高海拔与低海拔地区人群血常规参数的差异分析
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摘要
目的分析长期生活在高海拔地区和低海拔地区人群的血常规参数的差异。方法回顾性分析966例香格里拉地区(平均海拔3 280m)和961例上海地区(平均海拔4m)年龄在21～40岁男性体检者的血常规参数,按年龄分为4组:21～25岁组、26～30岁组、31～35岁组和36～40岁组,比较高海拔地区和低海拔地区人群血常规参数的差异。结果高海拔地区人群的红细胞相关参数红细胞计数(RBC)、血红蛋白浓度(Hb)、血细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)及红细胞分布宽度(RDW)分别为(5.63±0.41)×1012/L、(172±11)g/L、(0.504±0.032)%、(89.7±3.7)fL、30.6(29.7～31.4)pg、341(336～346)g/L和[13.1(12.7～13.6)%],均高于低海拔地区人群的(5.21±0.33)×1012/L、(156±8)g/L、(0.459±0.026)%、(88.1±3.4)fL、[29.9(29.2～30.7)pg]、[340(336～344)g/L]和[12.9(12.6～13.3)%],差异有统计学意义(P=0.001、0.001、0.001、0.001、0.001、0.003、0.001)。高海拔地区人群的血小板计数(PLT)低于低海拔地区人群,差异有统计学意义[199(174～229)×1012/Lvs.215(187～224.5)×1012/L,P=0.001),两地的白细胞计数(WBC)差异无统计学意义[6.4(5.5～7.4)×109/L vs.6.23(5.41～7.28)×109/L,P=0.09]。按年龄分组统计后,发现高海拔地区和低海拔地区21～25岁组和26～30岁组人群MCHC差异无统计学意义[340(335～345)g/L vs.341(336～344)g/L,P=0.484;340(336～346)g/L vs.340(337～344)g/L,P=0.061],其他红细胞参数在高海拔地区和低海拔地区人群中的差异与整体数据相似。在各项指标数据中,与年龄存在一定相关性的是:高海拔地区人群MCV(P=0.046,r=0.064)、MCH(P=0.003,r=0.094)、MCHC(P=0.001,r=0.104);低海拔人群MCV(P=0.001,r=0.158)、MCH(P=0.001,r=0.132)、RBC(P=0.023,r=-0.074)。结论高海拔地区由于氧浓度低,导致人群的红细胞相关参数均高于低海拔地区人群,PLT显著低于低海拔地区人群,而两者间WBC差异无统计学意义。
Objective To analyze the differences in blood routine parameters of people living in high altitude areas and low altitude areas for a long time.Methods The blood routine parameters of 966 males from Shangri-La(average altitude of 3 280 meters)and 961 males from Shanghai(average altitude 4 meters)at ages of 21-40 years old were retrospectively analyzed.All males were divided into four groups based on ages:group in age of 21-25,group in age of 26-30,group in age of 31-35,and group in age of 36-40.The differences in blood routine parameters between people in high-altitude areas and low-altitude areas were compared.Results The RBC-related parameters red blood cell count(RBC),hemoglobin concentration(Hb),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin content(MCH),mean corpuscular hemoglobin concentration(MCHC)and red blood cell distribution width(RDW)in high-altitude population respectively were(5.63±0.41)×1012/L,(172±11)g/L,(0.504±0.032)%,(89.7±3.7)fL,30.6(29.7-31.4)pg,341(336-346)g/L and 13.1(12.7-13.6),which were significantly higher than(5.21±0.33)×1012/L,(156±8)g/L,(0.459±0.026)%,(88.1±3.4)fL,29.9(29.2-30.7)pg,340(336-344)g/L and 12.9(12.6-13.3)in low-altitude population,respectively,and the differences were statistically significant(P=0.001,0.001,0.001,0.001,0.001,0.003,0.001).Platelet count(PLT)of high-altitude population were significantly lower than those in low-altitude population,and the difference was statistically significant [199(174-229)vs.215(187-224.5),P=0.001].There was no significant difference in white blood cell counts(WBC)[6.40(5.5-7.4)vs.6.23(5.41-7.28),P=0.09].The results based on age grouping showed that there was no significant difference in MCHC between the group in age of 21-25 and group in age of 26-30 at both high altitude and low altitude[340(335-345)vs.341(337-344),P=0.484,340(336-346)vs.340(337-344),P=0.061].The difference of other red cell parameters of people in high-altitude and low-altitude areas was similar to those in the whole group.Among the indicators,there were correlations between age and MCV(P=0.046,r=0.064),age and MCH(P=0.003,r=0.094),age and MCHC(P=0.001,r=0.104),age and MCV(P=0.001,r=0.158),age and MCH(P=0.001,r=0.132),age and RBC(P=0.023,r=-0.074).Conclusion Due to the low oxygen concentration in high altitude areas,red cell parameters of highaltitude population are higher than those of low-altitude population,while PLT is significantly lower than that of low-altitude population,and there is no significant difference in WBC between the two groups.
