摘要
目的探讨网织红细胞血红蛋白含量(Ret-He)结合铁代谢参数诊断成人缺铁性贫血(IDA)的临床价值。方法选取该院血液科2018-11~2019-10收治的165例患者,检测各自红细胞参数[血红蛋白(Hb)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)]、网织红细胞参数(Ret-He)、铁代谢参数[血清铁(SI)、血清铁蛋白(SF)]及炎症标志物[C反应蛋白(CRP)]。根据Hb水平和骨髓铁染色结果将受试者分为缺铁性贫血组(IDA组)53例、非缺铁性贫血组(NIDA组)34例、缺铁非贫血组35例和对照组43例,比较各组间上述指标的差异,并考虑炎症的影响。绘制各血液分析指标单独诊断IDA和Ret-He+SI+SF结合诊断IDA的受试者工作特征(ROC)曲线,计算各自的灵敏度和特异度。结果IDA组各参数水平明显低于NIDA组、缺铁非贫血组和对照组,差异均有统计学意义(P<0.05);NIDA组SI、SF水平明显高于缺铁非贫血组和对照组,差异均有统计学意义(P<0.05);缺铁非贫血组Ret-He、Hb、MCV、MCH、SI、SF水平明显低于对照组,差异均有统计学意义(P<0.05)。炎症组与无炎症组患者血液SI、SF水平差异有统计学意义(P<0.05),Ret-He、Hb、MCV、MCH水平差异无统计学意义(P>0.05)。ROC曲线分析结果表明,Ret-He诊断IDA的cut-off值为28.8 pg,灵敏度为91.1%,特异度为90.9%,曲线下面积(AUC)为0.947(95%CI:0.875~0.984)。Ret-He+SI+SF结合诊断IDA的灵敏度为92.7%,特异度为93.5%,AUC为0.959(95%CI:0.900~0.988)。结论Ret-He结合SI、SF诊断IDA具有较高的临床价值,其综合诊断效能优于Ret-He、Hb、MCV、MCH、SI、SF等指标的单独诊断。
Objective To investigate the clinical value of reticulocyte hemoglobin content(Ret-He)combined with iron metabolism parameters in diagnosis of iron deficiency anemia(IDA)in adults.Methods One hundred and sixty-five patients were selected from the Department of Hematology of Haimen People′s Hospital during November 2018 and October 2019.The red blood cell parameters[hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin content(MCH)],reticulocyte parameters(Ret-He),iron metabolism parameters[serum iron(SI),serum ferritin(SF)]and inflammatory markers[C-reactive protein(CRP)]were detected in the patients.The research subjects were divided into four groups according to different hemoglobin levels and bone marrow iron staining results:iron deficiency anemia(IDA)group(n=53),non-iron deficiency anemia(NIDA)group(n=34),iron-deficiency non-anemia group(n=35)and control group(n=43).The differences of the above-mentioned indexes were compared among the four groups and the effect of inflammation was also considered.The receiver operating characteristic(ROC)curves of IDA and Ret-He+SI+SF were drawn to diagnose IDA by the individual indicator and the joint indicator respectively.The sensitivities and the specificities of each indicator and Ret-He+SI+SF were calculated.Results The levels of the parameters in the IDA group were significantly lower than those in the NIDA group,the iron-deficiency non-anemia group and the control group(P<0.05).The levels of SI and SF in the NIDA group were significantly higher than those in the iron-deficiency non-anemia group and the control group(P<0.05).The levels of Ret-He,Hb,MCV,MCH,SI and SF in the iron-deficiency non-anemia group were significantly lower than those in the control group(P<0.05).There were significant differences in the levels of SI and SF in the patients′blood between the inflammatory group and the non-inflammatory group(P<0.05),while there were no significant differences in the levels of Ret-He,Hb,MCV and MCH between the two groups(P>0.05).The results o
作者
周亮
郭建晖
张小蓬
ZHOU Liang;GUO Jian-hui;ZHANG Xiao-peng(Department of Clinical laboratory, Haimen People′s Hospital, Jiangsu 226100, China)
出处
《中国临床新医学》
2020年第7期708-713,共6页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
网织红细胞血红蛋白含量
缺铁性贫血
成人
Reticulocyte hemoglobin content(Ret-He)
Iron deficiency anemia(IDA)
Adults
