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目的:调查分析新生儿凝血指标及部分生化指标检测参考区间。方法:以十所三甲医院2012年1月~2014年6月收治的新生儿2683例为研究对象,其中足月儿1700例,早产儿983例,选择同期十所医院职工健康体检1000例为对照组,通过全自动血凝仪、全自动生化分析仪测定所有对象凝血指标及12项生化指标,并建立相关指标参考区间。结果:足月新生儿PT、TT、APTT凝血指标较对照组延长,Fib较对照组降低,差异均有统计学意义(P=0.000);早产儿PT、TT、APTT较足月儿延长(P=0.000),Fib(P=0.001)降低;足月新生儿Glc水平较对照组低(P=0.000),早产儿Glc水平较足月新生儿更低(P=0.000);足月新生儿血钙水平低于对照组,血清TC、Cr、BUN、ALT含量均在对照组之下(P=0.000),早产儿相对更低(P均<0.05);足月新生儿LDH、CK酶活性及K+水平均高于对照组(P均<0.05),早产儿水平更高(P<0.05);足月儿血清Alb、TP及Na+水平低于对照组(P<0.05),早产儿更低(P均<0.05)。结论:新生儿凝血表达与成人不同,凝血及部分生化指标参考区间的变化与年龄有联系,有必要为新生儿建立与年龄相关的凝血、生化指标参考区间。
Objective: To investigate and analyze neonatal coagulation index and some biochemical index detection reference interval. Methods: A total of 2683 newborns were enrolled in 10 top-three hospitals from January 2012 to June 2014, of which 1700 were full-term infants and 983 were premature infants. A total of 1000 healthy volunteers from 10 hospitals in the same period were selected as controls Group, through automatic coagulation analyzer, automatic biochemical analyzer determination of coagulation index in all subjects and 12 biochemical indicators, and the establishment of relevant indicators reference interval. Results: The clotting indexes of PT, TT and APTT of full-term newborn were longer than those of control group and Fib was lower than that of control group (P = 0.000). PT, TT and APTT of premature infants were longer than that of full-term infants = 0.000) and Fib (P = 0.001). The level of Glc in term neonates was lower than that in control group (P = 0.000), Glc in preterm infants was lower than that in term infants (P = 0.000) The levels of serum TC, Cr, BUN and ALT were lower in the control group (P = 0.000) and premature infants (P <0.05) (P <0.05). The serum levels of Alb, TP and Na + in full-term infants were lower than those in control group (P <0.05) and premature infants (P <0.05) P <0.05). CONCLUSION: The clotting expression in neonates is different from that in adults. The change of reference interval between coagulation and some biochemical indexes is related to age. It is necessary to establish the age-related coagulation and biochemical reference interval for neonates.