儿童全血钙、铁、锌等矿物质测定参考值的研究现状
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摘要
钙、铁、锌、镁、铜是我国儿童保健领域检测较多的矿物质,全血检测操作简单、采血量少,且可以用于检验人体水平,因此,被临床检验和科学研究领域接受。建立儿童全血钙、铁、锌、镁、铜参考值是有意义的。该文综述中国10年来的多地区和单个地区的儿童全血中钙、铁、锌、镁、铜参考值的研究,提出:①各研究中制定参考值的实验室都有质量控制相关操作,但标准不统一,建议建立中国儿童群体自己参考区间,并进行更加规范化的管理;②确定参考区间供临床和科研调查使用,因此,确定了实验室参考区间,只是提供了依据,需要进一步论证;③确定参考区间如果要推广到其他区域,就需要更多的人群参与检测,或使用能反应目标人群的更合理的抽样方法 ;④争取纳入更多小年龄儿童和农村地区的儿童。
Calcium(Ca),iron(Fe),zinc(Zn),magnesium(Mg) and copper(Cu) are the most common trace elements in blood test for child health assessment in China.Whole blood test of these trace elements has been applied in clinical examination and scientific research for its simple operation and little blood sample needed,and it can be used to evaluate level in the body.It is valuable to build reference intervals for Ca,Fe,Zn,Mg and Cu for Chinese children.This article reviewed the studies of reference intervals for these trace elements in children' s whole blood in the past decade,and the following suggestions were provided.Reference intervals for Chinese children should be set and more standard management should be taken since the standards for quality control in laboratories of the studies are not unified.Reference intervals are used for clinical diagnosis and prevalence survey,thus defining reference intervals of laboratories provides evidence only and more work is needed to confirm.More population and feasible sampling methods are needed to apply the reference intervals.Furthermore,more studies should be conducted in young children and in rural areas.
Calcium(Ca),iron(Fe),zinc(Zn),magnesium(Mg) and copper(Cu) are the most common trace elements in blood test for child health assessment in China.Whole blood test of these trace elements has been applied in clinical examination and scientific research for its simple operation and little blood sample needed,and it can be used to evaluate level in the body.It is valuable to build reference intervals for Ca,Fe,Zn,Mg and Cu for Chinese children.This article reviewed the studies of reference intervals for these trace elements in children' s whole blood in the past decade,and the following suggestions were provided.Reference intervals for Chinese children should be set and more standard management should be taken since the standards for quality control in laboratories of the studies are not unified.Reference intervals are used for clinical diagnosis and prevalence survey,thus defining reference intervals of laboratories provides evidence only and more work is needed to confirm.More population and feasible sampling methods are needed to apply the reference intervals.Furthermore,more studies should be conducted in young children and in rural areas.
引文
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[15]王晓燕,金春华,刘玉兰,等.儿童全血部分常量和微量元素含量的年龄差异分析[J].北京医学,2005,29(1 1):647-649.
[16]于行堂,王磊,张春江,等.威海市儿童静脉血微量元素钙铁锌参考值调查[J].检验医学与临床,2013,10(8):921-922.
[17]罗阳,张雪,府伟灵,等.重庆地区儿童全血中5种微量元素正常值的确立[J].重庆医学,2004,33(8):1143-1144.
[18]Liu J J,Yuan E W,Zhang Z,et al.Age-and sex-specific reference intervals for blood copper,zinc,calcium,magnesium,iron,lead,and cadmium in infants and children[J].Clinical Biochemistry,2012,45(6):416-419.
[19]张长礼,秦淑国.1542例儿童全血中6种微量元素参考值的调查研究[J].安徽卫生职业技术学院学报,2010,9(4):107-108.
[20]厉勇,肖琨,陈姝姝,等.310例新生儿全血5种元素正常值研究[J].中国妇幼保健,2005,20(18):2368-2369.
[21]吴定昌,肖婷,王跃华,等.福建闽西地区儿童全血铜锌钙镁铁微量元素参考范围调查[J].国际检验医学杂志,2013,34(3):317-319.
