上海地区成人网织红细胞相关参数参考区间的建立

doi:10.3969/j.issn.1673-8640.2022.07.009

摘要/Abstract

摘要：

目的建立上海地区成人网织红细胞（RET）相关参数的参考区间。方法选取2 080名体检健康者,检测RET相关参数[网织红细胞绝对值（RET#）、网织红细胞百分比（RET%）、高荧光强度网织红细胞百分比（HFR%）、中荧光强度网织红细胞百分比（MFR%）、低荧光强度网织红细胞百分比（LFR%）、未成熟网织红细胞百分比（IRF%）、网织红细胞血红蛋白含量（RET-He）、网织红细胞生成指数（RPI）]。按性别和年龄（18~40岁、41~60岁和61~80岁）分别分组进行比较,建立参考区间。另收集40份健康体检者血常规检测样本,用于参考区间验证。结果正态性检验结果显示,RET相关参数均呈偏态分布（P<0.05）。RET%、RET#、RPI各年龄组之间差异均无统计学意义（P>0.05）。41~60岁组、61~80岁组IRF%、LFR%、MFR%、HFR%、RET-He与18~40岁组比较差异均有统计学意义（P<0.05）,而41~60岁组与61~80岁组之间差异均无统计学意义（P>0.05）。合并年龄、性别各组后采用百分位数法建立参考区间：RET%、RET#、RPI男性分别为0.92%~2.15%、（46.30~107.30）×10⁹/L、0.9~2.4,女性分别为0.87%~2.27%、（37.96~101.90）×10⁹/L、0.6~1.8;IRF%、LFR%、MFR%、HFR% 18~40岁男性分别为4.1%~16.1%、83.9%~96.0%、3.6%~12.1%、0.2%~5.0%,女性分别为3.9%~17.9%、82.1%~96.1%、3.6%~12.5%、0.1%~5.5%,41~80岁（不分性别）分别为4.4%~18.0%、82.0%~95.6%、4.0%~12.8%、0.2%~5.1%;RET-He 18~40岁男性为30.3~35.5 pg、女性为27.6~34.6 pg,41~80岁男性为30.4~35.7 pg、女性为27.8~34.6 pg。40份验证样本检测结果均在建立的参考区间内。结论初步建立了上海地区成人RET相关参数的参考区间,可提高RET检测的临床应用价值。

关键词: 网织红细胞, 网织红细胞血红蛋白含量, 网织红细胞生成指数, 参考区间

Abstract:

Objective To establish the reference intervals for adult reticulocyte（RET）-related parameters in Shanghai. Methods The RET-related parameters [the absolute value of reticulocyte（RET#）,the percentage of reticulocyte（RET%）,high fluorescence intensity reticulocyte percentage（HFR%）,medium fluorescence intensity reticulocyte percentage（MFR%）,low fluorescence intensity reticulocyte percentage（LFR%）,immature reticulocyte fraction percentage（IRF%）,reticulocyte hemoglobin（RET-He） and reticulocyte production index（RPI）] of 2 080 healthy adults were determined. According to sex,the research subjects were classified into male and female groups,and according to ages,they were classified into 18-40-year-old,41-60-year-old and 61-80-year-old groups. Another 40 samples for blood routine test were collected for the verification of reference intervals. Results The results of normality test showed that the RET-related parameters were skewed distribution（P<0.05）. There was no statistical significance in RET%,RET# and RPI among different age groups（P>0.05）. There was statistical significance in IRF%,LFR%,MFR%,HFR% and RET-He between 41-60-year-old group,61-80-year-old group and 18-40-year-old group（P<0.05）,while there was no statistical significance between 41-60-year-old and 61-80-year-old groups（P>0.05）. The reference intervals were established by percentile method after combining age and sex groups. The reference intervals of RET%,RET# and RPI in males were 0.92%-2.15%,（46.30-107.30）×10⁹/L,0.9-2.4,and those in females were 0.87%-2.27%,（37.96-101.90）×10⁹/L,0.6-1.8,respectively. The reference intervals of IRF%,LFR%,MFR% and HFR% in 18-40-year-old males were 4.1%-16.1%,83.9%-96.0%,3.6%-12.1%,0.2%-5.0%,those in 18-40-year-old females were 3.9%-17.9%,82.1%-96.1%,3.6%-12.5%,0.1%-5.5%,and those in 41-80-year-old males and females were 4.4%-18.0%,82.0%-95.6%,4.0%-12.8%,0.2%-5.1%,respectively. The reference interval of RET-He in 18-40-year-old males was 30.3-35.5 pg,that in 18-40-year-old females was 27.6-34.6 pg,that in 41-80-year-old males was 30.4-35.7 pg,and that in 41-80-year-old females was 27.8-34.6 pg. The results of 40 verification samples were all in the reference intervals. Conclusions The reference intervals of RET-related parameters for adults in Shanghai have been established preliminarily,which can improve the clinical application roles of RET-related parameters.

