肾性贫血患者网织红细胞参数的变化及临床意义

目的探讨网织红细胞参数在肾性贫血治疗中的变化及临床意义。方法采用Sysmex XE-2100型自动血液分析仪,检测88例各种肾病(包括45例用抗贫血药治疗组和43例未用抗贫血药治疗组)和80例正常对照组的网织红细胞百分率(Ret%)、网织红细胞绝对值(Ret#)、未成熟网织红细胞比率(IRF%)、低荧光网织红细胞比率(LFR%)、中荧光网织红细胞比率(MFR%)、高荧光网织红细胞比率(HFR%),并进行比较分析。结果治疗组的Ret%、Ret#、IRF%、MFR%、HFR%均显著高于未治疗组(P<0.01)。未治疗组的Ret%、IRF%和MFR%均显著低于对照组(P<0.01)。治疗组的Ret%、IRF%、MFR%、HFR%均显著高于对照组(P<0.01)。以Ret%>1.73%和IRF%>8.99%为界线,评价本组抗贫血治疗效果的特异性为86.1%和97.7%,敏感性为62.2%和53.3%,阳性预测值为82.4%和96.0%,阴性预测值为68.5%和66.7%。结论网织红细胞参数的检测有助于了解肾病患者骨髓增生程度和红系的生长情况;IRF在肾病早期降低,经促红细胞生成素(EPO)等抗贫血药治疗后IRF升高,提示EPO等治疗有效。

Changes of Retculocyte Parameters in Renal Anemia Patients and Their Clinical Significance

Objective To probe into the changes and clinical significance of retculocyte parameters in renal anemia patients.Method The reticulocyte percent(RET%),absolute reticulocyte count(RET#),immature reticulocyte rate(IRF%),low fluorescent reticulocyte rate(LFR),middle fluorescent reticulocyte rate(MFR) and high fluorescent reticulocyte(HFR) were measured by Sysmex XE-2100 hematology analyzer in 88 renal anemia patients(including 45 patients treated with anti-anemia drugs and 43 patients not treated with anti-anemia drugs) and 80 healthy subjects.Results The levels of Ret%,Ret#,IRF%,MFR% and HFR% in patients treated with anti-anemia drug were significantly higher than those in patients not treated with anti-anemia drugs and healthy subjects(P<0.01);the levels of Ret%,IRF%,MFR% and HFR% in untreated patients were significantly lower than those in healthy subjects(P<0.01).If Ret%>1.73% and IRF%>8.99% were set as a threshold,the specificity of the efficacy of anti-anemia drugs was 86.1% and 97.7%,the sensitivity was 62.2% and 53.3%,the positive forecast values were 82.4 % and 96.0 %,the negative forecast values were 68.5% and 66.7%.Conclusions The measurement of retculocyte parameters is helpful to understand the hyperplastic degree of bone marrow and the gowth of red blood cell system.The level of IRF decreases in the early period of renal anemia,and then increases after the treatment of EPO and other anti-anemia drug,which demonstrates that EPO and other anti-anemia drug are effective.