%Micro/%Hypo比值在珠蛋白生成障碍性贫血和缺铁性贫血辅助诊断中的应用价值

目的探讨小红细胞百分比(%Micro)与低色素红细胞百分比(%Hypo)的比值对常见3种珠蛋白生成障碍性贫血(地贫)和缺铁性贫血(IDA)的诊断价值。方法选择49例IDA患者、24例轻型α地贫患者、24例轻型β地贫患者、24例静止型α地贫患者、120例健康体检者作为研究对象,将其分为6组:健康组、IDA组、轻型α地贫组、轻型β地贫组、静止型α地贫组、轻型地贫组(为轻型α地贫组和轻型β地贫组的合并组)。分别检测各组%Micro和%Hypo并计算出两者比值,对结果进行分析比较。结果轻型地贫组与IDA组之间,轻型地贫组、IDA组分别与健康组之间,%Micro/%Hypo比较差异均有统计学意义(P0.01)。静止型α地贫组与健康组之间,轻型α地贫组与轻型β地贫组之间,%Micro/%Hypo比较差异均无统计学意义(P0.05)。以0.9作为%Micro/%Hypo鉴别诊断轻型地贫和IDA的判别值,则其诊断轻型地贫的敏感度、特异度、准确度分别为91.67%、91.89%、91.72%,诊断IDA的敏感度、特异度、准确度分别为91.94%、91.25%、91.18%。结论 %Micro/%Hypo对轻型α地贫、轻型β地贫、IDA有较好的鉴别诊断和辅助筛查价值,对静止型α地贫的临床价值不大。

Application value of % Micro/% Hypo in auxiliary diagnosis of thalassemia and iron-deficiency anemia

Objective To investigate the diagnostic value of the ratio of % Micro to % Hypo in the diagnosis of three kinds of common thalassemia and iron‐deficiency anemia (IDA ) .Methods Forty‐nine cases of IDA ,24 cases of mildα‐thalassemia ,24 cases of mildβ‐thalassemia ,24 cases of silent α‐thalassemia and 120 individuals undergoing healthy physical examination were selected as the research subjects and divided into 6 groups:normal group ,IDA group ,mildα‐thalassemia group ,mildβ‐thalassemia group ,silentα‐thalassemia and mild thalassemia group(in duding mild α‐thalassemia group and mild β‐thalassemia group) .The % Micro and %Hypo were deteced in each group and their ratio was calculated .The results were performed the analysis and comparison .Results The % Micro/% Hypo ratio had statistical difference between the mild thalassemia group and IDA group ,between the mild thalasse‐mia and IDA group with the normal group(P<0 .01) .The% Micro/% Hypo ratio had no statistical difference between the silent α‐thalassemia group and normal group ,and between the mild α‐thalassemia group and mildβ‐thalassemia group (P>0 .05) .With the% Micro/% Hypo ratio of 0 .9 as the discriminant value to diagnose mild thalassemia and IDA ,its sensitivity ,specificity and accuracy for diagnosing mild thalassemia were 91 .67% ,91 .89% and 91 .72% respectively ,the sensitivity ,specificity and accuracy in diagno‐sing IDA were 91 .94% ,91 .25% and 91 .18% respectively .Conclusion The ratio of % Micro/% Hypo has good differential diagno‐sis and assisted diagnosis screening value ,but has little value for diagnosing silent α‐thalassemia .