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
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南京医科大学科技发展基金(2010njmu128)


Application of parameters and morphology of red blood cells combined with iron staining and ferritin detection in diagnosis of iron deficiency anemia in children
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    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(P<0.05);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(P<0.05);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 explore diagnosis value of the abnormal red blood cell morphology and red blood cell parameters test combined with bone marrow iron staining and serum ferritin in children with iron deficiency anemia (IDA). Methods: A total of 388 children with IDA were administrated by abnormal red blood cell morphology and ferritin(SF) content detection, and the bone marrow smear were detected by iron staining. We selected 388 patients with IDA and 255 patients with chronic diseases anemia(ACD) on detection of red blood cell parameters [mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC) and red blood cell distribution width(RDW)] and SF, and compared with 203 cases of healthy controls. Results: Abnormal morphology of red blood cells in 388 children accounted for about 56.25% to 92.34%. Iron staining of bone marrow cells increased with the increasing of serum ferritin detection index. Compared with the ACD group, MCV, MCH, SF in the IDA group were significantly decreased, RDW was increased, and the differences were statistically significant(all P<0.05). Compared with the control group, MCV and SF in the IDA group were significantly decreased; while in the ACD group, no obvious change of the MCV was found, SF was increased obviously, the difference was statistically significant(P<0.05). Combinding MCV, RDW and SF in diagnosis of IDA had the highest sensitivity, up to 99.9%. Combinding MCV, RDW and SF play a great role in diagnosis and differential diagnosis in IDA. Conclusion: Abnormal red blood cell morphology and red blood cell parameters test combined with bone marrow iron staining and serum ferritin in IDA in children has significant clinical value in the differential diagnosis.

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张雯雯,朱 君,常 林,韩晶晶,陈红兵.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[J].南京医科大学学报(自然科学版),2017,(11):1468-1472

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  • 收稿日期:2017-01-18
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  • 在线发布日期: 2017-12-06
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