网织红细胞血红蛋白含量在缺铁性贫血诊断中的应用价值

Application Value of Reticulocyte Hemoglobin Content in Diagnosis of Iron Deficiency Anemia

目的探讨网织红细胞血红蛋白含量(CHr)对缺铁性贫血(IDA)进行诊断及鉴别诊断的价值。方法用ADVIA2120全自动血细胞分析仪检测IDA组、非IDA贫血组和健康对照组的CHr,通过两样本均数的t检验,比较IDA组与健康对照组I、DA组与非IDA贫血组、非IDA贫血组与健康对照组之间CHr是否差异有统计学意义。计算CHr诊断IDA的灵敏度及特异性,用ROC曲线评价CHr诊断IDA的应用价值。结果健康对照组CHr为(34.2±0.8)pg,IDA组CHr为(25.2±4.2)pg,非IDA贫血组Chr为(34.7±3.1)pg,IDA组与健康对照组CHr差异有统计学意义(P<0.001),IDA组与非IDA贫血组CHr差异有统计学意义(P<0.001),非IDA贫血组与健康对照组CHr差异无统计学意义(P>0.05)。CHr诊断IDA灵敏度为90%,特异性96.7%,阳性预测值96.4%,阴性预测值93.5%,ROC曲线下面积为0.968。结论 CHr对IDA有早期诊断、确定诊断及鉴别诊断价值,在临床有良好的应用前景。

Objective To evaluate the value of reticulocyte hemoglobin content in the diagnosis and differential diagnosis of iron deficiency anemia. Methods The samples were divided into three groups： healthy control group,IDA group,non-IDA anemia group.ADVIA2120 automated hematology analyzer was used to detect the CHr in all the samples.Independent sample t-test was performed to detect statistical deviation among the three groups,P〈0.05 was considered to be statistically significant.The sensitivity and specificity of CHr in the diagnosis of IDA were also calculated. Results The mean CHr level in IDA group,healthy control group,and non-IDA group was was（25.2±4.2） pg,（34.2±0.8） pg,and（34.7±3.1） pg,respectively.There were statistically significant differences in the mean CHr level between IDA group and control group（P〈0.001）,and moreover,between IDA group and non-IDA anemia group（P〈0.001）.No statistically significant difference was found in the mean CHr level between healthy control group and non-IDA anemia group（P〈0.05）.The Chr provided a sensitivity of 90% and a specificity of 96.7% for the diagnosis of IDA,and with a positive predictive of 96.4% and a negative predictive of 93.5%.The areas under ROC curve were 0.968. Conclusions CHr has a good efficiency in the early diagnosis,confirmed diagnosis,and differential diagnosis of IDA.It also has a good prospect in clinical application.