摘要
目的：了解血清维生素B12（VitB12）、叶酸（FA）及血清铁蛋白（SF）、血清转铁蛋白（TF）、总铁结合力（TIBC）、血清铁（SI）4项铁代谢指标检测在贫血的诊断和鉴别诊断中的价值。方法选择该院2013年1～5月贫血患者126例和健康对照组30例，测定其血清中VitB12、FA、SF、TF、TIBC和SI浓度并进行比较，贫血患者同时抽取骨髓标本涂片，经铁染色及形态学检查，检查结果与上述血清学指标测定结果进行临床诊断符合率的比较。结果铁代谢相关的各个指标的血清浓度在贫血患者和健康对照组比较差异有统计学意义（ P＜0．05），各类贫血均有其较为特异的血清学特征；126例贫血患者的临床诊断符合率，骨髓检查为82．5％，明显高于血清学检查（69．8％）（χ2＝5．600，P＝0．018）；但在骨髓形态学不能明确诊断的23例贫血患者中，82．6％（19/23）血清学指标检测结果符合临床诊断；两种检查方法的不符合率达25．4％（32/126）。结论骨髓检查和血清学检测对贫血诊断的侧重点不同，各有优势，不能相互替代。二者联合应用对缺铁性贫血（IDA）与慢性病贫血伴缺铁（ACD/ID）、MDS与巨幼细胞性贫血（M A ）以及混合细胞性贫血的鉴别诊断上具有一定的临床价值。
Objective To explore the application value of the detection of vitamin B12 （VitB12 ） ,folic acid （FA） and four iron met-abolic indexes including serum ferritin （SF） ,transferring （TF） and total iron binding capacity （TIBC） and serum iron （SI） in the diagnosis and differential diagnosis of anemia .Methods 126 patients with anemia and 30 healthy controls were enrolled from Janu-ary to May 2013 and determined serum VitB12 ,FA ,SF ,TF ,TIBC and SI levels for conducting the comparison with each other . Meanwhile ,the patients with anemia were extracted bone marrow to carry out ferric stain and morphological test ,their detection re-sults and the results of above-mentioned serological markers determination were performed the comparison of the diagnostic accord-ance rate .Results The serum levels of various iron metabolism-related indexes had significant differences between the anemia group and the healthy control group （P＆lt;0 .05） ,and various different kinds of anemia had their comparatively specific serological characteristics .In 126 cases of anemia ,the diagnostic accordance rate of the bone marrow examination was 82 .5% ,which was sig-nificant higher than that of the serological examination（69 .8% ）（χ2 =5 .600 ,P=0 .018）;nevertheless ,in 23 cases anemia unable to determine the diagnosis by bone marrow examination ,the diagnostic accordance rate of the serological examination was 82 .6% （19/23）;the inconsistent rate of the two examinations was 25 .4% （32/126） .Conclusion The bone marrow examination and the sero-logical examination have different emphasis points for the anemia diagnosis and have their own advantages ,which cannot replace each other .Their combination use has certain clinical value in the differential diagnosis between iron deficiency anemia （IDA） with anemia of chronic disease complicated with iron deficiency （ACD/ID） ,myelodysplastic syndromes （MDS） ,megaloblastic anemia （M A ） and mixed cellular anemia .
出处
《国际检验医学杂志》
CAS
2014年第5期552-554,556,共4页
International Journal of Laboratory Medicine
