红细胞相关参数与HbA2联合检测在α-珠蛋白生成障碍性贫血并发缺铁性贫血诊断中的应用

Application of Combined Detection of Red Blood Cell Related Parameters and HbA2 in the Diagnosis of Alpha-Globin-Producing Anemia Complicated with Iron Deficiency Anemia

目的探讨红细胞相关参数与血红蛋白A2(HbA2)联合检测在α-珠蛋白生成障碍性贫血并发缺铁性贫血诊断中的应用。方法回顾性分析选取2017年1月～2018年6月α-珠蛋白生成障碍性贫血和缺铁性贫血患者,其中α-珠蛋白生成障碍性贫血组1 164例、缺铁性贫血组974例、α-珠蛋白生成障碍性贫血并发缺铁性贫血组765例,所有患者均经过地贫基因诊断和铁蛋白测定。另选同期健康体检者500例作为对照组。所有研究对象进行红细胞相关参数(包括Hb,MCV,MCH,MCHC,RDW)和HbA2检测并比较检测结果。结果α-珠蛋白生成障碍性贫血组的HbA2,Hb,MCV,MCH,MCHC高于缺铁性贫血组,α-珠蛋白生成障碍性贫血并发缺铁性贫血组的HbA2水平低于缺铁性贫血组,MCV平均值高于缺铁性贫血组,差异均有统计学意义(P<0.05);不同基因型珠蛋白生成障碍性贫血中HbA2,Hb,MCV,MCH,MCHC水平比较,在-α^(3,7(4,2))/αα,^(-sea)/αα,-α^(3,7(4,2))/--^(sea)中依次降低。与对照组比较,其余各组红细胞指标与HbA2水平统计方差值F=53.3～1103.7,均P<0.01;与ααcs/αα比较,其余各基因型组红细胞指标与HbA2水平统计方差值F=71.8～903.2,均P<0.01。结论利用红细胞相关参数各项指标与HbA2相结合检测,能够有效地鉴别出缺铁性贫血和α-珠蛋白生成障碍性贫血以及α-珠蛋白生成障碍性贫血并缺铁性贫血。

Objective To discuss the application of combined detection of red blood cell（RBC）related parameters and HbA2 in the diagnosis of alpha-globin-producing anemia complicated with iron deficiency anemia（IDA）.Methods A retrospective analysis was conducted for patients with alpha-globin-producing anemia and iron deficiency anemia from January 2017 to June 2018 which were divided into 1 164 cases of alpha-globin-producing anemia group,974 cases of iron deficiency anemia group and 765 cases of alpha-globin-producing anemia complicated with IDA group.Another 500 healthy persons in the same period were selected as control group.All patients were diagnosed by genetic diagnosis of thalassemia and ferritin.Another 500 healthy persons in the same period were selected as control group.All subjects were tested for RBC related parameters（including Hb,MCV,MCH,MCHC and RDW）and HbA2 and the results were compared.Results The HbA2,Hb,MCV,MCH and MCHC in the alpha-globin-producing anemia group were higher than that of the iron deficiency anemia group.The HbA2 level of the alpha-globin-producing anemia combined with the IDA group was lower than that of the iron deficiency anemia group and the MCV average was higher than that of the iron deficiency anemia group.The differences were statistically significant（P<0.05）.The levels of HbA2,Hb,MCV,MCH and MCHC in different genotypes of thalassemia decreased from -α3,7（4,2）/αα,-sea/ααto -α3,7（4,2）/--sea.Compared with control group,statistical variance of erythrocyte index and HbA2 level were（F=53.3～1 103.7,P<0.01）.Compared withααcs/αα,statistical variance of erythrocyte index and HbA2 level were F=71.8～903.2,P<0.01.Conclusion The combination of all RBC related parameters indicators and HbA2 can effectively identify iron deficiency anemia,alpha-globin-producing anemia and alpha-globin-producing anemia with IDA.