红细胞参数及铁指标联合诊断慢性病贫血伴缺铁的临床研究

Diagnosis of chronic anemia associated with iron deficiency by joint erythrocyte parameters and index of iron

目的探讨联合应用红细胞参数及铁指标鉴别诊断慢性病贫血伴缺铁(CDID)的临床价值。方法分别测定比较缺铁性贫血(IDA)组、慢性病贫血(ACD)组及慢性病贫血伴缺铁(CDID)组患者的红细胞参数红细胞平均容积(MCV)、红细胞平均血红蛋白量(MCH)、红细胞平均血红蛋白浓度(MCHC)及铁指标血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)、未饱和铁结合力(UIBC)、铁饱和度(ISAT)。结果红细胞参数比较:IDA组与ACD组比较,MCV、MCH、MCHC均明显降低,差异有显著性意义,P<0.05;IDA组与CDID组比较,MCV、MCH、MCHC均明显降低,差异有显著性意义,P<0.05;ACD组与CDID组比较,MCV、MCH、MCHC差异无显著性意义,P>0.05。铁指标比较:IDA组与ACD组比较,SF、SI、ISAT明显减低,TIBC、UIBC明显增高,差异有显著性意义,P<0.05;IDA组与CDID组比较,SF、SI、ISAT明显减低,TIBC、UIBC明显增高,差异有显著性意义,P<0.05;ACD组与CDID组比较,SF明显增高,TIBC、UIBC明显减低,差异有显著性意义,P<0.05,SI、ISAT差异无显著性意义,P>0.05。结论联合检测红细胞参数及铁指标对鉴别诊断CDID有较大的临床价值。

Objective To explore the clinical value of combined use of red blood cell parameters and iron index in differential diagnosis of chronic disease anemia associated with iron deficiency （CDID）. Method Determination of iron deficiency anemia （IDA）, chronic anemia group （ACD） and chronic anemia patients with iron deficiency （group CDID） was performed using red blood cell parameters including red blood cell volume （MCV）, red blood hemoglobin （MCH）, red blood hemoglobin concentration （MCHC） and iron index including serum ferritin （SF）, serum iron （SI）, total iron binding force （TIBC）, unsaturated iron binding force （UIBC）, and iron saturation （ISAT）. Each two groups were compared using paired t test with P〈0.05 for statistical significance. Results Red blood cell parameters： IDA and ACD group comparison, MCV, MCH, MCHC were significantly decreased; IDA group compared with CDID group, MCV, MCH, MCHC were significantly decreased, P〈0.05. ACD group compared with CDID group, MCV, MCH, MCHC were similar, P〉0.05. Iron index comparison： IDA and ACD group comparison, SF, SI, ISAT were significantly decreased, while TIBC and UIBC were significantly higher, P〈0.05. IDA group compared with CDID group, SF, SI, ISAT were significantly decreased and TIBC, UIBC were significantly higher, P〈0.05. ACD group compared with CDID group, SF was significantly higher, P〈0.05, while TIBC and UIBC were significantly decreased, P〈0.05, SI and ISAT were similar, P〉0.05. Conclusion The combined detection of red blood cell parameters and iron index has great clinical value in the differential diagnosis of CDID.