Okan V, Cigiloglu A, Cifci S, Yilmaz M, Pehlivan M
Gaziantep University School of Medicine, Department of Haematology, Gaziantep, Turkey.
J Int Med Res. 2009 Jan-Feb;37(1):25-30. doi: 10.1177/147323000903700103.
This study examined the diagnostic accuracy of nine indices to discriminate between patients with mild-to-moderate (haemoglobin 8.5 - 11 g/dl) or moderate-to-severe (haemoglobin < 8.5 g/dl) iron deficiency anaemia (IDA) from those with beta-thalassaemia (beta-TT) (n = 100 per group). Indices examined were red blood cell (RBC) count, RBC distribution width (RDW), Mentzer index (MI), Shine and Lal index (S&L), England and Fraser index (E&F), Srivastava index (S), Green and King index (G&K), RDW index (RDWI), and Ricerca index (R). Index sensitivity, specificity, and positive and negative prognostic values were examined. Youden's indices were calculated and showed: S&L > G&K > E&F > RBC = RDWI > MI > S > R > RDW to differentiate between beta-TT and mild-to-moderate IDA; and S&L > G&K > E&F = RDWI > RBC > R > MI > S > RDW to differentiate between beta-TT or moderate-to-severe IDA. For both groups, S&L and G&K offered the best discrimination and RDW the worst. S&L showed the highest Youden index for beta-TT and IDA discrimination, but sensitivity and specificity were not 100%. In both mild and severe IDA, the S&L index may be used to differentiate cases of beta-TT from IDA cases, but large clinical trials are needed to explore this further.
本研究检测了九种指标对区分轻度至中度（血红蛋白8.5 - 11 g/dl）或中度至重度（血红蛋白< 8.5 g/dl）缺铁性贫血（IDA）患者与β地中海贫血（β-TT）患者（每组n = 100）的诊断准确性。检测的指标包括红细胞（RBC）计数、红细胞分布宽度（RDW）、门泽指数（MI）、施奈德和拉尔指数（S&L）、英格兰和弗雷泽指数（E&F）、斯里瓦斯塔瓦指数（S）、格林和金指数（G&K）、RDW指数（RDWI）以及里塞尔卡指数（R）。对各指标的敏感性、特异性、阳性和阴性预测值进行了检测。计算了约登指数，结果显示：区分β-TT与轻度至中度IDA时，S&L > G&K > E&F > RBC = RDWI > MI > S > R > RDW；区分β-TT与中度至重度IDA时，S&L > G&K > E&F = RDWI > RBC > R > MI > S > RDW。对于两组患者，S&L和G&K的区分能力最佳，RDW最差。S&L在区分β-TT和IDA时约登指数最高，但敏感性和特异性并非100%。在轻度和重度IDA中，S&L指数均可用于区分β-TT病例与IDA病例，但需要进一步开展大型临床试验进行探究。