Key words: Reticulocyte, Reticulocyte hemoglobin, Reticulocyte production index, Reference interval

中图分类号:

R446.11

徐倩倩, 姜王庆, 沈林杰, 陆英杰, 陈健, 蒋浩琴. 上海地区成人网织红细胞相关参数参考区间的建立[J]. 检验医学, 2022, 37(7): 641-645.

XU Qianqian, JIANG Wangqing, SHEN Linjie, LU Yingjie, CHEN Jian, JIANG Haoqin. Establishment of the reference intervals for related parameters of adult reticulocytes in Shanghai[J]. Laboratory Medicine, 2022, 37(7): 641-645.

图/表 7

参考文献 11

[1]	HILLMAN R S. Characteristics of marrow production and reticulocyte maturation in normal man in response to anemia[J]. J Clin Invest, 1969, 48(3):443-453. DOI URL
[2]	PIVA E, BRUGNARA C, SPOLAORE F, et al. Clinical utility of reticulocyte parameters[J]. Clin Lab Med, 2015, 35(1):133-163. DOI URL
[3]	CAI J, WU M, REN J, et al. Evaluation of the efficiency of the reticulocyte hemoglobin content on diagnosis for iron deficiency anemia in Chinese adults[J]. Nutrients, 2017, 9(5):450. DOI URL
[4]	CANALS C, REMACHA A F, SARDÁ M P, et al. Clinical utility of the new Sysmex XE 2100 parameter-reticulocyte hemoglobin equivalent-in the diagnosis of anemia[J]. Haematologica, 2005, 90(8):1133-1134.
[5]	BORBA R, LIMA C S, GROTTO H Z. Reticulocyte parameters and hemoglobin F production in sickle cell disease patients undergoing hydroxyurea therapy[J]. J Clin Lab Analy, 2003, 17(2):66-72.
[6]	FENDEL R, BRANDTS C, RUDAT A, et al. Hemolysis is associated with low reticulocyte production index and predicts blood transfusion in severe malarial anemia[J]. PLoS One, 2010, 5(4):e10038. DOI URL
[7]	PIVA E, BRUGNARA C, CHIANDETTI L, et al. Automated reticulocyte counting:state of the art and clinical applications in the evaluation of erythropoiesis[J]. Clin Chem Lab Med, 2010, 48(10):1369-1380.
[8]	IBÁÑEZ-ALCALDE M M, VÁZQUEZ-LÓPEZ M Á, RUÍZ-SÁNCHEZ A M, et al. Reference values of reticulocyte hemoglobin content in healthy adolescents[J]. J Pediatr Hematol Oncol, 2018, 40(4):298-303. DOI URL
[9]	韩启福, 彭海, 李子安, 等. 西宁地区健康成人网织红细胞血红蛋白含量参考区间的建立与验证[J]. 国际检验医学杂志, 2020, 41(1):111-113.
[10]	李小龙, 陶洪群, 王薇薇, 等. 温州地区健康成人外周血网织红细胞血红蛋白及网织红分群值正常值范围调查[J]. 中华检验医学杂志, 2011, 34(2):147-151.
[11]	赵丽娟, 王言, 肖贺欣, 等. 长春地区网织红细胞血红蛋白含量参考区间的建立[J]. 中国实验诊断学, 2018, 22(9):1546-1548.

