Xu Yuchan, Yang Wang, Liao Lin, Deng Zengfu, Qiu Yuling, Chen Wenqiang, Lin Faquan
The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Eur J Haematol. 2016 Feb;96(2):170-4. doi: 10.1111/ejh.12563. Epub 2015 May 6.
This study assessed the value of mean reticulocyte volume (MRV) for differential diagnosis of hereditary spherocytosis (HS) so as to develop conventional and new specific screen indexes. Subjects in this study were divided into three groups: 53 cases in HS group, 217 cases in hemolytic anemia control group (109 cases of thalassemia (THAL), 56 cases of glucose-6-phosphate dehydrogenase G6PD deficiency anemia, and 52 cases of autoimmune hemolytic anemia (AIHA)), and 100 cases in healthy control group. We analyzed erythrocyte and reticulocyte parameters including MRV, mean sphered corpuscular volume, mean corpuscular hemoglobin concentration, and immature reticulocyte fraction. Results demonstrated that MRV was significantly lower in the HS group but significantly higher in the AIHA and G6PD deficiency anemia groups than that in the healthy control group (P = 0.000). MRV was not significantly different between the AIHA and G6PD deficiency anemia groups (P = 0.977) and between the healthy control and THAL groups (P = 0.168). The area under the ROC curve of MRV for diagnosis of HS was 0.942, with a standard error of 0.019, 95% confidence interval of 0.905-0.979, and optimal critical diagnosis point of 95.77 fL. When the MRV was ≤95.77 fL, the sensitivity and specificity for diagnosis of HS were 86.80% and 91.20%, respectively. Therefore, MRV is a general and specific new index for screening HS and important for differential diagnosis of different types of hemolytic anemia.
本研究评估了平均网织红细胞体积（MRV）在遗传性球形红细胞增多症（HS）鉴别诊断中的价值，以建立传统及新的特异性筛查指标。本研究的受试者分为三组：HS组53例，溶血性贫血对照组217例（其中地中海贫血（THAL）109例、葡萄糖-6-磷酸脱氢酶（G6PD）缺乏性贫血56例、自身免疫性溶血性贫血（AIHA）52例），健康对照组100例。我们分析了红细胞和网织红细胞参数，包括MRV、平均球形红细胞体积、平均红细胞血红蛋白浓度和未成熟网织红细胞比例。结果显示，HS组的MRV显著低于健康对照组，但AIHA组和G6PD缺乏性贫血组的MRV显著高于健康对照组（P = 0.000）。AIHA组和G6PD缺乏性贫血组之间的MRV无显著差异（P = 0.977），健康对照组和THAL组之间也无显著差异（P = 0.168）。MRV诊断HS的ROC曲线下面积为0.942，标准误为0.019，95%置信区间为0.905 - 0.979，最佳临界诊断点为95.77 fL。当MRV≤95.77 fL时，诊断HS的敏感性和特异性分别为86.80%和91.20%。因此，MRV是筛查HS的一项通用且特异的新指标，对不同类型溶血性贫血的鉴别诊断具有重要意义。
