Analysis of Blood Cells and Establishment of Reference Interval of Elderly Derivative Index in Anning Area of Yunnan Province
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摘要:
目的 建立云南安宁地区高原老年人血细胞分析及血细胞分析衍生指标淋巴细胞/单核细胞比值(lymphocyte to monocyte ratio,LMR)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)参考区间,观察与多中心调查的差异,以确定建立该参考区间的必要性。 方法 回顾性收集2022年6月至2022年9月安宁市第一人民医院信息系统中 60岁以上体检人群分析结果。根据国际CLSI EP28-A3c指南中间接法建立安宁市健康老年人生物参考区间。 结果 共纳入8877例研究对象,红细胞计数(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、平均红细胞血红蛋白浓度(MCHC)、血小板计数(PLT)、淋巴细胞百分数(LYM%)则随着年龄增大而减低,且男女之间差异具有统计学意义(P < 0.05),仅红细胞体积分布宽带变异系数(RDWCV)随着年龄增加而升高。白细胞计数(WBC)、中性粒细胞绝对值(NEU#)、嗜酸性粒细胞绝对值(EOS#)、中性粒细胞百分数(NEU%)、嗜酸性粒细胞百分数(EOS%)、平均红细胞体积(MCV)、红细胞体积分布宽度标准差(RDWSD)、血小板体积分布宽度(PDW)仅在男女间差异具有统计学意义(P < 0.05),其余项目则年龄和性别差异无统计学意义(P > 0.05)。NLR随年龄不断升高,且男性明显高于同年龄段女性。LMR、PLR均为女性高于男性。 结论 自建参考区间内WBC、RBC、HGB、PLT、HCT等结果与多中心调查参考区间结果有较大差异。 -
关键词:
- 老年人 /
- 中性粒细胞/淋巴细胞比值 /
- 淋巴细胞/单核细胞比值 /
- 血小板/淋巴细胞比值 /
- 参考区间
Abstract:Objective To establish the derived indicators from blood cell analysis of the elderly in Anning region of Yunnan province, lymphocyte to monocyte ratio (LMR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) reference interval, Observed differences from multicenter surveys, To determine the necessity to establish this reference interval. Methods The analysis results of people above 60 years old for physical examinations in the information system of Anning First People’ s Hospital from June 2022 to September 2022 were collected retrospectively. The biological reference interval for healthy elderly people in Anning City was established according to the indirect method in the international CLSI EP28-A3c guidelines. Results A total of 8877 cases were included. Red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), mean red blood cell hemoglobin concentration (MCHC), platelet count (PLT), and lymphocyte percentage (LYM%) decreased with age, and the difference between men and women was statistically significant (P < 0.05). Only the broadband coefficient of variation of red blood cell volume distribution (RDWCV) increased with age. White blood cell count (WBC), absolute value of neutrophils (NEU#), absolute value of eosinophils (EOS#), percentage of neutrophils (NEU%), percentage of eosinophils (EOS%), mean red cell volume (MCV), standard deviation of red blood cell volume distribution width (RDWSD), platelet volume distribution width (PDW) were