红细胞参数及形态学检查结合铁染色和铁蛋白在儿童缺铁性贫血诊断中的临床应用

发布时间：2018-07-07 07:15

本文选题：缺铁性贫血 + 红细胞参数　；参考：《南京医科大学学报(自然科学版)》2017年11期

【摘要】：目的:探讨异常红细胞形态学和红细胞参数检查结合骨髓铁染色及血清铁蛋白在儿童缺铁性贫血诊断中的应用价值。方法:对388例缺铁性贫血(iron deficiency anemia,IDA)患儿进行了异常红细胞形态检验并进行血清铁蛋白(serum ferritin,SF)含量检测,还对其骨髓涂片进行铁染色检查。选取388例IDA及255例慢性病性贫血(chronic diseases anemia,ACD)患者进行平均红细胞体积(mean corpuscular volume,MCV)、平均红细胞血红蛋白量(mean corpuscular hemoglobin,MCH)、红细胞平均血红蛋白浓度(mean corpuscular hemoglobin concentration,MCHC)、红细胞分布宽度(red blood cell distribution width,RDW)和SF的检测,并与203例健康对照比较,对结果进行统计学分析。结果 :388例IDA患儿异常形态红细胞占56.25%~92.34%,骨髓细胞铁染色随血清铁蛋白检测指标的增高而增高。与ACD组比较,IDA组MCV、MCH、SF均明显降低,RDW增高,差异有统计学意义(P0.05);与对照组比较,IDA组MCV、SF明显降低,ACD组MCV无明显变化,SF明显增高,差异有统计学意义(P0.05);MCV、RDW和SF三项联合诊断IDA的敏感性最高,达99.9%。MCV、RDW和SF联合应用可在IDA诊断与鉴别诊断中发挥更大作用。结论:异常红细胞形态学和红细胞参数检查结合骨髓铁染色及血清铁蛋白在儿童IDA鉴别诊断中有临床参考价值。
[Abstract]:Objective: To investigate the value of abnormal erythrocyte morphology and erythrocyte parameter examination combined with bone marrow iron staining and serum ferritin in the diagnosis of iron deficiency anemia in children. Methods: the abnormal erythrocyte morphology of 388 iron deficiency anemia (IDA) children and the content of serum ferritin (serum ferritin, SF) were carried out. The average red blood cell volume (mean corpuscular volume, MCV), the average red blood cell hemoglobin (mean corpuscular hemoglobin, IDA), and the average hemoglobin concentration of red blood cells were selected in 388 Cases of IDA and 255 cases of chronic diseases anemia (ACD). Hemoglobin concentration, MCHC), the detection of red blood cell distribution width (red blood cell distribution width, RDW) and SF, and compared with 203 healthy controls, the results were statistically analyzed. Results: 388 Cases of IDA children with abnormal morphologic red cells accounted for 56.25%~92.34%, bone marrow cell iron staining increased with the increase of serum ferritin detection index. Compared with the ACD group, IDA group MCV, MCH, SF were significantly decreased, RDW increased, the difference was statistically significant (P0.05). Compared with the control group, IDA group MCV, SF obviously decreased, ACD group MCV had no significant changes, and the difference was statistically significant. A diagnosis and differential diagnosis play a greater role. Conclusion: abnormal erythrocyte morphology and erythrocyte parameter examination, combined with bone marrow iron staining and serum ferritin, have clinical reference value in the differential diagnosis of children's IDA.
【作者单位】：南京医科大学附属儿童医院检验科;
【基金】：南京医科大学科技发展基金(2010njmu128)
【分类号】：R446.11;R725.5

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