摘要
目的:红细胞分布宽度联合网织红细胞参数在缺铁性贫血(IDA)和自身免疫性溶血性贫血(AIHA)鉴别诊断中的应用价值。方法:选取2022年6月-2024年5月在我院治疗的50例IDA患儿和50例AIHA患儿作为研究对象。比较两组的一般资料、红细胞分布览度[红细胞分布览度标准差(RDW-SD)和红细胞分布宽度变异系数(RDW-CV)]和网织红细胞参数[网织红细胞绝对值(RET#)、未成熟网织红细胞比率(IRF%)、中荧光强度网织红细胞百分率(MFR%)、高荧光强度网织红细胞百分率(HFR%)、低荧光强度网织红细胞百分率(LFR%)]水平,采用受试者工作曲线(ROC)分析红细胞分布宽度联合网织红细胞参数鉴别诊断IDA和AIHA的价值。结果:两组一般资料比较无显著差异(P>0.05)。IDA组患儿RDW-SD和RDW-CV明显低于AIHA组(P<0.05);IDA组患儿RET#、IRF%、MFR%、HFR%明显低于AIHA(P<0.05),LFR%明显高于AIHA组患儿(P<0.05)。红细胞分布宽度RDW-SD、RDW-CV鉴别诊断IDA和AIHA的AUC分别为0.759和0.749,联合检测AUC为0.830;网织红细胞参数RET#、IRF、LFR、MFR、HFR鉴别诊断IDA和AIHA的AUC分别为0.725、0.736、0.774、0.735、0.796,联合检测AUC为0.820。联合检测采用串联提高特异度,ROC分析结果显示,红细胞分布宽度联合网织红细胞参数鉴别诊断IDA和AIHA的AUC为0.790,灵敏度为80.62%、特异度为90.35%。结论:红细胞宽度和网织红细胞参数联合检测可以鉴别诊断IDA和AIHA,为临床医师提供参考。
Objective:To explore the application value of red cell distribution width(RDW)combined with reticulocyte parameters in the differential diagnosis ofiron–deficiency anemia(IDA)and autoimmune hemolytic anemia(AIHA).Methods:A total of 50 childrenwith IDA and 50 children with AIHA treated in the hospital were enrolled as the research objects between January 2021 and January 2023.The general dat,RDW parameters[standard deviation of RDW(RDW-SD),variation coeffcient of RDW(RDW-CV)]and reticulocyte parameters[absolute value of reticulocytes(RET#),percentage of immature reticulocytes(IRF%),percentage of moderate fluorescence–intensity reticulocytes(MFR%),percentage of high fluorescence–intensity reticulocytes(HFR%),percentage of low fluorescence–intensity reticulocytes(LFR%)]were compared between the two groups.The value of all the above parameters in the differential diagnosis of IDA and AIHA was analyzed by receiver operating characteristic(ROC)curves.Results:There was no significant difference in general data between the two groups(P>0.05).RDW–SD and RDW–CV in IDA group were significantly lower than those in AIHA group(P<0.05).RET#,IRP%,MFR%and HFR%in IDA group were significantly lower than those in AIHA group(P<0.05),while LFR%was significantly higher than that in AIHA group(P<0.05).AUC values of RDW–SD,RDW–CV and combined detection in the differential diagnosis of IDA and AIHA were 0.759,0.749 and 0.830,respectively.AUC values of RET#,IRF,LFR,MFR,HFR and combined detection in the differential diagnosis of IDA and AIHA were 0.725,0.736,0.774,0.735,0.796 and 0.820,respectively.The combined detection(tandem mode)could improve specificity.The results of ROC analysis showed that AUC,sensitivity and specificity of RDW combined with reticulocyte parameters in the difterential diagnosis of IDA and AIHA were 0.790,80.62%and 90.35%,respectively.Conclusion:The combined detection of RDW and reticulocyte parameters can be applied in the differential diagnosis of IDA and AIHA,which can provide reference for clinicians.
作者
刘洋
周玄
LIU Yang;ZHOU Xuan(Xuzhou Children's Hospital Blood Transfusion Department,Jiangsu Xuzhou 221000)
出处
《医学检验与临床》
2025年第11期13-18,共6页
Medical Laboratory Science and Clinics
