红细胞与网织红细胞参数在缺铁性贫血与地中海贫血患儿中的意义

目的探讨红细胞参数:平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW)与网织红细胞6项参数: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%)在地中海贫血与缺铁性贫血患儿中的筛查与临床鉴别诊断价值。方法收集中山大学孙逸仙纪念医院门诊及住院的地中海贫血与缺铁性贫血儿童患者共计108例,另选取50名正常儿童作为对照组,用Sysmex XE-5000全自动血液分析仪检测患儿与正常儿童的红细胞参数与网织红细胞相关参数。结果缺铁性贫血组、地中海贫血组MCV、MCH、MCHC出现降低,与对照组比较差异均有统计学意义(P0.05)。缺铁性贫血组RDW升高,与地中海贫血组和对照组比较差异均有统计学意义,而地中海贫血组与对照组比较差异无统计学意义(P0.05)。缺铁性贫血组、地中海贫血组RET#、RET%、IRF、MFR%、HFR%均升高,LFR%降低,且地中海贫血组变化更为显著。结论 MCV、MCH、RDW三项指标可对地中海贫血与缺铁性贫血进行初步鉴别。网织红细胞相关参数对临床筛查地中海贫血和缺铁性贫血有提示作用,且其变化在地中海贫血中比缺铁性贫血更显著。结合运用红细胞参数与网织红细胞相关参数,可以提高两种疾病的筛查率和初步鉴别。

The value of red blood cell parameters and reticulocyte parameters in the chirldren patients with iron deficiency anemia and mediterranean anemia

Objective To study the diagnostic value of red blood cell parameters ： mean corpuscular volume（MCV）, mean corpuscular hemoglobin（MCH）, mean corpuscular hemoglobin concentration（MCHC）, red cell volume distribution width（RDW） and reticulocyte parameters： percentage of reticulocytes（RET%）, absolute reticulocyte（RET #）, immature reticulocyte fraction（IRF）, low fluorescence intensity reticulocyte（LFR%）, the fluorescence intensity reticulocyte（MFR%）,high fluorescence intensity reticulocyte（HFR%） in the clinical identification of iron deficiency anemia and mediterranean anemia. Methods A total of 108 cases of children with iron deficiency anemia and mediterranean anemia, who were enrolled in the Sun Yat-sen Memorial Hospital outpatient and hospitalization, were selected as the research group and 50 cases of healthy children as the control group, the parameters of red blood cells and reticulocyte were tested by Sysmex XE-5000 automatic blood analyzer. Results MCV, MCH, MCHC in iron deficiency anemia group and mediterranean anemia group decreased. Compared with the control group,the differences were statistically significant（P〈0.05）. RDW in iron deficiency anemia group increased. Compared with the mediterranean anemia group,the differences in RDW showed no significant difference（P〉0.05）. RET#, RET%, IRF, MFR%, HFR% of the iron deficiency anemia group and mediterranean anemia group rose while LFR% reduced. The changes of the mediterranean anemia group were more significant. Conclusion The red blood cell parameters（MCV, MCH, RDW）can be preliminary identification of mediterranean anemia and iron deficiency anemia. Reticulocytes parameters are of clinical implications value in screening mediterranean and iron deficiency anemia. The changes of the mediterranean anemia group were more significant. Combined with the use red blood cell parameters and the reticulocyte parameters, can improve the rate of screening two kinds of disease and conduct a preliminary identificati