the immunoglobulin values. IgE levels increased significantly by about 80°, per year up to the age of 5 years, without noticeable impact of age on these levels thereafter. History of allergic disease showed a significant positive association with serum levels of IgE in both younger (less than 5 years) and older children. History of frequent infections was positively associated with IgE levels, although the relation was statistically significant only in the older age group. IgE levels in Greek children appear to be higher than the corresponding levels of children living in northern Europe, but much lower than those of children in Southeast Asia, a fact that may reflect different exposure level during childhood to infections known to influence IgE levels.     

Long-term effects of pediatric adenotonsillectomy on serum immunoglobulin levels: results of a randomized controlled trial.

BACKGROUND: It remains controversial whether pediatric adenotonsillectomy ultimately results in decreased serum immunoglobulin levels and if so whether such a decrease is associated with increased susceptibility to upper respiratory tract infections (URIs). OBJECTIVE: To evaluate changes in serum immunoglobulin levels in relation to occurrence of URIs in children participating in a randomized controlled trial on the effectiveness of adenotonsillectomy. METHODS: A total of 300 children aged 2 to 8 years, with symptoms of recurrent throat infections or tonsillar hypertrophy, were randomly assigned to either adenotonsillectomy or watchful waiting (WW). Serum samples were collected at baseline and at 1-year follow-up. Occurrence of throat infections and other URIs during first-year follow-up was recorded in a diary by the child's parents. RESULTS: Paired serum samples were available for 123 children (63 in the adenotonsillectomy group and 60 in the WW group). IgG1 and IgG2 levels decreased but remained within the reference range for age in both study arms. IgM and IgA levels decreased as well but remained elevated. The IgA level in the adenotonsillectomy group decreased in significantly greater degree compared with the WW group, but this difference disappeared in cases where children experienced frequent URIs. In general, no relation between immunoglobulin levels and the number of throat infections or URIs at 1-year follow-up was found. CONCLUSIONS: Immunoglobulin levels of children undergoing adenotonsillectomy decreased from elevated to slightly elevated or reference values for age during 1-year follow-up irrespective of treatment (adenotonsillectomy or WW). IgA showed a greater decrease in the adenotonsillectomy group but rose to levels comparable with the WW group in cases of frequent URIs. This finding indicates that the remaining mucosa-associated lymphoid tissue can compensate for the loss of tonsil and adenoid tissue.     

呼吸道疾病患儿免疫功能分析

目的 探讨呼吸道感染儿童免疫功能指标的变化.方法 将2012年1月至2012年9月在大连儿童医院住院的呼吸道疾病患儿按临床诊断结果分为支气管炎组、咽炎组、肺炎组.另选取40名正常儿童作为对照组.运用流式细胞术分别检测全血T淋巴细胞分化抗原三项CD3、CD4、CD8及CD4/CD8的比值;同时利用散射比浊终点法检测血清中免疫球蛋白（IgG、IgM、IgA）、补体（C3、C4）.结果 ①支气管炎组、咽炎组、肺炎组检验结果显示,CD3、CD4、CD8、CD4/CD8低于对照组.②以上3组的血清免疫球蛋白与C3水平均低于对照组,差异有统计学意义,C4水平与对照组检测结果基本一致,差异无统计学意义.③不同年龄组结果显示：0～3、4～6年龄段的患儿细胞免疫功能和体液免疫功能均低于对照组,C4与对照组检测结果基本一致,差异无统计学意义.7～12岁患儿体液免疫和细胞免疫功能与对照组比较无显著性差异.④呼吸道感染在患儿性别间无统计学差异.结论 呼吸道疾病患儿免疫功能低下并紊乱;6岁以下患儿年龄越低,免疫功能越低,易引起呼吸道疾病;患儿主要集中在6岁以下;患病儿童与性别无关.     

Serologic responses to ACYW135 polysaccharide meningococcal vaccine in Saudi children under 5 years of age

An immunization campaign with meningococcal ACYW135 polysaccharide vaccine was conducted in 2003 by the Saudi Arabian Ministry of Health and included a study to evaluate the immune responses in children under 5 years of age in the Al Qassim region of Saudi Arabia. Children who were >/=24 months old were given one dose of tetravalent polysaccharide vaccine, while younger children were given two doses with an interval of 2 to 3 months. Blood samples were collected prevaccination and 1 month after the second dose for children younger than 24 months old and 1 month after the single dose for older children. Serogroup-specific antibody responses were determined by serum bactericidal antibody (SBA) assays and a tetraplex immunoglobulin G (IgG) bead assay. Significant increases in the proportions of individuals who were >/=24 months old with SBA titers of >/=8 were observed pre- to postvaccination for all serogroups. Age-dependent increases in the percentage of individuals with SBA titers of >/=8 1 month postvaccination were observed for each serogroup. Age-dependent increases in postvaccination IgG levels were observed for serogroup A (menA), serogroup W135 (menW), and serogroup Y (menY) but not for serogroup C (menC). Two doses of tetravalent polysaccharide vaccine in individuals who were /=8. A high percentage of subjects who were >/=2 years of age were putatively protected for menA; a similar level was observed for menY for children who were 4 years of age but not for younger children. However, for menC and menW poor levels of putative protection were still evident at 4 years of age.     

儿童青少年血清IGF-1及IGFBP-3的 正常参考值研究

目的 探讨儿童青少年血清胰岛素生长因子-1（IGF-1）及胰岛素因子结合蛋白-3（IGFBP-3）的正常参考值。方法 选取2018年1月~2019年1月在我院体检的312例健康的儿童、青少年为研究对象,分别测定其IGF-1、IGFBP-3水平,并分析IGF-1、IGFBP-3与年龄、性别、发育阶段的关系。结果 男孩血清IGF-1峰值为13岁,女孩为11岁;男孩血清IGFBP-3峰值为14岁,女孩为11岁;高峰值出现后,IGF-1、IGFBP-3水平随年龄增长缓慢下降或维持高峰值;同年龄比较男孩血清IGF-1水平高于女孩、IGFBP-3水平低于女孩,差异有统计学意义（P＜0.05）;年龄、发育阶段与血清IGF-1值呈正相关（r=0.241,P＜0.01）,IGFBP-3与年龄呈正相关（r=0.323,P＜0.01）。结论 建立儿童青少年IGF-1、IGFBP-3水平正常参考值,可与监测其生长、临床症状以及生长激素治疗后随访具有重要的参考价值。     

Campylobacter jejuni-specific serum antibodies are elevated in healthy Bangladeshi children

In Bangladesh and other developing countries, isolation of Campylobacter jejuni is common in healthy children, and the illness/infection ratio falls with age. To determine whether specific serum antibodies correlate with this phenomenon, using an enzyme-linked immunosorbent assay, we studied sera from 93 healthy Bangladeshi children and 121 healthy U.S. children under 15 years of age. For each age group (less than 1, 2 to 4, and 5 to 14 years) studied, specific serum antibody levels were significantly higher in the Bangladeshi children. Among Bangladeshi children, for each of the three immunoglobulin subclasses, the change in antibody levels with age was different. Specific immunoglobulin A antibody levels rose linearly with age, immunoglobulin G levels peaked in the 2- to 4-year age group and then fell, and immunoglobulin M levels peaked in the 2- to 4-year age group and then plateaued. Elevated serum antibody levels to C. jejuni in Bangladeshi children may be protective in themselves or may reflect other protective phenomena.