[1]戴学庆a,蔡守兵b.网织红细胞多参数分析对肾性贫血患者治疗的应用价值[J].现代检验医学杂志,2017,32(02):146-148，152.[doi:10.3969/j.issn.1671-7414.2017.02.041]
　DAI Xue-qinga,CAI Shou-bingb.Application Value of Multi Parameter Analysis of Net and Red Blood Cells in the Treatment of Renal Anemia[J].Journal of Modern Laboratory Medicine,2017,32(02):146-148，152.[doi:10.3969/j.issn.1671-7414.2017.02.041]
点击复制

网织红细胞多参数分析对肾性贫血患者治疗的应用价值()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年02期
页码:
146-148，152
栏目:
检验与临床
出版日期:
2017-03-25

文章信息/Info

Title:
Application Value of Multi Parameter Analysis of Net and Red Blood Cells in the Treatment of Renal Anemia
文章编号:
1671-7414(2017)02-146-04
作者:
戴学庆a; 蔡守兵b
江苏省金湖县人民医院a.检验科; b.血液科,江苏金湖 211600
Author(s):
DAI Xue-qinga; CAI Shou-bingb
a.Department of Clinical Laboratory; b.Department of Hematology, the People's Hospital of Jinhu County in Jiangsu Province,Jiangsu Jinhu211600,China
关键词:
网织红细胞相关参数;  肾性贫血;  未成熟网织红细胞指数;  网织红细胞生成指数
分类号:
R556.9; R446.11
DOI:
10.3969/j.issn.1671-7414.2017.02.041
文献标志码:
A
摘要:
目的 通过对网织红细胞相关参数进行检测,探讨金湖县人民医院肾性贫血患者治疗前后骨髓红系造血功能的动态变化以及判断药物治疗的疗效。方法采用迈瑞-6900全自动血液细胞分析仪,将54例肾性贫血患者分成三组,分别为肾功能不全代偿组、肾功能不全失代偿组和肾功能衰竭组,与45例正常健康组作对比分析,分别检测网织红细胞百分比(Ret%)、未成熟网织红细胞指数(IRF%)、红细胞(RBC)计数、血红蛋白含量(Hb)、血清肌酐(Cr)和尿素氮(BUN)含量,同时检测治疗前后的红细胞比容(HCT)和Ret%,并通过校正公式计算网织红细胞生成指数(RPI),对结果进行对比分析。结果 Ret%在肾功能不全失代偿组和肾功能衰竭组显著高于对照组(P<0.05); IRF%在肾功能不全代偿期组显著低于对照组(P<0.05),而肾功能不全失代偿组和肾功能衰竭组均显著高于对照组(P<0.05); RBC,Hb水平随着Cr和BUN水平的升高而显著减低,在肾功能不全代偿期组开始显著低于对照组(P<0.05),并随着肾病的严重程度逐渐减低。肾功能不全代偿组治疗前后HCT(%),Ret(%),HFR(%),MFR(%),RPI(%),差异有统计学意义(t=2.103,2.062,2.079,2.354,2.368; 均P<0.05),LFR(%)差异无统计学意义(t=1.812,P>0.05); 肾功能不全失代偿组治疗前后HCT(%),Ret(%),HFR(%),MFR(%),LFR(%),RPI差异均有统计学意义(t=2.228,2.172,2.894,2.185,2.023,2.455; 均P<0.05); 肾功能衰竭组HCT(%),Ret(%),HFR(%),MFR(%),RPI(%)治疗前后差异有统计学意义(t=2.148,2.351,2.642,2.086,2.686; P<0.05),LFR(%)差异无统计学意义(t=1.921,P>0.05)。IRF%的ROC面积较其他血液学指标大,在临界值为22.3%时,其诊断灵敏度和特异度分别为88.4%和80.2%。结论 网织红细胞中的相关参数能够有效的协助医师对肾性贫血患者进行诊断与治疗,尤其是IRF%和RPI指标较网织红细胞更加敏感,且这些指标更能准确的反映出骨髓造血功能和红系的生长情况,值得在临床中应用。
Abstract:
Objective The dynamic changes of hematopoieticfunction of bone marrow in patients with renal anemia before and after treatmentand the curative effect of drug treatment were discussed through the detectionof the related parameters of the red blood cell.Methods Reticulated red cells using Mindray-6900 automatic blood cell analyzer,54 cases of renal anemia patients were divided into three groups,respectively for renal function of compensatory group,renal function insufficiency decompensation group and renal failure group,and 45 cases of normal healthy group for comparisonanalysis were used to detect the reticulocyte percentage(RET),immature red blood cell index(IRF),red blood cell(RBC)count,hemoglobin(HB),serum creatinine(CR)and blood urea nitrogen(BUN)were detected before and after treatmentof red blood cell hematocrit(HCT)and RET,and through the correction formula to calculate the net knits red blood cell production index(RPI).The results were compared and analyzed.Results RET in renal failure compensatory group and renal failure group was significantly higher than that of the control group(P<0.05); IRF% in renal insufficiency compensatory group was significantly lower than that of control group(P<0.05),and renal failure compensatory group and renal failure group were significantly higher than those of the control group(P<0.05); RBC,Hb levels with the levels of bun andCr increased significantly reduced,in kidney function not full decompensated group was significantly lower than that of control group(P<0.05),and withthe severity of the kidney was decreased gradually.Renal insufficiency compensatory group before and after treatment with HCT(%),Ret(%),HFR(%),MFR(%),RPI the difference was statistically significant(t=2.103,2.062,2.079,2.354,2.368; all P<0.05),LFR(%)showed no significant difference(t=1.812,P>0.05); renal insufficiency decompensation group before and after treatment with HCT(%),Ret(%),HFR(%),MFR(%),LFR(%),HFR showed significant differences(t=2.228,2.172,2.894,2.185,2.023,2.455; all P<0.05); renal failure group HCT(%),Ret(%),HFR(%),MFR(%)HFR was statistically significant differences before and after the treatment(t=2.148,2.351,2.642,2.086,2.686; all P<0.05),LFR(%)showed no significant difference(t=1.921,P>0.05).The ROC area of IRF% was larger than other hematological indexes,and its diagnostic sensitivity and specificity were 88.4% and 80.2%,respectively,when the critical value was 22.3%.Conclusion Reticulocyte erythrocyte parameters can effectively assist physicians in renalanemia patients for diagnosis and treatment,especially the IRF% and RPI is netwoven red cells more sensitive,and the index can more accurately reflect the growth of hematopoietic function of bone marrow and erythroid,worthy of clinicalapplication.

