Teryaeva N B, Kvan O K, Strunina Yu V, Kulikov A S
Clinical Laboratory Diagnostician; N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia.
Head of the Department of Clinical and Industrial Transfusiology; N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia.
Sovrem Tekhnologii Med. 2025;17(2):48-53. doi: 10.17691/stm2025.17.2.05. Epub 2025 Apr 30.
was to assess the diagnostic value of laboratory indicators of hemoglobin content in reticulocytes for the early detection of predisposition for perioperative anemia in patients with total hemoglobin within the reference range.
Observational retrospective single-center continuous cross-sectional study has been carried out to determine the need for transfusion of erythrocyte-containing components (ECC) depending on the values of reticulocyte hemoglobin (Ret-He) and delta-hemoglobin (Delta-He) in patients with unchanged (within the reference range) values of the total hemoglobin. The groups of comparison were formed using the diagnostic Hema-Plot algorithm, under which Ret-He and Delta-He values deviate from the reference range towards greater or smaller magnitudes in various types of anemia.
Deviations from the reference intervals of Ret-He and Delta-He values were observed in 26% of patients not formally meeting the WHO criteria for anemia on admission. Indications for ECC transfusion therapy were more likely to occur in patients who had changes in Ret-He and Delta-He corresponding to the signs of anemias of different genesis according to the Hema-Plot algorithm.
The Ret-He and Delta-He values in patients with unchanged hemoglobin allow for making a decision on the need for ECC transfusion therapy in the postoperative period.The differences between the groups formed on the basis of Ret-He and Delta-He deviations from the reference values are in line with the diagnostic signs of anemias of various origins. They also allow one to discuss the variants of impaired erythropoiesis at the very early stages of the disorder and the risk of anemia development in patients with formally unchanged total hemoglobin levels.
目的是评估网织红细胞血红蛋白含量的实验室指标对早期发现总血红蛋白在参考范围内的患者围手术期贫血易感性的诊断价值。
进行了一项观察性回顾性单中心连续横断面研究,以根据总血红蛋白值未改变(在参考范围内)的患者的网织红细胞血红蛋白(Ret-He)和δ-血红蛋白(Delta-He)值确定输注含红细胞成分(ECC)的必要性。使用诊断性血细胞图算法形成比较组,在该算法下,Ret-He和Delta-He值在各种类型的贫血中偏离参考范围,幅度有大有小。
在入院时未正式符合世界卫生组织贫血标准的患者中,26%观察到Ret-He和Delta-He值偏离参考区间。根据血细胞图算法,Ret-He和Delta-He发生与不同成因贫血体征相符变化的患者更有可能需要ECC输血治疗。
血红蛋白未改变的患者的Ret-He和Delta-He值有助于决定术后是否需要ECC输血治疗。基于Ret-He和Delta-He偏离参考值形成的组间差异与各种起源贫血的诊断体征一致。它们还允许人们在疾病的非常早期阶段讨论红细胞生成受损的变体以及总血红蛋白水平正式未改变的患者发生贫血的风险。