释放网织红细胞分析的力量:推进对科福里杜瓦东部地区医院血红蛋白异常变体患者的护理。

Unlocking the power of reticulocyte analysis: Advancing care for patients with abnormal haemoglobin variants at Eastern Regional Hospital, Koforidua.

作者信息

Duneeh Richard Vikpebah, Bedzina Israel, Johnson Melody Yaaba Korkor, Agyei Amponsah Francis, Ofori Boadu Wina Ivy, Ablordey Kenneth

机构信息

Department of Medical Laboratory Sciences, University of Health and Allied Sciences, Ho, Ghana.

Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

PLoS One. 2025 May 9;20(5):e0323056. doi: 10.1371/journal.pone.0323056. eCollection 2025.

Abstract

Reticulocytes are immature erythrocytes that have been released into the peripheral circulation after being extruded from the bone marrow. However, it has not been investigated whether these reticulocyte indicators are helpful in treating conditions linked to abnormal haemoglobin variants. In the current investigation, participants with abnormal haemoglobin variants were evaluated for the utility of reticulocyte parameters using a high-end haematology analyser. We conducted a prospective cross-sectional study among 217 participants with abnormal haemoglobin variants at the Eastern Regional Hospital, Koforidua. Statistical analyses were performed with IBM SPSS V.26.0 (Chicago, IL, USA) and R programming language version 4.2.3. A p-value of < 0.05 was considered statistically significant for all analyses. We found a significant association between age groups and anaemia severity (p = 0.016). Haemoglobin levels varied significantly among abnormal haemoglobin variants (p < 0.05), with the "SF" phenotype showing the lowest levels. Production defects accounted for 1.4% of cases, while maturation defects were present in 91.7%. An increase in low-fluorescence reticulocytes was linked to a 0.03 g/dL rise in haemoglobin (β = 0.03, p < 0.05), whereas increases in high- and medium-fluorescence reticulocytes led to declines of 0.069 g/dL and 0.052 g/dL, respectively (p < 0.05). Haemoglobin levels were significantly lower in participants with maturation abnormalities (p < 0.01). The study found relationships between the severity of anaemia, age, and haemoglobin phenotypes in individuals with abnormal haemoglobin variants. Given the predominance of maturation defects, management aimed at addressing ineffective erythropoiesis is necessary. The differences in how reticulocyte subpopulations affect haemoglobin levels imply that reticulocyte indices may be helpful biomarkers for monitoring and guiding therapeutic approaches.

摘要

网织红细胞是从骨髓中挤出后释放到外周循环中的未成熟红细胞。然而,这些网织红细胞指标是否有助于治疗与异常血红蛋白变体相关的病症尚未得到研究。在当前的研究中,使用高端血液分析仪对具有异常血红蛋白变体的参与者的网织红细胞参数效用进行了评估。我们在科福里杜瓦东部地区医院对217名具有异常血红蛋白变体的参与者进行了一项前瞻性横断面研究。使用IBM SPSS V.26.0(美国伊利诺伊州芝加哥)和R编程语言版本4.2.3进行统计分析。所有分析中,p值<0.05被认为具有统计学意义。我们发现年龄组与贫血严重程度之间存在显著关联(p = 0.016)。不同异常血红蛋白变体之间的血红蛋白水平差异显著(p < 0.05),“SF”表型的血红蛋白水平最低。生成缺陷占病例的1.4%,而成熟缺陷占91.7%。低荧光网织红细胞增加与血红蛋白升高0.03 g/dL相关(β = 0.03,p < 0.05),而高荧光和中荧光网织红细胞增加分别导致血红蛋白下降0.069 g/dL和0.052 g/dL(p < 0.05)。成熟异常参与者的血红蛋白水平显著较低(p < 0.01)。该研究发现了具有异常血红蛋白变体个体的贫血严重程度、年龄和血红蛋白表型之间的关系。鉴于成熟缺陷占主导,旨在解决无效红细胞生成的管理是必要的。网织红细胞亚群对血红蛋白水平影响的差异表明,网织红细胞指数可能是监测和指导治疗方法的有用生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5309/12063815/8370932a8753/pone.0323056.g001.jpg

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