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[杂合子β地中海贫血与缺铁性贫血的鉴别诊断]

[Differentiation between heterozygotic beta-thalassemia and iron deficiency anemia].

作者信息

Sonati M de F, Grotto H Z, Kimura E M, Costa F F

机构信息

Departamento de Patologia Clínica, Faculdade de Ciências Médicas da UNICAMP, Campinas, SP.

出版信息

Rev Assoc Med Bras (1992). 1993 Oct-Dec;39(4):221-3.

PMID:8162086
Abstract

Several laboratory tests have been proposed for the differentiation of beta thalassemia from iron deficiency, including decision functions based on red blood cells indices generated by electronic cell counters. The accuracy of these screening methods was assessed in 192 patients with microcytosis known to be secondary to beta thalassemia minor and 72 patients with iron deficiency. The functions evaluated were: 1) discriminant function of England an Fraser: MCV--(5xHb)--RBC--8.4; 2) ratio of MCH/RBC; 3) ratio of MCV/RBC; 4) ratio of (MCV)2 x MCH and 5) the erythrocyte count. The discriminant function of England and Fraser showed the highs, percentage of correct distinction between iron deficiency and beta thalassemia minor, although diagnosis errors occurred in 10%. Mentzer ratio MCV/RBC detected all cases of beta thalassemia but was a poor index for iron deficiency detection. The tested discriminant function, with exception of the Mentzer ratio, although not sufficiently accurate for definitive diagnosis, appears to be a useful technique in the initial screening of patients with microcytosis.

摘要

已经提出了几种实验室检测方法来区分β地中海贫血和缺铁性贫血,包括基于电子细胞计数器生成的红细胞指数的判别函数。在192例已知继发于轻型β地中海贫血的小红细胞症患者和72例缺铁性贫血患者中评估了这些筛查方法的准确性。评估的函数有:1)英格兰和弗雷泽判别函数:平均红细胞体积(MCV)-(5×血红蛋白(Hb))-红细胞计数(RBC)-8.4;2)平均红细胞血红蛋白含量(MCH)与红细胞计数的比值;3)平均红细胞体积与红细胞计数的比值;4)(平均红细胞体积)²×平均红细胞血红蛋白含量的比值;5)红细胞计数。英格兰和弗雷泽判别函数显示出缺铁性贫血和轻型β地中海贫血之间正确区分的最高百分比,尽管有10%的诊断错误。门泽尔比值(平均红细胞体积/红细胞计数)检测出了所有β地中海贫血病例,但对于缺铁性贫血检测是一个较差的指标。除门泽尔比值外,所测试的判别函数虽然对于明确诊断不够准确,但似乎是对小红细胞症患者进行初步筛查的一种有用技术。

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