血液检验技术在贫血诊断与鉴别中的应用价值

Application Value of Blood Test in the Diagnosis and Differentiation of Anemia

目的:探讨在贫血诊断中采用血液检验技术的价值。方法:随机选取173例自2020年6月至2022年6月在三明市第一医院进行诊治的贫血患者,包括缺铁性贫血患者84例、地中海贫血患者89例,并按贫血严重程度分为轻度贫血患者116例、中度贫血患者37例、重度贫血患者20例,另随机选取71例同期接受体检的健康者,应用血液检验技术进行疾病诊断和鉴别,比较缺铁性贫血、地中海贫血患者与健康者之间以及不同贫血程度患者之间的平均血红蛋白量(MCH)、平均血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW)、红细胞平均体积(MCV)、血红蛋白浓度(Hb)、红细胞计数(RBC)及血清铁蛋白(SF)检测结果,并计算血液检验诊断地中海贫血及缺铁性贫血的效能。结果:地中海贫血、缺铁性贫血患者的MCH、MCHC、MCV、Hb、RBC及SF水平均低于健康者,RDW水平均高于健康者;地中海贫血患者MCH、MCHC、Hb、RBC及SF水平均高于缺铁性贫血患者,RDW、MCV均低于缺铁性贫血患者,差异均具有统计学意义(P<0.05)。血液检验对地中海贫血与缺铁性贫血的诊断灵敏度为96.53 %,特异度为90.28 %,准确度为95.08 %。中、重度贫血患者的MCH、MCHC、MCV、Hb、RBC及SF水平均低于轻度贫血患者,RDW水平高于轻度贫血患者;重度贫血患者的MCH、MCHC、MCV、Hb、RBC及SF水平均较中度贫血患者低,RDW水平较中度贫血患者高,差异均具有统计学意义(P<0.05)。结论:血液检验技术有助于鉴别地中海贫血与缺铁性贫血,还可为临床评估贫血严重程度提供指导。

Objective To explore the value of blood test in the diagnosis of anemia.Methods A total of 173 patients with anemia who were treated in Sanming First Hospital from June 2020 to June 2022 were randomly selected,including 84 patients with iron deficiency anemia and 89 patients with thalassemia.According to the severity of anemia,they were divided into 116 patients with mild anemia,37 patients with moderate anemia and 20 patients with severe anemia.Another 71 healthy subjects who received physical examination at the same time were randomly selected for disease diagnosis and differentiation using blood test technology.Comparison between iron deficiency anemia,the thalassemia patients and healthy subjects and patients with different degree of anemia of the average amount of mean corpsular hemoglobin (MCH),mean hemoglobin concentration (MCHC),red blood cell volume distribution width (RDW),mean corpuscular volume (MCV),concentration of hemoglobin (Hb),red blood cell count (RBC) and serum ferritin (SF),and the efficacy of blood test in diagnosing thalassemia and iron deficiency anaemia was calculated.Results The levels of MCH,MCHC,MCV,Hb,RBC and SF in patients with thalassemia and iron deficiency anemia were lower than those in healthy subjects,and the level of RDW was higher than that in healthy subjects.The levels of MCH,MCHC,Hb,RBC and SF in patients with thalassemia were higher than those in patients with iron deficiency anemia,while the levels of RDW and MCV were lower than those in patients with iron deficiency anemia,and the differences were statistically significant(P < 0.05).The sensitivity,specificity and accuracy of blood test for thalassemia and iron deficiency anemia were 96.53 %,90.28 % and 95.08 %,respectively.The levels of MCH,MCHC,MCV,Hb,RBC and SF in patients with moderate and severe anemia were lower than those in patients with mild anemia,and the level of RDW was higher than that in patients with mild anemia.The levels of MCH,MCHC,MCV,Hb,RBC and SF in patients with severe anemia were lower than those in patients with moderate anemia,and the level of RDW was higher than that in patients with moderate anemia,and the differences were statistically significant(P < 0.05).Conclusion Blood test technology is helpful to differentiate thalassemia from iron deficiency anemia,and can also provide guidance for clinical assessment of anemia severity.