网织红细胞血红蛋白及低色素性红细胞在妊娠期缺铁性贫血筛查中的应用价值

目的:探讨妊娠期缺铁性贫血(IDA)患者筛查检测低色素性红细胞百分比及外周血网织红细胞血红蛋白量的临床应用价值。方法:选择产检孕产妇220例,检测所有研究对象的网织红细胞百分比(Ret%)、网织红细胞血红蛋白量(CHr)、红细胞分布宽度(RDW)、低色素性红细胞百分比(Hypo%)、平均红细胞血红蛋白浓度(MCHC)、平均红细胞血红蛋白(MCH)、平均红细胞体积(MCV)、血红蛋白(Hb)、红细胞(RBC),同时检测血清铁(SI)含量。结果:IDA组的MCV、Hb、RBC等参数指标显著低于对照组(P<0.05),IDA组的Hypo%和RDW%显著高于对照组(P<0.05);而MCH、MCHC等指标显著低于对照组(P<0.05);IDA组的Ret%、SI、CHr检测指标显著低于对照组(P<0.05)。结论:妊娠期缺铁性贫血的早期敏感指标为Hypo%及CHr,二者联合检测可提高妊娠期缺铁性贫血的诊断率,指导孕妇补充营养。     

无锡健康成人静脉血红细胞系统LH750参考值的调查

目的 通过对贝克曼库尔特LH750型血液分析仪所测红细胞相关参数(RBC、HGB、MCV、MCH、MCHC和HCT)的调查,确定无锡地区该型号仪器健康成人的正常参考范围,同时观察异常情况下的相应变化.方法 用贝克曼库尔特LH750型血液分析仪对居住无锡的健康男女各1000名静脉血标本进行检测分析;采用SPSS10.0软件进行参考范围调查.结果 红细胞计数:男性(5.04±0.42)×1012/L、女性(4.40±0.38)×1012/L;血红蛋白:男性(149.00±10.00)g/L、女性(130.20±11.2 0)g/L;红细胞平均体积:男性(90.10±4.10)fL、女性(90.00±4.50)fl;红细胞压积:男性(0.45±0.03)%、女性(0.38±0.04)%.结论 调查结果与<全国临床检验操作规程>(第3版)提供的参考范围存在一定的轻微差异,因此,各实验室有必要根据具体情况建立各自的血细胞参考范围.     

潮汕地区健康人群静脉血红细胞数及其各项参数分布特点

目的调查分析潮汕地区健康成人静脉血RBC及其相关参数:血红蛋白(HGB)、红细胞压积(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白量(MCH)、红细胞平均血红蛋白浓度(MCHC)和红细胞体积分布宽度变异系数(RDW-CV)的分布特点。方法采用Sysmex XE-2100全自动血细胞分析仪,对2012年2月至2013年5月潮汕地区各企事业单位健康体检人群的静脉血进行检测分析,对检测结果采用PASW19.0统计软件分析。结果 (1)通过性别分析,男(总)参数RBC、HGB、HCT、MCV、MCHC、RDW-CV与现行参考范围比较,差别均有统计学意义(P<0.05)。女(总)参数RBC、HGB、HCT、MCV、MCH、MCHC、RDW-CV与现行参考范围比较,差别均有统计学意义(P<0.05)。(2)女性组内按年龄分析比较,青年组参数RDW-CV与中年组比较差别有统计学意义(P=0.001)、青年组参数MCHC与老年组比较差别有统计学意义(P=0.008);男性组内按年龄分析比较,多项参数差别均有统计学意义(P<0.05)。结论潮汕地区健康人群静脉血RBC数及其各个参数与现行实验室参考区间存在一定的差异,建立本地区健康人群静脉血RBC数及其各个参数参考范围,为临床医生诊断、治疗贫血性疾病和判断体检报告提供准确参考依据。     

