From the Division of Neonatal Medicine, MEDNAX Services, Inc, Phoenix Perinatal Associates, Phoenix, Arizona.
University of Arizona College of Medicine - Phoenix.
Arch Pathol Lab Med. 2021 Jan 1;145(1):66-74. doi: 10.5858/arpa.2019-0444-OA.
CONTEXT.—: Automated analyzers have advanced the field of clinical hematology, mandating updated complete blood count (CBC) reference intervals (RIs) to be clinically useful. Contemporary newborn CBC RI publications are mostly retrospective, which some authors have cited as one of their cardinal limitations and recommended future prospective studies.
OBJECTIVE.—: To prospectively establish accurate hematologic RIs for normal healthy term newborns at 24 hours of life given the limitations of the current medical literature.
DESIGN.—: This prospective study was conducted at an academic tertiary care center, and hematology samples were collected from 120 participants deemed to be normal healthy term newborns. Distributions were assessed for normality and tested for outliers. Reference intervals were values between the 2.5th percentile and 97.5th percentile.
RESULTS.—: The novel RIs obtained for this study population are as follows: absolute immature granulocyte count, 80/μL to 1700/μL; immature granulocyte percentage, 0.6% to 6.1%; reticulocyte hemoglobin equivalent, 31.7 to 38.4 pg; immature reticulocyte fraction, 35.9% to 52.8%; immature platelet count, 4.73 × 103/μL to 19.72 × 103/μL; and immature platelet fraction, 1.7% to 9.8%.
CONCLUSIONS.—: This prospective study has defined hematologic RIs for this newborn population, including new advanced clinical parameters from the Sysmex XN-1000 Automated Hematology Analyzer. These RIs are proposed as the new standard and can serve as a strong foundation for continued research to further explore their value in diagnosing and managing morbidities such as sepsis, anemia, and thrombocytopenia.
自动化分析仪推动了临床血液学领域的发展，要求更新的全血细胞计数（CBC）参考区间（RI）具有临床实用性。当代新生儿 CBC RI 出版物大多是回顾性的，一些作者认为这是他们的主要局限性之一，并建议未来进行前瞻性研究。
鉴于当前文献的局限性，前瞻性地为 24 小时龄正常健康足月新生儿建立准确的血液学 RI。
这项前瞻性研究在一家学术性三级保健中心进行，从 120 名被认为是正常健康足月新生儿的参与者中采集血液样本。评估分布是否正态并检验是否存在异常值。RI 为第 2.5 百分位数和第 97.5 百分位数之间的值。
本研究人群获得的新 RI 如下：绝对未成熟粒细胞计数，80/μL 至 1700/μL；未成熟粒细胞百分比，0.6%至 6.1%；网织红细胞血红蛋白等价物，31.7 至 38.4pg；未成熟网织红细胞分数，35.9%至 52.8%；未成熟血小板计数，4.73×103/μL 至 19.72×103/μL；未成熟血小板分数，1.7%至 9.8%。
这项前瞻性研究为该新生儿人群定义了血液学 RI，包括 Sysmex XN-1000 自动化血液学分析仪的新的先进临床参数。这些 RI 被提议作为新标准，可以为进一步研究其在诊断和治疗脓毒症、贫血和血小板减少症等疾病中的价值提供坚实的基础。
