Horibata Ken, Kondo Seigo, Hashimoto Shuji, Takemura Yousuke
Department of Internal Medicine Kameyama Municipal Medical Center Kameyama Mie Japan.
Department of Community Medicine Kameyama Mie University School of Medicine Tsu Mie Japan.
J Gen Fam Med. 2025 Feb 14;26(3):246-254. doi: 10.1002/jgf2.776. eCollection 2025 May.
Clinical pallor has traditionally served as a screening tool for anemia; however, its assessment lacks objectivity. Therefore, this study aimed to investigate the correlation between skin and mucosal color, as measured by a spectrophotometer, and venous hemoglobin (Hb) values, to identify the optimal anatomical assessment site for detecting anemia.
A cross-sectional design. Ninety-two adult Japanese outpatients participated in the study. Using a spectrophotometer, the color of the lip and conjunctiva was measured indirectly, while the color of the nail, palm, and inside of the upper arm was measured directly. Colors were quantified using the *** color scale. This is an international color scale, where the * value is an index of brightness, * value is red/green, and * value is yellow/blue. The color difference ( *) was employed to evaluate the discriminability of anemia identification across different assessment sites. Additionally, Hb values were recorded, with anemia defined as Hb <12.0 g/dL.
The * values of the lip, conjunctiva, palm, and arm exhibited a positive correlation with Hb values and were significantly lower in the anemic group. While the * levels for the conjunctiva and lip were readily discernible by the human eye when comparing the normal and anemic groups, recognition at this level proved challenging for other sites.
The conjunctiva and lip demonstrate potential suitability for visual diagnosis of anemia. In the nail, palm, and arm, anemia detection may require highly trained observation. Consequently, reliance on these sites for anemia diagnosis may lead to potential oversight.
临床面色苍白传统上一直作为贫血的筛查工具；然而，其评估缺乏客观性。因此，本研究旨在调查用分光光度计测量的皮肤和黏膜颜色与静脉血红蛋白（Hb）值之间的相关性，以确定检测贫血的最佳解剖学评估部位。
采用横断面设计。92名成年日本门诊患者参与了本研究。使用分光光度计间接测量嘴唇和结膜的颜色，同时直接测量指甲、手掌和上臂内侧的颜色。颜色使用**色标进行量化。这是一种国际色标，其中值是亮度指标，*值是红/绿，值是黄/蓝。采用色差（）来评估不同评估部位对贫血识别的辨别能力。此外，记录Hb值，贫血定义为Hb<12.0 g/dL。
嘴唇、结膜、手掌和手臂的值与Hb值呈正相关，且在贫血组中显著较低。当比较正常组和贫血组时，结膜和嘴唇的水平肉眼易于辨别，但其他部位在这个水平上的识别具有挑战性。
结膜和嘴唇显示出对贫血进行视觉诊断的潜在适用性。在指甲、手掌和手臂部位，贫血检测可能需要经过高度训练的观察。因此，依靠这些部位进行贫血诊断可能会导致潜在的漏诊。
