红细胞体积分布宽度标准差在鉴别儿童小细胞低色素性贫血中的应用

Application of standard deviation of red blood cell volume distribution width in the identification of microcytic anemia in children

目的:评价红细胞体积分布宽度标准差(RDW-SD)从小细胞低色素性贫血儿童中检出β-地中海贫血(β-TT)患儿的效能。方法:选取2017年1月~2018年12月儿科门诊行贫血检查的小细胞低色素性贫血患儿作为研究对象(按β-TT基因检测结果分为β-TT组80例与非β-TT组68例),回顾性分析两组患者红细胞(RBC)参数差别,并比较两组患者两种RDW形式以及基于不同RDW形式计算的红细胞体积分布宽度指数(RDWI)在鉴别两类贫血中的效能。结果:除血红蛋白(HGB)、红细胞压积(HCT)、红细胞血红蛋白浓度(MCHC)和红细胞体积分布变异系数(RDW-CV)无统计学意义以外,两组儿童中其他主要RBC参数均存在显著性差异。基于不同RDW形式计算的RDWI-CV和RDWI-SD亦呈显著性差异。从小细胞低色素性贫血儿童中检出β-TT时,无论RDW还是RDWI,RDW-SD均较RDW-CV具有更高的敏感度和特异度。结论:RDW-SD作为从小细胞低色素性贫血儿童中检出β-TT患儿指标时,较RDW-CV具有更高的鉴别效能。

Objective To evaluate the efficacy of RDW-SD in detectingβ-thalassemia(β-TT)in children with microcytic anemia.Method From January 2017 to December 2018,children with microcytic anemia were selected as research objects(divided intoβ-TT group and nonβ-TT group according toβ-TT gene detection results).The differences of RBC parameters between the two groups were analyzed retrospectively,and the two RDW forms and the RBC volume distribution width calculated based on different RDW forms were compared.Results The present studyshowed that there was no significant difference between the two groups except for hemoglobin(HGB),hematocrit(HCT),hemoglobin concentration(MCHC)and RBC volume distribution coefficient of variation(RDW-CV).RDWI-CV and RDWI-SD calculated based on different RDW forms were also significantly different.No matter RDW or RDW index,RDW-SD had higher sensitivity and specificity than RDW-CV whenβ-TT was detected in children with microcytic anemia.Conclusion RDW-SD is more effective than RDW-CV in the detection ofβ-TT in children with microcytic anemia.