CAJ | 학술논문

目的探讨轻型α地中海贫血与缺铁性贫血的临床鉴别，为降低轻型α地中海贫血的误诊率和漏诊率提供参考依据。方法选取2013年10月～2014年9月门诊及住院部收治的贫血孕妇1947例作为研究对象，以贫血类型的标准诊断为依据将患者分为轻型α地贫组和IDA组，轻型α地贫组879例，IDA组1068例；另选择500例正常健康孕妇作为对照组。对所有研究对象的病例资料进行回顾分析，对血常规检查结果的各个方面进行总结归纳，探讨三组研究对象之间相关指标的联系和差别。结果轻型α地中海贫血患者RBC水平明显高于健康孕妇，而IDA患者则低于健康孕妇；轻型α地中海贫血患者和IDA患者MCV和MCH水平均低于健康孕妇；三组间比较统计学差异显著（P均＜0.05）。85.10％的轻型α地中海贫血患者RDW处于正常水平低于对照组，而6.74％的IDA患者RDW处于正常水平低于轻型α地贫组和对照组。三组研究对象在RDW单项检测结果比较差异有统计学意义（x2=61.29，P＜0.05）。结论鉴别轻型α地中海贫血和缺铁性贫血时，依次采用血常规各项指标的分析法，能有效地区分这两种疾病，特别是RBC水平和RBC体积的分布宽度筛查可显著提高轻型α地中海贫血的临床诊断准确率。
목적탐토경형α지중해빈혈여결철성빈혈적림상감별，위강저경형α지중해빈혈적오진솔화루진솔제공삼고의거。방법선취2013년10월～2014년9월문진급주원부수치적빈혈잉부1947례작위연구대상，이빈혈류형적표준진단위의거장환자분위경형α지빈조화IDA조，경형α지빈조879례，IDA조1068례；령선택500례정상건강잉부작위대조조。대소유연구대상적병례자료진행회고분석，대혈상규검사결과적각개방면진행총결귀납，탐토삼조연구대상지간상관지표적련계화차별。결과경형α지중해빈혈환자RBC수평명현고우건강잉부，이IDA환자칙저우건강잉부；경형α지중해빈혈환자화IDA환자MCV화MCH수평균저우건강잉부；삼조간비교통계학차이현저（P균＜0.05）。85.10％적경형α지중해빈혈환자RDW처우정상수평저우대조조，이6.74％적IDA환자RDW처우정상수평저우경형α지빈조화대조조。삼조연구대상재RDW단항검측결과비교차이유통계학의의（x2=61.29，P＜0.05）。결론감별경형α지중해빈혈화결철성빈혈시，의차채용혈상규각항지표적분석법，능유효지구분저량충질병，특별시RBC수평화RBC체적적분포관도사사가현저제고경형α지중해빈혈적림상진단준학솔。
ObjectiveTo explore clinical identification on mild α thalassemia and iron deficiency anemia (IDA), so as to provide the reference to decrease misdiagnosis rate and missed diagnosis rate of mild α thalassemia. Methods 1947 pregnant women with anemia admitted by the outpatient and inpatient department from October 2013 to September 2014 were selected as research subjects, who were divided into mild α thalassemia and IDA group according to diagnosis criteria of anemia types, with 879 patients in the mild α thalassemia group and 1068 patients in IDA group. Meanwhile, another 500 healthy pregnant women were selected into control groups. The data of medical records of all research subjects were retrospectively analyzed, and all aspects of blood routine examination were summarized, and then relations and differences of the relative indicators among research subjects in three groups were analyzed.ResultsRBC level of patients with mild α thalassemia was significantly higher than that of healthy pregnant women, while this level of patients with IDA was lower than that of healthy pregnant women. MCV and MCH levels of patients with mild α thalassemia and IDA were lower than those of healthy pregnant women, however, the difference among three groups were statistically significant(allP<0.05). On the basis of RDW level of healthy pregnant women, 85.10% of RDW of poor patients with mild α thalassemia were at normal level, while 93.26% of RDW of patients with IDA increased. Chi-square of the single test of RDW in comparison among the three groups was 61.29, the difference among groups were statistically significant(P<0.05).Conclusion Sequence analysis of blood routine indicators to identify mild α thalassemia and iron deficiency anemia can effectively distinguish these two diseases, especially level of RBC and volume distribution width screening of RBC can significantly improve the accuracy of clinical diagnosis on mild α thalassaemia.