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目的探讨细胞形态学及血清学的多项指标对慢性病贫血(ACD)评价的临床意义。方法用STKS血细胞分析仪检测外周血红细胞参数,化学发光免疫测定血清铁蛋白、叶酸及维生素B12,骨髓常规计数粒红比例及骨髓幼红细胞数。并以缺铁性贫血、巨幼细胞性贫血、溶血性贫血、难治性贫血为对照。结果ACD的MCH、MCV、MCHC除HA外,与其它各型贫血比较均有显著性差异;ACD的RDW在治疗前后的结果变化明显小于IDA;ACD的骨髓粒红比例较高,总幼红细胞值较其它各组低;ACD的铁蛋白明显高于IDA组(P<0.01),其血清叶酸和维生素B12无明显临床价值。结论多项指标的综合评价对ACD诊断和鉴别诊断及其发病机理探讨有一定参考价值。
Objective To investigate the clinical significance of multiple morphological and serological markers in the evaluation of anemia of chronic diseases (ACD). Methods Peripheral blood erythrocyte parameters were detected by STKS hematology analyzer. Chemiluminescence immunoassay was used to detect serum ferritin, folic acid and vitamin B12, and the proportion of erythrocytes and bone marrow were counted. And iron deficiency anemia, megaloblastic anemia, hemolytic anemia, refractory anemia as a control. Results MCH, MCV and MCHC of ACD were significantly different from other types of anemia except for HA. The changes of RDW in ACD before and after treatment were significantly less than those in IDA. The percentage of matrigel in ACD was high, and the total erythrocyte Compared with other groups, the ferritin of ACD was significantly higher than that of IDA (P <0.01), and serum folate and vitamin B12 had no obvious clinical value. Conclusion The comprehensive evaluation of multiple indicators has certain reference value for the diagnosis and differential diagnosis of ACD and its pathogenesis.