260例成人缺铁性贫血的诊断和病因分析

目的探讨成人缺铁性贫血(IDA)的实验室诊断方法和常见病因。方法分析260例成人IDA患者的血象、骨髓象、骨髓铁染色和有关铁指标的实验室检测结果,分析总结IAD的发病原因。结果260病例中轻度贫血60例,中度106例,重度88例,极重度6例。238例骨髓细胞学检查全部支持IAD诊断,铁染色细胞外铁全部阴性或减少,铁粒幼细胞<15%的病例占92.9%。红细胞三个平均值低,红细胞分布宽度(RDW)增高,血清铁和铁蛋白降低,总铁结合力增高。260例IDA患者的病因中,女性生殖道出血为首位,占女性患者的52.4%,占全部患者的33.8%;胃疾病居第二位,占27.7%;肠道疾病占9.2%;血小板减少占8.5%。结论骨髓细胞学检查及相关实验室检查是确诊IDA的主要方法,分析IDA病因,利于去除病因和合理治疗。

Diagnosis and Etiology Study of 260 Adult Patients with Iron Deficiency Anemia

Objective To explore the laboratory diagnosing methods and common etiology of adult patients with iron deficiency anemia (IDA).Methods All 260 patients underwent hemogram and bone marrow cytomorphology examinations, bone marrow iron stain and other laboratory examinations associated with the index. The causes of IDA were drawn from the analyzing on the results.Results Of all the patients, there were 60 patients with lighter degree anemia, 106 patients with moderate degree anemia, 88 patients with serious degree anemia, and 6 patients with especially serious anemia. Among the 238 patients whose bone marrow cytomorphology examination were wholly consistent with the diagnostic standard, the iron outside the cell in bone marrow totally decreased or disappeared, the proportion of patients whose sideroblasts was lower than 15% accounted for 92.9%. Three mean values evaluating red blood cells decreased, the red cell distribution width (RDW) increased, serum iron and ferritin were lower, total iron binding capacity was higher. Among the causes in all patients, the first one is female reproduction tract hemorrhages which consisting 52.4% of female patients and 33.8% of all patients; the second one was stomach disease accounted for 27.7%, the third was intestine disease(9.2%), then was platelet reduction(8.5%) and other diseases. Conclusions Bone marrow cytomorphology checking and other associated laboratory examinations are the major determined methods for the diagnosis of the IDA. The etiological analysis is benefit to earlier etiology removal and reasonable iron reagent therapy.