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目的:探讨血液检验在临床贫血鉴别诊断中的应用。方法:选取2015年10月至2016年12月来广东省乐昌市第二人民医院检查和就诊的贫血患者107例,按照患者所患贫血类型不同将其分为研究组(地中海贫血)和对照组(缺铁性贫血),采用日本希森美康900i全自动血液分析仪对两组血液进行检验分析,观察比较两组血液中红细胞分布宽度(RDW)、红细胞平均体积(MCV)、平均红细胞血红蛋白含量(MCH)以及平均红细胞血红蛋白浓度(MCHC)等指标,并对比两组血液检测灵敏度、特异性以及符合率等指标。结果:通过血液检验后,研究组血液中RDW和MCV分别为(11.4±1.6)%、(68.1±4.0)fl,均低于对照组(20.0±2.3)%、(72.3±4.6)fl,差异具有统计学意义(P<0.05),同时,研究组血液中MCH为(320.1±5.2)g·L~(-1)高于对照组(271.3±4.5)g·L~(-1),差异具有统计学意义(P<0.05),而两组血液中MCHC水平比较,差异无统计学意义(P>0.05)。研究组的灵敏度为96%、特异性为67%、符合率为77%,对照组(缺铁性贫血)血液检测灵敏度、特异性以及符合率分别为97%、69%和78%。结论:贫血通过血液检验的鉴别诊断,为贫血类型做出有效的判断,并且提高了鉴别和诊断的灵敏度以及准确度,具备极高的准确性。
Objective: To investigate the application of blood test in the differential diagnosis of clinical anemia. Methods: From October 2015 to December 2016, 107 patients with anemia who were examined and treated in the Second People’s Hospital of Lechang City, Guangdong Province were selected and divided into study group (thalassemia) and control group according to their different types of anemia. (Iron deficiency anemia). The blood samples of two groups were tested and analyzed by Japan’s Sysmex 900i automatic blood analyzer. The distribution of RDW, MCV and mean erythrocyte Hemoglobin content (MCH) and mean erythrocyte hemoglobin concentration (MCHC) were measured. The sensitivity, specificity and coincidence rate of two blood tests were compared. Results: After the blood test, the RDW and MCV in the study group were (11.4 ± 1.6)% and (68.1 ± 4.0) fl, respectively, which were lower than those in the control group (20.0 ± 2.3) and (72.3 ± 4.6) (320.1 ± 5.2) g · L -1 in the study group were significantly higher than those in the control group (271.3 ± 4.5) g · L -1, the difference was statistically significant (P <0.05) (P <0.05). There was no significant difference in MCHC levels between the two groups (P> 0.05). The sensitivity, specificity and compliance of the study group were 96%, 67%, and 77%, respectively. The sensitivity, specificity, and compliance of the control group (iron deficiency anemia) were 97%, 69%, and 78%, respectively. Conclusion: Anemia can make effective judgment of anemia type through the differential diagnosis of blood test, and improve the sensitivity and accuracy of identification and diagnosis with high accuracy.