网织红细胞参数对儿童炎症性肠炎铁储备的评价

Evaluation of reticulocyte parameters on iron reserve in children with inflammatory bowel disease

目的:评价不同网织红细胞参数对儿童炎症性肠炎(IBD)铁储备的判断意义。方法:选择2016-01—2018-05就诊的IBD患儿99例为试验组,再选择同期体检的健康儿童110例为对照组,对比2组红细胞分布宽度(RDW)、红细胞体积因子(RSF)、未成熟网织红细胞比例(IRF)、网织红细胞分布宽度标准差(RDWR-SD)、网织红细胞分布宽度变异系数(RDWR-CV)等网织红细胞参数的差异,同时评价不同指标与血清铁蛋白、转铁饱和度(Tsat)和血清可溶性转铁蛋白受体(sTfR)的相关性。结果:试验组99例患儿中溃疡性结肠炎(UC)42例(42.42%),Crohn病(CD)57例(57.58%)。UC组、CD组和对照组血红蛋白、红细胞平均体积(MCV)、RDW、IRF、RDWR-CV、RDWR-SD、血清铁蛋白、Tsat、sTfR、C反应蛋白(CRP)、血沉(ESR)比较差异有统计学意义(P<0.05),其中UC和CD组均高于对照组(P<0.05),而UC和CD组间比较差异无统计学意义(P>0.05),3组RSF组间比较差异无统计学意义(P>0.05);Tsat与RDW、RDWR-CV、RDWR-SD呈正相关,与RSF呈负相关(P<0.05);sTfR与RDW、RDWR-CV、RDWR-SD呈负相关,与RSF呈正相关(P<0.05);IDA组RDW、RDWRCV、RDWR-SD高于非IDA组,而RSF低于非IDA组(P<0.05),IDA组与非IDA组IRF组间比较差异无统计学意义(P>0.05)。结论:RSF、RDWR为IBD患儿贫血的诊断提供了简单、低廉的评价指标,但确切的诊断价值有待进一步研究。

Objective:To evaluate the significance of different reticulocyte parameters on iron reserve estimating in children with inflammatory bowel disease(IBD).Method:From January 2016 to May 2018,99 children with IBD in our hospital were selected as experimental group,and 110 healthy children were selected as control group.The red cell distribution width(RDW),red blood cell size factor(RSF),immature reticulocyte ratio(IRF)and reticulocyte distribution width-standard deviation(RDWR-SD),reticulocyte distribution width-coefficient of variation(RDWR-CV)and other reticulocyte parameters were compared in two groups.The correlation of different indexes with serum ferritin,iron conversion saturation(Tsat)and serum soluble transferrin receptor(sTfR)were evaluated.Result:There were 42 cases(42.42%)of ulcerative colitis(UC)and 57 cases(57.58%)of Crohn disease(CD)in 99 cases.The hemoglobin,mean corpuscular volume(MCV),RDW,IRF,RDWR-CV,RDWR-SD,serum ferritin,Tsat,sTfR,C reactive protein(CRP)and erythrocyte sedimentation rate of three groups were statistically different.Group UC and CD were higher than those of control group(P<0.05),but there was no statistical difference between groups UC and CD(P>0.05).There was no statistical difference in RSF between three groups(P>0.05).Tsat was positively correlated with RDW,RDWR-CV and RDWR-SD,and negative correlated with RSF.STfR was negatively correlated with RDW,RDWR-CV and RDWR-SD and positively correlated with RSF(P<0.05).RDW,RDWR-CV and RDWR-SD of group IDA were higher than those of non IDA groups,but RSF was lower than that of non IDA group(P<0.05).There was no statistical difference between IDA group and non IDA group.Conclusion:RSF and RDWR could provide a simple and inexpensive index for diagnosis of IDA in children with IBD,but the exact diagnostic value needs further study.