新生儿凝血指标及部分生化指标检测参考区间调查

目的:调查分析新生儿凝血指标及部分生化指标检测参考区间。方法:以十所三甲医院2012年1月~2014年6月收治的新生儿2683例为研究对象,其中足月儿1700例,早产儿983例,选择同期十所医院职工健康体检1000例为对照组,通过全自动血凝仪、全自动生化分析仪测定所有对象凝血指标及12项生化指标,并建立相关指标参考区间。结果:足月新生儿PT、TT、APTT凝血指标较对照组延长,Fib较对照组降低,差异均有统计学意义(P=0.000);早产儿PT、TT、APTT较足月儿延长(P=0.000),Fib(P=0.001)降低;足月新生儿Glc水平较对照组低(P=0.000),早产儿Glc水平较足月新生儿更低(P=0.000);足月新生儿血钙水平低于对照组,血清TC、Cr、BUN、ALT含量均在对照组之下(P=0.000),早产儿相对更低(P均0.05);足月新生儿LDH、CK酶活性及K+水平均高于对照组(P均0.05),早产儿水平更高(P0.05);足月儿血清Alb、TP及Na+水平低于对照组(P0.05),早产儿更低(P均0.05)。结论:新生儿凝血表达与成人不同,凝血及部分生化指标参考区间的变化与年龄有联系,有必要为新生儿建立与年龄相关的凝血、生化指标参考区间。

Investigation of the Reference Interval for Detection of Blood Coagulation Indexes and Partial Biochemical Indexes in Infants

Objective:To investigate and analyze the reference interval for the detection of blood coagulation indexes and partial biochemical indexes in infants.Methods:2683 infants who were admitted into the ten top-three hospitals between January 2012 and June 2014 were treated as the study object, including 1700 cases of terminfants and 983 cases of premature infants. 1000 staff who underwent health examination in the ten hospitals in the same period were selected as the control group. Blood coagulation indexes and 12 biochemical indexes were measured by automatic blood coagulation analyzer and automatic biochemical analyzer and the reference interval for related indexes was established.Results:The blood coagulation indexes such as PT, TT and APTT of the term infants were longer than that of the control group and Fib was decreased with statistical significance (P=0.000). PT, TT and APTT of premature infants was longer than that of terminfants and Fib was decreased (P<0.05). The Glc level in term infants was decreased compared with control group (P= 0.000) and it was lower in premature infants than that in term infants (P=0.000). The serum calcium level in term infants was lower and the contents of serum TC, Cr, BUN and ALT were also lower than those in the control group (P=0.000), and those in premature infants were relatively lower (P<0.05). LDH, CK enzymatic activity and K+ level in term infants were higher than those in the control group(P<0. 05) and those in premature infants were relatively higher (P<0.05); the serum Alb, TP and Na+ levels in term infants were lower than those in the control group (P<0.05) and those in premature infants were lower (P<0.05).Conclusion:Blood coagulation expression in infants is different from that in adults. The changes of reference intervals of blood coagulation and partial biochemical indexes are related to age. It is necessary to establish reference intervals of blood coagulation and partial biochemical indexes related to age for infants.