【摘要】 目的研究网织红细胞血红蛋白含量(CHr)对铁缺乏的诊断价值。方法用ADVIA120血细胞分析仪检测常用血液学指标,包括CH(单个红细胞血红蛋白含量)、MCH、HGB、MCV、RDW和CHr。同时测定血清铁代谢指标,包括血清铁(SI)、血清总铁结合力(TIBC),血清转铁蛋白饱和度(TfS)、血清铁蛋白(SF)。以SF为“金标准”,统计分析CHr的对铁缺乏的诊断效率。结果518例病人和141例健康人的CH均低于CHr,二者有良好的相关性(P<0001)。铁缺乏病人的CHr(265±44pg)显著减低,与铁正常病人(332±39pg)和健康人(331±14pg)的CHr有显著差异(P<00001),缺铁性贫血病人的CHr降至最低(252±35pg)。当临界值为285pg时,CHr诊断铁缺乏的灵敏度和特异性分别为857%和913%。结论CHr优于传统的血液学指标,可准确地诊断铁缺乏和缺铁性贫血,而且简便、快速、价廉,可广泛用于铁缺乏的筛查。更多还原

【Abstract】 Objective To study performance of iron deficiency diagnosis by reticulocyte hemoglobin content. Methods The general hematologic indices, which were red cell hemoglobin(CH), mean corpuscular hemoglobin(MCH), hemoglobin(HGB), mean corpuscular volume(MCV), red cell volume distribution width(RDW), reticulocyte hemoglobin content(CHr), were measured by ADVIA 120 hematology analyzer. Iron metabolism indices, which were serum iron(SI), serum total iron binding capacity(TIBC), serum transferrin saturation(TfS) and serum ferritin(SF), were detected by biochemical method or chemiluminescent immunoassay. The performance of CHr used for iron deficiency diagnosis was analysed by statistics, and serum ferritin was used for “gold standard”.Results The CH was lower than CHr in 518 in-patients and 141 normal individuals, there was a close correlation between CH and CHr(P<0.001). The CHr of patients with iron deficiency patients(26.5±4.4 pg) were significantly lower than that of iron normal patients(33.2±3.9 pg) and normal individuals(33.1±1.4 pg), the CHr of patients with iron deficiency anemia(25.2±3.5 pg) were lowest in all patients. If the cutoff value of CHr was 28.5 pg, sensitivity was 85.7% and specificity was 91.3% for iron deficiency diagnosis. Conclusion CHr was more useful than conventional hematology parameters to diagnose iron deficiency and iron deficiency anemia accurately. Because the measurement of CHr is an inexpensive and rapidly available alternative to iron metabolism indices, it can be widely used for screening iron deficiency.更多还原