血液学指标对儿童不同类型地中海贫血并IDA的临床价值  

Clinical value of hematologic indexes in different types of thalassemias complicated with iron deficiency anemia in children

作　　者：吴洪秋[1] 陈兴[1] 李桦[1] 黄明星[1] 周玉球[1] 

机构地区：[1]珠海市妇幼保健院检验科,广东珠海519001

出　　处：《中国热带医学》2016年第8期811-814,共4页China Tropical Medicine

摘　　要：目的研究不同类型珠蛋白生成障碍性贫血并发缺铁性贫血(IDA)儿童各项血液学指标的变化,为指导临床筛查和治疗奠定理论依据。方法择取2012年2月至2015年3月就诊的360例贫血患儿,通过DNA诊断法及铁代谢筛查法确定患儿的基因类型及其相应铁代谢指标情况,并将患儿分为地贫组160例、地贫合并IDA组170例和IDA组30例,同时选择30名健康儿童为对照组,检测上述各组的血液学指标并进行统计学分析。结果与对照组比较,各组地贫患儿的红细胞相关参数均有差异性(P均<0.05),其中α地贫轻型及β地贫杂合子型患儿表现小红细胞低色素症状,而α地贫Hb H型及β地贫纯合子型患儿表现中重度贫血症状;与非合并IDA组相比,合并IDA型患儿的血液学参数均有统计学意义(P均<0.05),且部分且铁代谢指标有显著性差异(P<0.05);与男性组患儿相比,女性组患儿合并IDA及IDA型的患病例数普遍高于男性组患儿例数。结论应密切关注正常儿童及地贫患病儿童的各项血液学指标变化,为贫血症的有效预防和临床筛查奠定理论基础。Objective To investigate the differences in various hematologic indexes of children with thalassemia complicated with iron deficiency anemia （IDA） in order to found a theoretical basis for the guidance of clinical screening and treatment. Methods A total of 360 anemia children admitted in our hospital from February 2012 to March 2015 were subjected in this study. According to the results of DNA diagnosis and iron metabolism screening,the children were divided into 3 groups,that is,thalassemia group （n=160）,thalassemia complicated with IDA group （n=170）,and IDA group （n=30）. Another 30 healthy children served as the control group. The hematological indexes were detected in each group,and the results were compared among them. Results Compared with the healthy control group,there were significant differences in the parameters related to erythrocytes in the children with thalassemia （P〈0.05）. Among them,those with light α-thalassemia and β-thalassemia heterozygote showed the microcytic hypochromic symptom,while those with HbH α-thalassemia and β-thalassemia homozygote manifested as moderate and severe symptom. Compared with the thalassemia group without IDA,the hematologic parameters were statistically significant in those complicated with IDA （P〈0.05）,and significant differences were seen in some iron metabolism indicators （P〈0.05）. The incidences of thalassemia complicated with IDA and without were higher in the females than that the males. Conclusion A close attention should be paid to the changes of various hematologic indexes in both healthy children and those with thalassemia. Our findings establish a theoretical foundation for the effective prevention and clinical screening of anemia.

关 键 词：地中海贫血 α地贫 Β地贫 缺铁性贫血 血液学指标 铁代谢 

分 类 号：R556.5[医药卫生—血液循环系统疾病]