高原世居藏族儿童青少年血常规检测结果

谢慎威; 许珂; 董明; 施俊屹; 曹玖见; 董华平; 吴玉; 李鹏; 谢佳新

doi:10.16835/j.cnki.1000-9817.2022.08.026

高原世居藏族儿童青少年血常规检测结果

doi: 10.16835/j.cnki.1000-9817.2022.08.026

1.
解放军陆军第953医院传染科，西藏日喀则 857000
2.
陆军军医大学高原军事医学系

基金项目:

国家自然科学基金项目 81571842

详细信息

作者简介:
谢慎威(1980-)，男，湖北仙桃人，大学本科，副主任医师，主要从事高原病防治工作

通讯作者:
谢佳新，E-mail: xiejiaxin1006@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R446 R179 G478
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出版历程
- 收稿日期: 2022-02-17
- 修回日期: 2022-04-24
- 网络出版日期: 2022-08-24
- 刊出日期: 2022-08-25

Routine blood test results of Tibetan children and adolescents in plateau areas

1.
Department of Infectious Disease, the 953rd Hospital of PLA, Shigatse(857000), Tibet Autonomous Region, China

摘要

摘要: 目的探讨3~19岁高原世居藏族儿童青少年血常规指标水平及其变化趋势，为建立该人群血常规参考值范围提供依据。方法采取整群随机抽样方法，以西藏日喀则地区1 568名3~19岁高原世居藏族儿童青少年为研究对象，进行血常规检测，比较各年龄组、不同性别人群血常规指标水平并分析其随年龄变化趋势。结果红细胞计数(RBC)、血红蛋白质量浓度(HGB)、红细胞压积(HCT)、平均红细胞体积(MCV)、红细胞平均血红蛋白含量(MCH)、白细胞计数(WBC)、中性粒细胞计数(NEU)、中性粒细胞计数百分比(NEU%)、淋巴细胞数(LYM)、淋巴细胞数百分比(LYM%)、单核细胞计数比例(MON%)、嗜酸性粒细胞计数比例(EOS%)、嗜碱性粒细胞计数比例(BAS%)、血小板计数(PLT)在3~5，6~12，13~15，16~19岁4个年龄段间差异均有统计学意义(F/H值分别为60.22，179.41，249.45，115.03，74.90，14.34，33.46，78.90，49.20，97.29，24.45，24.28，42.65，20.10，P值均 < 0.05)，其中RBC、HGB、HCT、MCH红细胞指标在藏族男生中随年龄呈现上升趋势(F值分别为148.77，493.04，623.14，249.92，P值均 < 0.05)，在女生中无显著变化趋势(F值分别为1.37，0.15，2.94，0.11，P值均>0.05)。HCT在3~5，6~12，13~15，16~19岁年龄段的男女生间[(41.33±2.31)%，(41.98±2.40)%；(43.28±2.60)%，(43.75±2.36)%；(46.20±3.11)%，(44.83±2.67)%；(51.10±4.15)%，(43.61±4.70)%]差异均有统计学意义(t值分别为-2.10，-2.88，3.50，10.82，P值均 < 0.05)。WBC、NEU、NEU%、LYM、LYM%、单核细胞计数(MON)、MON%等指标在男女中随年龄具有相同的变化趋势(P值均 < 0.05)。从12~13岁开始，RBC、HGB、HCT在高原世居藏族男性与女性青少年中呈现相反的变化趋势并逐渐拉开差距。结论红细胞指标在不同年龄、性别的高原世居藏族儿童青少年中变化趋势差异显著，在制定血常规参考值范围时应考虑地域民族、年龄、性别等因素影响。
- 血液 /
- 健康调查 /
- 方差分析 /
- 儿童 /
- 青少年 /
- 少数民族
Abstract: Objective To investigate routine blood test results and secular changes among Tibetan children and adolescents aged from 3 to 19 in the plateau, and to provide the basis for reference range of routine blood test for this population. Methods A total of 1 568 Tibetan children and adolescents aged from 3 to 19 living in Shigatse, Tibet were selected by cluster random sampling method. Routine blood test results and its secular trends were compared by age and gender. Results Significantly differences were found in red blood cell(RBC), hemoglobin(HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin(MCH), white blood cell(WBC), neutrophil(NEU), neutrophil percentage (NEU%), lymphocyte(LYM), lymphocyte percentage(LYM%), monocyte percentage(MON%), eosinophil percentage(EOS%), basophil percentage(BAS%) and platelet(PLT) among the four age groups of 3-5, 6-12, 13-15, and 16-19 years (F/H=60.22, 179.41, 249.45, 115.03, 74.90, 14.33, 33.46, 78.90, 49.20, 97.29, 24.45, 24.28, 42.65, 20.10, P < 0.05). Among red blood cell indexes, RBC, HGB, HCT, MCH increased with age in boys(F=148.77, 493.04, 623.14, 249.92, P < 0.05), but there was no similar trend in girls(F=1.37, 0.15, 2.94, 0.11, P>0.05). HCT showed significant sex differences among the four age groups of 3-5 years, 6-12 years, 13-15 years, and 16-19 years [(41.33±2.31)% vs (41.98±2.40)%; (43.28±2.60)% vs (43.75±2.36)%; (46.20±3.11)% vs (44.83±2.67)%; (51.10±4.15)% vs (43.61±4.70)%, t=-2.10, -2.88, 3.50, 10.82, P < 0.05]. WBC, NEU, NEU%, LYM, LYM%, monocyte(MON), and MON% increased significantly with age in both boys and girls (P < 0.05). From the age of 12 to 13, RBC, HGB and HCT in Tibetan male and female adolescents showed an opposite trend and widened gradually. Conclusion Red blood cell index shows significantly different trends among Tibetan adolescents and children of different ages and genders. Regional nationality, age, gender, and other factors should be considered when developing the reference value range of blood routine index.
- Blood /
- Health surveys /
- Analysis of variance /
- Child /
- Adolescent /
- Minority groups
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图 1 高原世居藏族男女生红细胞计数年龄变化趋势