[22]段虹舫,刘伟旗,邝桂星,等.广州市番禺区健康儿童微量元素参考区间调查[J].国际检验医学杂志,2013,34(17):2283-2284.
[23]张治青,王玉,赵波,等.中国城市<17岁健康人群末梢血铁元素水平分析[J].中国公共卫生,2011,27(10):1316-1317.
[24]陈建波,程雅婷,史林飞,等.广东地区儿童全血铅、锰、锌、铜、铁参考区间的调查分析[J].广东微量元素科学,2009,16(3):27-31.
[25]虞洁,马剑华,张书楠,等.101 600例0~17岁人群末梢血锌元素参考值研究[J].广东微量元素科学,2011,18(4):16-20.
[26]朱清红,张吉才,柏中喜,等.湖北十堰地区儿童全血锌正常参考值范围的建立[J].儿科药学杂志,2013,19(1):7-8.
[27]马剑华,唐娇,张印红,等.0~17岁儿童青少年指尖血镁水平分析[J].营养学报,2011,33(4):408-410.
[28]张书楠,李若冰,等.101 600例0-17岁人群末梢血铜元素参考值的研究.广东微量元素科学.2011.18(1):24-28.
[29]International Organization for Standardization.Medical laboratories particular requirements for quality and Competence[S].ISO 15189.Geneva:ISO.2012.
[30]钟堃,王薇,白玉,等.全国干化学室间质量评价项目参考区间现况调查[J].检验医学,2012,27(8):684-687.
[31]钟堃,王治国.采用多中心相同检测系统建立人体参考区间[J].中华检验医学杂志,2010,33(8):790-792.
[32]Zhao T T,Chen B,Wang HP,et al.Evaluation of toxic and essential elements in whole blood from 0-to 6-year-old children from Jinan,China[J].Clinical Biochemistry,2013,46(7-8):612-616.
[33]李晓松.医学统计学[M].2版.北京:高等教育出版社,2008.
[34]王武光,胡桂木.1228例学龄前儿童末梢血微量元素调查分析[M].医学临床研究,2011,28(3):546-657.
[35]侯文权,侯文锋,张高明,等.沭阳县不同年龄组儿童微量元素水平调查[J].牡丹江医学院学报,2011,32(3):35-37.
[2]Bhutta Z A,Das J K,Rizvi A,et al.Evidence-based interventions for improvement of maternal and child nutrition;What can be done and at what cost?[J].Lancet,2013,382(9890):452-477.
[3]Zhang W,Stoecklin E,Eggersdorfer M,et al.A glimpse of vitamin D status in Mainland China[J].Nutrition,2013,29(7-8):953-957.
[4]Domell6f M,Braegger C,Campoy C,et al.Iron requirements of infants and toddlers[J].J Pediatr Gastroenterol Nutr,2014,58(1):119-129.
[5]Imdad A,Bhutta Z A.Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries:A meta-analysis of studies for input to the lives saved tool[J].BMC Public Health,2011,11(Suppl 3):S22.
[6]Ozmen H,Akarsu S,Cemek M,et al.The levels of calcium and magnesium,and of selected trace elements,in whole blood and scalp hair of children with growth retardation[J].Iran J Pediatr,2013,23(2):125-130.
[7]Fenton T R.Lyon A W,Rose S M,et al.Cord blood calcium,phosphate,magnesium,and alkaline phosphatase gestational agespecific reference intervals for preterm infants[J].BMC Pediatrics,2011,11:76.
[8]Tuakuila J,Kabamba M,Mata H,et al.Toxic and essential elements in children's blood(<6 years)from Kinshasa,DRC(the Democratic Republic of Congo)[J].J Trace Elem Med Biol,2014,28(1):45-49.
[9]Xu J,Zhou Q,Liu G,et al.Analysis of serum and urinal copper and zinc in Chinese northeast population with the prediabetes or diabetes with and without complications[J].Oxid Med Cell Longev,2013,2013:635214.
[10]National Center for Environmental Health.2nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S.Population[Z].USA,CDC,2012:299-340.
[11]陈敏,黄勤烽.多通道火焰原子吸收光谱法测定全血与血浆中5种元素含量的相关性分析[J].分析仪器,2010,1:80-83.