地中海贫血患儿网织红细胞6项参数分析

[目的]探讨地中海贫血(地贫)患儿网织红细胞百分率(RET%)、网织红细胞绝对值(RET#)、未成熟网织红细胞比率(IRF)、低荧光强度网织红细胞百分率(LFR)、中荧光强度网织红细胞百分率(MFR)、高荧光强度网织红细胞百分率(HFR)6项参数的变化情况. [方法]用Sysmex XE-2100全自动血细胞分析仪测定106例地贫患儿网织红细胞6项参数,进行地贫与正常儿童间的比较.α、β地贫间的比较,β贫问轻度贫血者与中、重度贫血者的比较. [结果]α地贫RET%、RET#、IRF、LFR、MFR、HFR 6项参数与正常儿童及轻型β地贫比较差异有显著性;中、重型β地贫IRF、LFR、MFR、HFR 4项参数与正常儿童及轻型β地贫比较差异有显著性;轻型β地贫IRF、LFR、MFR 3项参数与正常儿童比较差异有显著性,(P<0.05). [结论]地贫患者RET%、RET#、IRF、MFR、HFR随着贫血程度的增加的而增高,LFR随着贫血程度的增加而减低,用网织红细胞6项参数筛查地贫比过去RET%、RET#两项参数更有意义,尤以IRF、LFR、MFR筛查轻型β地贫价值更高.     

缺铁性贫血诊治中网织红细胞相关参数的临床意义

目的：研究缺铁性贫血诊治中网织红细胞相关参数的临床意义。方法：选取缺铁性贫血患者158例和健康体检者161例，缺铁性贫血组使用硫酸亚铁治疗60天，观察诊治全程网织红细胞参数变化。结果：Hb、RBC缺铁性贫血组治疗前与健康对照组比较显著降低，治疗第5天上升，治疗第10天显著增高。RET、CHr、MCVr、CHCMr,缺铁性贫血组治疗前低于对照组，RDWr高于对照组。RET、CHr、MCVr、CHCMr,均在治疗第5、10天显著高于治疗前；RDWr在治疗第10天最高。结论：网织红细胞参数在诊治缺铁性贫血中具有重要临床意义。     

Sysmex XN-10(B3)血液分析仪检测网织红细胞参数对鉴别诊断贫血性疾病的应用价值

目的：探讨贫血性疾病鉴别诊断中Sysmex XN-10(B3)血液分析仪检测网织红细胞参数的应用价值。方法：回顾性选取2019年2月～2021年2月本院贫血性疾病患者80例作为贫血组、健康体检人员80例作为健康组。统计分析两组网织红细胞参数检测结果，并统计分析缺铁性贫血诊断中网织红细胞参数的效能。结果：贫血组巨幼细胞性贫血、溶血性贫血、肾性贫血、缺铁性贫血、再生障碍性贫血患者的网织红细胞血红蛋白（RETHe）、未成熟网织红细胞比率（IRF%）、网织红细胞百分率（RET%）、中荧光强度网织红细胞百分率（MFR%）、高荧光强度网织红细胞百分率（HFR%）均逐渐降低（P<0.05）,RET%均高于健康组（P<0.05），低荧光强度网织红细胞百分率（LFR%）逐渐升高（P<0.05），均低于健康组（P<0.05）。巨幼细胞性贫血患者的RET-He高于健康组（P<0.05），溶血性贫血、肾性贫血、缺铁性贫血、再生障碍性贫血患者的RET-He均低于健康组（P<0.05）；巨幼细胞性贫血、溶血性贫血、肾性贫血、缺铁性贫血患者的IRF%、MFR%、HFR%均高于健康...     

MCV、RDW实验室检测对贫血诊断的临床应用价值研究

目的:探讨检测MCV和RDW值对各型贫血的诊断价值。方法:采用ABX PENTRA60全自动血细胞分析仪检测106例患者红细胞平均体积和分布宽度。结果:缺铁性贫血、巨幼细胞性贫血、再生障碍性贫血、溶血性贫血、铁粒幼细胞性贫血和单纯小细胞性贫血MCV结果差别有统计学意义(t=6.4715,P<0.001),而RDW无差别(t=1.8697,P>0.05);各型贫血MCV与RDW检测的敏感性为86.7%～94.4%,特异性为90.7%～100%。结论:检测MCV和RDW对贫血诊断准确性高,值得临床推广应用。     

