网织红细胞血红蛋白含量相关参数在缺铁性贫血和再生障碍性贫血诊治中的作用

Diagnostic Value of RET-He in Iron Deficiency Anemia and Aplastic Anemia

目的 建立网织红细胞血红蛋白含量(RET-He)相关参数的参考范围及讨论其在贫血性疾病诊治中的作用.方法 应用希森美康XN9000全自动血液分析流水线对137 名健康成人、66 例经生物化学法或化学发光免疫学方法测定血清铁(SI)、血清铁蛋白(SF)、转铁蛋白(TF)、转铁蛋白饱和度(Tfs)等项目确诊为缺铁性贫血(IDA)患者、60 例经骨髓形态学及网织红细胞检查确诊为再生障碍性贫血(AA)患者进行血细胞分析,检测包括RET-He、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞压积(HCT)、网织红细胞绝对值(RET#)、网织红细胞百分比(RET%)等参数.对健康成人的参数进行统计分析得出95%参考范围,再比较各疾病组参数与健康对照组之间的差异,分析其在各疾病组中的诊断价值.结果 健康成人的95%参考范围分别为RET-He:31.8~37.3(34.1)pg;MCV:男性为84~99.8(90.3)fL,女性为85.9~96.5(92.3)fL;MCH:28.6~33.2 (30.7)pg;MCHC:男性为346~364(341)g/L,女性为315~348(337)g/L;HCT:男性为38.2%~49.2%(45.2%),女性为33.5%~43.0%(38.7%);RET#:男性为20.8~112(58.4)×109/L,女性为24.9~84.9(46.7)×109/L;RET%:0.54%~2.20%(1.15%).其中RET-He、MCH、RET%男女间差异无统计学意义(P>0.05).IDA组及AA组中的RET-He、MCV、MCH、MCHC 4项参数与健康对照组比较,除AA组中的MCV外,其余参数差异均具有统计学意义(P<0.05).结论 通过对正常人群进行调查得出了RET-He相关参数的参考范围,并提示其在IDA、AA的临床诊断中有一定的临床价值.

Objective To establish reference ranges of parameters related to RET-He, and to assess their roles in the diagnosis and treatment of iron deficiency anemia (IDA) and aplastic anemia (AA). Methods The red blood indices (RET-He, MCV, MCH, MCHC, HCT, RET# and RET%) were detected by SYSMEX XN9000 automated blood analyzer in 66 cases of IDA (IDA group), 60 cases of AA (AA group) and 137 healthy individuals (control group). The 66 cases of IDA were confirmed by using biochemistry or immunochemistry method to assay SI, SF, TF and Tfs, and the 60 cases of AA were confirmed by bone marrow cell morphology and red blood indices. The parameters of healthy controls were statistically analyzed to establish the 95% reference ranges. Then the differences between the parameters of each disease group and control group were compared, and their diagnostic value in each disease group was analyzed. Results The 95% reference ranges for healthy adults were RET-He: 31.8-37.3 (34.1) pg, MCV: 84-99.8 (90.3) fL for men and 85.9-96.5 (92.3) fL for women, MCH: 28.6-33.2 (30.7) pg, MCHC: 346-364 (341) g/L for men and 315-348 (337) g/L for women, HCT: 38.2%-49.2% (45.2%) for men and 33.5%-43.0% (38.7%) for women, RET#: 20.8-112 (58.4) ×109/L for men and 24.9-84.9 (46.7) ×109/L for women, RET%: 0.54%-2.20% (1.15%) . There was no significant difference in RET-He, MCH and RET% between men and women (P>0.05). Except for MCV in AA group, RET-He, MCV, MCH and MCHC in IDA group and AA group were significantly different from those in healthy control group (P<0.05). Conclusion The reference ranges of RET-He related parameters was established by investigating the healthy adults, and it suggested that it has certain clinical value in the clinical diagnosis of IDA and AA.