铁缺乏对巨幼细胞贫血实验室指标影响.docVIP

铁缺乏对巨幼细胞贫血实验室指标影响 　　[摘要] 目的 观察铁缺乏对巨幼细胞贫血（MA）血常规、生化及铁代谢指标的影响。 方法 回顾性分析2008年1月～2015年10月我院门诊或住院确诊MA的患者103例，以合并铁缺乏者44例为观察组，无铁缺乏者59例为对照组，比较两组的血常规、乳酸脱氢酶（LDH）、非结合胆红素（UB）、血清叶酸（FA）、维生素B12 （VitB12）及铁代谢等指标。 结果 两组的年龄、血红蛋白（Hb）水平及血清FA水平差异无统计学意义（P0.05），观察组女性比例较对照组增高，两组的平均红细胞体积（MCV）、红细胞分布宽度（RDW）、UB及血清铁蛋白（SF）、总铁结合力（TIBC）、血清铁（SI）、转铁饱和度（TfS）、VitB12水平等差异有统计学意义（P0.05）。 结论 单纯MA常表现为全血细胞减少，MCV、UB、SF增高。MA合并铁缺乏以女性多见，实验诊断特点不典型或缺失，不利于与再生障碍性贫血及其他恶性血液病的鉴别诊断。 　　[关键词] 巨幼细胞贫血；铁缺乏；平均红细胞体积；非结合胆红素；血清铁蛋白 　　[中图分类号] R556.9 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0116-04 　　[Abstract] Objective To observe the influence of iron deficiency on indexes of blood routine，biochemistry and iron metabolism in megaloblastic anemia （MA）. Methods From January 2008 to October 2015，103 patients definitely diagnosed as MA in outpatient clinic and hospital were retrospectively analyzed.There were 44 patients together with iron deficiency and they were classified into observation group，and the rest without iron deficiency were categorized into control group.The indexes including blood routine，lactate dehydrogenase （LDH），unconjugated bilirubin （UB），serum folic acid （FA），vitamin B12 （VitB12） and iron metabolism and so on between two groups was compared respectively. Results There were no statistical difference of age，hemoglobin level （Hb） or serum FA level （P0.05）.The proportion of female in observation group was higher than that in control group，and level of mean corpuscular volume （MCV），red cell distribution width （RDW），UB and serum ferritin （SF），total iron binding capacity （TIBC），serum iron （SI），transferrin saturation （TfS）， and VitB12 were displayed statistical difference （P0.05）. Conclusion Simple MA only usually presents with pancytopenia，and increase of MCV，UB，and SF.MA complicated with iron deficiency is commonly-seen in female sex.The experimental diagnostic characteristics are atypical or even deficiency，which is not beneficial to differentiation and diagnosis of aplastic anemia and other malignant hematologic d