网织红细胞参数在儿童血液病中的应用

目的:探讨网织红细胞参数在儿童血液病中的临床应用价值.方法:应用Sysmex XE-2100全自动血细胞分析仪检测106例儿童血液病患儿的网织红细胞计数(RET#)、网织红细胞百分比(RET)、未成熟网织红细胞比率(IRF)、低荧光强度网织红细胞比值(LFR)、中荧光强度网织红细胞比值(MFR)、高荧光强度网织红细胞比值(HFR)等参数.结果:营养性缺铁性贫血、溶血性贫血、血小板减少性紫癜患儿RET、IRF等指标显著增高(P＜0.05),再生障碍性贫血、白血病患儿RET#显著降低(P＜0.05),IRF显著增高(P＜0.05).结论:测定网织红细胞及其相关参数有助于判断骨髓生成红细胞的活动度,对贫血类型的鉴别诊断有实用价值.     

12152名体检职工贫血及红细胞增多的现况分析

[目的]了解体检者贫血及红细胞增多患病率。[方法]用库尔特5diff血细胞分析仪上检测12152名体检者的静脉血红血细胞参数。[结果]RBC、HGB和HCT50岁前的各年龄组均高于其后的各个年龄组,差异有统计学意义(P﹤0.05);男性表现与总体相近,女性30～49岁的RBC、HGB和HCT较低,50岁后明显升高,其差异有统计学意义(P﹤0.05);男、女贫血患病率呈现上述走势,但总患病率是60岁后明显增加,其差异有统计学意义(P﹤0.05);红细胞增多患病率男性明显高于女性(P﹤0.05),各年龄组男、女之间除30～岁组外差异均有统计学意义(P﹤0.05),男性40～59岁年龄段较多,女性60岁以后明显升高,各年龄段均出现一定的非贫血性小红细胞增多者,但≥70岁组显著低于各组(P﹤0.01)。[结论]中、老年人应加强身体锻炼,注意合理饮食,定期检查身体.预防疾病的发生。特别是30～49岁的女性要防治贫血症,40～59岁的男性要警惕血栓性疾病发生。另外,应了解健康人中有一定的非贫血性小红细胞增多者。     

1386例孕妇红细胞参数检测及结果分析

目的:分析我院1386例孕妇血红蛋白结果及贫血孕妇红细胞参数结果,了解孕妇贫血情况及贫血类型,探讨预防和降低孕妇贫血的有效途径。方法:采集孕妇及健康女性静脉血用五分类血液细胞仪进行Hb及红细胞参数检测。结果:1386例孕妇中有15例重度贫血(Hb<60g/L),占1.08%;有188例中度贫血(Hb结果61~90g/L),占13.56%;有312例轻度贫血(Hb结果91~110g/L),占22.51%;共515例孕妇贫血,占37.15%。贫血孕妇与正常女性的红细胞参数比较,孕妇的MCV、MCH、MCHC小于正常值,RDW高于正常值,孕妇的贫血种类为小细胞低色素性贫血即缺铁性贫血。结论:提示孕妇合并贫血百分率很高(高达37.15%),孕妇合并贫血对胎儿和孕妇健康影响很大,加强孕妇怀孕期间的营养(特别是含铁丰富的食物),定期检测血红蛋白及红细胞参数,对孕妇贫血的早发现,及时治疗很重要。     

