Vreugdenhil G, Baltus C A, van Eijk H G, Swaak A J
Zuiderziekenhuis, Department of Internal Medicine, Rotterdam, The Netherlands.
Br J Rheumatol. 1990 Apr;29(2):105-10. doi: 10.1093/rheumatology/29.2.105.
Erythrocyte and serological parameters were assessed in 44 anaemic rheumatoid arthritis (RA) patients to detect iron deficiency as assessed by stainable bone marrow iron. The anaemia was normochromic normocytic in 60% and hypochromic normocytic in 30% of those with anaemia of chronic disease (ACD). Iron deficiency was present in 55% and the anaemia was hypochromic microcytic in 54% and hypochromic normocytic or normochromic normocytic in 21%. Iron absorption was found to be higher in iron deficient patients. In ACD patients, iron absorption correlated inversely with ESR and CRP. For the detection of iron deficiency among RA patients with ACD, the MCV showed the highest specificity (90%) and predictive value (87%). Serum ferritin was the most sensitive (82%) and valid (86%) test. Combination of MCV, ferritin and transferrin resulted in 100% validity. It was concluded that iron deficiency can be detected accurately without bone marrow aspiration using combinations of blood parameters.
对44例贫血类风湿关节炎（RA）患者的红细胞和血清学参数进行评估，以通过可染色骨髓铁评估来检测缺铁情况。在慢性病贫血（ACD）患者中，60%的贫血为正细胞正色素性，30%为低色素正细胞性。55%存在缺铁，54%的贫血为低色素小细胞性，21%为低色素正细胞性或正细胞正色素性。发现缺铁患者的铁吸收较高。在ACD患者中，铁吸收与血沉（ESR）和C反应蛋白（CRP）呈负相关。对于患有ACD的RA患者中缺铁的检测，平均红细胞体积（MCV）显示出最高的特异性（90%）和预测价值（87%）。血清铁蛋白是最敏感（82%）且有效的（86%）检测指标。MCV、铁蛋白和转铁蛋白联合使用的有效性达100%。得出的结论是，使用血液参数组合无需进行骨髓穿刺即可准确检测缺铁情况。
