巨幼红细胞性贫血患者Hcy、SF及α-HBDH水平变化及临床意义  

Levels changs of Hcy,SF andα-HBDH in and its clinical significance of patients with megaloblastic anemia

作　　者：李海婷 李婧 LI Haiting;LI Jing(Department of Blood Transfusion,Baoji High-tech Hospital,Province,Baoji,Shaanxi 721000;Department of Laboratory Medicine,Baoji High-tech Hospital,Province,Baoji,Shaanxi 721000)

机构地区：[1]陕西省宝鸡市高新医院输血科,陕西宝鸡721000 [2]陕西省宝鸡市高新医院检验科,陕西宝鸡721000

出　　处：《检验医学与临床》2023年第2期189-192,共4页Laboratory Medicine and Clinic

摘　　要：目的检测巨幼红细胞性贫血(MA)患者血清同型半胱氨酸(Hcy)、铁蛋白(SF)及α-羟丁酸脱氢酶(α-HBDH)的水平,分析三者对MA的诊断效能。方法选取2018年2月至2021年11月该院收治的41例MA患者作为MA组,选取32例骨髓增生异常综合征(MDS)患者作为MDS组,另选取同期40例健康体检者作为对照组。比较3组Hcy、SF、α-HBDH水平,记录MA组治疗前后Hcy、SF、α-HBDH水平的变化情况,绘制受试者工作特征曲线(ROC曲线),并计算Hcy、SF、α-HBDH诊断MA的曲线下面积(AUC)。结果3组Hcy、SF、α-HBDH水平比较,差异均有统计学意义(P<0.05),对照组Hcy、SF、α-HBDH水平均低于MA组和MDS组,MA组治疗前SF水平低于MDS组,Hcy、α-HBDH水平均高于MDS组,差异均有统计学意义(P<0.05)。MA组治疗后Hcy、SF、α-HBDH水平均低于治疗前,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,Hcy、SF、α-HBDH单项指标检测诊断MA的AUC分别为0.748、0.677、0.587,低于3项指标联合检测的0.821,3项指标联合检测诊断MA的灵敏度(82.9%)、特异度(80.0%)最高。结论相对于健康人群,MA患者Hcy、SF及α-HBDH水平异常升高,与MDS患者有共同点,同时存在差异;临床可通过检测血清Hcy、SF及α-HBDH水平来评估MA的治疗效果,3项指标联合检测对MA的诊断效能更高。Objective To investigate the serum levels of homocysteine(Hcy),ferritin(SF)and serumα-hydroxybutyrate dehydrogenase(α-HBDH)in patients with megaloblastic anemia(MA),and the diagnostic efficacy of the three for MA was analyzed.Methods A total of 41 MA patients(MA group)who were diagnosed and treated in our hospital from February 2018 to November 2021 were retrospectively selected.During the same period,32 myelodysplastic syndrome(MDS)patients were selected as MDS group and 40 healthy subjects were selected as healthy group.The blood routine indexes and the levels of Hcy,SF,andα-HBDH in the three groups were compared,and the changes in the levels of Hcy,SF,andα-HBDH in the MA group before and after treatment were recorded,and the receiver operating characteristic curve(ROC curve)was drawn and the area under the cure(AUC)value of different detection and diagnosis of MA was calculated.Results The levels of Hcy,SF andα-HBDH in the three groups were compared,and the differences were statistically significant(P<0.05).The levels of Hcy,SF andα-HBDH in the healthy group were lower than those in the MA group and the MDS group,and the level of SF in the MA group was significantly lower than those in the MDS group,Hcy andα-HBDH levels were significantly higher than those in MDS group(P<0.05).After treatment,the levels of Hcy,SF andα-HBDH of MA group were significantly lower than before(P<0.05).According to the ROC curve,the AUC values of Hcy,SF,andα-HBDH for the diagnosis of MA were 0.748,0.677 and 0.587,respectively,which were lower than the combined detection of the three(0.821).The diagnostic sensitivity(82.9%)and specificity(80.0%)were the highest.Conclusion Compared with healthy people,the expression levels of Hcy,SF andα-HBDH in MA patients are abnormally increased,which has similarities with MDS patients,and there are differences at the same time.Clinically,the serum Hcy,SF andα-HBDH levels can be detected to evaluate the treatment of MA.The results show that the combination of the three has reliable diagno

关 键 词：同型半胱氨酸 铁蛋白 Α-羟丁酸脱氢酶 巨幼红细胞性贫血 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R556[医药卫生—内科学]