云南德宏地区Hb WS异常血红蛋白突变的血液学和基因型分析

目的分析云南德宏地区Hb WS异常血红蛋白突变的血液学和基因型。方法获取云南德宏地区6 043例外周静脉血样本,采用突变阻滞扩增系统ARMS-PCR进行Hb WS基因突变的筛查,突变携带者的样本采用血细胞分析仪进行血常规检测,采用毛细管电泳法进行血红蛋白电泳,采用Gap-PCR检测缺失型α珠蛋白基因突变,采用反向点杂交法检测常见非缺失型α珠蛋白基因突变和β地中海贫血基因突变。结果在6 043例样本中,共检出Hb WS突变携带者38例(携带率0. 63%),包含4种地中海贫血基因突变组合。单纯携带Hb WS突变患者中,2例表现为轻度贫血,2例表现为中重度贫血,21例无贫血症状。Hb WS复合3. 7缺失型α地中海贫血的患者平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)均低于正常参考值,2例表现为小细胞低色素性贫血,2例表现为轻中度贫血;Hb WS复合β地中海贫血突变的患者中,57%表现为轻中度贫血;1例同时复合3. 7缺失型和β地中海贫血的Hb WS突变携带者表现为小细胞低色素性贫血。结论 Hb WS突变复合α地中海贫血和β地中海贫血突变可出现不同的基因型和血液学表型,杂合子未发现有规律的血液学表征,可表现为正常、轻中重度贫血及小细胞低色素性贫血,应通过血液学和基因分析来进行临床诊断。     

Nutritional anemia and its epidemiological correlates among women of reproductive age in an urban slum of Bhubaneswar, Orissa

The present cross-sectional study involving 240 women of reproductive age as the study population was carried out in the beneficiary slum area, the field practice area of Community Medicine department to find out the burden of nutritional anemia and study its epidemiological correlates. The prevalence of anemia was found to be 60.8%, of which 39.6, 20.0 and 1.2% women had mild, moderate and severe anemia, respectively. Almost 63, 21.2 and 15.7% of the study subjects had microcytic hypochromic picture, indicative of iron deficiency anemia, normocytic hypochromic picture suggestive of early stage of iron deficiency anemia and dimorphic/ macrocytic hypochromic anemia implying iron deficiency anemia and or folate/vitamin B12 deficiency respectively. Statistical analyses have shown that epidemiological factors like age, education of respondents, socioeconomic status, history of excessive menstrual bleeding and inadequate intake of green leafy vegetables and pulses were found to be significantly associated with anemia.     

Hematological and clinical profile in sickle cell or thalassemic patients

Clinical and hematological characteristics of 14 patients with sickle cell anemia; one heterozygous AS, and 7, with diagnostic of microcytic hypochromic anemia were analyzed. Hemoglobin phenotypes were identified by electrophoresis, fetal hemoglobin was quantificated for alkaline denaturation and the HbA2 for ionic exchange chromatography; -alpha3,7 -thalassemia was detected by mutation identification using polymerase chain reaction (PCR). SS phenotype was confirmed in 10 patients, two were SSF increased, one was SSFincreasedA2increased, and one was ASFincreased (HbF = 2%). The patient diagnosed as AS was SSFincreased (HbF = 21%). AD-patients presented a moderate clinical course of the illness. Five microcytic hypochromic anemia patients were HbAA, one was HbAAA2increased and another HbAAFincreased; those patients present a high hematological and clinical variation. beta-thalassemia was 19%. -alpha3,7-thalassemia was not detected. Infection was most frequent clinical manifestation (respiratory tract infection and intestinal parasitism). These results shows that -alpha3,7-thalassemia are not modulator genetic factors of clinical and hematological manifestations of patients with microcytic hypochromic anemia and sickle cell anemia. We suggest that environmental factors such as respiratory tract infection and intestinal parasitism may be affect the course of illness.     

Anemia among female college students attending the University of Sharjah, UAE: prevalence and classification

Anemia remains a public health challenge worldwide. Very few studies have been conducted on anemia in the United Arab Emirates and they have focused on children and pregnant women. Little is known about anemia among college female students from a preliminary study of iron deficiency anemia that was conducted on medical college students. This study aimed to estimate the prevalence of anemia among female college students attending the University of Sharjah (UoS) in the United Arab Emirates (UAE). A secondary analysis of the records of 258 complete blood cell count results from consented female college students. Hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were used to determine the prevalence of and classify anemia according to RBC indices and disease severity. Emirati students represented 50.8% of the studied population. The overall prevalence of anemia (Hb <12g/dL) was 26.7% and the majority (88.4%) of the 69 anemic students had mild anemia, whereas 7.2% were moderately anemic and 2.3% Emirati students were severely anemic (hemoglobin <7g/dL). About 15.9% of the anemia cases were microcytic (MCV <80fL) and 1.6% were macrocytic (MCV >96fL). The results showed that anemia constitutes a health problem among female college students in the UAE, and most of the detected anemia was microcytic with mild severity. This warrants further study on a larger sample of healthy college students to validate these findings and eventually encourage the development of directed educational and nutritional programs to safeguard the health of these future mothers.     

