血清铁蛋白与网织红细胞血红蛋白含量明显不一致的 reconciliating。
Reconciling markedly discordant values of serum ferritin versus reticulocyte hemoglobin content.
机构信息
Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA.
Women and Newborns Research, Intermountain Healthcare, Murray, UT, USA.
出版信息
J Perinatol. 2021 Mar;41(3):619-626. doi: 10.1038/s41372-020-00845-2. Epub 2020 Oct 4.
OBJECTIVE
To determine why serum ferritin and reticulocyte hemoglobin (RET-He), drawn to assess neonatal iron sufficiency, sometimes have markedly discordant results.
STUDY DESIGN
Retrospective records review of five NICUs over 28 months, identifying all patients with a ferritin and RET-He within 48 h. We examined records of all who had marked discordance (one value >95th % reference interval, the other <5th %).
RESULTS
Of 190 paired ferritin and RET-He measurements, 16 (8%) were markedly discordant. Fifteen of the 16 discordant samples involved a high ferritin and a low RET-He. In these, low MCV and high %Micro-R, and low MCH and high %HYPO-He were present. In total, 8 of the 15 had laboratory or clinical evidence of an inflammatory process and five had suspicion of infection documented.
CONCLUSIONS
When ferritin and RET-He were discordant, erythrocyte microcytosis and hypochromasia suggested that the RET-He gave the more accurate interpretation; that iron deficiency was likely present.
目的
确定为什么检测血清铁蛋白和网织红细胞血红蛋白（RET-He）以评估新生儿铁充足时，有时结果会明显不一致。
研究设计
对 28 个月内的 5 个 NICU 进行回顾性记录回顾，确定所有在 48 小时内进行铁蛋白和 RET-He 检测的患者。我们检查了所有差异明显（一个值>第 95 个参考区间，另一个<第 5 个）的记录。
结果
在 190 对铁蛋白和 RET-He 测量值中，有 16 对（8%）明显不一致。在这 16 个差异较大的样本中，有 15 个铁蛋白较高而 RET-He 较低。在这些样本中，MCV 较低和 %Micro-R 较高，MCH 较低和 %HYPO-He 较高。总共，有 8 个样本有实验室或临床炎症过程的证据，有 5 个有感染的可疑记录。
结论
当铁蛋白和 RET-He 不一致时，红细胞小细胞症和低色素性提示 RET-He 给出了更准确的解释；很可能存在铁缺乏。
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