血液检查鉴别地中海贫血与缺铁性贫血的价值探析

Value of blood examinations in differentiating thalassemia and iron-deficiency anemia

目的探究平均红细胞血红蛋白量(MCH)、平均红细胞体积(MCV)和红细胞分布宽度(RDW)鉴别地中海贫血与缺铁性贫血(IDA)的价值。方法回顾性分析2015年10月至2017年10月本院收治的106例贫血患者的临床资料。根据基因诊断和骨髓穿刺血涂片检查结果将患者分为地中海贫血组(46例)和IDA组(60例),另选择同时期50例健康体检者作为对照组。比较3组受试者MCH、MCV、RDW水平差异,以基因诊断和骨髓穿刺血涂片检查结果为“金标准”,评估血液检查鉴别地中海贫血和IDA的准确性。结果MCH水平:IDA组<地中海贫血组<对照组(P<0.05);MCV水平:地中海贫血组<IDA组<对照组(P<0.05);RDW水平:IDA组>地中海贫血组>对照组(P<0.05);血液检查鉴别地中海贫血和IDA的灵敏度为91.30%(42/46),特异度为86.67%(52/60),准确率为88.68%(94/106),阳性预测值84.00%(42/50),阴性预测值92.86%(52/56)。结论血液检查对贫血类型鉴别有较高的应用价值,MCH、MCV、RDW水平可作为地中海贫血与IDA的鉴别诊断依据。

Objective To explore the value of mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV) and red blood cell distribution width (RDW) in differentiating thalassemia and iron-deficiency anemia (IDA). Methods The clinical data of 106 cases of patients with anemia in the hospital from October 2015 to October 2017 were retrospectively analyzed. The patients were divided into thalassemia group (n=46) and IDA group (n=60) according to the results of gene diagnosis and blood film comment of bone marrow puncture, and other 50 healthy examiners at the same time were selected as the control group. The levels of MCH, MCV and RDW were compared among the three groups, and the results of gene diagnosis and blood film comment of bone marrow puncture were taken as "gold standards" to assess the accuracy of blood tests for the identification of thalassemia and IDA. Results MCH level was that IDA group<thalassemia group<control group (P<0.05). MCV level was that thalassemia group<IDA group<control group (P<0.05). RDW level was that IDA group>thalassemia group>control group (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of blood tests were 91.30%(42/46), 86.67%(52/60), 88.68%(94/106), 84.00%(42/50) and 92.86%(52/56) in identifying thalassemia and IDA. Conclusion Blood tests have high application value in the identification of anemia type, and the levels of MCH, MCV and RDW can be used as the differential diagnosis basis for thalassemia and IDA.