某部新入伍青年男性战士血细胞分析参考范围调查

目的建立青年男性战士静脉血细胞分析各项指标的参考范围,为以后新兵入伍体检作依据。方法对体系部队2008年底新入伍青年男性战士1540人的血样进行血细胞分析检测,通过统计分析,得出其参考区间。结果部分项目较现有参考范围要宽,如淋巴细胞比例、红细胞平均体积、红细胞平均血红蛋白浓度等,部分项目与现有参考范围接近,如单核细胞比例、嗜碱粒细胞比例、巨大未成熟细胞比例、红细胞、血红蛋白、红细胞平均血红蛋白量等;部分项目参考区间落在现有区间内,如淋巴细胞绝对值、单核细胞绝对值、嗜碱粒细胞绝对值、异常淋巴细胞数、巨大未成熟细胞数、异常淋巴细胞数比例、血细胞比容、红细胞分布宽度标准差、平均血小板比容、血小板分布宽度等;部分项目偏高,如白细胞、中性粒细胞绝对值、嗜酸粒细胞绝对值、中性粒细胞比例、嗜酸粒细胞比例、血小板等;另外红细胞分布宽度变异系数和平均血小板容积结果偏低。结论新入伍战士血细胞分析各指标参考区间与现行实验室参考区间存在一定的差异,在今后每年战士入伍体检中,应以此次调查参考区间为判断依据。     

小儿佝偻病末梢血液象的改变

红细胞数及血红蛋白量常减低;轻症时红细胞数在正常范围。白细胞总数正常或稍增多。中性粒细胞减少。嗜酸性粒细胞数正常。淋巴细胞数的相对值和绝对值皆增多.单核细胞数正常.佝偻病儿     

海洛因依赖者外周血细胞变化分析

目的:了解海洛因依赖者外周血细胞变化情况。方法:应用日本SYSMEXCD-21全自动血细胞分析仪对340例海洛因依赖者的外周血细胞进行检测,并与290例健康体检者对照。结果:海洛因依赖者的红细胞计数(RBC)、血红蛋白浓度(HGB)、红细胞比积(HCT)低于对照组,平均红细胞体积(MCV)、平均红细胞血红蛋白浓度(MCH)、红细胞体积分布宽度(RDW)高于对照组(P<0.01);白细胞计数(WBC)、淋巴细胞计数绝对值(LYM)、中性粒细胞绝对值(GRAN)高于对照组;血小板计数(PLT)、血小板体积分布宽度(PDW)高于对照组,平均血小板体积(MPV)显著低于对照组,差异有统计学意义(P<0.01)。结论:海洛因依赖对外周血细胞的数量和形态都有影响,应监测外周血细胞变化并对症治疗。     

血液涂片细胞形态学联合全自动血细胞分析仪在血常规检验中的应用

目的探究血液涂片细胞形态学联合全自动血细胞分析仪在血常规检验中的应用。方法选择我院在2016年9月～2017年2月期间收治的血常规检验患者共计105例,均在全自动血细胞分析仪检测后予以血液涂片细胞形态学检测,比较不同检测方法下血红蛋白、白细胞、红细胞检出率及嗜酸性粒细胞、单核细胞、淋巴细胞、中粒细胞阳性检出率。结果全自动血细胞分析仪检测阳性率中,血红蛋白58.09%、白细胞68.57%、红细胞62.85%,血液涂片细胞形态学联合全自动血细胞分析仪检测阳性率中,血红蛋白80.95%、白细胞85.71%、红细胞82.85%,联合检测的检出率均高于单一使用全自动血细胞分析仪检测,差异有统计学意义(P <0.05);全自动血细胞分析仪阳性检出率中,嗜酸性粒细胞47.61%、单核细胞45.71%、淋巴细胞38.09%、中粒细胞33.33%,血液涂片细胞形态学联合全自动血细胞分析仪阳性检出率中,嗜酸性粒细胞61.90%、单核细胞60.00%、淋巴细胞59.04%、中粒细胞50.47%,全自动血细胞分析仪检测阳性率均低于联合检测,差异有统计学意义(P <0.05)。结论血液涂片细胞形态学联合全自动血细胞分析仪在血常规检验中的结果相对准确,极大的避免了单一检测下误诊、漏诊可能性,可在临床实践中予以推广和应用。     

