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CCLM:如何在小红细胞性贫血病人中区分地中海贫血症与缺铁性贫血症

2017-09-10 MedSci MedSci原创

之前已经报道了许多用于区分小细胞性贫血患者的地中海贫血特征与铁缺乏症的判别式。然而对几种判别式的独立验证是不足,甚至是缺乏的。因此,研究人员在一个大型良好表征的患者群体中回顾性地研究了判别式。

近日,国际杂志《Clinical Chemistry and Laboratory Medicine》在线发表了一篇关于在小红细胞性贫血病人中区分地中海贫血症与缺铁性贫血症的研究。

之前已经报道了许多用于区分小细胞性贫血患者的地中海贫血特征与铁缺乏症的判别式。然而对几种判别式的独立验证是不足,甚至是缺乏的。因此,研究人员在一个大型良好表征的患者群体中回顾性地研究了判别式。

调查人群包括2664例微红细胞性贫血患者,其中1259例有缺铁缺陷,1196例为地中海贫血症状(877 β-型和319α-型),150例地中海贫血症伴有铁缺乏症或慢性贫血性贫血,36例其他疾病。研究人员调查了只能使用所有分析仪上可用的血液学参数的25个判别式, 忽略了具有更高级参数的公式,使用ROC分析来评估诊断性能。

研究发现表现最好的判别式是JayaboseRDW指数),Janel11T)和GreenKing。判别式间差异无统计学意义(P> 0.333),但ROC曲线下的面积均优于任何其他公式。JayaboseGreenKing判别式的灵敏度最高为0.917Janel公式的最高特异度为0.925,为11个其他判别式的综合得分。所有研究的判别式在区分β-地中海贫血与铁缺乏症方面表现更好。

在患者人群中,Jayabose RDW指数,GreenKingJanel 11T评分优于所有其他区分地中海贫血症状和缺铁性贫血的判别式。研究证实,所有判别式在β-地中海贫血症患者中比区分α-型表现出更好的效果,并错误地将大约30%的地中海贫血携带者归类为无地中海贫血。即便是最好的判别式的诊断性能也不足以进行最终的地中海贫血诊断,但在医疗资源匮乏的国家,此方法可以帮助确定需要进一步检查遗传性贫血的患者。

原始出处:

Urrechaga, Eloísa, Hoffmann, Johannes J.M.L. et.al. Critical appraisal of discriminant formulas for distinguishing thalassemia from iron deficiency in patients with microcytic anemia.

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    2017-09-12 wgx311
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    2017-09-11 139****5926

    好好文章学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1805132, encodeId=6ab21805132a4, content=<a href='/topic/show?id=3138e790655' target=_blank style='color:#2F92EE;'>#细胞性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77906, encryptionId=3138e790655, topicName=细胞性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Sat Mar 31 14:10:00 CST 2018, time=2018-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776809, encodeId=82ca1e7680967, content=<a href='/topic/show?id=5b989244667' target=_blank style='color:#2F92EE;'>#贫血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92446, encryptionId=5b989244667, topicName=贫血症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=81a339030187, createdName=medscijoin, createdTime=Fri Sep 22 21:10:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813398, encodeId=11f218133981d, content=<a href='/topic/show?id=3cfa924456f' target=_blank style='color:#2F92EE;'>#贫血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92445, encryptionId=3cfa924456f, topicName=贫血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Tue Aug 14 07:10:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281971, encodeId=761b12819e15e, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Tue Sep 12 12:10:00 CST 2017, time=2017-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395159, encodeId=19421395159ed, content=<a href='/topic/show?id=c268e940840' target=_blank style='color:#2F92EE;'>#缺铁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79408, encryptionId=c268e940840, topicName=缺铁)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eb32500176, createdName=luckyshitiancai_42705684, createdTime=Tue Sep 12 12:10:00 CST 2017, time=2017-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575467, encodeId=fbc115e54675d, content=<a href='/topic/show?id=cd9941326bc' target=_blank style='color:#2F92EE;'>#地中海#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41326, encryptionId=cd9941326bc, topicName=地中海)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=303116130321, createdName=wgx311, createdTime=Tue Sep 12 12:10:00 CST 2017, time=2017-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242769, encodeId=47dd242e69df, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Mon Sep 11 07:19:07 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242707, encodeId=1a2c242e0743, content=学习了.不错的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Mon Sep 11 01:23:19 CST 2017, time=2017-09-11, status=1, ipAttribution=)]
    2017-09-11 明崖

    学习了.不错的研究

    0

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