地中海贫血与缺铁性贫血应用血液检验鉴别诊断的临床研究

Clinical Study on Differential Diagnosis of Blood Test for Thalassemia and Iron Deficiency Anemia

目的探讨地中海贫血与缺铁性贫血应用血液检验鉴别诊断的临床效果。方法选取2017年2月-2019年3月附属医院接收的94例贫血患者为研究对象,根据患者的贫血类型将其分为2组,即地中海贫血组和缺铁性贫血组,每组各47例,并选取同期在附属医院接受体检的健康者50例为对照组,比较3组血液检查结果、检验情况,同时使用ROC曲线判断血液检验的诊断价值。结果与对照组比较,地中海贫血组、缺铁性贫血组的血红蛋白、血清铁蛋白、红细胞计数、红细胞平均体积、红细胞平均血红蛋白、红细胞平均血红蛋白浓度水平更低,血红细胞分布宽度水平更高,比较差异显著(P<0.05);与地中海贫血组比较,缺铁性贫血组的血红蛋白、血清铁蛋白、红细胞计数、红细胞平均血红蛋白、红细胞平均血红蛋白浓度水平更高,血红细胞分布宽度、红细胞平均体积水平体积更低,比较差异显著(P<0.05);根据ROC曲线的结果,单独检测血液样本中血红蛋白、红细胞平均体积和红细胞分布宽度的AUC与联合检测的AUC均超过0.80,诊断价值较高。结论血液检验对临床诊断地中海贫血、缺铁性贫血具有重要意义,且血红蛋白、红细胞平均体积和红细胞分布宽度联合检验拥有较高的诊断价值。

Objective To explore clinical effect of differential diagnosis between thalassemia and iron deficiency anemia by blood test.Methods The paper chose 94 patients with anemia treated in the affiliated hospital from February 2017 to March 2019 as research objects,and divided them into two groups according to anemia type,namely,thalassemia group and iron deficiency anemia group,with 47 cases in each group.50 healthy people in control group were treated with physical examination in affiliated hospital during the same period.Result s and conditions of blood tests among three groups were compared.At the same time,diagnostic value of blood tests was detected by ROC curve.Results Levels of hemoglobin,serum ferritin,erythrocyte count,mean corpuscular volume,mean corpuscular hemoglobin,and mean corpuscular hemoglobin in thalassemia group and iron deficiency anemia group were lower than control group,and level of erythrocyte distribution width was higher,with significant differences(P<0.05).Levels of hemoglobin,serum ferritin,red blood cell count,average red blood cell hemoglobin,and average red blood cell hemoglobin in iron deficiency anemia group were higher than thalassemia group,distribution width of red blood cells and average volume of red blood cells were lower,with significant differences(P<0.05);According to results of ROC curve,AUC of hemoglobin,average volume of red blood cells and distribution width of red blood cells in blood samples detected separately and AUC of combined detection exceeded 0.80,with high diagnostic value.Conclusion Blood test is of great significance in clinical diagnosis of thalassemia and iron deficiency anemia,and combined test of hemoglobin,mean corpuscular volume and red cell distribution width has high diagnostic value.