网织红细胞参数在大细胞贫血诊断中的初探

目的探讨网织红细胞参数在大细胞贫血中的临床价值,以此鉴别大细胞性贫血,并辅助临床进行诊断。方法应用Sysmex XE-5000全自动血细胞分析仪检测急性失血性贫血组(70例)、巨幼细胞性贫血组(65例)、溶血性贫血组(42例)、肝病性贫血组(40例)、骨髓增生异常综合征组(28例)及健康对照组(63例)的网织红细胞参数,并进行比较。结果不同类型大细胞贫血患者组与健康对照组比较,急性失血性贫血组、溶血性贫血组、肝病性贫血组网织红细胞百分率(Ret%)明显增高(P<0.01),骨髓增生异常综合征组呈明显下降(P<0.01),巨幼细胞性贫血组的差异无统计学意义(P>0.05);未成熟网织红细胞指数(IFR)明显升高(P<0.01)。急性失血性贫血组、溶血性贫血组,巨幼细胞性贫血组和骨髓增生异常综合征组低荧光强度网织红细胞比率(LFR)明显下降(P<0.01)。除肝细胞贫血组中荧光强度网织红细胞比率(MFR),与对照组比较差异无统计学意义(P>0.05),其他各大细胞贫血组中MFR、高荧光强度网织红细胞比率(HFR)均呈明显增高,差异具有统计学意义(P<0.01)。结论网织红细胞及参数是反映骨髓造血功能的灵敏指标,网织红细胞参数在大细胞贫血的诊断和鉴别诊断中具有重要意义,具有很好的应用前景。

The Preliminary Discuss of Reticulocyte Parameters in Large Cell Anemia Diagnosis

Objective To investigate the value of reticulocyte parameters applied in large cell anemia which are acute posthemorrhagic anemia,megaloblastic anemia （MgA）,hemolytic anemia （HA）, anemia for liver disease and myelodysplastic syndrome（MDS）, in order to identify large cell anemia, and assist in clinical diagnosis. Methods Reticulocyte parameters were measured by Sysmex XE-5000 automatic blood cell analyzer in 70 acute posthemorrhagic anemia patients, 42 HA patients, 65 MgA patients, 40 anemia for liver disease patients 28 MDS patients and 63 normal controls, and the differences were compared to normal controls. Results Compared with normal controls, reticulocyte percentage （Ret%） were remarkably increased in acute posthemorrhagic anemia group, hemolytic anemia group （HA）, liver disease anemia group （P 〈0. 01）. But in myelodysplastic syndrome group （MDS） it decreased significantly （P〈0.01）, in megaloblastic anemia group （MA） there was no significant difference （P〉0. 05）. Immature reticulocyte indexs （IFR） increased significantly （P 〈 0.01） in all large cell anemia groups （P〈0. 01）. Compared with the control groups low fluorescent ratio （LFR） decreased in acute blood loss anemia, hemolytic anemia group （HA）, megaloblastic anemia （MA） and myelodysplastic syndrome groups（MDS）. In liver cell anemia group the middle fluorescent ratio （MFR） had no significant difference （P〉0. 05）. The other large cell anemia groups in the middle fluorescent ratio （MFR） ,all high fluorescent ratio （HFR） were significantly increased（P〈0. 01）. Conclusion Reticulocyte and parameters are sensitive index to reflex the function of bone marrow hematopoietic, reticulocyte and parameters play an important pole in large cell anemia diagnosis and differential di- agnosis which have good application prospect.