用直接方法估计的儿童血红蛋白参考间隔和曲线:系统性审查和元分析
Vid Bijelić1,2, Marijana Bijelić1, Josh Larock3
1School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
International journal of laboratory hematology
|May 3, 2025
概括
这项研究综合了儿科血红蛋白参考间隔 (RIs) 和参考曲线 (RCs) 的证据,发现了显著的异质性. 需要更严格的全球估计来准确地定义儿童,特别是最年轻的贫血.
科学领域:
- 临床化学 临床化学
- 儿科血液学 儿科血液学
- 公共卫生 公共卫生
背景情况:
- 血红蛋白检测对于评估儿童健康至关重要.
- 实验室使用参考间隔 (RIs) 和参考曲线 (RCs) 来解释儿科血红蛋白结果.
- 现有的RI/RC显示出相当大的差异,影响贫血的诊断.
研究的目的:
- 系统地审查和综合有关儿科血红蛋白RI/RCs的证据.
- 调查现有的儿科血红蛋白RI/RCs中异质性的来源.
- 将结果与世界卫生组织 (WHO) 贫血门进行比较.
主要方法:
- 对儿科血红蛋白RI/RCs的研究进行系统审查 (PROSPERO:CRD42023399802).
- 在EMBASE,MEDLINE,SCOPUS和Cochrane图书馆搜索到2023年7月31日.
- 包括遵守CLSI指南并报告置信区间的研究;不包括不健康的儿童和带血RI.
主要成果:
- 分析了来自25个国家的48项研究 (123,498名参与者).
- 0-3个月的统计估计是不可能的;对于年长的儿童,RI通常随着年龄的增长而增加.
- 发现了显著的异质性,来源包括年龄,性别,分析器类型和国家;许多RI不同于世卫组织的值.
结论:
- 儿科血红蛋白RI/RC的实质性异质性需要更强大的全球估计.
- 需要改进RI/RC,以与世卫组织的贫血门保持一致,以便进行一致的诊断.
- 建议对婴儿的RI进行进一步的研究,并使用百分位曲线.
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