Thalassemia minor: routine erythrocyte measurements and differentiation from iron deficiency.
Thalassemia minor: routine erythrocyte measurements and differentiation from iron deficiency.
复制标题
轻型地中海贫血：常规红细胞测量和与缺铁的鉴别。
DOI：
10.1093/ajcp/80.1.31
复制
发表时间：
1983
影响因子：
3.5
通讯作者：
Beutler,E
中科院分区：
文献类型：
--
作者：
Johnson,CS;Tegos,C;Beutler,E
由于缺乏α地中海贫血的诊断方法，临床上很难区分小红细胞症的病因。已经提出了许多实验室测试用于区分α地中海贫血和缺铁，包括基于电子细胞计数器产生的红细胞指数的决策功能。这些筛查方法的准确性进行了评估，在93例已知是继发于缺铁或β地中海贫血的小红细胞症患者，前瞻性地，在26例小红细胞症患者中，珠蛋白链合成率被用来诊断地中海贫血。评价的功能为：红细胞体积分布曲线;渗透脆性;红细胞计数;判别函数= MCV -（5 × Hgb）- RBC - 8.4; MCH/RBC比值; MCV/RBC比值; 0.01 × MCH ×（MCV）2。用红细胞体积分布曲线测量红细胞大小不等的简化方法在区分铁缺乏和地中海贫血方面比任何其他决策函数都更准确（P< 0.01）。分析红细胞体积分布，虽然不足以准确的明确诊断，似乎是一个有用的技术在初步筛选患者的小红细胞症，并在确定哪些额外的测试应该做。
The clinical differentiation of the causes of microcytosis is difficult because of the lack of a method for the diagnosis of alpha thalassemia. A number of laboratory tests have been proposed for the differentiation of alpha thalassemia from iron deficiency, including decision functions based on the red blood cell indices generated by electronic cell counters. The accuracy of these screening methods was assessed in 93 patients with microcytosis known to be secondary to either iron deficiency or beta thalassemia minor and, prospectively, in 26 patients with microcytosis in whom globin chain synthesis ratio was used to diagnose thalassemia. The functions evaluated were: RBC volume distribution curve; osmotic fragility; erythrocyte count; discriminant function = MCV - (5 × Hgb) - RBC - 8.4; ratio of MCH/RBC; ratio of MCV/RBC; and 0.01 × MCH × (MCV)2. A simplified method of measuring anisocytosis using the RBC volume distribution curve was significantly more accurate (P< 0.01) in distinguishing iron deficiency from thalassemia than any of the other decision functions. Analysis of red blood cell volume distribution, although not sufficiently accurate for definitive diagnosis, appears to be a useful technic in the initial screening of patients with microcytosis and in determining which additional testing should be done.