网织红细胞血红蛋白当量：评估甲状腺功能减退症患者缺铁的诊断效能
Reticulocyte Hemoglobin Equivalent: Diagnostic Performance in Assessment of Iron Deficiency in Patients with Hypothyroidism.
作者信息
Aslam Wardah, Habib Maryam, Aziz Saeeda, Habib Madiha
机构信息
Nuclear Medicine Oncology and Radiotherapy Institute, Islamabad, Pakistan.
Shifa College of Medicine (STMU), Islamabad, Pakistan.
出版信息
Anemia. 2021 Nov 12;2021:9071057. doi: 10.1155/2021/9071057. eCollection 2021.
INTRODUCTION
Iron deficiency affects approximately 30% of the world population and is frequently encountered in hypothyroid patients. Early recognition and prompt treatment of iron deficiency in hypothyroid patients lead to a favorable outcome. The aim of this study is to prove the usefulness of reticulocyte hemoglobin equivalent (Ret-He) as a reliable and effective tool in diagnosis of iron deficiency in hypothyroid patients.
MATERIALS AND METHODS
154 patients with hypothyroidism were included in the study. They were divided into 4 groups. Group 1 included 66 hypothyroid patients without iron deficiency. They were taken as controls. Group 2 included 66 hypothyroid patients with iron deficiency anemia (IDA). Group 3 included 12 hypothyroid patients with iron deficiency but without anemia (ID). Group 4 included 10 hypothyroid patients which had concomitant iron deficiency with anemia of chronic disorder (ACDC). Ret-He was measured by analyzing blood samples on System XN 350. Thyroid profile, serum ferritin, and biochemical data were measured by an automated analyzer. Statistical analysis was performed by using SPSS 23.
RESULTS
Ret-He was significantly lower with ( < 0.001) in group 2 (hypothyroid patients with IDA), group 3 (hypothyroid patients with ID), and in group 4 (hypothyroid patients with ACDC) as compared to controls in group 1 (hypothyroid patients without iron deficiency). After ROC analysis area under the curve (AUC) of Ret-He for hypothyroid patients with IDA was 0.96 at cutoff 28.5 pg with sensitivity of 93% and specificity of 90%. AUC of Ret-He in the hypothyroid group with ACDC was 0.99 at cutoff 30.8 pg with sensitivity of 90% and specificity of 90%. AUC of Ret-He in hypothyroid patients with ID was 0.97 at cutoff 31.7 pg with sensitivity of 91% and specificity of 70%.
CONCLUSION
Ret-He is a reliable, rapid, and cost-effective tool for diagnosing iron deficiency in hypothyroid patients.
引言
缺铁影响着全球约30%的人口，在甲状腺功能减退患者中也较为常见。早期识别并及时治疗甲状腺功能减退患者的缺铁情况会带来良好的预后。本研究的目的是证明网织红细胞血红蛋白当量（Ret-He）作为诊断甲状腺功能减退患者缺铁的可靠有效工具的实用性。
材料与方法
154例甲状腺功能减退患者纳入本研究。他们被分为4组。第1组包括66例无缺铁的甲状腺功能减退患者，作为对照组。第2组包括66例患有缺铁性贫血（IDA）的甲状腺功能减退患者。第3组包括12例有缺铁但无贫血（ID）的甲状腺功能减退患者。第4组包括10例伴有缺铁及慢性病贫血（ACDC）的甲状腺功能减退患者。通过在XN 350系统上分析血样来测定Ret-He。通过自动分析仪测定甲状腺功能指标、血清铁蛋白和生化数据。使用SPSS 23进行统计分析。
结果
与第1组（无缺铁的甲状腺功能减退患者）的对照组相比，第2组（患有IDA的甲状腺功能减退患者）、第3组（有ID的甲状腺功能减退患者）和第4组（患有ACDC的甲状腺功能减退患者）的Ret-He显著降低（<0.001）。经ROC分析，IDA甲状腺功能减退患者的Ret-He曲线下面积（AUC）在截断值为28.5 pg时为0.96，敏感性为93%，特异性为90%。ACDC甲状腺功能减退组中Ret-He的AUC在截断值为30.8 pg时为0.99，敏感性为90%，特异性为90%。ID甲状腺功能减退患者中Ret-He的AUC在截断值为31.7 pg时为0.97，敏感性为91%，特异性为70%。
结论
Ret-He是诊断甲状腺功能减退患者缺铁的可靠、快速且经济有效的工具。
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