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目的探讨红细胞相关参数和铁代谢检验项目鉴别诊断缺铁性贫血(IDA)与慢性病贫血(ACD)的临床价值。方法分析30例IDA和29例ACD患者的红细胞(RBC)相关参数与铁代谢检测结果;比较总铁结合力(TIBC)、血清铁(SI)、红细胞分布宽度(RDW)的ROC曲线特性。结果 RBC、TIBC、铁蛋白浓度(SF)、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)和RDW两组患者间差异有统计学意义(P<0.01),SI、HCT两组患者间差异无统计学意义(P>0.05);TIBC、SI、RDW用于诊断IDA的ROC曲线下分别为0.986、0.457和0.905,对应的最优截断点分别为3.23 mg/L,95.5μg/L和15.56%,其灵敏度为93.3%,86.7%和76.7%,特异性为100%,31.0%和93.1%;TIBC的阳性预测值和阴性预测值分别为100%和93.5%。结论RBC、TIBC、SF、MCV、MCH、MCHC和RDW对诊断IDA非常有临床价值;TIBC、RDW鉴别诊断IDA与ACD时都有很好的准确性、灵敏度和特异性,TIBC优于RDW。
Objective To investigate the clinical value of erythrocyte related parameters and iron metabolism test in the differential diagnosis of iron deficiency anemia (IDA) and chronic anemia (ACD). Methods The RBC parameters and iron metabolism in 30 patients with IDA and 29 patients with ACD were analyzed. The ROC curves of total iron binding capacity (TIBC), serum iron (SI) and red blood cell distribution width (RDW) were compared. Results The differences of RBC, TIBC, SF, MCV, MCH, MCHC and RDW between the two groups were statistically significant (P <0.01) (P> 0.05). The ROC curves of TIBC, SI and RDW for diagnosis of IDA were 0.986, 0.457 and 0.905, respectively, corresponding to the optimal cutoff points of 3.23 mg / L, 95.5 μg / L and 15.56% respectively. The sensitivity and specificity of TIBC were 93.3%, 86.7% and 76.7%, 100%, 31.0% and 93.1% respectively. The positive predictive value and negative predictive value of TIBC were 100% and 93.5% %. Conclusions RBC, TIBC, SF, MCV, MCH, MCHC and RDW are very valuable in the diagnosis of IDA. TIBC and RDW have good accuracy, sensitivity and specificity in distinguishing IDA from ACD. TIBC is better than RDW.