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目的 :探讨细胞形态学、骨髓铁染色及血清铁蛋白 ( SF)对缺铁性贫血的诊断价值。方法 :对 3 5例缺铁性贫血 ( IDA)及 2 4例非 IDA病人 ,行骨髓穿刺涂片及静脉采血分离血清 ,分别以瑞氏 -姬姆氏法及亚铁氰化钾法染色骨髓涂片行细胞形态学及铁染色检查 ;以 EL ISA双抗体夹心法测定血清 SF,并对结果作相关统计学评价。结果 :细胞形态学、铁染色及 SF对 IDA的诊断敏感性分别为 91.4 %、85 .7%、85 .7% ,以形态学最高 ,而 SF对 IDA的诊断特异性及阳性预测值可高达 10 0 %。3者中以形态学所有评价指标最优。将 3者分别作 2、3项联合检测 ,各组组合均可大大提高诊断敏感性 ,形态学 +铁染色、形态学 + SF及 3项同时检测敏感性可达 10 0 %。联合检测以形态学 + SF最优 ,其各项评价指标在各组合中均列首位 ,且两者联检特异性下降不很明显。结论 :细胞形态学、骨髓铁染色及血清 SF对缺铁性贫血均具有较好的诊断价值 ,联合检测可显著提高诊断敏感性 ,尤以细胞形态学 + SF为最佳。
Objective: To investigate the value of cell morphology, bone marrow iron staining and serum ferritin (SF) in the diagnosis of iron deficiency anemia. Methods: Thirty-five cases of IDA and 24 cases of non-IDA were treated with bone marrow aspirate and venous blood respectively. The bone marrow was stained with Wright-Giemsa method and potassium ferrocyanide Smear line morphology and iron staining; EL ISA double antibody sandwich method for the determination of serum SF, and the results for the relevant statistical evaluation. Results: The diagnostic sensitivity of cell morphology, iron staining and SF to IDA were 91.4%, 85.7% and 85.7%, respectively, with the highest morphological value. However, the diagnostic specificity and positive predictive value of SF for IDA were as high as 10 0%. Among the three, morphological evaluation index was the best. The three were made for 2,3 joint detection, the combination of each group can greatly improve the diagnostic sensitivity, morphology + iron staining, morphology + SF and 3 simultaneous detection sensitivity up to 10%. Joint detection with morphological + SF optimal, the evaluation index of each combination in the first place, and the combination of the two decreased specificity is not obvious. Conclusion: Cell morphology, bone marrow iron staining and serum SF have good diagnostic value for iron deficiency anemia. Combined detection can significantly improve the diagnostic sensitivity, especially SF + SF.