Figure 1. The trend of red blood cell with age among native Tibetan boys and girls on the plateau

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图 2 高原世居藏族男女生白细胞计数年龄变化趋势

Figure 2. The trend of white blood cell with age among native Tibetan boys and girls on the plateau

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图 3 高原世居藏族男女生血小板计数年龄变化趋势

Figure 3. The trend of Platelets with age among native Tibetan boys and girls on the plateau

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图 4 高原世居藏族男女生血红蛋白质量浓度年龄变化趋势

Figure 4. The trend of hemoglobin with age among native Tibetan boys and girls on the plateau

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图 5 高原世居藏族男女生红细胞压积年龄变化趋势

Figure 5. The trend of hematocrit with age among native Tibetan boys and girls on the plateau

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图 6 高原世居藏族男女生红细胞平均血红蛋白量年龄变化趋势

Figure 6. The trend of mean corpuscular hemoglobin with age among native Tibetan boys and girls on the plateau

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表 1 不同年龄段藏族儿童青少年血常规指标水平比较(x±s)

Table 1. Comparison of blood routine indexes among Tibetan children and adolescents of different age groups(x±s)

年龄组/岁	人数	RBC/(×10¹²·L^-1)	HGB/(g·L^-1)	HCT/%	MCV/fL	MCH/pg	MCHC/(g·L^-1)	WBC/(×10⁹·L^-1)	NEU/(×10⁹·L^-1)
3~5	232	5.25±0.32	141.86±9.70	41.65±2.37	79.47±4.50	27.07±1.87	340.43±9.45	5.59±1.65	2.49±1.26
6~12	900	5.30±0.31	148.24±9.86^a	43.52±2.49^a	82.27±3.95^a	28.02±1.60^a	340.54±9.47	5.40±1.55	2.72±1.23
13~15	240	5.43±0.36^ab	155.73±12.49^ab	45.66±3.01^ab	84.26±5.05^ab	28.74±2.14^ab	340.82±10.32	5.78±1.97	3.21±1.81^ab
16~19	196	5.63±0.49^abc	167.37±22.41^abc	49.07±5.44^abc	87.08±5.85^abc	29.65±2.69^abc	340.03±15.18	6.21±1.61^ab	3.61±1.48^ab
F值		60.22	179.41	249.45	115.03	74.90	0.21	14.34	33.46
P值		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.89	< 0.01	< 0.01

年龄组/岁	人数	NEU比例/%	LYM/(×10⁹·L^-1)	LYM比例/%	MON比例/%	EOS比例/%^*		BAS比例/%^*	PLT/(×10⁹·L^-1)
3~5	232	43.14±10.58	2.62±0.76	48.15±10.66	6.55±2.44	1.60(1.10, 2.28)		0.20(0.20, 0.34)	291.32±69.55
6~12	900	49.03±9.77^a	2.21±0.60^a	42.17±9.61^a	6.74±1.96	1.50(1.00, 2.30)		0.20(0.20, 0.34)	282.26±66.70
13~15	240	53.41±9.75^ab	2.05±0.50^ab	37.55±9.14^ab	7.05±1.84	1.50(1.00, 2.18)		0.20(0.10, 0.30)	274.42±70.82
16~19	196	56.70±10.04^abc	2.00±0.51^ab	33.42±9.09^abc	8.08±2.62^abc	1.20(0.70, 1.80)		0.20(0.10, 0.29)	244.73±67.15^abc
H/F值		78.90	49.20	97.29	24.45	24.28		42.65	20.10
P值		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01		< 0.01	< 0.01
注： * 数据不符合正态分布，用M(P₂₅, P₇₅)描述；经Bonferroni校正后，a与3~5岁组比较，b与6~12岁组比较，c与13~15岁组比较，P < 0.05。

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表 2 不同年龄组藏族男女童血常规检查结果比较(x±s)

Table 2. Comparison of blood routine examination results between Tibetan boys and girls of different age groups(x±s)