回收式自体输血与异体输血在手术大出血患者治疗中应用效果的比较研究

目的比较回收式自体输血与异体输血在手术大出血患者治疗中的应用效果。方法选取阳江市人民医院2016年9月-2018年10月收治的手术大出血患者100例,采用随机数字表法分为自体输血组和异体输血组,各50例。自体输血组采用回收式自体输血,异体输血组患者采用常规异体输血。比较两组输血前和输血后第3天红细胞计数、血红蛋白含量、血细胞比容、白细胞计数、中性粒细胞计数、血小板计数、淋巴细胞计数。结果术前两组红细胞计数、血红蛋白含量、血细胞比容、白细胞计数、中性粒细胞计数、血小板计数、淋巴细胞计数比较,差异无统计学意义(P>0.05);术后第3天自体输血组红细胞计数、血红蛋白含量、血细胞比容、白细胞计数、血小板计数、淋巴细胞计数高于异体输血组,中性粒细胞计数低于异体输血组(P<0.05)。结论与异体输血相比,回收式自体输血能促进手术大出血患者相关指标的快速恢复,减轻炎性反应。     

本地区新入伍战士1720人血清生化指标值的分析

目的分析本地区新入伍战士血清生化指标,为新兵体检结果的判读提供参考依据。方法对本地区2008年底新入伍战士1 720人血样进行生化项目检测,通过统计分析,得出其参考值区间。结果部分如葡萄糖、总蛋白、γ-谷氨酰转移酶、载脂蛋白等项目与现有参考值区间接近 ;部分项目在现有参考值区间范围内,如尿素、肌酐、总胆固醇等;部分项目偏高,如尿酸、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、肌酸激酶、乳酸脱氢酶、甘油三酯等。结论新入伍战士血清生化指标与现行实验室参考值区间存在一定的差异,应不断积累数据,建立符合本地区新入伍战士血清生化指标参考值区间。     

酒精所致精神障碍患者血液细胞学对照研究

目的:探讨酒精所致精神障碍患者的血液细胞质量和形态学的变化.方法:采用深圳迈瑞公司生产的BC-3000 PLUS型全自动血液细胞分析仪,对100例酒精所致精神障碍患者和100例正常对照者进行血液细胞学检测.结果:酒精所致精神障碍患者的RBC总数、HGB、红细胞压积(HCT)、红细胞分布宽度分布系数(RDW-CV)降低、平均红细胞血红蛋白浓度(MCHC)降低、平均红细胞体积(MCV)和平均红细胞血红蛋白量升高;血小板总数升高,血小板压积(PCT)、血小板体积分布宽度(PDW)、血小板平均体积(MPV)降低;WBC总数降低,中性粒细胞(Gran)相对升高,淋巴细胞(Lymph)降低,而单核细胞(MON)无明显变化.结论:酒精所致精神障碍患者存在明显的血液细胞学的改变,这对探讨酒精的成瘾机制和对机体的影响及指导临床治疗等都有一定的价值.     

附:临床常用检验正常参考值

一、血液学检验正常参考值检验项目正常范围总血量比重全血男性女性血浆红细胞计数男性女性白细胞计数 分类 总数髓细胞杆状核分叶核淋巴细胞单核细胞嗜酸粒细胞嗜硷粒细胞红细胞渗透性脆性试验 (S:;n ford法)嗜酸粒细胞直接计数血小板计数网织红细胞出血时IbJ(Duke)出血时间(Lvy)血凝时间(Lee一入Vhite)65一90毫升/公斤体重1 .054一1 .0621 .048一1 .0591 .024一1.029429万一538万/立方毫米383万一483万/立方毫米4000一1 0000/立方毫米0肠绝对值o/立方毫米3一5肠150一40。/立方毫米54一62肠3000一5500/立方毫米25一33肠1500一3000/立方…     

