基于干式化学法建立深圳地区3月龄至18岁健康儿童青少年心肌酶谱参考区间值

目的建立深圳地区3月龄至18岁健康人群干式化学法血清乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和天冬氨酸氨基转移酶(AST)的参考区间值。方法根据儿童青少年生长发育规律分为3月龄至3岁、~6岁、~12岁和~18岁组。标本来源为健康体检常规检测后的剩余血标本。采用美国强生公司VITROS 350干式化学分析仪检测血清LDH、CK、CK-MB和AST水平,比较不同年龄组和不同性别间的差异,并建立4项指标在3月龄至18岁不同年龄组中的参考区间值。结果 2 345名儿童青少年合格标本进入本文分析,男1 346名,女999名。3月龄至3岁组187名,~6岁组918名,~12岁组916名,~18岁组324名。1~6岁组CK,~12岁组CK、AST,~18岁组CK、AST、CK-MB男、女童间检测结果差异均有统计学意义(P均﹤0.05),均为男童高于女童,其他指标男、女童间检测结果差异均无统计学意义(P均﹥0.05)。4项指标在不同年龄组间检测结果差异均有统计学意义(P均﹤0.05),两两比较3月龄至3岁组与~18岁组CK、3月龄至3岁组与~6岁组CK-MB、3月龄至3岁组与~6岁组AST检测结果差异无统计学意义(P均﹥0.05),其他各组间两两比较均有统计学意义(P均﹤0.05)。24项指标检测结果均与年龄呈负相关。3LDH参考区间值(U·L-1):3月龄至3岁504~896,3~12岁491~790,12~18岁342~716。CK参考区间值(U·L-1):3月龄至12岁50~226,12~18岁男童47~256,12~18岁女童34~235。CK-MB参考区间值(U·L-1):3月龄至6岁18~44,6~12岁7~35,12~18岁7~28。AST参考区间值(U·L-1):3月龄至3岁23~60,3~12岁24~47,12~18岁17~47。结论干式化学法建立的深圳地区3月龄至18岁健康儿童青少年心肌酶谱的参考区间值有其独特性,均与年龄呈负相关,与国内外报道和厂家说明书有差异。

Investigation of Myocardial Enzymes reference intervals in children and adolescents on dry chemical system

Objective To establish the reference intervals of lactate dehydrogenase(LDH), creatine kinase(CK), creatine kinase MB(CK-MB) and aspartate aminotransferase(AST) based on dry chemical system in healthy pediatric population aged from 3 months to 18 years in Shenzhen. Methods Healthy pediatric population aged from 3 months to 18 years were divided into four groups by age according to the rule of growth and development:3 months to 3 years,-6 years,-12 years and -18 years age groups.The serum samples were from the remaining specimens of routine physical examination after routine testing.Serum LDH,CK,CK-MB and AST were detected by the VITROS 350 system,and the differences between different age groups and different genders were compared and the reference intervals of 4 items among healthy children and adolescents aged from 3 months to 18 years were established. Results A total of 2 345 qualified specimens from children and adolescents were recruited, including 1 346 males and 999 females, with 187, 918, 916 and 324 subjects for 3 months to 3 years, -6 years, -12 years and -18 years age groups. ①The reference intervals of LDH showed no significant difference between boys and girls (P>0.05), but the CK of -6 years boys, CK, AST of -12 years boys, CK, AST, CK-MB of -18 years old boys were significantly higher than those in girls (P<0.05). ② The 4 items showed significant differences in different age groups (P<0.05), but the CK showed no significant difference between 3 months to 3 years group and -18 years group, the CK-MB showed no significant difference between 3 months to 3 years group and -6 years group, the AST showed no significant difference between -6 years group and -12 years group (P>0.05). The reference intervals of serum LDH (U·L-1): 3 months to 3 years 504-896, 3-12 years 491-790, 12-18 years 342-716; reference intervals of CK (U·L-1):3 months to 12 years 50-226, 12-18 years 47-256 (male), 34-235 (female); reference intervals of CK-MB (U·L-1): 3 months to 6 years 18-44, 6-12 years 7-35, 12-18 years 7-35; reference intervals of AST (U·L-1): 3 months to 3 years 23-60, 3-12 years 24-27, 12-18 years 17-47 U·L-1. ③The reference intervals of 4 items overall decrease with age. Conclusion Dry chemical system of minor myocardial enzymes reference intervals are unique and significantly associated with the change of age.