缺铁性贫血和溶血性贫血中的网织红细胞分析

Reticulocyte analysis in iron deficiency anemia and hemolytic anemia.

作者信息

Butthep P, Wisedpanichkij R, Jindadamrongwech S, Kaewkethong P, Pattamakom S, Sila-Asna M, Bunyaratvej A

机构信息

Sirikit Medical Center, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2000 Mar;83 Suppl 1:S114-22.

PMID:10865417

Abstract

Reticulocyte analysis was studied in 28 anemic patients, 15 with iron deficiency anemia (IDA), and 13 with hemolytic anemia including 9 glucose 6 phosphate dehydrogenase deficiency (G6PD def.), and 4 with G6PD def. combined with HbE trait or alpha thalassemia trait (alpha thal trait). The reticulocyte analysis among these patients showed the increased number of reticulocyte percentage with low degree of maturation in both IDA and G6PD def. patients. The significantly decreased reticulocyte hemoglobin content (CHr) was found in IDA (CHr = 21.74 +/- 4.61 pg in IDA vs 28.41 +/- 1.34 pg in normal; p-value = < 0.0001), whereas, increased CHr was found in G6PD def. patients. In addition, the G6PD def. patients also showed a significant increase in mean corpuscular reticulocyte volume (MCVr) when compared to normal (MCVr = 132.0 +/- 8.39 fl. in G6PD def. vs 110.39 +/- 5.09 in normal; p-value = < 0.0001). However, a significant decrease in MCVr was found in IDA patients (MCVr = 95.89 +/- 8.57 fl.; p-value = < 0.0001 vs normal). From this study, we can suggest that the reticulocyte hemoglobin content (CHr) and mean corpuscular reticulocyte volume (MCVr) are the important defects in patients with iron deficiency anemia.

摘要

对28例贫血患者进行了网织红细胞分析，其中15例为缺铁性贫血（IDA），13例为溶血性贫血，包括9例葡萄糖6磷酸脱氢酶缺乏症（G6PD缺乏症），4例G6PD缺乏症合并HbE性状或α地中海贫血性状（α地贫性状）。这些患者的网织红细胞分析显示，IDA和G6PD缺乏症患者的网织红细胞百分比增加，成熟度较低。IDA患者的网织红细胞血红蛋白含量（CHr）显著降低（IDA患者CHr = 21.74 +/- 4.61 pg，正常人为28.41 +/- 1.34 pg；p值 = < 0.0001），而G6PD缺乏症患者的CHr升高。此外，与正常人相比，G6PD缺乏症患者的平均网织红细胞体积（MCVr）也显著增加（G6PD缺乏症患者MCVr = 132.0 +/- 8.39 fl.，正常人为110.39 +/- 5.09；p值 = < 0.0001）。然而，IDA患者的MCVr显著降低（MCVr = 95.89 +/- 8.57 fl.；与正常人相比p值 = < 0.0001）。从这项研究中，我们可以认为，网织红细胞血红蛋白含量（CHr）和平均网织红细胞体积（MCVr）是缺铁性贫血患者的重要缺陷。