INT J LAB HEMATOL:小细胞性贫血的鉴别诊断:小红细胞和低色素红细胞的作用

2017-04-13 MedSci MedSci原创

目前已经研究关于衍生自红细胞(RBC)参数的各种指标,用于区分地中海贫血和缺铁性贫血。该研究了小红细胞与低色素红细胞的比值作为小细胞性贫血的判别指标,并将其与传统指标进行比较,且在实验组中确证其中的发现。

近日,来自西班牙Galdakao Usansolo Galdakao医院血液科,的研究人员报道了一项关于小细胞性贫血的鉴别诊断的研究,相关研究成果刊登于国际杂志INT J LAB HEMATOL上。

目前已经研究关于衍生自红细胞(RBC)参数的各种指标,用于区分地中海贫血和缺铁性贫血。该研究了小红细胞与低色素红细胞的比值作为小细胞性贫血的判别指标,并将其与传统指标进行比较,且在实验组中确证其中的发现。

研究组包括来自371名小细胞性贫血症患者的样本,其平均细胞体积(MCV <80fL),在CELL-DYN蓝宝石分析仪上测量这些样本并计算各种判别函数。使用ROC分析建立最佳临界值。这些值用于338名患者的实验组。

研究显示,研究组中,小红细胞与低色素红细胞比> 6.4是明确指示地中海贫血(曲线0.948下的面积)。 Green-KingEngland-Fraser指数在ROC曲线下显示一致的面积。然而,小细与低色素的比率具有最高的灵敏度(0.964)。在实验组中,91.1%的小细胞性贫血患者能被M / H比正确分类。

总体而言,CELL-DYN蓝宝石测得的小红细胞与低色素红细胞比率与Green-King指数在识别地中海贫血携带者方面表现相同,但灵敏度更高,使其成为快速而廉价的筛选工具。

原始出处:

E. Urrechaga,J. J. M. L. Hoffmann,S. Izquierdo,J. F. Escanero. et al. Differential diagnosis of microcytic anemia: the role of microcytic and hypochromic erythrocytes. INT J LAB HEMATOL . DOI: 10.1111/ijlh.12289

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    2017-10-20 sunylz
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    2017-04-14 fengyi812
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由此可见,在小鼠复苏过程中输入储存红细胞引起的不良效应可被输注结合珠蛋白或血红素结合蛋白所改善,结合珠蛋白输液可防止复苏过程输入储存红细胞引起血浆中高血红蛋白浓度相关的肾损伤,给予人血浆蛋白中结合珠蛋白和血红素结合蛋白可能在长时间低血压导致的严重溶血治疗中有益处。

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大量输注红细胞悬液常见于严重外伤出血、产后大出血、术中大出血、创伤性肝脾破裂出血等。大量输血是指24h以内输血总量达到患者自身总血容量,或4h内输血量超过患者总血容量的1/2。大量出血患者常使用晶体扩容配合红细胞悬液输注,是治疗失血性休克常用输血方案,当失血量超过血容量的30%,还应及时补充胶体液,输注红细胞悬液虽然是临床救治患者的重要手段,但是大量输注红细胞悬液可导致稀释性的血小板和凝血因子缺乏