参考文献/References:

[1] 乐家新，丛玉隆，彭文红，等．新型网织红细胞参数在缺铁性贫血疗效 观察中的应用［Ｊ］．临床检验杂志，2002，20(1)：15-17． Yue JX，Cong YL，Peng WH，et al．The application of new reticulocyte indices on iron therapy of IDA［J］．Chinese Journal of Clinical Laboratory Sci ence，2002，20(1)：15-17．
[2］ 熊立凡，刘成玉．临床检验基础［M］．北京：人民卫生出版社，2008：124-125． Xiong LF，Liu CY．Foundation of clinical laboratory［M］．Beijing： People's Medical Publishing House，2008：124-125．
[3］ 程玉萍．促红细胞生成素测定及其在临床中的应用［J］．中国中医药现代远程教育 ，2011，9(6)：78-79． Cheng YP．Determination of erythropoietin and its application in cli nical practice［J］．Chinese Medicine Modern Distance Education of China，2011 ，9(6)：78-79．
[4］ Zini G，Di Mario A，Garzia M，et al．Reticulocyte population data in d ifferent erythropoietic states［Ｊ］．J Clin Pathol，201l，64(2)：159-163．
[5］ 陈灏珠，李宗明，段生福，等．内科学［Ｊ］．4版北京：人民卫生出版社，1997 ：511-514． Chen HZ，Li ZM，Dua SF，et al．Internal Medicine［J］．4th EdBe ijing：People’s Medical Publishing House，1997：511-514．
[6］ 金艳慧，王明山，郑加永，等．肾性贫血中未成熟网织红细胞的变化及意义［Ｊ］ ．实用医学杂志，2005，21(17)：1951-1953． Jin YH，Wang MS，Zheng JY，et al．The changes of immature reticulocy te fraction in renal anemia and its signifance［J］．Journal of Practical Medic ine，2005，21(17)：1951-1953．
[7］ Chang CC，Kass L．Cinical significance of immature reticulocyte fration d etermined by automated reticuloeyte counting［Ｊ］．Am J Clin Patti，1997，108(1 )：69-73．
[8］ Yesmin S，Sultana T，Roy CK，et al．Immature reticulocyte fraction as a predictor of bone marrow recovery in children leukaemia on remission induction p hase［Ｊ］．Bangladesh Med Res Counc Bull，2011，37(2)：57-60．
[9］ Heimpel H，Diem H，Nebe T．Counting reviculocytes：new impertance of an o ld method［Ｊ］．Med Klin (Munich，Germany)，2010，105(8)：538-543．〖ZK)〗
[10］ 买买提伊明．吐尔逊，李 鲁动态检测网织红细胞生成指数对缺铁性贫 血疗效的判断［J］．河北医学，2014，20(4)：699-701． Mamatimin TES，Li L．Dynamic detection of the efficacy of J in the tr eatment of iron deficiency anemia［J］．Hebei Medicine，2014，20(4)：699-701．
[11］ 唐 斌．外源性EPO治疗肾性贫血患者相关红细胞参数研究［J］．现代检验医学杂 志，2013，28(5)：53-55． Tang B．Study of related erythrocyte parameters of renal anemia patie nts treated by exogenous EPO［J］．Journal of Modern Laboratory Medicine， 2013，28(5)：53-55．
[12］ 曾学辉，李忠新，李秀玉，等．网织红细胞血红蛋白含量诊断老年人铁缺乏的临床 应用［Ｊ］．重庆医学，2015，44(20)：2842-2844． Zeng XH，Li ZX，Li XY，et al．Clinical application of hemoglobin content i n the diagnosis of iron deficiency in elderly patients with the diagnosis of iro n deficiency in the elderly［J］．Chongqing Medicine，2015，44(20)：2842-2844．

备注/Memo

备注/Memo:

作者简介:戴学庆(1976-),男,本科,副主任技师,主要从事临床检验工作,E-mail:dxq_@163.com。
更新日期/Last Update: 2017-04-10