骨髓间充质干细胞促进异基因骨髓移植后造血恢复

目的探讨骨髓间充质干细胞(BMMSC)对异基因骨髓移植小鼠造血功能恢复的影响。方法将供鼠C57BL/6(H-2b)的骨髓细胞和体外培养的BMMSC联合输给致死量照射的受鼠BalB/c(H-2d)。在移植后第1、7、14天检测受鼠外周血红细胞(RBC)、白细胞(WBC)、血小板(BPC);移植后第7、14天检测受鼠骨髓中的脾集落形成单位(CFU-S)。结果联合移植组小鼠第7、14天的外周血红细胞、白细胞、血小板、CFU-S数均显著高于单纯移植组(P<0.01)。结论BMMSC能促进异基因骨髓移植后造血功能重建。     

大剂量重组人促红细胞生成素治疗慢性肾衰竭贫血的效果及机制

目的：研究和探讨大剂量重组人促红细胞生成素用于慢性肾衰竭（CRF）贫血的临床治疗效果及治疗机制。方法：选取本院2012年3月-2014年3月收治的慢性肾衰竭贫血患者58例,所有患者均予以1.2万IU rHuEPO皮下注射,每周1次,共治疗8周。患者每日服用维铁缓释片1粒,并常规运用维生素B12和叶酸。检测患者的骨髓象、血象、SI、SF及铁粒幼细胞计数。结果：58例患者中显效28例,有效26例,无效4例,总有效率为93.1%。用药2周后患者的Ret、RBC、Hb、Hct开始升高,用药8周后血象红系各指标较用药前有显著升高,差异均有统计学意义（P〈0.01）。患者骨髓红系增生较治疗前而言活跃显著,且早幼红、中幼红、晚幼红和E值较用药前有显著升高,其中晚幼红增生最显著,故G/E值较用药前显著降低,经治疗8周后患者SI、SF及铁粒幼细胞值均显著降低,差异均有统计学意义（P〈0.05）。结论：大剂量重组人促红细胞生成素可有效用于慢性肾衰竭贫血患者的临床治疗,通过刺激骨髓造血的机理恢复机体的正常造血功能,在慢性肾衰竭贫血患者的临床治疗上具有广泛的发展前景。     

老年人巨幼细胞性贫血临床分析

目的探讨老年人巨幼细胞性贫血（巨幼贫）的特点。方法对１９９５～１９９８年住院的１７例患者进行临床分析。结果全部患者均呈典型的巨幼贫骨髓象,血清叶酸或维生素Ｂ１２下降。病因方面７例有消化道疾患,其他方面为高血压,糖尿病,冠心病等。有１２例患者全血细胞下降。与非老年巨幼细胞贫血骨髓增生程度比较,呈增生下降,有明显差异。２例呈双相性贫血,即同时合并缺铁性贫血。结论当老年人以头昏、眼花、纳差等主诉就诊,而血常规呈大细胞、高色素贫血,要考虑巨幼贫的诊断,而一旦巨幼贫确诊,用叶酸、维生素Ｂ１２治疗效果非常显著。     

