红细胞指数在我国缺铁性贫血和地中海贫血特质患者鉴别中的应用价值研究  

Preliminary study on the application value and cut-off value of red blood cell indexe in the differentiation of patients with iron deficiency anemia and thalassemia trait in China

作　　者：纪宇 李涛 吴妮 张静 张辉 曹菊 樊青 王厚芳[2] 毕铭华[1] Ji Yu;Li Tao;Wu Ni;Zhang Jing;Zhang Hui;Cao Ju;Fan Qing;Wang Houfang;Bi Minghua(Department of Internal Medicine,Beijing United Family Hospital,Beijing 100015,China)

机构地区：[1]北京和睦家医院内科,100015 [2]北京和睦家医院检验科,100015

出　　处：《北京医学》2022年第1期58-63,共6页Beijing Medical Journal

摘　　要：目的探讨红细胞指数用于鉴别缺铁性贫血(iron deficiency anemia,IDA)与地中海贫血特质(thalassemia trait,TT)患者的应用价值和最佳界值。方法选取2017年10月1日至2021年3月31日北京和睦家医院确诊为IDA或TT的中国患者40例。根据血常规结果,计算8种红细胞指数,分析其对于鉴别IDA或TT的灵敏度与特异度、约登指数,根据ROC探讨其在我国患者中的适合界值。结果40例患者中有22例IDA和18例TT。Jayabose、Green and King和Ricerca 3种红细胞指数用于鉴别IDA和TT的约登指数分别为0.667、0.667和0.682,ROC的AUC分别为0.990、0.995和0.992,均为十分可靠的指标。同时,Jayabose、Green and King和Ricerca 3种红细胞指数的最适合界值分别为251.69、79.56和3.91。调整界值后,Jayabose、Green and King和Ricerca 3种红细胞指数鉴别IDA和TT的准确率均提高至97.5%。结论含有红细胞分布宽度指标的红细胞指数对于鉴别我国小细胞低色素性贫血患者的病因具有很高的应用价值,值得临床推广。Objective To explore the application value and the best cut-off value of red blood cell index in distinguishing patients with iron deficiency anemia(IDA)and thalassemia trait(TT)in China.Methods A total of 40 Chinese patients diagnosed with IDA or TT at Beijing United Family Hospital from October 1,2017 to March 31,2021 were selected.According to the blood routine results,the sensitivity and specificity of eight kinds of red blood cell indexes for the identification of IDA or TT were analyzed,as well as the Yoden index.The appropriate threshold value in Chinese patients was discussed according to ROC.Results There were 22 cases of IDA and 18 cases of TT in the 40 patients.The Yoden index of Jayabose,Green and King and Ricerca were 0.667,0.667 and 0.682 for the identification of IDA and TT,respectively.The AUC of ROC were 0.990,0.995 and 0.992,which were all very reliable indicators.Meanwhile,the optimal cut-off values of Jayabose,Green and King and Ricerca were 251.69,79.56 and 3.91,respectively.After adjusting the cut-off value,the accuracy of Jayabose,Green and King and Ricerca in distinguishing IDA and TT was improved to 97.5%.Conclusions The red blood cell index containing red blood cell distribution width index has high application value in identifying the etiology of patients with small cell hypochromic anemia in China and is worthy of clinical promotion.

关 键 词：缺铁性贫血 地中海贫血基因携带者 地中海贫血特质 红细胞指数 鉴别诊断 

分 类 号：R556[医药卫生—血液循环系统疾病]