红细胞参数计算公式+红细胞形态学积分在地中海贫血和缺铁性贫血中的鉴别价值  

The differential diagnostic value of erythrocyte parameter calculation formula and erythrocyte morphology integral in thalassemia trait and iron deficiency anemia

作　　者：陆甜甜 莫伟明 施国美 Lu Tiantian;Mo Weiming;Shi Guomei(Department of Laboratory,Xiaoshan Hospital Affiliated to Hangzhou Normal University,Hangzhou 311202,China)

机构地区：[1]杭州师范大学附属萧山医院检验科,杭州311202

出　　处：《中华地方病学杂志》2025年第2期106-111,共6页Chinese Journal of Endemiology

基　　金：杭州市萧山区农业和社会发展重大科技计划项目(2021206)。

摘　　要：目的探讨红细胞参数计算公式+红细胞形态学积分在鉴别地中海贫血(TT)和缺铁性贫血(IDA)中的价值。方法在杭州师范大学附属萧山医院,收集2021年8月至2023年12月确诊的103例TT和101例IDA病例作为回顾性研究对象,分析TT基因分型以及红细胞参数检测结果差异;评估红细胞参数计算公式中的Matos&Carvalho Index(简称MCI公式)和MCI公式+红细胞形态学积分筛查方法分别在筛查TT中的诊断效能;绘制受试者工作特征曲线,并按照约登指数最大原则设置诊断截点,评估两种筛查方法的诊断特异性、敏感性。结果分别检出α-TT 40例、β-TT 59例。与IDA组比较,TT组红细胞参数中红细胞计数(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、平均红细胞血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW)差异均有统计学意义(t=8.96、10.03、7.48、3.88、12.07、-6.20,均P<0.001),而平均红细胞体积(MCV)差异无统计学意义(t=-0.47,P=0.639)。α-TT与β-TT组红细胞参数比较,RBC、HGB、HCT、MCHC差异均有统计学意义(t=2.27、3.57、4.28、-2.00,均P<0.05),MCV、MCH、RDW差异均无统计学意义(t=1.86、1.05、-1.18,均P>0.05)。TT组MCI公式+红细胞形态学积分筛查方法的计算值(24.69±1.78)明显高IDA组(21.03±1.66,t=15.15,P<0.001)。MCI公式+红细胞形态学积分筛查方法的曲线下面积(AUC)=0.946,MCI公式的AUC=0.904。当MCI公式+红细胞形态学筛查方法的诊断截点为22.790时,其敏感性为91.30%,优于MCI公式(76.70%),差异有统计学意义(χ^(2)=7.29,P=0.007);其特异性(89.10%)与MCI公式(89.10%)比较,差异无统计学意义(χ^(2)=0.00,P>0.999)。结论红细胞参数计算公式+红细胞形态学积分在鉴别TT和IDA中具有较大的应用价值。ObjectiveThis study aims to assess the utility of erythrocyte parameter calculation formula in combination with erythrocyte morphology integral in distinguishing thalassemia trait(TT)and iron deficiency anemia(IDA).MethodsA total of 103 cases of TT and 101 cases of IDA diagnosed from August 2021 to December 2023 were collected as retrospective study subjects at Xiaoshan Hospital Affiliated to Hangzhou Normal University,the differences in TT genotype and erythrocyte parameter detection results were analyzed.The diagnostic efficacy of the erythrocyte parameter calculation formula Matos&Carvalho Index(MCI formula)and the MCI formula+erythrocyte morphology integral in screening TT was evaluated,respectively.Receiver operating characteristic curve was plotted,and diagnostic cut-off points were set according to the principle of maximum Jorden index to evaluate the diagnostic specificity and sensitivity of the two screening methods.ResultsA total of 40 cases ofα-TT and 59 cases ofβ-TT were detected.Compared with the IDA group,there were statistically significant differences in erythrocyte parameters such as erythrocyte count(RBC),hemoglobin(HGB),hematocrit(HCT),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),and red cell volume distribution width(RDW)in the TT group(t=8.96,10.03,7.48,3.88,12.07,-6.20,P<0.001),but there was no statistically significant difference in mean corpuscular volume(MCV,t=-0.47,P=0.639).There were statistically significant differences in RBC,HGB,HCT,and MCHC betweenα-TT andβ-TT groups(t=2.27,3.57,4.28,-2.00,P<0.05),but there were no significant differences in MCV,MCH,and RDW(t=1.86,1.05,-1.18,P>0.05).The calculated value of MCI formula+erythrocyte morphology integral in TT group(24.69±1.78)was significantly higher than that in IDA group(21.03±1.66,t=15.15,P<0.001).The area under the curve(AUC)of MCI formula+erythrocyte morphology integral was 0.946,and the AUC of MCI formula was 0.904.When the diagnostic cut-off point of MCI formula+erythrocyte morphology int

关 键 词：地中海贫血 缺铁性贫血 红细胞参数计算公式 红细胞形态学积分 鉴别诊断 

分 类 号：R44[医药卫生—诊断学]