Cheng Chu-Yin, Hsu Ting-Hsuan, Yang Ya-Ling, Huang Ying-Hsien
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 333, Taiwan.
Children (Basel). 2023 Aug 17;10(8):1402. doi: 10.3390/children10081402.
Febrile disease and age of children were associated with a variation in hemoglobin (Hb) level. Both CRP and Hb serve as laboratory markers that offer valuable insights into a patient's health, particularly in relation to inflammation and specific medical conditions. Although a direct correlation between CRP and Hb levels is not established, the relationship between these markers has garnered academic attention and investigation. This study aimed to determine updated reference ranges for Hb levels for age and investigated its correlation with CRP in febrile children under the age of 18.
This is a cohort study of in Chang Gung Memorial Hospitals conducted from January 2010 to December 2019. Blood samples were collected from 98,572 febrile children who were or had been admitted in the pediatric emergency department. The parameters of individuals were presented as the mean ± standard deviation or 2.5th and 97.5th percentiles. We also determined the variation of Hb and Z score of Hb between CRP levels in febrile children.
We observed that the Hb levels were the highest immediately after birth and subsequently underwent a rapid decline, reaching their lowest point at around 1-2 months of age, and followed by a steady increment in Hb levels throughout childhood and adolescence. In addition, there was a significant and wide variation in Hb levels during the infant period. It revealed a significant association between higher CRP levels and lower Hb levels or a more negative Z score of Hb across all age subgroups. Moreover, in patients with bacteremia, CRP levels were higher, Hb concentrations were lower, and Z scores of Hb were also lower compared to the non-bacteremia group. Furthermore, the bacteremia group exhibited a more substantial negative correlation between CRP levels and a Z score of Hb (r = -0.41, < 0.001) compared to the non-bacteremia group (r = -0.115, < 0.049).
The study findings revealed that the Hb references varied depending on the age of the children and their CRP levels. In addition, we established new reference values for Hb and its Z scores and explore their relationship with CRP. It provides valuable insights into the Hb status and its potential association with inflammation in febrile pediatric patients.
发热性疾病和儿童年龄与血红蛋白（Hb）水平的变化有关。CRP和Hb均作为实验室指标，能为患者的健康状况提供有价值的见解，特别是在炎症和特定疾病方面。虽然CRP与Hb水平之间未建立直接关联，但这些指标之间的关系已引起学术关注和研究。本研究旨在确定18岁以下发热儿童Hb水平的更新参考范围，并研究其与CRP的相关性。
这是一项在长庚纪念医院进行的队列研究，时间跨度为2010年1月至2019年12月。从98572名在儿科急诊科就诊或已入院的发热儿童中采集血样。个体参数以平均值±标准差或第2.5和第97.5百分位数表示。我们还确定了发热儿童中不同CRP水平下Hb的变化及Hb的Z评分。
我们观察到，Hb水平在出生后即刻最高，随后迅速下降，在1 - 2个月龄左右达到最低点，然后在整个儿童期和青少年期稳步上升。此外，婴儿期Hb水平存在显著且广泛的差异。研究发现，在所有年龄亚组中，较高的CRP水平与较低的Hb水平或更负的Hb Z评分之间存在显著关联。此外，与非菌血症组相比，菌血症患者的CRP水平更高，Hb浓度更低，Hb的Z评分也更低。而且，与非菌血症组（r = -0.115，P < 0.049）相比，菌血症组CRP水平与Hb Z评分之间的负相关性更强（r = -0.41，P < 0.001）。
研究结果表明，Hb参考值因儿童年龄及其CRP水平而异。此外，我们建立了Hb及其Z评分的新参考值，并探讨了它们与CRP的关系。这为发热儿科患者的Hb状态及其与炎症的潜在关联提供了有价值的见解。
