评估炎症性肠病贫血时网织红细胞和红细胞指数的测量。
Measurement of reticulocyte and red blood cell indices in the evaluation of anemia in inflammatory bowel disease.
机构信息
Department of Gastroenterology, University Hospital Heraklion, Crete, Greece.
出版信息
J Crohns Colitis. 2011 Aug;5(4):295-300. doi: 10.1016/j.crohns.2011.02.002. Epub 2011 Apr 3.
BACKGROUND
The commonest types of anemia in inflammatory bowel disease (IBD) are iron deficiency (IDA) and anemia of chronic disease. The differentiation between these two conditions is important for the management of the patient. The aim of this study was to investigate the usefulness of reticulocyte and red blood cell indices in the evaluation of anemia in IBD.
METHODS
One hundred IBD patients [49 ulcerative colitis (UC), 51 Crohn's disease (CD)] and 102 healthy controls were enrolled. Measurement of reticulocyte and red blood cell indices was performed using the Coulter LH780 Hematology Analyzer (Beckman Coulter). Additionally, serum levels of ferritin, transferrin saturation (Tsat) and soluble transferrin receptor (sTfR) were analyzed in all patients and controls.
RESULTS
The prevalence of anemia was 41.2% for UC and 42.9% for CD, whereas 30 IBD patients (30%) had IDA. Red cell Distribution Width (RDW), Red blood cell Size Factor (RSF), and Reticulocyte Distribution Width-Coefficient of Variation (RDWR-CV) were found significantly correlated with both Tsat and sTfR but not with ferritin levels. Patients with IDA had significantly higher RDW and RDWR-CV and significantly lower RSF levels compared with those without IDA. High values of RDW (sensitivity 93%, specificity 81%) and low values of RSF (sensitivity 83%, specificity 82%) were the best markers for the diagnosis of IDA. Both RDWR-CV and RDWR-SD were significantly correlated with disease activity and CRP levels.
CONCLUSION
RDW, RSF and RDWR, could be useful markers for the evaluation of anemia and disease activity in IBD.
背景
炎症性肠病（IBD）中最常见的贫血类型是缺铁性贫血（IDA）和慢性病性贫血。区分这两种情况对于患者的治疗非常重要。本研究旨在探讨网织红细胞和红细胞指数在评估 IBD 贫血中的作用。
方法
纳入 100 例 IBD 患者[49 例溃疡性结肠炎（UC），51 例克罗恩病（CD）]和 102 名健康对照者。使用库尔特 LH780 血液分析仪（贝克曼库尔特）检测网织红细胞和红细胞指数。此外，所有患者和对照者均检测血清铁蛋白、转铁蛋白饱和度（Tsat）和可溶性转铁蛋白受体（sTfR）水平。
结果
UC 患者贫血的患病率为 41.2%，CD 患者为 42.9%，而 30 例 IBD 患者（30%）存在 IDA。红细胞分布宽度（RDW）、红细胞大小因子（RSF）和网织红细胞分布宽度变异系数（RDWR-CV）与 Tsat 和 sTfR 均显著相关，但与铁蛋白水平无关。与非 IDA 患者相比，IDA 患者的 RDW 和 RDWR-CV 显著升高，RSF 水平显著降低。高 RDW（敏感性 93%，特异性 81%）和低 RSF（敏感性 83%，特异性 82%）值是诊断 IDA 的最佳标志物。RDWR-CV 和 RDWR-SD 与疾病活动度和 CRP 水平均显著相关。
结论
RDW、RSF 和 RDWR 可作为评估 IBD 贫血和疾病活动度的有用标志物。
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