Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China.
Department of Pediatrics, First Hospital of Jilin University, Changchun, China.
BMC Pediatr. 2021 Mar 31;21(1):156. doi: 10.1186/s12887-021-02565-8.
Biochemical analytes provide information for neonatal disease management and therapy, and population-based reference intervals (RIs) are essential to accurately interpret laboratory test results. This study aimed to establish local RIs for biochemical assays in term neonates.
A total of 195 healthy term neonates from birth to 3rd day were recruited as reference individuals prospectively. Analytes of 26 common biochemistries were measured using the VITROS 5600 Integrated System. The 3-level nested ANOVA was performed to assess the need for partitioning RIs of each analyte, and RIs were derived by a nonparametric method or robust method. Multiple regression analysis was used to evaluate specific correlations between the analytes and individual characteristics including age, gender, gestational age, birthweight and delivery mode.
There were no between-sex differences in all analytes, whereas there were significant between-day-age differences in 6 analytes. Small between-delivery-mode differences were observed in the results for potassium, phosphorus, and urea. The major related factor of most analytes was postnatal age. During the first 3 days, values of iron, lipids and lipoproteins increased; creatinine, urea, uric acid, creatine kinase and lactate dehydrogenase decreased; other analytes showed slight changes or relatively stable trends. Reference limits of some analytes, particularly lactate dehydrogenase and alkaline phosphatase, were significantly different from adult and pediatric groups.
RIs of 26 common biochemical analytes are established for term neonates aged 0 to 3 days in northeast China. Additionally, it is suggested that age-related changes should be valued in the clinical decision-making process for newborns.
生化分析物为新生儿疾病管理和治疗提供信息，基于人群的参考区间（RIs）对于准确解释实验室检测结果至关重要。本研究旨在为足月新生儿建立生化分析的本地 RIs。
前瞻性招募 195 名来自出生至第 3 天的健康足月新生儿作为参考个体。使用 VITROS 5600 集成系统测量 26 种常见生化指标的分析物。采用 3 级嵌套方差分析评估每个分析物 RIs 进行分区的必要性，并采用非参数方法或稳健方法得出 RIs。多元回归分析用于评估分析物与个体特征（包括年龄、性别、胎龄、出生体重和分娩方式）之间的特定相关性。
所有分析物在性别之间均无差异，而在 6 种分析物中存在显著的日龄差异。钾、磷和尿素的结果存在小的分娩方式差异。大多数分析物的主要相关因素是出生后年龄。在最初的 3 天内，铁、脂质和脂蛋白的含量增加；肌酐、尿素、尿酸、肌酸激酶和乳酸脱氢酶的含量降低；其他分析物的变化较小或呈现相对稳定的趋势。一些分析物的参考限值，特别是乳酸脱氢酶和碱性磷酸酶，与成人和儿科群体明显不同。
为中国东北地区 0 至 3 天的足月新生儿建立了 26 种常见生化分析物的 RIs。此外，建议在新生儿的临床决策过程中重视与年龄相关的变化。
