慢性病贫血病人的多项指标评价

Comprehensive evaluation in the patients with anemia of chronic disease

目的探讨细胞形态学及血清学的多项指标对慢性病贫血(ACD)评价的临床意义。方法用STKS血细胞分析仪检测外周血红细胞参数,化学发光免疫测定法测定血清铁蛋白、叶酸及维生素B12,骨髓常规计数粒红比例及骨髓幼红细胞数。并以缺铁性贫血、巨幼细胞性贫血、溶血性贫血及难治性贫血为对照。结果ACD的MCH、MCV,MCHC与其它各组贫血(除HA外)比较均有显著性差异;ACD的RDW在治疗前后的结果变化小;ACD的骨髓粒红比例较高,总幼红细胞值较其它各组低;ACD的铁蛋白明显高于IDA组(P<0.01),其血清叶酸和维生素B12的检测无明显临床价值。结论多项指标的评价对ACD的诊断和鉴别诊断及其发病机理的探讨有一定的参考价值。

Objective To investigate the clinical meaning of cell ular morphology and several serum indicators of the anemia of chronic disease(ACD).Methods Periph-eral erythrocyte parameters were determined by Coulter STKS analyzer.The serum fer-ritin,folic acid and vitamin B 12 were determined by chemiluminescent immunoassay method.The granule/red ratio and the number of the nucleated erythrocyte of bone marrow were counted.Re sults MCV,MCH,MCHC in ACD were all significantly dif-firent with those in other amemia except HA.The change s of the RDW in ACD were small before and after treatment.The rate of granule /red in ACD was higher and the total nucleated erythrocyte lower.The ferritin in ACD was obviously higher than that in IDA(P<0.01).Measuring serum folic acid and vitamin B 12 had no obvious clinical value.Con clusion Comprehen sive evaluation is important to the diagnosis and differential di-agnosis of ACD.