CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada.
Int J Lab Hematol. 2023 Aug;45(4):469-480. doi: 10.1111/ijlh.14068. Epub 2023 Mar 29.
Hematological parameters vary significantly throughout growth and development due to physiological processes such as fetal-to-adult erythropoiesis and puberty. Pediatric age- and sex-specific reference intervals (RIs) are thus essential for appropriate clinical decision-making. The current study aimed to establish RIs for both common and novel hematology parameters on the Mindray BC-6800Plus system.
Six hundred and eighty-seven healthy children and adolescents (30 days to 18 years) were enrolled. Participants were recruited as part of the Canadian Laboratory Initiative on Pediatric Reference Intervals Program upon informed consent or identified from apparently healthy outpatient clinics. Whole blood was collected and assayed for 79 hematology parameters on the BC-6800Plus system (Mindray). Age- and sex-specific RIs were established as per Clinical and Laboratory Standards Institute EP28-A3c guidelines.
Dynamic reference value distributions were observed for several hematology parameters, including erythrocytes, leukocytes, platelets, reticulocytes, and research-use-only markers. Age partitioning was required for 52 parameters, demonstrating changes in infancy and puberty. Sex partitioning was required for 11 erythrocyte parameters (i.e., red blood cell (RBC), hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, RBC distribution width coefficient of variation, hemoglobin distribution width, macrocyte count, macrocyte percentage, RBC (optical), and reticulocyte production index). Few parameters had undetectable levels in our healthy cohort (i.e., nucleated RBC count and immature granulocyte count).
The current study completed hematological profiling for 79 parameters on the BC-6800Plus system in a healthy cohort of Canadian children and adolescents. These data emphasize the complex biological patterns of hematology parameters in childhood, particularly at the onset of puberty, and support the need for age- and sex-specific RIs for clinical interpretation.
由于胎儿到成人的红细胞生成和青春期等生理过程，血液学参数在整个生长发育过程中会发生显著变化。因此，儿科年龄和性别特异性参考区间（RIs）对于正确的临床决策至关重要。本研究旨在建立 Mindray BC-6800Plus 系统上常见和新型血液学参数的 RIs。
纳入了 687 名健康的儿童和青少年（30 天至 18 岁）。参与者是在知情同意的情况下作为加拿大实验室儿科参考区间计划的一部分招募的，或者是从明显健康的门诊诊所中确定的。采集全血并在 BC-6800Plus 系统（Mindray）上检测 79 项血液学参数。按照临床和实验室标准协会 EP28-A3c 指南建立年龄和性别特异性 RIs。
观察到几个血液学参数（包括红细胞、白细胞、血小板、网织红细胞和仅供研究使用的标志物）具有动态参考值分布。需要进行年龄分区的参数有 52 个，这表明婴儿期和青春期发生了变化。需要进行性别分区的参数有 11 个红细胞参数（即红细胞（RBC）、血红蛋白、血细胞比容、平均红细胞体积、平均红细胞血红蛋白浓度、红细胞分布宽度变异系数、血红蛋白分布宽度、大细胞计数、大细胞百分比、RBC（光学）和网织红细胞生成指数）。我们的健康队列中很少有参数无法检测到（即有核红细胞计数和未成熟粒细胞计数）。
本研究在加拿大儿童和青少年的健康队列中完成了 BC-6800Plus 系统上 79 个参数的血液学分析。这些数据强调了儿童时期血液学参数的复杂生物学模式，特别是在青春期开始时，支持为临床解释制定年龄和性别特异性 RIs 的必要性。
