Hönemann C, Hagemann O, Doll D, Luedi M M L, Ruebsam M L, Meybohm P
Abteilung für Anästhesie und Intensivmedizin, Marienhospital Vechta gGmbH, Lehrauftrag an der Westfälischen Wilhelms Universität Münster, Uniklinikum Münster, Marienstr. 6-8, 49377, Vechta, Deutschland.
Abteilung für Proktochirurgie, Marienhospital Vechta gGmbH, Vechta, Deutschland.
Anaesthesist. 2020 Dec;69(12):919-925. doi: 10.1007/s00101-020-00870-y.
The reticulocyte hemoglobin equivalent (RET-He) is presented as a biomarker for the diagnostics and monitoring of iron deficiency. The marker is independent of the acute phase and can be determined within a few minutes by a blood count. Due to the approximately 120-day lifetime of erythrocytes, iron deficiency and changes in the iron status of erythropoiesis can first be recognized at a relatively late stage using classical hematological parameters, such as hemoglobin, mean corpuscular volume, mean cellular hemoglobin content and also with determination of hypochromic erythrocytes (% hypo). The RET-He is a cost-effective parameter for the diagnosis and monitoring of the iron supply for erythropoiesis. Reticulocytes, the precursors of mature erythrocytes, are washed out of the bone marrow into the peripheral blood and normally mature within 2 days to mature erythrocytes. The determination of the reticulocyte number therefore enables a timely statement about erythropoiesis. A measurement of the hemoglobin content of reticulocytes therefore reflects the actual iron metabolism of erythropoiesis and enables assessment of the quality of the cells. Changes in the iron status of erythropoiesis can thus be detected much earlier than by determining only the hemoglobin content of mature erythrocytes, i.e. the mean cellular hemoglobin content. It is recommended that the evaluation of RET-He should be carried out as an inexpensive routine preoperative marker of latent anemia in order to identify patients at risk. In the sense of a perioperative prehabilitation and the enhanced recovery after surgery (ERAS) concept, patients with iron deficiency can be treated proactively at an early stage in order to prevent complications and extended hospital stays.
网织红细胞血红蛋白当量（RET-He）作为缺铁诊断和监测的生物标志物被提出。该标志物不受急性期影响，可通过血细胞计数在几分钟内测定。由于红细胞的寿命约为120天，使用经典血液学参数，如血红蛋白、平均红细胞体积、平均细胞血红蛋白含量以及低色素红细胞（%低色素）的测定，缺铁和红细胞生成铁状态的变化首先在相对较晚的阶段才能被识别。RET-He是诊断和监测红细胞生成铁供应的一个性价比高的参数。网织红细胞是成熟红细胞的前体，从骨髓释放入外周血，通常在2天内成熟为成熟红细胞。因此，网织红细胞数量的测定能够及时反映红细胞生成情况。测量网织红细胞的血红蛋白含量因此反映了红细胞生成的实际铁代谢情况，并能够评估细胞质量。与仅测定成熟红细胞的血红蛋白含量，即平均细胞血红蛋白含量相比，红细胞生成铁状态的变化能够更早被检测到。建议将RET-He评估作为潜在贫血的廉价术前常规标志物，以识别有风险的患者。从围手术期预康复和术后加速康复（ERAS）概念的角度来看，缺铁患者可以在早期得到积极治疗，以预防并发症和延长住院时间。
