Ittarat W, Ongcharoenjai S, Rayatong O, Pirat N
Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2000 Mar;83(3):259-65.
The most widely used discriminant functions and red cell indices for differential diagnosis of thalassemia traits from iron deficiency anemia were evaluated for their abilities to identify HbE-containing blood samples. The functions were as follows: F1 = 0.01 x MCH x (MCV)2; F2 = RDW x MCH x (MCV)2/Hb x 100; F3 = MCV/RBC; and F4 = MCH/RBC. Other red cell parameters including RDW, hemoglobin content, mean cell volume, mean cell hemoglobin as well as red cell counts, were also evaluated to distinguish HbE from the normal population. Hemoglobin electrophoresis was used as a confirmatory test. The results showed that F1, F2 and F3 as well as other red cell parameters of HbE-containing samples were different from those of HbA2A-containing red cells although there was no statistical significance. However, F4 and MCHC showed no difference between the two groups. It can be concluded from the present study that identification of hemoglobin E especially the heterozygous form by using parameters from an electronic cell counter is not easy. Discriminant functions and red cell indicies might be used as an initial diagnosis. But confirmation is needed in all cases. Applying the MCV of 80 fl will miss 5 per cent of hemoglobin E carrier but will not miss the homozygous form.
评估了用于鉴别地中海贫血特征与缺铁性贫血的最常用判别函数和红细胞指数识别含血红蛋白E(HbE)血样的能力。这些函数如下:F1 = 0.01×平均红细胞血红蛋白含量(MCH)×(平均红细胞体积(MCV))²;F2 = 红细胞分布宽度(RDW)×MCH×(MCV)²/血红蛋白(Hb)×100;F3 = MCV/红细胞计数(RBC);F4 = MCH/RBC。还评估了包括RDW、血红蛋白含量、平均红细胞体积、平均红细胞血红蛋白以及红细胞计数在内的其他红细胞参数,以区分HbE与正常人群。血红蛋白电泳用作确证试验。结果显示,含HbE样本的F1、F2和F3以及其他红细胞参数与含血红蛋白A2A红细胞的参数不同,尽管无统计学意义。然而,两组之间F4和平均红细胞血红蛋白浓度(MCHC)无差异。从本研究可以得出结论,使用电子细胞计数器的参数识别血红蛋白E,尤其是杂合形式并不容易。判别函数和红细胞指数可用作初步诊断。但所有病例均需确证。应用80飞升的平均红细胞体积会漏检5% 的血红蛋白E携带者,但不会漏检纯合形式。