自身免疫性溶血性贫血患者胆红素特点的分析

Analysis on the bilirubin levels in patients with autoimmune hemolytic anemia

目的:总结我院自身免疫性溶血性贫血患者胆红素水平以及直接胆红素与总胆红素的比值,为鉴别诊断溶血性黄疸提供实验室依据。方法:对我院2005年3月~2015年4月诊治的81例自身免疫性溶血性贫血(AIHA)患者及70例肝细胞性黄疸患者的胆红素测定结果进行回顾性分析。结果:81例AIHA患者总胆红素范围为6.30~214.90μmol/L,中位数62.30μmol/L;65例(80.2%)患者直接胆红素占总胆红素的比值>20%。70例肝细胞性黄疸患者总胆红素范围29.40~730.40μmol/L,中位数203.24μmol/L;56例(80%)直接胆红素与总胆红素比值范围30%~60%。结论:我院AIHA患者直接胆红素与总胆红素的比值高于诊断学教科书推荐的数值,建议扩大数据进一步总结,减少溶血性黄疸的误诊。

Objective：To analyze the bilirubin levels and the ratio of direct bilirubin（DBIL） to total bilirubin（TBIL） in patients with autoimmune hemolytic anemia（AIHA） for laboratory evidence to diagnose hemolytic jaundice.Methods： Retrospective analysis was performed in 81 cases of AIHA and 70 cases of hepatocellular jaundice diagnosed and treated in our hospital between March 2005 and April 2015.Results： In the 81 patients with AIHA,TBIL ranged from 6.30 μmol / L to 214.90 μmol / L,with a median level of 62.30 μmol / L.Sixty-five patients had a ratio of DBIL to TBIL equal to or over 20%.TBIL level ranged between 29.40 μmol/L and 730.40 μmol/L with a median of 203.24 μmol/L in the 70 patients with hepatocellular jaundice,in whom 56 had DBIL to TBIL ratio between30% and 60%.Conclusion： The ratio of DBIL/ TBIL measured in patients in our hospital appears significantly higher than the reference values recommended in the diagnostics textbooks.This difference should be verified through large clinical data in order to reduce misdiagnosis of hemolytic jaundice.