联合检测血清铁蛋白、叶酸、维生素B12、乳酸脱氢酶在鉴别诊断巨幼细胞性贫血中的意义

目的 探讨联合检测血清铁蛋白,叶酸,维生素B12,乳酸脱氢酶在鉴别诊断巨幼细胞性贫血中的意义。方法 2015年1月~2017年2月经萍乡市人民医院骨髓细胞学形态和临床确诊的,分组为巨幼细胞性贫血组34例，缺铁性贫血组53例,再生障碍性贫血组25例，骨髓异常增生综合症组36例，另随机选取60例体检健康者为正常对照组，回顾性分析不同组别患者的血清铁蛋白,叶酸,维生素B12,乳酸脱氢酶水平变化。结果 巨幼细胞性贫血患者铁蛋白轻度升高，与正常对照组及MDS组差异不明显（P>0.05）,与IDA组及AA组相比较，差异具有统计学意义（P<0.05）；MA组叶酸,维生素B12水平降低幅度明显，与正常对照组及其他类型贫血组水平相比，差异明显（P<0.05）；MA组乳酸脱氢酶水平明显增高，与正常对照组及其他类型贫血组变化水平相比较具有明显差异（P<0.05）。结论 联合检测血清铁蛋白,叶酸,维生素B12,乳酸脱氢酶可为鉴别诊断MA提供有效的依据，对减少误诊率，减轻患者身心及经济负担方面具有积极的意义。

Clinical Significance of Combined Determination of Serum Ferritin,Folic acid,Vitamin B12 and Lactate Dehydrogenase in Differential Diagnosis of Megaloblastic Anemia

Abstract:Objective To explore the significance of combined detection of serum ferritin, folic acid,vitamin B12,and lactate dehydrogenase in the differential diagnosis of megaloblastic anemia.Methods From January 2015 to February 2017,the patients were diagnosed with bone marrow cytology and clinical diagnosis at the people's hospital of Pingxiang.They were grouped into 34 cases of megaloblastic anemia,53 cases of iron deficiency anemia,and 25 cases of aplastic anemia.There were 36 cases of dysplasia syndrome group.Another 60 healthy subjects were randomly selected as the normal control group.Serum ferritin,folic acid,vitamin B12 and lactate dehydrogenase levels were analyzed retrospectively in different groups.Results Ferritin in patients with megaloblastic anemia increased slightly,and the normal control group and MDS group was not significantly different(P>0.05),compared with the IDA group and AA group,the difference was statistically significant(P<0.05);Group MA,folic acid,vitamin B12 levels decreased significantly, compared with normal control group and other types of anemia group were significantly different(P<0.05);group MA lactate dehydrogenase levels were significantly increased,and the normal control group and other types of anemia group level changes compared with significant difference(P<0.05).Conclusion Combined detection of serum ferritin,folic acid,vitamin B12 and lactate dehydrogenase can provide effective evidence for differential diagnosis of MA,and it has a positive significance in reducing misdiagnosis rate and relieving patients' physical and mental economic burden.