statistically significant only between men and women (P < 0.05), while the remaining items were not significant by age and sex (P > 0.05). NLR increased with age, and men were significantly higher than women of the same age. Both LMR and PLR were higher in females than in males. Conclusion The results of WBC, RBC, HGB, PLT and HCT in the self-built reference interval were quite different from the reference interval of the multi-center survey. -
表 1 老年人群各年龄段血细胞分析内容描述指标比较[M(P25,P75)]
Table 1. Comparison of blood cell analysis in older ages[M(P25,P75)]
名称 性别 60~69岁(n=3569) 70~79岁(n=4005) >80岁(n=1303) Z P WBC(×109/L) 男 6.56(5.63~7.73) 6.53(5.6~7.73) 6.47(5.43~7.7) 1.88 0.391 女 6.07(5.18~7.1) 6.26(5.34~7.35) 6.05(5.11~7.34) 19.34 <0.001*** NEU#(×109/L) 男 3.79(3.11~4.62) 3.8(3.09~4.7) 3.76(3.04~4.69) 0.60 0.742 女 3.38(2.74~4.15) 3.56(2.93~4.4) 3.53(2.81~4.39) 34.98 <0.001*** LYM#(×109/L) 男 2.06(1.67~2.51) 2.02(1.59~2.5) 1.94(1.57~2.43)a 12.43 0.002** 女 2.11(1.7~2.55) 2.07(1.68~2.51) 1.95(1.54~2.40) 26.09 <0.001*** MON#(×109/L) 男 0.4(0.32~0.485) 0.41(0.33~0.5) 0.42(0.34~0.51) 12.81 0.002** 女 0.32(0.27~0.39) 0.35(0.29~0.43) 0.36(0.28~0.44) 77.27 <0.001*** EOS#(×109/L) 男 0.15(0.09~0.24) 0.15(0.09~0.24) 0.15(0.09~0.23) 1.61 0.447 女 0.11(0.06~0.17) 0.11(0.07~0.17) 0.12(0.07~0.18) 6.55 0.038* BAS#(×109/L) 男 0.03(0.02~0.05) 0.03(0.02~0.04) 0.03(0.02~0.04)a 19.26 <0.001*** 女 0.03(0.02~0.04) 0.03(0.02~0.04) 0.03(0.02~0.04) 2.09 0.352 NEU% 男 58.3(52.7~63.9) 58.9(52.6~64.7) 59.2(52.4~65.2)a 2.32 0.314 女 56.4(50.5~61.6) 57.9(51.8~63.4) 58.8(51.88~64.7) 39.95 <0.001*** MON% 男 32(26.6~37.1) 31.1(25.8~37.1) 30.5(25.4~37.0) 10.46 0.005** 女 35.1(30.1~40.8) 33.5(28.3~39.28) 32.4(26.58~38.7) 63.74 <0.001*** LYM% 男 6(5.15~7) 6.2(5.3~7.2) 6.45(5.4~7.7) 38.57 <0.001*** 女 5.3(4.6~6.2) 5.6(4.8~6.5) 5.8(4.9~6.8) 62.45 <0.001*** EOS% 男 2.2(1.4~3.6) 2.3(1.4~3.6) 2.25(1.375~3.6) 1.03 0.597 女 1.8(1.1~2.7) 1.8(1.1~2.7) 2(1.2~3) 7.87 0.02* BAS% 男 0.5(0.3~0.7)a 0.5(0.3~0.7)a 0.4(0.3~0.7)a 10.33 0.006** 女 0.5(0.3~0.7) 0.5(0.3~0.7) 0.5(0.3~0.7) 8.38 0.015* RBC(×1012/L) 男 5.12(4.83~5.39) 5.07(4.76~5.39) 4.91(4.56~5.26) 69.79 <0.001*** 女 4.73(4.49~4.97) 4.68(4.45~4.95) 4.56(4.26~4.87) 68.07 <0.001*** HGB(g/L) 男 160(152~167) 159(150~167) 152(143~163) 125.58 <0.001*** 女 144(138~151) 144(137~150) 141(132~149) 50.49 <0.001*** HCT(L/L) 男 47.7(45.35~50.3) 47.6(45~50.2) 46.45(43.3~50) 37.89 <0.001*** 女 43.5(41.5~45.5) 43.5(41.3~45.7) 43.15(40.3~45.9) 4.55 