网织红细胞、血清铁蛋白、VitB_(12)联合检测在MDS与MA鉴别诊断中的应用价值  

Application Value of Reticulocyte,Serum Ferritin and VitB_(12) Combined Detection in Differential Diagnosis of MDS and MA

作　　者：徐小津 丁益群 刘苏琴 杨子东 XU Xiaojin;DING Yiqun;LIU Suqin;YANG Zidong(Department of Nuclear Medicine,Ji’an Central People's Hospital,Ji’an 343000,China;不详)

机构地区：[1]吉安市中心人民医院核医学科,江西吉安343000 [2]吉安市中心人民医院输血科,江西吉安343000 [3]吉安市中心人民医院检验科,江西吉安343000

出　　处：《中国医学创新》2024年第27期148-152,共5页Medical Innovation of China

基　　金：吉安市指导性科技计划项目(吉市科技字【2020】20号(90))。

摘　　要：目的:探讨网织红细胞、血清铁蛋白(SF)、维生素B_(12)(VitB_(12))联合检测在骨髓增生异常综合征(MDS)与巨幼细胞贫血(MA)鉴别诊断中的应用价值。方法:选取2020年7月—2023年11月吉安市中心人民医院收治的MDS患者43例纳入MDS组,MA患者43例纳入MA组,另选取于本院体检的健康体检者43例纳入对照组,比较三组血浆网织红细胞、SF及血清VitB_(12)水平,通过受试者操作特征(ROC)曲线分析三项指标单独或联合检测对MDS的诊断效能。结果:MDS组、MA组网织红细胞血红蛋白(Ret-He)、未成熟网织红细胞指数(IRF)、中荧光强度网织红细胞比率(MFR)、高荧光强度网织红细胞比率(HFR)水平均高于对照组,差异均有统计学意义(P<0.05);MDS组、MA组的低荧光强度网织红细胞比率(LFR)均低于对照组(P<0.05);两组IRF、LFR、MFR、HFR水平比较,差异均无统计学意义(P>0.05);MDS组Ret-He水平低于MA组,差异有统计学意义(P<0.05);MDS组、MA组SF水平均高于对照组,差异均有统计学意义(P<0.05);MDS组血清VitB_(12)水平高于对照组,MA组血清VitB_(12)水平低于对照组,差异均有统计学意义(P<0.05);MDS组SF、VitB_(12)水平均高于MA组,差异均有统计学意义(P<0.05)。网织红细胞参数Ret-He与SF、VitB_(12)联合检测诊断MDS时ROC曲线下面积为0.942,高于三项指标单独检测曲线下面积0.755、0.813、0.830,差异均有统计学意义(P<0.05)。结论:网织红细胞联合SF和VitB_(12)对于指导MDS诊断具有一定的价值,MDS的SF、VitB_(12)均高于MA,Ret-He低于MA,可作为临床疾病鉴别的重要参考指标。Objective:To investigate the value of reticulocyte,serum ferritin(SF)and vitamin B_(12)(VitB_(12))combined detection in the differential diagnosis of myelodysplastic syndrome(MDS)and megaloblastic anemia(MA).Method:A total of 43 patients with MDS admitted to Ji’an Central People's Hospital from July 2020 to November 2023 were included in the MDS group,43 patients with MA were included in the MA group,and 43 healthy subjects who underwent physical examination in our hospital were included in the control group.The plasma reticulocyte,SF and serum VitB_(12)levels of the three groups were compared,and the diagnostic efficiency of the three indicators alone or combined in MDS was analyzed by receiver operating characteristic(ROC)curve.Result:The levels of reticulocyte hemoglobin(Ret-He),immature reticulocyte fraction(IRF),medium fluorescence intensity reticulocyte ratio(MFR)and high fluorescence intensity reticulocyte ratio(HFR)in MDS group and MA group were higher than those in control group,the differences were statistically significant(P<0.05);the low fluorescence intensity reticulocyte ratio(LFR)in MDS and MA group was lower than that in control group(P<0.05).there were no significant differences in IRF,LFR,MFR and HFR levels between the two groups(P>0.05);the level of Ret-He in MDS group was lower than that in MA group,the difference was statistically significant(P<0.05);SF level in MDS group and MA group was higher than that in control group,the differences were statistically significant(P<0.05);the serum VitB_(12)level in MDS group was higher than that in control group,and the serum VitB_(12)level in MA group was lower than that in control group,the differences were statistically significant(P<0.05);the levels of SF and VitB_(12)in MDS group were higher than those in MA group,the differences were statistically significant(P<0.05).In the diagnosis of MDS,the area under ROC curve of Ret-He combined with SF and VitB_(12)was 0.942,which was higher than 0.755,0.813 and 0.830 under the curve of the three indexes al

关 键 词：骨髓增生异常综合征 再生障碍性贫血 网织红细胞 血清铁蛋白 维生素B_(12) 

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] R446.11[医药卫生—临床医学]