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目的广西为地中海高发区,地中海贫血不能治疗,通过明确地中海贫血与缺铁性贫血的鉴别,减少临床上的误诊漏诊。明确诊断后针对性的对两种不同贫血的孕妇采取不同的处理方法,缺铁性贫血可以通过补充铁剂治疗,而地中海贫血孕妇则没有治疗方法,只能通过产前筛查或产前诊断来明确其所怀的胎儿是否为地贫儿,从而避免中重度地贫儿的出生。方法从我院2012-2014年的贫血孕妇,中随机选取120名地中海贫血的患者和120名缺铁性贫血的孕妇,并根据贫血的类型诊断标准将这240名患者命名为地中海组合缺铁性组。回顾性分析两组患者的病例,从发病的高发年龄,性别的比例,发病时肝脾肿大的情况和重度贫血所占的比例等因素鉴别地中海贫血与缺铁性贫血。结果地中海的男女发病比例为:1.35∶1,缺铁性组的男女发病比例为:2.75∶1,P<0.05,两组在男女发病比例上有明显差异;地中海组患者的发病高发年龄为0-6个月,缺铁性组患者的发病高发年龄为6个月到2岁,P<0.05,两组在发病高发年龄上有明显的差异;地中海组患者贫血程度比例最高的是重度贫血(41.7%),缺铁性组患者贫血程度比例最高的是中度贫血(45%),P<0.05,两组在患者的贫血程度比例上有明显的差异;地中海组患者的肝肿大率为78.5%,脾肿大率为72.5%,缺铁性组患者的肝肿大率为63.3%,脾肿大率为26.7%,P<0.05,两组患者在肝脾肿大的情况下有明显的差异。结论地中海贫血和缺铁性贫血在发病高发年龄,男女发病比例,患者贫血程度和肝脾肿大等因素上存在明显的差异,可以作为临床上鉴别要点,可以在临床鉴别上推广使用。
Purpose Guangxi is a high incidence area of the Mediterranean, and thalassemia can not be treated. By clearly distinguishing between thalassemia and iron deficiency anemia, it is possible to reduce the misdiagnosis of clinical diagnosis. A clear diagnosis of targeted treatment of two different anemia pregnant women take different treatments, iron deficiency anemia can be treated with iron supplements, while pregnant women without thalassemia there is no treatment, only through prenatal screening or prenatal diagnosis To determine whether the pregnant fetus is poor children, so as to avoid the birth of moderately poor poor children. Methods A total of 120 thalassemia patients and 120 pregnant women with iron deficiency anemia were randomly selected from pregnant women with anemia in our hospital from 2012 to 2014. According to the diagnostic criteria of type of anemia, 240 patients were named as Mediterranean combination iron deficiency group. Retrospective analysis of two groups of patients, from the incidence of high incidence of age, sex ratio, incidence of hepatosplenomegaly and the proportion of severe anemia and other factors to identify thalassemia and iron deficiency anemia. Results The incidence of males and females in the Mediterranean was 1.35:1. The incidence of males and females in the iron-deficient group was 2.75:1 (P <0.05). There was a significant difference in the incidence of males and females in the two groups. The incidence of the disease in the Mediterranean group was 0 -6 months, the incidence of iron deficiency in patients with high incidence of onset age of 6 months to 2 years, P <0.05, the two groups in the age of onset were significantly different; the highest proportion of patients with Mediterranean anemia is severe anemia 41.7%). In the iron-deficient group, the highest percentage of anemia was moderate anemia (45%), P <0.05. There was a significant difference in the proportion of anemia between the two groups. The hepatomegaly rate in the Mediterranean group was 78.5%, splenomegaly rate was 72.5%, iron deficiency in patients with hepatomegaly was 63.3%, splenomegaly rate was 26.7%, P <0.05, two groups of patients in the case of hepatosplenomegaly obvious The difference. Conclusion Thalassemia and iron-deficiency anemia in the incidence of high incidence of age, the incidence of male and female patients, the degree of anemia and hepatosplenomegaly and other factors there are significant differences can be used as a clinically important points, can be used in clinical identification.