0.103 MCV(fl) 男 93.6(90.7~97.25) 94.2(91~97.5) 95.5(91.775~99)a 37.28 <0.001*** 女 92.2(89.5~95.3) 92.9(90~95.9) 94.7(91.4~98.8) 125.64 <0.001*** MCH(pg) 男 31.4(30.4~32.4) 31.4(30.3~32.4) 31.2(30.1~32.2) 7.58 0.023* 女 30.6(29.8~31.4) 30.7(29.73~31.6) 30.8(29.7~31.8) 5.23 0.073* MCHC(g/L) 男 336(327~342) 334(325~341) 329(319.75~338) 140.76 <0.001*** 女 333(324~340) 331(321~338) 325(316~336) 123.84 <0.001*** PLT(×109/L) 男 201(167~238) 196(165~235) 183.5(152~219) 50.35 <0.001*** 女 225(188~269) 217(181~260) 205(171~244) 58.75 <0.001*** MPV(fl) 男 10.3(9.5~11.4) 10.3(9.5~11.3)a 10.1(9.38~11.2)a 12.44 0.002** 女 10.2(9.4~11.2) 10.3(9.4~11.2) 10.1(9.3~11.1) 9.13 0.01* PCT(%) 男 0.21(0.18~0.24) 0.21(0.18~0.24) 0.19(0.16~0.22) 108.51 <0.001*** 女 0.23(0.2~0.27) 0.23(0.2~0.26) 0.21(0.17~0.24) 92.90 <0.001*** NLR 男 1.84(1.43~2.39) 1.91(1.42~2.48) 1.94(1.41~2.54) 6.83 0.033* 女 1.61(1.25~2.03) 1.73(1.32~2.24) 1.83(1.34~2.42) 55.65 <0.001*** LMR 男 5.26(4.15~6.54) 4.92(3.89~6.30) 4.70(3.66~6.11) 41.49 <0.001*** 女 6.52(5.28~8.04) 5.95(4.72~7.34) 5.4(4.31~7.03) 131.00 <0.001*** PLR 男 97.6(76.0~124.7) 97.4(75.9~127.9) 95.0(72.2~121.9) 4.47 0.107 女 105(84.5~135.5) 105(82.9~133.8) 105(80.1~136.3) 1.39 0.5 WBC:白细胞计数;Neu%:中性粒细胞百分数;Neu#:中性粒细胞绝对值;Lym%:淋巴细胞百分数;Lym#:淋巴细胞绝对值;Mon%:单核细胞百分数;Mon#:单核细胞绝对值;Eos%:嗜酸性粒细胞百分数;Eos#:嗜酸性粒细胞绝对值;Bas%:嗜碱性粒细胞百分数;Bas#:嗜碱性粒细胞绝对值;RBC:红细胞计数;MCH:平均血红蛋白量;MCHC:平均红细胞血红蛋白浓度;HGB:血红蛋白;Hct:红细胞比容;MCV:平均红细胞体积;RDW-SD:红细胞体积分布宽度标准差;RDW-CV:红细胞体积分布宽度变异系数;PLT:血小板计数;PCT:血小板比容;PDW:血小板体积分布宽度;P-LCR:大血小板比率;MPV:血小板平均体积;NLR:中性粒细胞/淋巴细胞比值;LMR:淋巴细胞/单核细胞比值;PLR:血小板/淋巴细胞比值;*P<0.05;**P < 0.01;***P值<0.001。 表 2 高原地区老年人血常规指标参考区间(P2.5~ P97.5)
Table 2. Reference interval of the blood routine index of the elderly in the plateau areas
名称 性别 60~69岁(n=3569) 70~79岁(n=4005) >80岁(n=1303) WBC(×109/L) 男 4.1~10.5 4.0~11.0 3.8~10.9 女 3.7~9.5 3.8~10.4 3.8~9.8 NEU#(×109/L) 男 2.0~7.2 2.0~7.2 1.9~7.2 女 1.8~6.0 1.8~7.0 1.8~6.6 LYM#(×109/L) 男 1.1~3.7 1.0~3.8 0.9~3.8 女 1.1~3.7 1.1~3.9 0.9~3.7 MON#(×109/L) 男 0.22~0.71 0.22~0.76 0.21~0.73 女 0.17~0.6 0.19~0.62 0.17~0.63 EOS#(×109/L) 男 0.02~0.59 0.02~0.63 0.02~0.68 女 0.02~0.50 0.02~0.46 0.02~0.47 BAS#(×109/L) 男 0.01~0.08 0.01~0.09 0~0.08 女 0.01~0.07 0.01~0.08 0~0.07 NEU(%) 男 41~75 41~76 39~77 女 39~73 39~75 39~76 MON(%) 男 4~10 4~10 3~10 女 3~9 3~9 3~10 LYM(%) 男 18~48 16~49 15~49 女 20~52 18~51 17~52 EOS(%) 男 0.4~8.9 0.3~9.2 0.4~9.4 女 0.3~8.1 0.3~7.1 0.2~7.0 BAS(%) 男 0.1~1.3 0.1~1.3 0.1~1.4 女 0.1~1.2 0.1~1.2 0.1~1.3 