流式细胞术检测新生儿网织红细胞多参数参考范围的探讨

目的建立流式细胞术（flow cytometry,FCM）检测新生儿网织红细胞（reti culocyte,Ret）多参数的参考范围。方法选取2012年12月至2013年1月人住新生儿普通病区,排除感染、窒息和先天畸形,日龄≤12h的53例新生儿为研究对象。采用FCM检测生后1、3、7dRet百分率（Ret％）、网织红细胞成熟指数（reticulocyte maturityindex,RMI）及Ret平均荧光强度,并将Ret％与手工法比较。结果53例新生儿中早产儿36例,足月儿17例。早产儿生后1、3、7d流式Ret％分别为（5．18±1．34）％、（4．77±1．45）％、（1．84±0．64）％,RMI分别为（6．08±3．14）％、（5．43±3．08）％、（22．54±10．58）％,Ret平均荧光强度分别为（2626．06±808．63）、（2692．00±865．87）、（4422．37±1668．98）;足月儿生后1、3、7d流式Ret％分别为（4．53±0．98）％、（4．01±1．62）％、（1．55±0．29）％,RMI分另0为（11．17±6.31）％、（8．66±4．49）％、（24．09±5_38）％,Ret平均荧光强度分别为（3522．50±1398．45）、（3888．00±1814．06）、0731．53±1771．59）。随胎龄增加,足月儿1、3dRMI和Ret平均荧光强度明显高于早产儿（P〈0．05）,而两组不同日龄Ret％和7dRMI、Ret平均荧光强度之间差异无统计学意义。结论不同日龄和胎龄Ret多参数分析能更全面地了解新生儿Ret变化规律,为新生儿贫血的鉴别诊断、治疗和监测带来新的研究方向和发展前景。,

Study on the reference range of reticulocyte multi-parameter by flow cytometry in newborns

Objective To establish the reference range of reticulocyte multi-parameter by using flow cytometry （FCM） in newborns. Methods A prospective study of neonatal infants admitted to neonatal general ward, ruled out infection, asphyxia and congenital malformation and admission time less than 12 hours of life from Dec. 2012 to Jan. 2013 was conducted. Blood reticulocyte percent （Ret%）, reticulocyte maturity index （RMI） and reticulocyte mean fluorescence intensity on day 1,3,7 after birth were tested by using FCM. At the same time, Ret% was tested by manual method and compared with the FCM. Results Of all 53 neonatal infants, 36 were preterm infants with mean gestational age （35.08 ± 1.08） weeks, birth weight （2.35 ± 0.35） kg and 17 were term infants with mean gestational age （38.7 ± 0.89） weeks, birth weight （2.84 ±0.64） kg. In preterm infants, Ret% were （5.18 ± 1.34）%, （4.77 ± 1.45）% and （1.84 ± 0.64）%spectively on day 1, 3 and 7 after birth; RMI were （6.08 ±3.14）%, （5.43 ＋ 3.08）% and （22.54± 10.58）% respectively; reticulocyte mean fluorescence intensity were （2626.06 ± 808.63）, （2692.00 ± 865.87） and （4422.37± 1668.98） respectively. In term infants, Ret% were （4.53 ± 0.98）%, （4.01± 1.62）% and （1.55 ± 0.29）% respectively on day 1, 3 and 7 of life; RMI were （11.17 ± 6.31）%, （8.66 ± 4.49）% and （24.09 ± 5.38）%; retieulocyte mean fluorescence intensity were （3522.50 ± 1398.45）, （3888.00 ± 1814.06） and （4731.53 ± 1771.59）. Compared with preterm infants, RMI and reticulocyte mean fluorescence intensity wet significantly higher on day 1, 3 of life in term infants （P〈0.05）. However, there was no statistical significant difference in Ret%, RMI and mean fluorescence intensity on day 7 after birth in two groups. Conclusion FCM reticulocyte multi-parameter analysis in different gestational age and time of life canunderstand more information related to change rule of reticulocyte and bring us to the new research orientation and prospect in differential diagnosis, treatment and monitoring in neonatal anemia.