联合检验对珠蛋白生成障碍性贫血与缺铁性贫血的诊断价值评价

目的研究联合检验对珠蛋白生成障碍性贫血(以下简称地贫)与缺铁性贫血(IDA)的诊断价值。方法选择2013年8月至2015年2月该院收治的地贫患者36例、IDA患者34例及健康体检者30例作为研究对象。对各组入选样本进行联合检验,检测内容包括平均红细胞比容(MCV)、红细胞体积分布宽度(RDW)、血红蛋白(Hb)电泳及红细胞(RBC)渗透脆性试验(以下简称RBC脆性)等血液学指标。结果IDA组和地贫组患者MCV、RBC脆性均下降,IDA组患者RDW上升,地贫组患者HbA2上升,与对照组比较差异均有统计学意义(P0.05)。RDW对IDA的灵敏度为70.6%,低于地贫(77.8%),但差异无统计学意义(P0.05)。MCV、Hb电泳、RBC脆性对地贫的灵敏度分别为97.2%、88.9%、77.8%,特异性分别为80.0%、90.0%、83.3%。MCV联合Hb电泳、Hb电泳联合RBC脆性、MCV联合Hb电泳联合RBC脆性并联试验对地贫的灵敏度分别为100.0%、97.2%、100.0%,明显高于单项检验的灵敏度;而MCV联合Hb电泳、Hb电泳联合RBC脆性、MCV联合Hb电泳联合RBC脆性串联试验对地贫的特异性分别为96.7%、100.0%、100.0%,明显高于单项检验特异性,差异均有统计学意义(P0.05)。结论应用血液学指标、Hb电泳及RBC脆性联合检验地贫与IDA能显著提高诊断准确性,值得推广应用。

The value of the combined test for the diagnosis of thalassemia and iron deficiency anemia

Objective To investigate the value of the combined test in the diagnosis of thalassemia and iron deficiency anemia (IDA) .Methods From August 2013 to February 2015 ,36 patients with thalassemia ,34 patients with IDA ,and 30 healthy people who had undergone physical examination were enrolled in the study .The blood samples of those people were tested ,and items of the combined test included content of red blood cell volume(MCA) ,red blood cell volume distribution width(RDW) ,hemoglobin(Hb) electrophoresis and red blood cell(RBC) .Results The patients with IDA or thalassemia had reduced MCA and RBC fragile ,pa‐tients with IDA had increased RDW ,and patients with thalassemia had increased HbA2 ,compared with the control group the differ‐ences were all statistically significant(P<0 .05) .The sensitivity of RDW to IDA was 70 .6% ,and to thalassemia was 77 .8% ,the difference was not statistically significant (P> 0 .05) .The sensitivities of MCV ,Hb electrophoresis ,RBC fragility to thalassemia were 97 .2% ,88 .9% ,77 .8% respectively ,and the specificity were 80 .0% ,90 .0% ,83 .3% respectively .The sensitivities of MCA test combined with Hb electrophoresis ,hemoglobin electrophoresis combined with RBC brittleness test and parallel combined test of MCA ,Hb electrophoresis and RBC brittleness to thalassemia were 100 .0% ,97 .2% ,100 .0% respectively ,which were significantly higher than those of single tests ;the specificities were 96 .7% ,100 .0% and 100 .0% respectively ,which were significantly higher than those of single tests ;the differences were statistically significant(P<0 .05) .Conclusion The application of hematological pa‐rameters ,Hb and RBC in the diagnosis of anemia and IDA could significantly improve the diagnostic accuracy ,and it is worthy of popularization and application .