缺铁性贫血与α-地中海贫血的血液学鉴别

The identification of hematology of iron-deficiency anemia and αlpha thalassaemia

目的探讨α-地中海贫血与缺铁性贫血的血液指标的区别。方法选取2015—2017年我院诊断为α-地中海贫血患者129例(剔除合并其他类型地中海贫血患者、合并缺铁性贫血患者、合并其他血红蛋白病患者)。选取同时期明确诊断为缺铁性贫血患者191例,健康对照组47名。回顾性分析比较血常规、血红蛋白电泳检测结果。结果α-地中海贫血组、缺铁性贫血组血红蛋白、血细胞比容(Hct)、平均红细胞体积(MCV)、平均血红蛋白含量(MCH)、平均血红蛋白浓度(MCHC)、血红蛋白A2值明显低于健康对照组,差异有统计学意义(P<0.05)。α-地中海贫血组MCV、MCH、血红蛋白A值明显低于缺铁性贫血组,血红蛋白、Hct明显高于缺铁性贫血组,差异有统计学意义(P<0.05);血红蛋白A、血红蛋白A2、MCHC差异无统计学意义(P>0.05)。结论α-地中海贫血和缺铁性贫血均属于小细胞低色素性贫血,二者在血红蛋白电泳筛查上,差异无统计学意义。但在红细胞的相关指数上存在差异,可通过血红蛋白、Hct、MCV、MCH区分两者。因此在基层,实验室条件不足时,可以通过红细胞的相关指数,粗略地区别缺铁性贫血和α-地中海贫血,协助临床诊疗。

Objective To investigate the difference betweenαlpha thalassemia and iron-deficiency anemia.Methods From January 2015 to December 2017,129 cases of patients with alpha thalassemia were selected in our hospital.Patients with other types of thalassemia,iron deficiency anemia,and other patients with hemoglobin were being eliminated.One hundrel and ninty one patients with iron deficiency anemia were selected at the same period,and the healthy control group(n=47).Retrospective analysis of blood,hemoglobin electrophoresis test results.Results The values of hemoglobin(Hb),hematocrit(Hct),erythrocyte mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC)and HbA2 were significantly lower in the treatment group,and the difference was statistically significant(P<0.05).The values of MCV,MCH in alpha thalassemia group were significantly lower than those in iron deficiency anemia group,Hb and Hct were significantly higher than those of iron deficiency anemia group,the difference was statistically significant(P<0.05).There was no significant difference between HbA,HbA2 and MCHC(P>0.05).Conclusion Alpha thalassemia and iron deficiency anemia belong to small cell low pigment anemia,through Hb,Hct,MCV,MCH,HbA can distinguish between the two,but HbA2,MCHC to identify poor ability.