模拟血常规检查对缺铁性贫血的临床诊断

Simulating blood routine test for clinical diagnosis of iron deficiency anemia

目的通过对缺铁性贫血的模拟诊断,培养学生根据血常规检查结果对疾病进行临床诊断的能力。方法建立缺铁性贫血大鼠模型,并设正常组以获取血常规各项指标的参考值范围。以模型组大鼠模拟临床门诊病例,学生依据血常规检查结果对贫血进行红细胞形态学分类,并对诊断结果进行分析。结果大鼠在低铁喂养第4周就开始呈小细胞不均一性贫血的特征,第5周开始呈小细胞低色素性贫血的特征,第6周模型大鼠呈典型的小细胞低色素性贫血和小细胞不均一性贫血的特征,显微镜下观察红细胞大小不等,以小细胞为主,中央淡染区扩大,初步诊断为缺铁性贫血。结论模拟诊断实验可以帮助培养学生综合运用所学知识和技能解决实际问题的能力,为学生将来适应医学检验与临床的沟通奠定了基础。

【Objective】To develop student＇s ability of diagnosis of clinical disease according to routine blood test results through the simulation of diagnosis of iron deficiency anemia.【Methods】The rat models of iron deficiency anemia were established and simulated as clinical patient cases,and the reference range of each index of routine blood test was acquired by normal rats.The students classified the anemia based on red blood cell morphology,and analyzed the diagnostic results.【Results】After fed with low-iron diet,the rats began to show non-homogeneity microcytic anemia from the fourth week and hypochromic microcytic anemia from the fifth week,and displayed typical characteristic of both non-homogeneity microcytic anemia and hypochromic microcytic anemia in sixth week.Observed under the microscope,the red blood cells were characterized by anisocytosis,vast majority of small cells,expansion of the central pale staining region,so that iron deficiency anemia could be diagnosed.【Conclusions】 Simulation of diagnostic test can help students use the integrated knowledge and skills to solve practical problems,which lays the foundation for students to adapt the future communication of medical laboratory and clinics.