伴有呼吸道感染症状或健康婴幼儿维生素A营养状况与其贫血的关系

目的探讨伴有呼吸道感染症状或健康婴幼儿维生素A营养状况与其贫血的关系。方法收集435例婴幼儿的临床资料,依据年龄分为0. 5~1岁组、2~3岁组、4~6岁组;依据有无呼吸道感染症状进行分组,其中伴有呼吸道感染症状51例为观察组,无呼吸道感染症状的婴幼儿384例为对照组。检测所有婴幼儿维生素A和血红蛋白(HGB)的水平,通过统计分析婴幼儿维生素A营养状况与其贫血的关系。结果 435例婴幼儿中,男264例,女171例,年龄0. 5~6岁,平均年龄(3. 43±0. 35)岁。观察组维生素A水平较对照组明显降低,差异有统计学意义(P<0. 01);而两组HGB水平的比较,差异无统计学意义(P>0. 05)。不同年龄组间维生素A和HGB水平的比较,差异均有统计学意义(均P<0. 01),随着年龄的增加,婴幼儿维生素A和HGB水平均有所升高。随着维生素A水平的升高,婴幼儿HGB水平亦明显上升,贫血发生率降低,而在维生素A水平低于0. 1 mg/L时,婴幼儿贫血发生率最高(16. 86%)。经Spearman相关性分析结果发现,维生素A和HGB水平均与年龄呈现显著正相关关系(r=0. 46、0. 64,均P<0. 01),并且维生素A与HGB水平存在正相关关系(r=0. 27,P=0. 01)。结论伴有呼吸道感染症状的婴幼儿维生素A水平较健康婴幼儿明显降低,提示其维生素A营养状况较差,并且维生素A水平与贫血发生率存在显著相关性。     

骨髓单个核细胞移植治疗慢性心力衰竭的疗效观察

目的 探讨自体骨髓单个核细胞移植治疗慢性心力衰竭患者的可行性.方法 人选慢性心力衰竭患者80例,分为骨髓细胞移植组(48例)和标准药物治疗组(32例).骨髓细胞移植组将骨髓单个核细胞悬液在冠状动脉造影时经导管注入冠状动脉内.标准药物治疗组仅采用常规治疗.用超声心动图、血浆脑钠肽(BNP)和单光子发射计算机断层扫描(SPECT)比较两组治疗前后心功能指标和心肌灌注缺损区面积.结果 骨髓细胞移植组和标准药物治疗组治疗前LVEF分别为(42.1±5.8)%、(43.9±6.7)%,术后1年随访分别为(54.1±4.8)%、(49.8±7.7)%;治疗前BNP分别为(699±101)ng/L、(687±95)ng/L,随访分别为(305±78)ng/L、(3994-89)ng/L;治疗前心肌灌注缺损面积分别为(26.8±8.6)%、(26.3±6.5)%,随访分别为(15.8±4.3)%、(20.5±7.8)%,两组随访比较差异均有统计学意义;骨髓细胞移植组术中和术后均无并发症发生.结论 骨髓单个核细胞移植治疗慢性心力衰竭患者安全可行,术后能改善心功能及心肌血流灌注.     

Hematopoietic stem-cell transplantation in aplastic anemia

Severe aplastic anemia is a rare syndrome characterized by bone marrow failure with cytopenias and hypocellular bone marrow biopsy (usually 10-15%), without blasts or myelodysplasia. The first choice treatment for these patients is allogeneic bone marrow transplantation from a sibling matched for HLA-A, HLA-B and HLA-DR. Unfortunately only 30% of patients have an HLA-matched sibling (a 25% chance per sibling). The alternative treatment for severe aplastic anemia for the rest of the patients (70%) is immunosuppression with antithymocyte globuline and cyclosporine. The evolution of bone marrow transplantation since 1970's has been positive in terms of survival and transplant success (initial overall survival 43% vs. 90% lately, and graft rejection of 29% vs. 4%). The favorable outcome of bone marrow transplantation for severe or very severe aplastic anemia is due to: the use of conditioning with antithymocyte globuline and cyclophosphamide, the use of graft-vs.-host disease prophylaxis with short curse methotrexate and cyclosporine and the use of filtrated and irradiated blood products. For those patients without an HLA-matched related donor the first treatment to use is the immunosuppression with antithymocyte globuline and cyclosporine. Another option emerged in the late 80's is the unrelated bone marrow transplantation, with survival hardly half of the HLA-identical related bone marrow transplants. In our country, the first allogeneic bone marrow transplant was done in the Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, in a patient with aplastic anemia, making possible to perform this procedure safely in our country.