北京地区幼儿血细胞参数范围的调查

目的调查北京地区1至3岁健康儿童指血血常规各项参数的范围，为临床诊断提供参考。方法用日本SySmexXS-800i全自动五分类血细胞分析仪检测1407名1至3岁健康儿童手指血常规，得出12项血细胞参数，将这些结果进行统计分析，并与文献进行比较。结果幼儿末梢血参考范围白细胞（4．7～10．1）×109／L，红细胞（4．0—5．6）×1012／L，血红蛋白109—142g／L，红细胞比积31．9％-43．3％，平均血红蛋白含量24．7～30．7pg，平均血红蛋白浓度330—365g／L，平均红细胞体积男68—86．5fL，女72～88．7fL，红细胞平均分布宽度男10．5％-17．5％，女10．9％-16．3％，血小板数（147—466）×109／L，平均血小板体积5．3—11．0fL，血小板平均分布宽度10．6—19．8fL，血小板比积0．12％～0．36％。结论儿童血常规参考范围与年龄、性别及地域等因素有关，幼儿需建立独立的血常规参考范围。     

男性素食者血细胞体积参数的变化

目的比较男性素食者血细胞体积参数的变化。方法使用CoulterLH750检测血常规，并记录体积参数。结果男性素食组红细胞体积（MCV）和平均血小板体积（MPV）均高于对照组（P〈0．05，P〈0．01）；男性素食组中性粒细胞、淋巴细胞、单核细胞的体积均值和分布宽度均大于对照组（均P〈0．01）；MPV与单核细胞体积平均值正相关（r=0．398，P〈0．01）。结论男性素食者血细胞体积大于对照组，且自细胞分布宽度明显大于对照组。     

Hematologic reference ranges in a population of patients with schizophrenia

The potential hematotoxic effects of antipsychotic drugs are well known and may limit the use of some effective therapies. Although some previous studies have suggested that patients with schizophrenia may have altered "normal" values, only limited data were available. It is now believed that biological values do not usually follow a normal distribution; therefore, reference ranges are frequently used when interpreting laboratory tests in clinical practice and in research. However, it may be important to use disease-specific hematologic reference ranges when evaluating laboratory test results for patients with schizophrenia. In this study, data taken from patients with schizophrenia prior to treatment in previous phase II and phase III pharmaceutical studies were analyzed to produce reference ranges for a variety of hematologic parameters. An increased variability was shown in the reference ranges for all white blood cell indices between patients with schizophrenia and the population without schizophrenia. Certain reference values also showed heterogeneity for gender, age, and racial descent. This study suggests that abnormal hematologic findings in patients with schizophrenia should be assessed in the context of a valid reference range. This information will be of value to psychiatrists, laboratory scientists, and other physicians who encounter hematologic problems in patients with schizophrenia, as well as in the assessment of the adverse effects of new therapeutic agents.     

育龄女性子宫弓状动脉多普勒频谱正常波形及参考值研究

目的:通过对正常育龄女性子宫弓状动脉经腹脉冲多普勒频谱(PW)检测,建立PW正常波形及参考值范围.方法:育龄女性260例,对能清楚显示弓状动脉的252例患者,共504支进行观察.根据舒张期有、无血流显像将PW波型分为双峰形和单峰形.并测量收缩期最大流速(Vs)、舒张期最低流速(Vd),计算阻力指数(RI)和脉动指数(PI).结果:(1)子宫弓状动脉95.2％(480/504 )舒张期有血流,PW波呈双峰形,4.8％( 24/504)舒张期无血流显像,PW呈单峰形.(2)子宫弓状动脉PW参考值范围:Vs 3.5～44.0 cm/s,Vd 0.0～11.8 cm/s,PI 0.7～2.2,RI 0.6～1.0.结论:波形分析及RI可靠、应用方便,可作临床诊断及治疗的重要参考指标.     

新型血细胞分析仪ADVIA 120成人静脉血参考范围调查

目的 调查广州地区成人静脉血新型血细胞分析仪ADVIA 120的参考范围.方法 收集ADVIA 120血细胞分析仪在1年内检测健康成人静脉血的结果数据.结果 少部分结果与常用的参考范围差异显著:明显偏高的是男LYMPH%参考上限47.9%、女LYMPH%参考上限48.0%、男PLT(149～353)× 109/L、男PDW(36.9～64.7)%、女PLT(155～369)×109/L和女PDW(31.2～64.9)%;明显偏低的是男NEUT%参考下限40.5%和女NEUT%参考下限41.3%;略偏高的是男性的WBC(4.36～10.53)×109/L、RBC(4.30～5.71)×1012/L和Hb(133～171)g/L.结论 不同地区的环境条件和检测手段会对参考范围产生较大影响,故应建立不同地区和不同性别的血细胞参考范围.     

