Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, P.R. China.
National Center for Clinical Laboratories (NCCL), Beijing, P.R. China.
Clin Chem Lab Med. 2022 May 24;60(8):1250-1260. doi: 10.1515/cclm-2022-0304. Print 2022 Jul 26.
Pediatric Reference Intervals in China (PRINCE) is a nationwide initiative that aims to establish and validate harmonized reference intervals (RIs) for Chinese children and adolescents, in which 15,150 healthy volunteers aged up to 20 years were recruited from 11 centers to establish RIs and 7,557 children and adolescents were enrolled from 21 centers to validate RIs.
The complete blood cell counts (CBC) of venous whole blood were measured by hematology analyzers through Sysmex systems in different centers. Age- and sex-specific RIs were calculated according to the guidelines.
Unlike adults with certain levels of analyte concentrations, hematological parameters of children changed through growth and development. Red blood cell counts, hemoglobin, and hematocrit increased with age, and revealed higher concentrations in boys than girls after puberty. White blood cell counts and platelet counts showed significant higher levels than adults before 2 years of age, and then gradually decreased without distinct sex differences. In addition, lymphocyte counts decreased with age while neutrophil counts showed an opposite trend. The lower and upper limits of pediatric RIs of CBC were different from those of adults.
The validation of RIs indicated that the PRINCE study provided a version of RIs suitable for most of regions in China. This first harmonized pediatric RIs of CBC across China provided a robust database to understand the dynamic changes of hematologic parameters from birth to adolescence, and will contribute to clinical diagnosis and prognosis evaluation for pediatric patients as well.
中国儿科参考区间（PRINCE）是一项全国性的计划，旨在为中国儿童和青少年建立和验证协调的参考区间（RI），其中从 11 个中心招募了 15150 名年龄最大为 20 岁的健康志愿者来建立 RI，从 21 个中心招募了 7557 名儿童和青少年来验证 RI。
通过不同中心的 Sysmex 系统，使用血液分析仪对静脉全血的全血细胞计数（CBC）进行检测。根据指南计算年龄和性别特异性 RI。
与具有一定分析物浓度水平的成年人不同，儿童的血液学参数随着生长发育而变化。红细胞计数、血红蛋白和血细胞比容随年龄增长而增加，青春期后男孩的浓度高于女孩。白细胞计数和血小板计数在 2 岁之前明显高于成年人，然后逐渐下降，没有明显的性别差异。此外，淋巴细胞计数随年龄下降，而中性粒细胞计数呈相反趋势。CBC 的儿科 RI 的下限和上限与成年人不同。
RI 的验证表明，PRINCE 研究提供了适用于中国大部分地区的 RI 版本。这是中国首次对 CBC 的儿科 RI 进行协调，为了解从出生到青春期血液参数的动态变化提供了一个强大的数据库，并将有助于儿科患者的临床诊断和预后评估。