Objective To analyze the differences in blood routine parameters of people living in high altitude areas and low altitude areas for a long time.Methods The blood routine parameters of 966 males from Shangri-La(average altitude of 3 280 meters)and 961 males from Shanghai(average altitude 4 meters)at ages of 21-40 years old were retrospectively analyzed.All males were divided into four groups based on ages:group in age of 21-25,group in age of 26-30,group in age of 31-35,and group in age of 36-40.The differences in blood routine parameters between people in high-altitude areas and low-altitude areas were compared.Results The RBC-related parameters red blood cell count(RBC),hemoglobin concentration(Hb),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin content(MCH),mean corpuscular hemoglobin concentration(MCHC)and red blood cell distribution width(RDW)in high-altitude population respectively were(5.63±0.41)×1012/L,(172±11)g/L,(0.504±0.032)%,(89.7±3.7)fL,30.6(29.7-31.4)pg,341(336-346)g/L and 13.1(12.7-13.6),which were significantly higher than(5.21±0.33)×1012/L,(156±8)g/L,(0.459±0.026)%,(88.1±3.4)fL,29.9(29.2-30.7)pg,340(336-344)g/L and 12.9(12.6-13.3)in low-altitude population,respectively,and the differences were statistically significant(P=0.001,0.001,0.001,0.001,0.001,0.003,0.001).Platelet count(PLT)of high-altitude population were significantly lower than those in low-altitude population,and the difference was statistically significant [199(174-229)vs.215(187-224.5),P=0.001].There was no significant difference in white blood cell counts(WBC)[6.40(5.5-7.4)vs.6.23(5.41-7.28),P=0.09].The results based on age grouping showed that there was no significant difference in MCHC between the group in age of 21-25 and group in age of 26-30 at both high altitude and low altitude[340(335-345)vs.341(337-344),P=0.484,340(336-346)vs.340(337-344),P=0.061].The difference of other red cell parameters of people in high-altitude and low-altitude areas was similar to those in the whole group.Among the indicators,there were correlations between age and MCV(P=0.046,r=0.064),age and MCH(P=0.003,r=0.094),age and MCHC(P=0.001,r=0.104),age and MCV(P=0.001,r=0.158),age and MCH(P=0.001,r=0.132),age and RBC(P=0.023,r=-0.074).Conclusion Due to the low oxygen concentration in high altitude areas,red cell parameters of highaltitude population are higher than those of low-altitude population,while PLT is significantly lower than that of low-altitude population,and there is no significant difference in WBC between the two groups.
引文
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[8]邱义稳,宋航,赵婕,等.高原环境血小板的变化及其作用机制探讨[J].西南国防医药,2015,25(10):1146-1148.
[9] MCDONALD T P,SULLIVAN P S.Megakaryocytic and erythrocytic cell lines share a common precursor cell[J].Exp Hematol,1993,21(10):1316-1320.
[10]马骏龙,乐家新,冯东方,等.西藏地区健康成人血细胞检测值调查[J].标记免疫分析与临床,2009,16(5):300-304.
[11]MAHESH S P,MATHURA J R.Images in clinical medicine.Retinal hemorrhages associated with high altitude[J].N Engl J Med,2010,362(16):1521.
[12]VIJ A G.Effect of prolonged stay at high altitude on platelet aggregation and fibrinogen levels[J].Platelets,2009,20(4):421-427.
[13]盛佳智.久坐不运动的男性最大摄氧量与MCH、MCHC参数的关系[J].科技视界,2014(23):48-48.
[2]林静,赵晋,秦晋,等.急进高原人群的血常规指标分析[J].解放军预防医学杂志,2016,34(6):809-811.
[3]白谊涵,马全福,张永青,等.高原低氧环境对呼吸系统影响的研究[J].中国急救复苏与灾害医学杂志,2012,7(7):601-603.
[4] LI P,HUANG J,TIAN H J,et al.Regulation of bone marrow hematopoietic stem cell is involved in high-altitude erythrocytosis[J].Exp Hematol,2011,39(1):37-46.
[5]邹在秋,易梅,任用坤,等.拉萨市1024例健康藏、汉族儿童静脉血血细胞参数正常参考范围调查[J].高原医学杂志,2000,10(4):22-24.
[6]石晓天,王珏,黄君富,等.高原藏区不同海拔血常规分析[J].国际检验医学杂志,2015,36(15):2265-2266.
[7]安文静,高芬.慢性高原病发病机制研究进展[J].医学综述,2009,15(14):2153-2154.
[8]邱义稳,宋航,赵婕,等.高原环境血小板的变化及其作用机制探讨[J].西南国防医药,2015,25(10):1146-1148.
[9] MCDONALD T P,SULLIVAN P S.Megakaryocytic and erythrocytic cell lines share a common precursor cell[J].Exp Hematol,1993,21(10):1316-1320.
[10]马骏龙,乐家新,冯东方,等.西藏地区健康成人血细胞检测值调查[J].标记免疫分析与临床,2009,16(5):300-304.
[11]MAHESH S P,MATHURA J R.Images in clinical medicine.Retinal hemorrhages associated with high altitude[J].N Engl J Med,2010,362(16):1521.
[12]VIJ A G.Effect of prolonged stay at high altitude on platelet aggregation and fibrinogen levels[J].Platelets,2009,20(4):421-427.
[13]盛佳智.久坐不运动的男性最大摄氧量与MCH、MCHC参数的关系[J].科技视界,2014(23):48-48.