[12]唐娇,王玉等.0~17岁健康人群全血钙元素的参考区间研究[J].现代预防医学,2012,39(15):3804-3808.
[13]Siest G,Henny J,Grasbeck R,et al.The theory of reference values:An unfinished symphony[J].Clin Chem Lab Med,2013,51(1):47-64.
[14]楼蔓藤,黎志明,李增禧,等.中国微量元素科学研究现状、意义、问题和对策[J].广东微量元素科学,2010,17(2):46-69.
[15]王晓燕,金春华,刘玉兰,等.儿童全血部分常量和微量元素含量的年龄差异分析[J].北京医学,2005,29(1 1):647-649.
[16]于行堂,王磊,张春江,等.威海市儿童静脉血微量元素钙铁锌参考值调查[J].检验医学与临床,2013,10(8):921-922.
[17]罗阳,张雪,府伟灵,等.重庆地区儿童全血中5种微量元素正常值的确立[J].重庆医学,2004,33(8):1143-1144.
[18]Liu J J,Yuan E W,Zhang Z,et al.Age-and sex-specific reference intervals for blood copper,zinc,calcium,magnesium,iron,lead,and cadmium in infants and children[J].Clinical Biochemistry,2012,45(6):416-419.
[19]张长礼,秦淑国.1542例儿童全血中6种微量元素参考值的调查研究[J].安徽卫生职业技术学院学报,2010,9(4):107-108.
[20]厉勇,肖琨,陈姝姝,等.310例新生儿全血5种元素正常值研究[J].中国妇幼保健,2005,20(18):2368-2369.
[21]吴定昌,肖婷,王跃华,等.福建闽西地区儿童全血铜锌钙镁铁微量元素参考范围调查[J].国际检验医学杂志,2013,34(3):317-319.
[22]段虹舫,刘伟旗,邝桂星,等.广州市番禺区健康儿童微量元素参考区间调查[J].国际检验医学杂志,2013,34(17):2283-2284.
[23]张治青,王玉,赵波,等.中国城市<17岁健康人群末梢血铁元素水平分析[J].中国公共卫生,2011,27(10):1316-1317.
[24]陈建波,程雅婷,史林飞,等.广东地区儿童全血铅、锰、锌、铜、铁参考区间的调查分析[J].广东微量元素科学,2009,16(3):27-31.
[25]虞洁,马剑华,张书楠,等.101 600例0~17岁人群末梢血锌元素参考值研究[J].广东微量元素科学,2011,18(4):16-20.
[26]朱清红,张吉才,柏中喜,等.湖北十堰地区儿童全血锌正常参考值范围的建立[J].儿科药学杂志,2013,19(1):7-8.
[27]马剑华,唐娇,张印红,等.0~17岁儿童青少年指尖血镁水平分析[J].营养学报,2011,33(4):408-410.
[28]张书楠,李若冰,等.101 600例0-17岁人群末梢血铜元素参考值的研究.广东微量元素科学.2011.18(1):24-28.
[29]International Organization for Standardization.Medical laboratories particular requirements for quality and Competence[S].ISO 15189.Geneva:ISO.2012.
[30]钟堃,王薇,白玉,等.全国干化学室间质量评价项目参考区间现况调查[J].检验医学,2012,27(8):684-687.
[31]钟堃,王治国.采用多中心相同检测系统建立人体参考区间[J].中华检验医学杂志,2010,33(8):790-792.
[32]Zhao T T,Chen B,Wang HP,et al.Evaluation of toxic and essential elements in whole blood from 0-to 6-year-old children from Jinan,China[J].Clinical Biochemistry,2013,46(7-8):612-616.
[33]李晓松.医学统计学[M].2版.北京:高等教育出版社,2008.
[34]王武光,胡桂木.1228例学龄前儿童末梢血微量元素调查分析[M].医学临床研究,2011,28(3):546-657.
[35]侯文权,侯文锋,张高明,等.沭阳县不同年龄组儿童微量元素水平调查[J].牡丹江医学院学报,2011,32(3):35-37.