RBC(×1012/L) 男 4.2~6.1 4.1~6.2 3.9~6.3 女 4.0~5.6 3.9~5.7 3.6~5.6 HGB(g/L) 男 132~184 126~184 118~183 女 124~162 118~164 109~164 HCT(L/L) 男 0.40~0.56 0.38~0.56 0.37~0.59 女 0.38~0.50 0.36~0.51 0.35~0.53 MCV(fl) 男 81~105 81~105 78~108 女 82~101 80~103 82~110 MCH(pg) 男 27~35 26~35 23~35 女 27~33 26~33 26~34 MCHC(g/L) 男 311~351 310~351 285~349 女 311~350 308~348 280~348 RDWSD(fl) 男 41~50 40~50 41~50 女 40~48 40~49 40~50 RDWCV(%) 男 12.4~15.7 12.4~16.0 12.3~16.9 女 12.2~15.1 12.2~15.8 12.4~16.5 PLT(×109/L) 男 106~339 106~322 104~309 女 119~358 118~355 105~354 PDW(fl) 男 15.6~17 15.6~17 15.6~17 女 15.5~16.9 15.5~16.9 15.5~16.9 表 3 安宁地区老年人血细胞分析衍生指标参考区间(P2.5~ P97.5)
Table 3. Reference interval of indicators derived from blood cell analysis in the elderly in Anning region(P2.5-P97.5)
名称 性别 60~69岁(n=3569) 70~79岁(n=4005) >80岁(n=1303) NLR 男 0.87~4.21 0.85~4.62 0.81~5.09 女 0.76~3.65 0.77~4.02 0.76~4.51 LMR 男 2.45~9.84 2.27~9.89 2.14~10.27 女 3.22~12.20 2.93~11.29 2.27~12.52 PLR 男 46.58~212.71 43.49~217.84 40.90~219.18 女 51.31~213.44 48.28~213.35 45.09~237.62 NLR:中性粒细胞/淋巴细胞比值;LMR:淋巴细胞/单核细胞比值;PLR:血小板/淋巴细胞比值。 表 4 不同参考区间内被验证人群在参考区间内的百分比(%)
Table 4. Percentages of the verified populations in the reference intervals for the different reference intervals (%)
名称 性别 60~69(n=389) 70~79(n=149) 80~100(n=58) 多中心区间 自建区间 多中心区间 自建区间 多中心区间 自建区间 WBC(×109/L) 男 96 96 90 93 95 91 女 96 96 90 96 95 96 NEU#(×109/L) 男 96 96 93 96 93 91 女 96 95 93 96 93 96 LYM#(×109/L) 男 94 94 91 89 95 94 女 94 97 91 94 95 100 MON#(×109/L) 男 93 92 96 94 96 97 女 93 97 96 90 96 100 EOS#(×109/L) 男 96 98 94 97 77 97 女 96 95 94 88 77 100 BAS#(×109/L) 男 92 93 86 82 86 91 女 92 88 86 84 86 92 NEU(%) 男 96 94 93 94 96 97 女 96 98 93 92 96 100 MON(%) 男 89 89 91 89 93 94 女 89 96 91 94 93 100 LYM(%) 男 95 91 94 83 89 91 女 95 98 94 96 89 100 EOS(%) 男 95 98 94 99 98 97 女 95 94 94 97 98 100 BAS(%) 男 88 96 79 83 82 94 女 88 89 79 87 82 80 RBC(×1012/L) 男 94 98 92 97 81 97 女 92 95 97 99 92 96 HGB(g/L) 男 90 98 88 97 75 100 女 85 94 82 97 96 96 HCT(L/L) 男 81 95 82 96 69 100 女 78 94 73 95 92 96 MCV(fl) 男 86 95 82 92 81 94 女 77 87 96 97 100 100 MCH(pg) 男 96 97 93 96 88 91 女 96 95 97 97 100 96 MCHC(g/L) 男 88 87 86 85 88 100 女 83 84 83 83 76 100 PLT(×109/L) 男 94 97 93 96 98 97 女 94 98 93 95 98 100 MPV(fl) 男 88 98 80 94 82 97 女 88 96 80 97 82 96 PCT(%) 男 85 96 93 97 96 97 女 85 99 93 96 96 100 多中心区间为《中国老年人健康人群血常规检测结果多中心调查》的老年健康人群参考区间;自建区间为本研究定义的参考区间。 -
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