Therapeutic challenges in the application of serum thyroid stimulating hormone testing in the management of patients with hypothyroidism on replacement thyroid hormone therapy: a review

Normalizing serum thyroid stimulating hormone (TSH) levels by lifelong treatment with levothyroxine (LT4) remains the primary goal of therapy for patients with hypothyroidism. The reference ranges for TSH are derived from populations with (supposedly) normal thyroid function. But, TSH results are affected by a number of factors including alterations in TSH levels with age, concurrent illnesses, circadian rhythm, inter- and intra-assay differences, and some commonly used medications that interfere with thyroid function or the TSH test. Furthermore, some patients are complex to manage and bringing serum TSH to within its reference range does not always resolve their symptoms of hypothyroidism. Furthermore, changes in TSH within the reference range may provoke symptoms in some sensitive patients, and others may have a personal “set point” for thyroid hormone levels that represents normal function for that individual, but which is outside the population reference range. The introduction of updated LT4 formulations, with better dosing accuracy and stability compared with older versions, should, in theory at least, provide better stability and accuracy of dosing over time. However, the new LT4 formulations are associated with manifold increases in the number of self-reported adverse events. Therefore, patients with hypothyroidism as well as the clinicians managing them need to better understand the utility as well as the limitations of the widely used TSH measurement. In addition, both pharmaceutical companies and the prescribing clinician need to take greater care when patients are switched from older to newer formulations.     

Normal and lethal mercury levels in human beings

Ethyl mercury in the form of Granosan M was used as a fungicide in dressing grains in Iraq. Disregarding warnings and precautions by the authorities, some villagers used this grain in making their bread.Tissue specimens of poisoned people were analysed for total mercury contents using the flameless atomic absorption spectroscopic technique. The analytical method used is highly sensitive 91 ppb/1% absorbence), and the precision in terms of relative standard deviation (RSD) was about 1.5%.The ranges of mercury content in ppm units in the two cases of poisoning were 8–9 for the kidneys, 6–7 for livers, 3–5 for the cerebella, and about 15 for the blood. The analyses included some other tissues as well.Control values were also present. These were obtained from human beings who died by accident and showed no signs of mercury poisoning.     

Age-specific reference ranges for polychlorinated biphenyls (PCB) based on the NHANES 2001-2002 survey

The Centers for Disease Control and Prevention (CDC) conducted analyses for 34 polychlorinated biphenyl (PCB) congeners in blood samples collected from a statistically representative sample of the U.S. population during the National Health and Nutrition Examination Survey (NHANES) and reported overall population percentiles. Because the serum concentrations of many persistent organochlorine compounds are strongly age dependent, data were analyzed from the NHANES 2001-2002 sampling cycle to identify age-specific reference ranges for the measured congeners on a lipid-adjusted serum basis. In addition, reference ranges were estimated for the sum of the 34 measured PCB congeners. Because many congeners were frequently nondetectable, estimates for summed PCB levels are dependent upon the assumption used to replace nondetectable concentrations in the calculation. The effect of nondetects on the summed congeners totals is particularly strong for younger ages. The NHANES 2001-2002 PCB serum data demonstrate strong age-related trends, with older individuals displaying higher concentrations of most congeners and of summed PCB congeners. These age-specific reference ranges for PCB concentrations are critical for accurate interpretation of measured serum concentrations of PCB congeners in individuals.     

