Objective: To investigate the distribution of Ret-He and RBC in thalassemia and the value of combining HbA2 in the detection of thalassemia among patients with microcytic or hypochromic.
Methods: 145 patients with microcytic or hypochromic outpatient or hospitalization in our hospital from May 2018 to December 2019 were selected and were divided into the thalassemia group(68 cases) and the non-thalassemia group (77 cases), and at the same time, the patients were divided into four groups of the non-anemia, mild anemia, moderate anemia and severe anemia group according to the degree of anemia. The Ret-He, RBC, RDW-CV and HbA2 in patients were detected, and the distribution of these parameters were compared, and the joint detection of Ret-He, RBC and HbA2 about its sensitivity, specific and other indicators of auxiliary diagnosis of thalassemia were analyzed.
Results: Among patients with microcytic or hypochromic, according to the anemia grade Ret-He gradually decreased from the non-anemia group to the severe anemia group (P<0.05); while RDW-CV was increased gradually from the mild anemia group to the severe anemia group (P<0.05); both RBC and Ret-He were increased in the thalassemia group as compared with the non- thalassemia group (P<0.05); while RDW-CV was decreased in the thalassemia group as compared with the non-thalassemia group (P<0.05); meanwhile Ret-He in the α-thalassemia group was higher than that in the β-thalassemia group. ROC curve analysis showed that combined with HbA2, the specificity was 93.51%, the sensitivity was 66.18%, the positive predictive value was 90% and the negative predictive value was 75.189% when Ret-He was truncated with 19.25 pg and RBC was truncated with 4.95×1012/L.
Conclusion: Among patients with microcytic or hypochromic, the distribution of RBC, Ret-He and RDW-CV was different in the thalassemia group and the non-thalassemia group, and was also affected by the degree of anemia. Combined Ret-He and RBC could improve the diagnostic specificity for thalassemia, which were screened by HbA2 in patients with microcytic or hypochromic.
题目: RBC、Ret-He与HbA2联合检测对地中海贫血的临床价值.
目的: 探讨小细胞或低色素人群中Ret-He和RBC在地中海贫血中的分布情况及联合HbA2对地中海贫血检测的价值.
方法: 选取本院2018年5月-2019年12月门诊检测出或住院的小细胞或低色素患者145例，将其分为地贫组（68例）及非地贫组（77例），并同时按贫血程度将患者分为非贫血、轻度贫血、中度贫血及重度贫血共4组，对患者进行Ret-He、RBC、RDW-CV及HbA2检测，比较各项参数的分布情况，并分析RBC、Ret-He与HbA2联合检测以辅助诊断地中海贫血的灵敏度、特异度.
结果: 在小细胞或低色素患者中，根据贫血程度分级，Ret-He从非贫血组至重度贫血组逐渐下降（P<0.05）；而RDW-CV则从轻度贫血组至重度贫血组逐渐上升（P<0.05）；RBC及Ret-He在地贫组患者中均较非地贫组明显升高（P<0.05），而RDW-CV则在地贫组中较非地贫组明显降低（P<0.05）；同时Ret-He在α-地贫中较β-地贫明显升高（P<0.05）。进行ROC曲线分析，Ret-He以19.25 pg为截断值，RBC以4.95×1012/L为截断值时，联合HbA2，特异度为93.51%，灵敏度为66.18%，阳性预测值为90%，阴性预测值为75.189.
结论: 在小细胞或低色素患者中， RBC、Ret-He及RDW-CV在地贫组及非地贫组的分布存在差异，并受贫血程度影响。加入Ret-He及RBC可提高小细胞或低色素患者依靠HbA2进行地中海贫血初筛时的特异度.