RBC、HB、RDW联合检测在缺铁性贫血及地中海贫血鉴别诊断中的应用

Application of combined detection of RBC,Hb and RDW in differential diagnosis of iron deficiency anemia and thalassemia

目的探讨红细胞(RBC)、血红蛋白(HB)、红细胞体积分布(RDW)联合检测在缺铁性贫血(IDA)及地中海贫血(THAL)鉴别诊断中的应用价值.方法采用前瞻性随机试验方法,选择本院2020年1月~2020年10月收治的2000例贫血患者作为研究对象,将1265例IDA患者纳入IDA组,将735例THAL患者纳入THAL组.检测两组RBC、HB、RDW水平,分析RBC、HB、RDW对THAL的预测效能.结果IDA组RBC、HB水平均低于THAL组,RDW水平高于THAL组,差异有统计学意义(P<0.05).绘制ROC曲线图显示,RBC预测THAL的曲线下面积(AUC)为0.804,预测价值中等;HB预测THAL的AUC为0.792,预测价值中等;RDW预测THAL的AUC为0.794,预测价值中等;RBC、HB、RDW联合预测THAL的AUC为0.850,预测价值较高.结论RBC、HB、RDW在鉴别IDA和THAL中有较高价值,早期检测RBC、HB、RDW有助于预测THAL的发生风险.

Objective To explore the application value of combined detection of red blood cell(RBC),hemoglobin(HB)and red blood cell volume distribution(RDW)in the differential diagnosis of iron deficiency anemia(IDA)and thalassemia(thal).Methods a prospective randomized trial was conducted in 2000 patients with anemia in our hospital from January 2020 to October 2020.1265 IDA patients were included in IDA group and 735 thal patients were included in thal group.The levels of RBC,Hb and RDW in the two groups were detected,and the predictive effect of RBC,Hb and RDW on thal was analyzed.Results the levels of RBC and Hb in IDA group were lower than those in thal group,and the level of RDW in IDA group was higher than that in thal group(P<0.05).The ROC curve shows that the area under the curve(AUC)of RBC predicting thal is 0.804,with medium predictive value;the AUC of HB predicting thal is 0.792,with medium predictive value;the AUC of RDW predicting thal is 0.794,with medium predictive value;the AUC of RBC,Hb and RDW jointly predicting thal is 0.850,with high predictive value.Conclusion RBC,Hb and RDW have high value in differentiating IDA from thal.Early detection of RBC,Hb and RDW can help to predict the risk of thal.