摘要
目的通过干化学法建立重庆地区3月龄至18岁健康儿童适合年龄和性别的8项肝功能指标参考值。方法选择3月龄至18岁健康儿童,根据年龄分为5组。采用美国强生公司VITROS 5600干化学分析仪检测8项肝功能指标:血清总胆红素(TB)、总蛋白(TP)、清蛋白(ALB)、丙氨酸转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)和乳酸脱氢酶(LDH),比较不同年龄和性别各项肝功能指标的差异,采用非参数方法计算参考区间。结果研究期间3 758名3月龄至18岁健康儿童符合纳入和排除标准,剔除35份不合格标本,3 723份合格标本纳入分析。3月龄至1岁组241份,~3岁组251份,~6岁组939份,~12岁组1 672份,~18岁组620份。①~3岁组TP和ALT,~6岁组TP和AST,~12岁组TB、ALT、AST、GGT和LDH,~18岁组TB、ALB、ALT、AST、ALP、GGT和LDH检测结果均为男高于女,差异有统计学意义(P均<0.05)。②ALT、AST和LDH检测结果与年龄呈负相关,TB、TP、ALB、ALP和GGT检测结果与年龄呈正相关。③8项肝功能指标参考区间为TB(μmol·L^-1):3月龄至1岁组1.0~11.0,~18岁组1.0~16.3;TP(g·L^-1):3月龄至3岁组60.2~74.2,~6岁组61.3~78.2,~12岁组62.8~81.5,~18岁组64.9~82.4;ALB:3月龄至18岁组38.4~49.5 g·L^-1;ALT(U·L^-1):3月龄至1岁组15.8~48.4,~12岁组14.0~42.2,~18岁组男14.7~45.7、女12.5~44.8;AST(U·L^-1):3月龄至1岁组23.9~54.3,~3岁组26.4~50.6,~6岁组22.8~45.8,~12岁组18.9~41.2,~18岁组男15.7~36.8、女14.2~33.7;ALP(U·L^-1):3月龄至12岁130.0~318.5,~18岁组男124.2~416.1、女79.9~320.3;GGT(U·L^-1):3月龄至1岁组10.0~30.0,~12岁组9.3~21.3,~18岁组男9.6~28.7、女9.5~26.2;LDH(g·L^-1):3月龄至3岁组165.9~266.0,~6岁组155.3~256.2,~12岁组142.9~240.9,~18岁组男134.3~225.3、女111.3~207.0。结论重庆地区3月龄至18岁健康儿童不同年龄和性别的肝功能水平存在差异,干化学法建立适应年龄和性别的肝功能指标参考区间对相关疾病的诊疗有重要意义。
Objective To establish age-and gender-specific reference intervals for 8 common liver function tests in healthy children aged 3 months to 18 years in Chongqing by dry chemical method.Methods Healthy children aged 3 months to 18 year were selected and divided into 3 months to 1 years,-3 years,-6 years,-12 years and-18 years old groups according to the rule of growth and development.Serum TB,TP,ALB,ALT,AST,ALP,GGT and LDH were detected by the VITROS 5600 system.Differences in test results of different ages and genders were compared and the reference intervals were calculated using nonparametric methods.Results During the study period,3,758 healthy children aged 3 months to 18 years met the inclusion and exclusion criteri;35 unqualified specimens were excluded,and 3,723 eligible specimens were included in the analysis.There were 241 children in the 3 months to 1 year,251 in the-3 years,939 in the-6 years old,1,672 in the-12 years old,and 620 in the-18 years old.①TP in early childhood,TP and AST in the preschool,TB,ALT,AST,GGT and LDH in the school age,and TB,ALB,ALT,AST,ALP,GGT and LDH in the adolescence were statistically significant between boys and girls(P<0.05),and in the adolescence boys were significantly higher than in those girls.②ALT,AST and LDH results were negatively correlated with age,and TB,TP,ALB,ALP and GGT were positively correlated with age.③The reference intervals of serum TB(μmol·L^-1):3 months to 1 year 1.0-11.0,1-18 years 1.0-11.0;reference intervals of TP(g·L^-1):3 months to 3 years 60.2-74.2,-6 years 61.3-78.2,-12 years 62.8-81.5,-18 years 64.9-82.4;reference intervals of ALB(g·L^-1):3 months to 18 years 38.4-49.5;reference intervals of ALT(U·L^-1):3 months to 1 year 15.8-48.4,1-12 years 14.0-42.2,-18 years 14.7-45.7(male),12.5-44.8(female);reference intervals of AST(U·L^-1):3 months to 1 year 23.9-54.3,-3 years 26.4-50.6,-6 years 22.8-45.8,-12 years 18.9-41.2,-18 years 15.7-36.8(male),14.2-33.7(female);reference intervals of ALP(U·L^-1):3 months to 12 years 130.0-318.5,-18 years 124.2-416.1(male),79.9-320.3(female);reference intervals of GGT(U·L^-1):3 months to 1 year 10.0-30.0,1-12 years 9.3-21.3,-18 years 9.6-28.7(male),9.5-26.2(female);reference intervals of LDH(g·L^-1):3 months to 3 years 165.9-266.0,-6 years 155.3-256.2,-12 years 142.9-240.9,-18 years 134.3-225.3(male),111.3-207.0(female).Conclusion There are differences in liver function levels among healthy children aged 3 months to 18 years in Chongqing.The age-and gender-specific pediatric reference intervals are important for the diagnosis and treatment of related diseases.
作者
饶露蓓
刘来成
刘曼
尹一兵
陈大鹏
RAO Lu-bei;LIU Lai-cheng;LIU Man;YIN Yi-bing;CHEN Da-peng(Department of Clinical Laboratory,Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation base of Child development and Critical Disorders,Children's Hospital of Chongqing Medical University,Chongging,P.R China)
出处
《中国循证儿科杂志》
CSCD
北大核心
2019年第4期260-265,共6页
Chinese Journal of Evidence Based Pediatrics
关键词
儿童
干化学
肝功能
参考区间
Children
Dry chemical
Liver function
Reference interval