项目	M（P₂₅,P₇₅）	偏度系数	峰度系数
RET%	1.45（1.22,1.66）	0.474	0.456
RET#	69.00（57.45,81.40）	0.259	-0.277
IRF%	8.80（6.90,10.80）	1.101	2.66
LFR%	91.20（89.20,93.10）	-1.101	2.66
MFR%	7.70（6.10,9.30）	0.358	0.177
HFR%	1.10（0.70,1.50）	3.321	14.114
Ret-He	32.80（31.90,33.60）	-1.268	5.365
RPI	1.30（1.00,1.70）	0.377	-0.479

项目	M（P₂₅,P₇₅）	偏度系数	峰度系数
RET%	1.45（1.22,1.66）	0.474	0.456
RET#	69.00（57.45,81.40）	0.259	-0.277
IRF%	8.80（6.90,10.80）	1.101	2.66
LFR%	91.20（89.20,93.10）	-1.101	2.66
MFR%	7.70（6.10,9.30）	0.358	0.177
HFR%	1.10（0.70,1.50）	3.321	14.114
Ret-He	32.80（31.90,33.60）	-1.268	5.365
RPI	1.30（1.00,1.70）	0.377	-0.479

性别	例数	RET%/%	RET#/（×10⁹/L）	IRF%/%	LFR%/%
男性	1 059	1.49（1.28,1.67）	75.60（63.90,85.55）	9.1（7.2,11.0）	90.9（89.0,92.9）
女性	1 021	1.39（1.19,1.65）	62.60（52.50,75.00）	8.5（6.6,10.6）	91.5（89.4,93.4）
Z值		-4.725	-15.088	-4.148	-4.148
P值		0.000	0.000	0.000	0.000
性别		MFR%/%	HFR%/%	RET-He/pg	RPI
男性		7.9（6.4,9.5）	1.1（0.7,1.6）	33.2（32.3,34.0）	1.6（1.3,1.9）
女性		7.5（5.9,9.1）	1.0（0.6,1.5）	32.4（31.5,33.2）	1.1（0.9,1.3）
Z值		-4.035	-3.274	-13.172	-26.922
P值		0.000	0.001	0.000	0.000

性别	例数	RET%/%	RET#/（×10⁹/L）	IRF%/%	LFR%/%
男性	1 059	1.49（1.28,1.67）	75.60（63.90,85.55）	9.1（7.2,11.0）	90.9（89.0,92.9）
女性	1 021	1.39（1.19,1.65）	62.60（52.50,75.00）	8.5（6.6,10.6）	91.5（89.4,93.4）
Z值		-4.725	-15.088	-4.148	-4.148
P值		0.000	0.000	0.000	0.000
性别		MFR%/%	HFR%/%	RET-He/pg	RPI
男性		7.9（6.4,9.5）	1.1（0.7,1.6）	33.2（32.3,34.0）	1.6（1.3,1.9）
女性		7.5（5.9,9.1）	1.0（0.6,1.5）	32.4（31.5,33.2）	1.1（0.9,1.3）
Z值		-4.035	-3.274	-13.172	-26.922
P值		0.000	0.001	0.000	0.000

组别	例数	RET%/%	RET#/（×10⁹/L）	IRF%/%	LFR%/%
18~40岁组	1 084	1.43（1.21,1.65）	68.70（56.75,81.75）	8.4（6.5,10.3）	91.6（89.7,93.5）
41~60岁组	823	1.46（1.24,1.67）	70.20（58.30,81.45）	9.3（7.4,11.1）^*	90.7（88.9,90.6）^*
61~80岁组	173	1.47（1.22,1.67）	67.90（58.80,79.20）	9.3（7.3,11.4）^*	90.7（88.6,92.7）^*
H值		4.248	1.997	40.915	40.915
P值		0.120	0.368	0.000	0.000
组别		MFR%/%	HFR%/%	RET-He/pg	RPI
18~40岁组		7.3（5.8,9.1）	1.0（0.6,1.4）	32.6（31.8,33.5）	1.3（1.0,1.7）
41~60岁组		8.0（6.5,9.4）^*	1.2（0.8,1.7）^*	32.9（32.0,33.7）^*	1.3（1.0,1.7）
61~80岁组		8.2（6.4,9.9）^*	1.2（0.8,1.8）^*	33.0（32.1,33.9）^*	1.3（1.1,1.7）
H值		34.341	39.27	28.938	3.146
P值		0.000	0.000	0.000	0.207