Therapeutic drug monitoring of antimetabolic cytotoxic drugs

Therapeutic drug monitoring is not routinely used for cytotoxic agents. There are several reasons, but one major drawback is the lack of established therapeutic concentration ranges. Combination chemotherapy makes the establishment of therapeutic ranges for individual drugs difficult, the concentration-effect relationship for a single drug may not be the same as that when the drug is used in a drug combination. Pharmacokinetic optimization protocols for many classes of cytotoxic compounds exist in specialized centres, and some of these protocols are now part of large multicentre trials. Nonetheless, methotrexate is the only agent which is routinely monitored in most treatment centres. An additional factor, especially in antimetabolite therapy, is the existence of pharmacogenetic enzymes which play a major role in drug metabolism. Monitoring of therapy could include assay of phenotypic enzyme activities or genotype in addition to, or instead of, the more traditional measurement of parent drug or drug metabolites. The cytotoxic activities of mercaptopurine and fluorouracil are regulated by thiopurine methyltransferase (TPMT) and dihydropyrimidine dehydrogenase (DPD), respectively. Lack of TPMT functional activity produces life-threatening mercaptopurine myelotoxicity. Very low DPD activity reduces fluorouracil breakdown producing severe cytotoxicity. These pharmacogenetic enzymes can influence the bioavailability, pharmacokinetics, toxicity and efficacy of their substrate drugs.     

Therapeutic drug monitoring of cytotoxic drugs

Therapeutic drug monitoring is not routinely used for cytotoxic agents. There are several reasons, but one major drawback is the lack of established therapeutic concentration ranges. Combination chemotherapy makes the establishment of therapeutic ranges for individual drugs difficult, the concentration-effect relationship for a single drug may not be the same as when that drug is used in a drug combination. Pharmacokinetic optimization protocols for many classes of cytotoxic compounds exist in specialized centres, and some of these protocols are now part of large multicentre trials. Nonetheless, methotrexate is the only agent which is routinely monitored in most treatment centres. An additional factor, especially in antimetabolite therapy, is the existence of pharmacogenetic enzymes which play a major role in drug metabolism. Monitoring of therapy could include assay of phenotypic enzyme activities or genotype in addition to, or instead, the more traditional measurement of parent drug or drug metabolites. The cytotoxic activities of mercaptopurine and fluorouracil are regulated by thiopurine methyltransferase (TPMT) and dihydropyrimidine dehydrogenase (DPD), respectively. Lack of TPMT functional activity produces life-threatening mercaptopurine myelotoxicity. Very low DPD activity reduces fluorouracil breakdown producing severe cytotoxicity. These pharmacogenetic enzymes can influence the bioavailability, pharmacokinetics, toxicity and efficacy of their substrate drugs.     

Reference ranges for the urinary steroid profile in a Latin‐American population

The urinary steroid profile has been used in clinical endocrinology for the early detection of enzyme deficiencies. In the field of doping, its evaluation in urine samples is used to diagnose the abuse of substances prohibited in sport. This profile is influenced by sex, age, exercise, diet, and ethnicity, among others; laboratories own reference ranges might compensate for ethnic differences among population and inter‐laboratory biases. This paper shows the reference ranges obtained in the Antidoping Laboratory of Havana for the following steroid profile parameters: ten androgens (testosterone, epitestosterone, androsterone, etiocholanolone, 5α‐androstan‐3α,17β‐diol, 5β‐androstan‐3α,17β‐diol, dehydroepiandrosterone, epiandrosterone, 11β‐hydroxyandrosterone and 11β‐hydroxyetiocholanolone), three estrogens (estradiol, estriol and estrone), two pregnanes (pregnanediol and pregnanetriol) and two corticosteroids (cortisol and tetrahydrocortisol). The urine samples (male: n = 2454 and female: n = 1181) and data obtained are representative of population from Latin‐American countries like Cuba, Venezuela, Mexico, Dominican Republic, Guatemala and Chile. Urine samples were prepared by solid‐phase extraction followed by enzymatic hydrolysis and liquid‐liquid extraction with an organic solvent in basic conditions. Trimethylsilyl derivatives were analyzed by gas chromatography coupled to mass spectrometry. Reference ranges were established for each sex, allowing the determination of abnormal profiles as a first diagnostic tool for the detection of the abuse of androgenic anabolic steroids. The comparison with the Caucasian population confirms that the urinary steroid profile is influenced by ethnicity. Copyright © 2013 John Wiley & Sons, Ltd.