Importance Appropriately established pediatric reference intervals are critical to the clinical decision-making process and should reflect the physiologic changes that occur during healthy child development. Reference intervals used in pediatric care today remain highly inconsistent across a broad range of common clinical biomarkers. Observations This narrative review assesses biomarker-specific pediatric reference intervals and their clinical utility with respect to the underlying biological changes occurring during development. Pediatric reference intervals from PubMed-indexed articles published from January 2015 to April 2021, commercial laboratory websites, study cohorts, and pediatric reference interval books were all examined. Although large numbers of pediatric reference intervals are published for some biomarkers, very few are used by clinical and commercial laboratories. The patterns, extent, and timing of biomarker changes are highly variable, particularly during developmental stages with rapid physiologic changes. However, many pediatric reference intervals do not capture these changes and thus do not accurately reflect the underlying biochemistry of development, resulting in significant inconsistencies between reference intervals. Conclusions and Relevance There is a need to correctly describe the biochemistry of child development as well as to identify strategies to develop accurate and consistent pediatric reference intervals for improved pediatric care.

中文翻译：

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儿科参考区间的现状和正确描述儿童发育生物化学的重要性：综述。

重要性 适当建立的儿科参考区间对临床决策过程至关重要，应反映健康儿童发育过程中发生的生理变化。今天儿科护理中使用的参考区间在广泛的常见临床生物标志物中仍然高度不一致。观察 这篇叙述性综述评估了特定于生物标志物的儿科参考区间及其在发育过程中发生的潜在生物学变化方面的临床效用。对 2015 年 1 月至 2021 年 4 月发表的 PubMed 索引文章、商业实验室网站、研究队列和儿科参考区间书籍的儿科参考区间进​​行了检查。尽管针对某些生物标志物发布了大量儿科参考区间，很少被临床和商业实验室使用。生物标志物变化的模式、程度和时间变化很大，尤其是在生理变化迅速的发育阶段。然而，许多儿科参考区间没有捕捉到这些变化，因此不能准确反映发育的潜在生物化学，导致参考区间之间存在显着的不一致。结论和相关性 需要正确描述儿童发育的生物化学以及确定制定准确和一致的儿科参考区间以改善儿科护理的策略。许多儿科参考区间没有捕捉到这些变化，因此不能准确反映发育的潜在生物化学，导致参考区间之间存在显着不一致。结论和相关性 需要正确描述儿童发育的生物化学以及确定制定准确和一致的儿科参考区间以改善儿科护理的策略。许多儿科参考区间没有捕捉到这些变化，因此不能准确反映发育的潜在生物化学，导致参考区间之间存在显着不一致。结论和相关性 需要正确描述儿童发育的生物化学以及确定制定准确和一致的儿科参考区间以改善儿科护理的策略。