年龄组/岁	性别	人数	统计值	RBC/(×10¹²·L^-1)	HGB/(g·L^-1)	HCT/%	MCV/fL	MCH/pg	MCHC/(g·L^-1)	WBC/(×10⁹·L^-1)	NEU/(×10⁹·L^-1)
3~5	男	116		5.27±0.33	141.24±9.49	41.33±2.31	78.53±4.15	26.85±1.80	341.59±9.48	5.50±1.50	2.39±1.06
	女	116		5.23±0.32	142.48±9.91	41.98±2.40	80.40±4.65	27.30±1.92	339.26±9.31	5.68±1.79	2.59±1.44
			t值	0.98	-0.98	-2.10	-3.23	-1.84	1.90	-0.85	-1.23
			P值	0.33	0.33	0.04	< 0.01	0.07	0.06	0.40	0.22
6~12	男	442		5.33±0.32	147.95±10.47	43.28±2.60	81.25±3.84	27.78±1.65	341.72±10.02	5.39±1.56	2.70±1.25
	女	458		5.26±0.29	148.51±9.24	43.75±2.36	83.24±3.81	28.25±1.53	339.39±8.76	5.41±1.53	2.75±1.20
			t值	3.44	-0.85	-2.88	-7.82	-4.51	3.73	-0.21	-0.59
			P值	< 0.01	0.40	< 0.01	< 0.01	< 0.01	< 0.01	0.84	0.56
13~15	男	146		5.55±0.35	158.17±12.66	46.20±3.11	83.36±4.97	28.55±2.15	342.18±10.52	5.60±2.02	3.08±1.92
	女	94		5.24±0.30	151.95±11.28	44.83±2.67	85.67±4.87	29.04±2.09	338.69±9.67	6.05±1.86	3.41±1.63
			t值	7.14	3.88	3.50	-3.55	-1.75	2.59	-1.72	-1.37
			P值	< 0.01	< 0.01	< 0.01	< 0.01	0.08	0.01	0.09	0.17
16~19	男	143		5.80±0.42	175.90±16.02	51.10±4.15	88.12±4.81	30.30±1.83	343.97±11.18	6.23±1.67	3.58±1.57
	女	53		5.17±0.37	144.34±21.00	43.61±4.70	84.30±7.38	27.89±3.68	329.40±19.12	6.17±1.45	3.70±1.22
			t值	9.61	11.22	10.82	3.45	4.58	5.23	0.21	-0.50
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.83	0.62

年龄组/岁	性别	人数	统计值	NEU比例/%	LYM/(×10⁹·L^-1)	LYM比例/%	MON比例/%	EOS比例/%^*		BAS比例/%^*	PLT/(×10⁹·L^-1)
3~5	男	116		42.49±9.70	2.61±0.77	48.37±10.06	6.86±2.61	1.80(1.30，2.58)		0.20(0.20，0.40)	294.29±71.80
	女	116		43.78±11.40	2.62±0.74	47.93±11.27	6.24±2.24	1.50(0.92，2.10)		0.20(0.20，0.30)	288.35±67.39
			Z/t值	-0.93	-0.11	0.32	1.95	2.00		0.85	0.65
			P值	0.36	0.91	0.75	0.06	0.05		0.40	0.52
6~12	男	442		48.65±9.68	2.20±0.57	42.13±9.58	1.98±1.59	1.70(1.10，2.40)		0.20(0.20，0.40)	284.97±65.29
	女	458		49.41±9.86	2.21±0.62	42.20±9.65	1.66±1.52	1.40(0.90，2.10)		0.20(0.20，0.30)	279.65±68.00
			Z/t值	-1.17	-0.38	-0.10	3.06	4.08		1.34	1.20
			P值	0.24	0.70	0.92	< 0.01	< 0.01		0.18	0.23
13~15	男	146		52.74±9.82	2.00±0.49	37.77±9.21	7.17±1.98	1.80(1.30, 2.53)		0.20(0.10, 0.30)	269.30±57.68
	女	94		54.47±9.59	2.14±0.50	37.19±9.07	6.86±1.59	1.25(0.70, 1.60)		0.20(0.10, 0.24)	282.37±87.16
			Z/t值	-1.35	-2.12	0.48	1.35	5.18		1.37	-1.28
			P值	0.18	0.04	0.63	0.18	< 0.01		0.17	0.20
16~19	男	143		55.83±10.32	2.03±0.49	34.07±9.28	8.27±2.79	1.20(0.70, 1.80)		0.20(0.10, 0.24)	230.50±54.50
	女	53		59.07±8.92	1.91±0.58	31.65±8.37	7.57±2.06	1.30(0.80, 1.75)		0.20(0.10, 0.30)	283.15±82.07
			Z/t值	-2.03	1.53	1.67	1.68	0.71		0.34	-4.33
			P值	0.04	0.13	0.10	0.10	0.48		0.74	< 0.01
注： * 数据不符合正态分布，用M(P₂₅, P₇₅)描述。

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