摘要
目的:探讨铁调素(Hdpcidin)、总铁结合力(TIBC)、血清铁(SF)等相关红细胞参数在缺铁性贫血(IDA)及慢性病贫血(ACD)中的诊断和鉴别诊断价值.方法:选取我院2017年01月~2017年12月100例于我院就诊的贫血患者的临床资料,依据患者贫血类型分为缺铁性贫血(IDA)组例和慢性病贫血(ACD)组,另纳入50例同期健康体检人群作为对照组;比较三组患者血清Hdpcidin、TIBC、SF、血红蛋白(Hb)、红细胞平均体积(MCV)、平均红细胞血红蛋白浓度(MCHC)、网织红细胞百分比(RET)、未成熟网织红细胞比率(IFR)差异;探讨血清Hdpcidin、TIBC、SF对鉴别缺铁性贫血和慢性病贫血的诊断价值,分析血清Hdpcidin与血清TIBC和SF的相关性.结果:共纳入IDA组和ACD组患者各50例、同期健康体检患者50例.IDA组和ACD组患者SF、Hb、MCH、MCHC水平均显著低于对照组;ACD组患者SF、Hb、MCV、MCH、MCHC水平均显著高于IDA组,ACD 组患者MCV水平与对照组比较无统计学差异;IDA组和ACD组患者TIBC、RET、IFR水平均显著高于对照组;IDA组患者TIBC、RET低于ACD组, IFR水平高于ACD组;ACD组患者Hdpcidin水平均显著高于对照组和IDA组;ROC曲线分析显示:血清Hdpcidin在鉴别IDA与ACD的最佳阈值为91.1ng/mL,其敏感性为88.32%,特异性为86.51%;血清TIBC在鉴别IDA与ACD的最佳阈值为59.01μmol/L,其敏感性为74.12%,特异性为72.35%;血清SF在鉴别IDA与ACD的最佳阈值为8.84μmol/L,其敏感性为72.63%,特异性为71.28%;相关性分析显示:IDA组患者血清Hdpcidin与TIBC呈显著显著负相关关系,与SF呈显著正相关关系;ACD组患者血清Hdpcidin与TIBC呈显著显著正相关关系,与SF呈显著正相关关系.结论:铁调素在鉴别缺铁性贫血及慢性病性贫血的鉴别诊断价值优于总铁结合力和血清铁,血液学指标结合血清铁调素能够更加准确的诊断贫血类型,值得临床推广.
Objective Our study was aimed to explore the diagnosis of iron modulator (Hdpcidin), total iron binding force (TIBC) and serum iron (SF) in iron deficiency anemia (IDA) and chronic anemia (ACD). Methods The clinical data of 100 anemia patients admitted to our hospital from January 2017 to December 2017 were selected and divided into IDA group and ACD group according to the anemia type.50 cases of healthy person at our hospital from January 2017 to December 2017 were taken as control. Compare the serum Hdpcidin, TIBC, SF, average hemoglobin (Hb), red blood cell volume (MCV), average red blood cell hemoglobin concentration (MCHC), reticulocyte percentage (RET), ratio of immature reticulocyte (IFR) in the three groups. Explore the diagnostic value of serum Hdpcidin, TIBC and SF for the identification of iron deficiency anemia and chronic anemia and analyze the correlation between serum Hdpcidin and serum TIBC and SF. Results A total of 50 patients as IDA group, 50 patients as ACD group and 50 healthy person as control group. The levels of SF, Hb, MCH and MCHC in IDA and ACD groups were significantly lower than those in the control group, the levels of SF, Hb, MCV, MCH and MCHC in ACD group were significantly higher than that in IDA group. There was no significant difference between the MCV level and the control group in ACD group. The levels of TIBC, RET and IFR were significantly higher in IDA group and ACD group than in control group and the levels of TIBC and RET In IDA group were lower than the ACD group, the level of IFR was higher than that of ACD group. The level of Hdpcidin in ACD group was significantly higher than that in the control group and IDA group. ROC analysis showed that the Hdpcidin、TIBC、SF cut-off point value of 91.1ng/mL、59.01μmol/L、8.84μmol/L as used for the diagnosis IDA provided a sensitivity of 88.32%、74.12%、72.63%, a specificity of 86.51%、72.35%、71.28%. Correlation analysis showed that the serum Hdpcidin was significantly negatively correlated with TIBC and significantly p
作者
陈兴明
肖敏
高娇
李丹
邴岩
魏平
董瑾
敬华
Chen Xing-ming;Xiao Min;Gao Jiao;Li Dan;Bin Yan;Wei Ping;Dong Jin;Jing Hua(Department of Clinic Laboratory,The 306th Hospital of PIA,Beijing 100101,China)
出处
《湖南师范大学学报（医学版）》
2019年第5期150-153,共4页
Journal of Hunan Normal University(Medical Sciences)
