Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan.
Int J Lab Hematol. 2010 Apr;32(2):248-55. doi: 10.1111/j.1751-553X.2009.01179.x. Epub 2009 Jul 13.
The evaluation of iron status in dialysis patients provides information essential to the planning of adequate recombinant human erythropoietin treatment. The cellular iron status of the patients can be determined from the recently available measurement of reticulocyte hemoglobin equivalent (RET-He). RET-He is measured on the basis of automated fluorescent flow cytometry which in the reticulocyte channel, using a polymethine dye, also measures the mean value of the forward light scatter intensity of mature red blood cells and reticulocytes. These values equate with reticulocyte hemoglobin content. In this study, to clarify the accuracy of RET-He in diagnosing iron deficiency in dialysis patients, we initially compared RET-He with such iron parameters as serum ferritin levels, transferrin saturation and content of reticulocyte hemoglobin (CHr) which has been established as indicators of functional iron deficiency. Secondly, we investigated the changes in RET-He during iron supplementation for iron-deficient patients to determine whether this marker is a prospective and reliable indicator of iron sufficiency. The participants in this study were 217 haemodialysis patients. Iron deficiency was defined as havsing a transferrin saturation (TSAT) < 20% or serum ferritin < 100 ng/ml. Conventional parameters of red blood cells and RET-He were measured by on a XE-2100 automated blood cell counter (Sysmex). CHr was measured on an ADVIA120 autoanalyser (Siemens). RET-He mean value was 32.4 pg and good correlation (r = 0.858) between RET-He and CHr is obtained in dialysis patients. Receiver operating characteristic curve analysis revealed, values of the area was 0.776 and at a cutoff value of 33.0 pg, a sensitivity of 74.3% and a specificity of 64.9%, were achieved. Iron supplements given to the patients with low TSAT or ferritin, RET-He responded within 2 weeks, and this seemed to be a potential advantage of using RET-He in the estimation of iron status. RET-He is a new parameter, equivalent value to CHr, and is easily measurable on the widely spread and popular blood cell counter and is a sensitive and specific marker of iron status in dialysis patients.
评估透析患者的铁状态为充分重组人红细胞生成素治疗提供了重要信息。患者的细胞铁状态可以通过最近可测量的网织红细胞血红蛋白当量（RET-He）来确定。RET-He 是基于自动化荧光流式细胞术测量的，该方法在网织红细胞通道中，使用多甲川染料，还测量成熟红细胞和网织红细胞的前向光散射强度的平均值。这些值等同于网织红细胞血红蛋白含量。在这项研究中，为了阐明 RET-He 在诊断透析患者缺铁中的准确性，我们首先将 RET-He 与血清铁蛋白水平、转铁蛋白饱和度和网织红细胞血红蛋白含量（CHr）等铁参数进行比较，CHr 已被确立为功能性缺铁的指标。其次，我们研究了缺铁患者在补充铁期间 RET-He 的变化，以确定该标志物是否是铁充足的前瞻性和可靠指标。这项研究的参与者是 217 名血液透析患者。铁缺乏症的定义为转铁蛋白饱和度（TSAT）<20%或血清铁蛋白<100ng/ml。通过 XE-2100 自动血细胞计数器（Sysmex）测量常规红细胞和 RET-He 参数。CHr 通过 ADVIA120 自动分析仪（西门子）测量。透析患者的 RET-He 平均值为 32.4pg，与 CHr 之间存在良好的相关性（r=0.858）。接受者操作特征曲线分析显示，曲线下面积为 0.776，在 33.0pg 的截断值处，灵敏度为 74.3%，特异性为 64.9%。给予低 TSAT 或铁蛋白的患者铁补充剂，RET-He 在 2 周内做出反应，这似乎是在估计铁状态时使用 RET-He 的潜在优势。RET-He 是一个新的参数，与 CHr 等效，易于在广泛传播和流行的血细胞计数器上测量，是透析患者铁状态的敏感和特异性标志物。
