红细胞参数和铁稳态指标在评价无贫血或轻度贫血小细胞增多症中的应用:一项诊断准确性研究

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-08-31 DOI:10.1055/s-0043-1774293
Paruvathavarthini Thambiraj, N. Nanda, R. Kar
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引用次数: 0

摘要

摘要简介 无症状的微细胞增多症可能是多种原因的微细胞低色素性贫血的前兆。红细胞指数的评估可能有助于描述需要进一步研究的情况,如血红蛋白高效液相色谱法(Hb-HPLC)。此外,铁稳态标志物将有助于确认缺铁性红细胞生成(IDE)/缺铁性贫血(IDA)。材料和方法 这是一项为期18个月的基于医院的单一机构研究。样本量为60,包括所有年龄组,男性和女性,平均红细胞体积(MCV)值 < 以80fL、Hb≥10g/dL为纳入标准。评估了各种衍生的红细胞指数、Hb HPLC和铁参数。Hb-HPLC和血清转铁蛋白饱和铁蛋白(TSAT)值分别作为诊断血红蛋白病/地中海贫血和IDA/IDE的金标准。后果 在60个样本中,24个(40%)和36个(60%)的Hb变体比例分别为异常和正常。总共评估了7个指数,包括Mentzer指数、红细胞分布宽度指数、Ehsani指数、Sirdah公式、Matos–Carvalho指数、Shine和Lal指数以及Sehgal指数。Shine和Lal指数对诊断纯地中海贫血具有较好的敏感性(89%)和特异性(73%)。Sirdah指数在诊断IDE/IDA方面显示出更好的敏感性(78%)和特异性(42%)。Ferritin在诊断纯IDA方面表现出更好的敏感性(74%)和特异性(84%),TSAT在诊断IDA/IDE方面表现出较好的结果。结论 Shine和Lal指数和Mentzer指数可作为筛查工具,有助于检测需要适当随访的受试者,并通过Hb HPLC进行确认。血清铁蛋白仍然是诊断IDA的金标准。
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Utility of Red Blood Cell Parameters and Indices of Iron Homeostasis in Evaluation of Microcytosis without Anemia or with Mild Anemia: A Diagnostic Accuracy Study
Abstract Introduction  Asymptomatic microcytosis may be a prelude to microcytic hypochromic anemia of varied causes. Evaluation of red cell indices may help delineate cases needing further investigation like hemoglobin high-performance liquid chromatography (Hb-HPLC). In addition, markers of iron homeostasis will help confirm iron-deficient erythropoiesis (IDE)/iron deficiency anemia (IDA). Materials and Methods  This was a single institutional hospital-based study over a period of 18 months. The sample size was 60, which include all age groups, males and females, and values of mean corpuscular volume (MCV) < 80 fL, Hb ≥ 10g/dL were taken as the inclusion criteria. Various derived red cell indices, Hb-HPLC, and iron parameters were assessed. Hb-HPLC and serum ferritin with transferrin saturation (TSAT) values were taken as the gold standard for diagnosis of hemoglobinopathies/thalassemia trait and IDA/IDE, respectively. Results  Out of 60 samples, 24 (40%) and 36 (60%) had abnormal and normal proportion of Hb variants, respectively. In total, seven indices were evaluated, which included Mentzer's index, red cell distribution width index, Ehsani's index, Sirdah's formula, Matos–Carvalho index, Shine and Lal index, and Sehgal's index. The Shine and Lal index showed better sensitivity (89%) and specificity (73%) for diagnosing pure thalassemia trait. The Sirdah index showed better sensitivity (78%) and specificity (42%) in diagnosing IDE/IDA. Ferritin showed better sensitivity (74%) and specificity (84%) in diagnosing pure IDA and TSAT showed better results in diagnosing IDA/IDE. Conclusion  The Shine and Lal index and Mentzer index can be used as screening tools and help detect subjects who require appropriate follow-up with confirmation by Hb-HPLC. Serum ferritin remains the gold standard for diagnosis of IDA.
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来源期刊
Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
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发文量
99
审稿时长
31 weeks
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