红细胞参数鉴别轻型地中海贫血与轻型缺铁性贫血的价值研究

Study on the value of red blood cell parameters in identifying mild thalassemia and mild iron deficiency anemia

目的研究外周血红细胞参数比值在鉴别轻型地中海贫血和轻型缺铁性贫血中的临床价值。方法选择2018年1月到12月确诊贫血的200例患者为研究对象,其中轻型地中海贫血患者100例为实验组,轻型缺铁性贫血患者100例为对照组,对比分析两组患者红细胞参数的差异性。结果RBC、Hb、MCV、MCH和RDW等血常规红细胞参数水平在轻型缺铁性贫血组和轻型地中海贫血组之间差异有统计学意义(P<0.05或0.01)。轻型地中海贫血组MCV、RDW和MCV/RBC比值单项检测阳性率均显著高于轻型缺铁性贫血组。以MCV的灵敏度最高,MCV/RBC比值的特异度最高。本研究设定MCV/RBC等于13.0作为鉴别诊断界点,MCV/RBC<13.0时,判定为轻型地中海贫血,此时灵敏度为78.00%,特异度为64.00%。3项指标并联实验灵敏度高于MCV和MCV/RBC比值单项灵敏度。3项指标串联实验特异度高于MCV和MCV/RBC比值单项特异度。结论采用MCV/RBC≥13.0鉴别轻型地中海贫血和轻型缺铁性贫血有很好的应用价值,MCV/RBC比值联合MCV和RDW筛查、鉴别轻型地中海贫血和缺铁性贫血具有简便、快速、经济的特点,特别适用于基层医院,值得推广应用。

Objective To explore the clinical value of peripheral red blood cell parameter ratio in differential diagnosis of mild thalassemia and mild iron deficiency anemia.Methods 200 patients with anemia diagnosed from January to December 2018 were selected as research objects.Among them,100 patients with mild thalassemia were included in experimental group,and 100 patients with mild iron deficiency anemia in control group.And then,the differences of red blood cell parameters between the two groups were compared and analyzed.Results Difference of RBC,Hb,MCV,MCH,RDW and other blood routine erythrocyte parameters between mild iron deficiency anemia group and mild thalassemia group was statistically significant(P<0.05 or 0.01).The positive rate of MCV,RDW and MCV/RBC ratio in the mild thalassemia group was significantly higher than that in the mild iron deficiency anemia group in experiment of single index.The sensitivity of MCV was the highest and the specificity of MCV/RBC ratio was the highest.In this study,MCV/RBC equal to 13.0 was set as critical point for differential diagnosis.When MCV/RBC<13.0,mild thalassemia was determined,and the sensitivity and specificity was 78.00%and 64.00%,respectively at this time.The sensitivity in parallel experiment of 3 indexes was higher than that in the experiment of single index of MCV and MCV/RBC ratio.In addition,the specificity in parallel experiment of 3 indexes was higher than that in experiment of single index of MCV and MCV/RBC ratio.Conclusion Using MCV/RBC≥13.0 to identify mild thalassemia and mild iron deficiency anaemia has good application value.The MCV/RBC ratio combined with MCV and RDW to screen and identify mild thalassemia and iron deficiency anaemia is simple,rapid and economical,which is especially suitable for primary hospitals,and thus it is worth popularizing.