联合检测叶酸、维生素B12、铁蛋白在贫血中的意义

Combined detection of folic acid,vitamin B12,ferritin in anemia

目的评价叶酸（FA）、维生素B12、铁蛋白（SF）联合检测在贫血中的意义。方法选取2015年6月～2017年2月湖州市第一人民医院收治的2154例贫血患者作为贫血组（包含小细胞性贫血组和大细胞性贫血组），另选取同期在本院进行检查但未诊断出贫血者1000例作为对照组，检测各组叶酸、维生素B12、铁蛋白水平，比较各组的叶酸、维生素B12及铁蛋白阳性检出率，并记录叶酸、维生素B12、铁蛋白单独检测和联合检测的结果。结果小细胞性贫血组和大细胞性贫血组患者的叶酸、维生素B12水平明显低于对照组（P＜0.05）；大细胞性贫血组患者铁蛋白水平明显高于小细胞性贫血组和对照组（P＜0.05）。贫血组叶酸、维生素B12、铁蛋白阳性检出率均明显高于对照组，差异具有统计学意义（P＜0.05）。大、小细胞性贫血行叶酸、维生素B12、铁蛋白联合检测的检出率均明显高于任何单一检测的检出率，差异具有统计学意义（P＜0.05）。结论联合检测叶酸、维生素B12、铁蛋白对贫血的诊断及贫血类型的鉴别具有重要意义。铁蛋白减少和/或维生素B12减少可用于大、小细胞性贫血，铁蛋白升高可用于大、小细胞性贫血的鉴别。

Objective To evaluate the significance of combined detection of folic acid(FA),vitamin B12and ferritin(SF)in anemia.Methods2154cases of patients with anemia from June2015to February2017in Huzhou First People's Hospital were as anemia group(including small cell anemia and large cell anemia group),were selected for examination in our hospital but without a diagnosis of anemia in1000cases as control group,were detected with folic acid and vitamin B12,ferritin levels,comparison each group of folic acid,vitamin B12and ferritin positive rate,and record the folic acid and vitamin B12and ferritin detection alone and combined detection results.Results Small cell anemia group and large cell anemia in patients with folic acid and vitamin B12levels were significantly lower than the control group(P<0.05);large cell anemia patients with ferritin levels were significantly higher than that of small cell anemia group and control group(P<0.05).The positive rates of folic acid,vitamin B12and ferritin in anemia group were significantly higher than those in control group(P<0.05),and the difference was statistically significant.The detection rate of combined detection of folic acid,vitamin B12and ferritin in large and small cell anemia was significantly higher than that of any single detection rate,the difference was statistically significant(P<0.05).Conclusion The combined detection of folic acid,vitamin B12and ferritin is of great significance in the diagnosis of anemia and the identification of anemia types.Decreased ferritin or reduced folate or vitamin B12can be used in the diagnosis of small cell low pigmented anemia;folic acid and vitamin B12reduction can be used for the diagnosis of megaloblastic anemia.