缺铁性贫血患者网织红细胞参数测定的临床意义

The Changes and Clinical Significance of Reticulocyte Indices in Patients with Iron Deficiency Anemia

目的探讨缺铁性贫血患者治疗前后网织红细胞参数的变化及临床意义。方法采用ADVIA120血细胞分析仪,测定46例缺铁性贫血(IDA)患者铁剂治疗前后网织红细胞绝对数(RET#)、平均网织红细胞体积(MCVr)、网织红细胞内血红蛋白量(CHr)、网织红细胞内血红蛋白浓度(CHCM r)、网织红细胞体积分布宽度(RDW r)等网织红细胞参数及血红蛋白量(Hb)、平均红细胞体积(MCV)、红细胞内血红蛋白量(CH)、红细胞内血红蛋白浓度(CHCM)、红细胞体积分布宽度(RDW)等红细胞参数,并与健康对照组比较。结果IDA患者治疗前,CHr、MCVr、CHCM r明显低于对照组(P<0.01),RDW r则升高(P<0.05),RET#无显著差异(P>0.05);红细胞参数呈现与网织红细胞参数一致的变化。铁剂治疗后第4天,RET#、CHr、MCVr及CHCM r明显升高(P<0.01),第7天恢复正常;Hb、CH、MCV、CHCM于第14天明显升高(P<0.01),Hb于第28天恢复正常,CH、MCV、CHCM则于第60天恢复正常;RDW和RDW r于第7天明显升高(P<0.01),第14天后逐渐降低,第120天恢复正常。结论网织红细胞参数是评价IDA患者铁剂治疗反应敏感、可靠的早期指标。

Objective To explore the changes and clinical significance of changes and clinical significance in reticulocyte indices of patients with iron deficiency anemia （IDA） before and after treatment. Methods Reticulocyte indices such as reticulocyte count （ RET#）, mean reticulocyte corpuscular volume（ MCVr）, reticulocyte hemoglobin content（CHr）, reticulocyte hemoglobin concentration mean（CHCMr） and reticulocyte volume distribution width （RDWr） and red blood cell indices such as hemoglobin （Hb）, mean corpuscular volume （MCV）, hemoglobin content of red blood cell （CH） ,cell hemoglobin concentration mean（CHCM） and red cell volume distribution width （RDW） were determined on ADVIA 120 hematology analyzer in 46 patients with IDA before and after iron therapy and compared with that of the control group. Results The CHr, MCVr and CHCMr were significantly lower （ P 〈0. 01 ） and the RDWr was significantly higher（ P 〈0. 05 ） in patients with IDA than that in control group before treatment,but the RET# did not show significant difference（ P 〉 0. 05）. The changs of red blood cell indices were consistent with reticulocyte indices. After iron therapy, the RET#,CHr,MCVr and CHCMr significantly increased（ P 〈 0. 01 ） at the 4th day, back to normal at the 7th day. The Hb,CH,MCV and CHCM significantly increased（ P 〈0. 01 ） at the 14th day, the Hb back to normal at the 28th day and the CH,MCV and CHCM back to normal at the 60th day. The RDW and RDWr significantly increased（ P 〈0.01 ） at the 7th day and then,gradually decreased after 14 days,back to normal at the 120th day. Conclusion Reticulocyte indices are the sensitive and reliable early indicators to evaluate the effect of iron therapy in patients with IDA.