摘要
目的探讨采用血液检验鉴别诊断缺铁性贫血以及地中海贫血的价值。方法对50例疑似缺铁性贫血患者以及50例疑似地中海贫血患者展开诊断研究,分别设为缺铁性贫血组以及地中海贫血组,将71例经临床综合诊断确诊的贫血患者根据贫血程度不同分为轻度贫血组(63例)、中度贫血组(23例)、重度贫血组(14例);选择同期50例健康体检者作为此次研究的参照,并将其设为参照组。临床对所有研究对象均开展血液检验。对比缺铁性贫血组以及地中海贫血组的血液检验诊断效能,确诊贫血患者与参照组的血液指标水平,不同程度贫血患者与参照组的血清铁指标水平。结果缺铁性贫血组以及地中海贫血组的血液检验诊断敏感度、特异度及准确度对比,无显著差异(P>0.05)。参照组血红蛋白、平均红细胞体积、平均红细胞血红蛋白含量、红细胞计数、红细胞计数与平均红细胞体积比值以及平均红细胞体积分布宽度分别为(133.95±9.56)g/L、(90.49±10.75)fl、(31.43±1.91)pg、(5.32±0.25)×10^(12)/L、(10.59±1.22)、(12.65±1.22)%,缺铁性贫血患者分别为(80.41±10.55)g/L、(66.69±2.81)fl、(16.51±1.15)pg、(3.33±0.23)×10^(12)/L、(23.45±0.45)、(16.89±1.45)%,地中海贫血患者分别为(100.89±9.45)g/L、(55.59±1.69)fl、(24.89±1.35)pg、(6.69±0.45)×10^(12)/L、(16.65±2.05)、(14.65±1.22)%。缺铁性贫血患者以及地中海贫血患者的血红蛋白、平均红细胞体积、平均红细胞血红蛋白含量、红细胞计数、红细胞计数与平均红细胞体积比值以及平均红细胞体积分布宽度与参照组对比呈现出显著差异(P<0.05);且地中海贫血患者的血红蛋白、平均红细胞体积、平均红细胞血红蛋白含量、红细胞计数、红细胞计数与平均红细胞体积比值以及平均红细胞体积分布宽度与缺铁性贫血患者对比呈现出显著差异(P<0.05)。参照组血清铁蛋白、血清转铁蛋白受体、血清铁分别为(48.95±9.31)μg/L、(31.12±8.59)mmol/L、(21.99±6.19)μmol/L,轻度贫血组分别为(12.32±4.55)μg/L、(50.55±9.79)mmol/L、(9.23±2.49)μmol/L,中度贫血组分别为(4.43±1.55)μg/L、(61.53±7.75)mmol/L、(5.29±1.23)μmol/L,重度贫血组分别为(1.02±0.59)μg/L、(72.79±7.85)mmol/L、(2.17±1.01)μmol/L。轻度贫血组、中度贫血组以及重度贫血组患者的血清铁蛋白、血清转铁蛋白受体以及血清铁水平与参照组对比均呈现出显著差异(P<0.05)。结论临床对缺铁性贫血患者以及地中海贫血患者进行有效的血液检验工作,可对患者的贫血类型进行精确鉴别诊断,且对两种贫血类型均表现出较高的诊断效能,临床呈现出显著的应用价值。
Objective To explore the value of blood test in differential diagnosis of iron deficiency anemia and thalassemia.Methods 50 patients with suspected iron deficiency anemia and 50 patients with suspected thalassemia were diagnosed and assigned as iron deficiency anemia group and thalassemia group respectively.71 patients with anemia diagnosed by comprehensive clinical diagnosis were divided into the mild anemia group(63 cases),the moderate anemia group(23 cases),and the severe anemia group(14 cases)according to the different degrees of anemia.50 healthy subjects during the same period were selected as the reference group for this study.Blood tests were performed on all three groups.Comparison was made on diagnostic efficiency of blood test in iron deficiency anemia group and thalassemia group,blood index levels of the three groups,as well as serum iron index level of patients with different degree of anemia and the reference group.Results Comparison of diagnostic sensitivity,specificity and accuracy of blood tests in the iron deficiency anemia group as well as in the thalassemia group did not show any significant difference(P>0.05).In reference group,the hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,red blood cell count,ratio of red blood cell count to mean corpuscular volume and red blood cell distribution width were(133.95±9.56)g/L,(90.49±10.75)fl,(31.43±1.91)pg,(5.32±0.25)×10^(12)/L,(10.59±1.22)and(12.65±1.22)%;in iron deficiency anemia group,those were were(80.41±10.55)g/L,(66.69±2.81)fl,(16.51±1.15)pg,(3.33±0.23)×10^(12)/L,(23.45±0.45)and(16.89±1.45)%;in thalassemia group,those were(100.89±9.45)g/L,(55.59±1.69)fl,(24.89±1.35)pg,(6.69±0.45)×10^(12)/L,(16.65±2.05)and(14.65±1.22)%.The hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,red blood cell count,ratio of red blood cell count to mean corpuscular volume and red blood cell distribution width of the iron deficiency anemia group and the thalassemia group presented a significant difference when compared with those in the reference group(P<0.05).Compared with the iron deficiency anemia group,patients in the thalassemia group presented significant differences in hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,red blood cell count,ratio of red blood cell count to mean corpuscular volume and red blood cell distribution width(P<0.05).In reference group,the serum ferritin,serum transferrin receptor and serum iron were(48.95±9.31)μg/L,(31.12±8.59)mmol/L and(21.99±6.19)μmol/L;in mild anemia group,those were(12.32±4.55)μg/L,(50.55±9.79)mmol/L and(9.23±2.49)μmol/L;in moderate anemia group,those were(4.43±1.55)μg/L,(61.53±7.75)mmol/L and(5.29±1.23)μmol/L;in severe anemia group,those were(1.02±0.59)μg/L,(72.79±7.85)mmol/L and(2.17±1.01)μmol/L.Compared with the reference group,there were significant differences in serum ferritin,serum transferrin receptor and serum iron levels among patients with mild anemia,moderate anemia and severe anemia(P<0.05).Conclusion Effective blood tests for patients with iron deficiency anemia and thalassemia can accurately differentiate the type of anemia,and has shown high diagnostic efficiency for both types of anemia,demonstrating significant clinical application value.
作者
孙璨璨
宋照民
SUN Can-can;SONG Zhao-min(Department of Laboratory Medicine,Yicheng District People's Hospital,Zaozhuang 277300,China)
出处
《中国实用医药》
2024年第20期28-32,共5页
China Practical Medicine
关键词
血液检验
鉴别诊断
缺铁性贫血
地中海贫血
诊断效能
血液指标
血清铁指标
Blood test
Differential diagnosis
Iron deficiency anemia
Thalassemia
Diagnostic efficiency
Blood index level
Serum iron index level
