Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing 100069, China; Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, No.56 Nanlishi Road, Beijing 100045, China.
Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, No.56 Nanlishi Road, Beijing 100045, China.
Clin Chim Acta. 2017 Jun;469:22-25. doi: 10.1016/j.cca.2017.03.017. Epub 2017 Mar 16.
We examined the critical gap for pediatric reference intervals in China byvalidating 3 existing pediatric reference intervals (RIs) of complete blood count(CBC) respectively.
A total of 2255 healthy children attended physical examination in Beijing Children's Hospital. Fasted blood was sampled and CBC, including red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), platelet count (PLT) and white blood cell (WBC) count were measured by automated hematological analyzer Sysmex Xs-800i. The observed proportions of out-of-range (OOR) values were calculated by three RIs in order to examine its applicability.
Compared with RIs of CBC recommended by Zhu Futang Practice of Pediatrics, the upper side OORs of RBC count, HGB, WBC count, and PLT deviated from upper reference limit, which ranged from 10% to 91.9%. On the contrary, the lower side OOR of WBC count was 64%. Compared with Chinese adult RIs, the upper side OORs of WBC count and PLT were >10%. While the lower sides OORs of RBC count, HGB and HCT were >10% among boys <14y. It appears that the RIs validated by Beijing Children's Hospital were relatively accurate RIs for children.
There is a gap for pediatric RIs in China. It is imperative to initiate research on establishing and validating pediatric RIs in China.
我们通过验证现有的 3 项儿童全血细胞计数（CBC）参考区间，来评估中国儿科参考区间的关键差距。
共有 2255 名健康儿童在北京儿童医院接受体检。采集空腹血，使用全自动血液分析仪 Sysmex Xs-800i 检测 CBC，包括红细胞计数（RBC）、血红蛋白（HGB）、血细胞比容（HCT）、血小板计数（PLT）和白细胞计数（WBC）。通过这 3 项参考区间分别计算出超出范围（OOR）值的比例，以评估其适用性。
与《诸福棠实用儿科学》推荐的 CBC 参考区间相比，RBC 计数、HGB、WBC 计数和 PLT 的上限 OOR 值偏离参考上限，范围为 10%至 91.9%。相反，WBC 计数的下限 OOR 值为 64%。与中国成人参考区间相比，WBC 计数和 PLT 的上限 OOR 值>10%。而男孩<14 岁时 RBC 计数、HGB 和 HCT 的下限 OOR 值>10%。北京儿童医院验证的参考区间似乎是儿童较为准确的参考区间。
中国存在儿科参考区间的差距。当务之急是开展中国儿科参考区间的建立和验证研究。
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