血常规检验在地中海贫血和缺铁性贫血诊断与鉴别诊断中的应用

目的 分析血常规检验在地中海贫血和缺铁性贫血诊断与鉴别诊断中的应用价值. 方法 选取2019年7月～2021年7月我院收治的100例地中海贫血、缺铁性贫血患者作为研究对象,两组患者均行血常规检验,比较两组患者检查结果中红细胞体积分布宽度(RDW)、红细胞平均体积(MCV)、红细胞平均血红蛋白浓度(MCHC)、红细胞平均...     

微量元素五项联合红细胞四项检测在小儿缺铁性贫血中的诊断价值

目的:探讨微量元素五项联合红细胞四项检测在小儿缺铁性贫血(IDA)中的诊断价值。方法:选取2013年1月至2016年1月于我院进行治疗的小儿缺铁性贫血(IDA)患儿130例作为缺铁性贫血(IDA)组及同期于我院进行常规体检的健康儿童40例作为对照组。检测和比较其钙、镁、铜、铁、锌、血红蛋白(Hb)、平均红细胞体积(MCV)、平均血红蛋白含量(MCH)、平均血红蛋白浓度(MCHC)水平,并比较微量元素五项、红细胞四项检查以及两者联合对IDA患儿的诊断效能。结果:缺铁性贫血(IDA)组患儿微量元素镁、铁、锌含量以及Hb、MCV、MCH及MCHC水平均明显低于对照组儿童,差异具有统计学意义(P0.05);两组儿童微量元素钙、铜含量比较差异不显著(P0.05)。微量元素五项联合红细胞四项的灵敏度、特异度、阳性预测值及阴性预测值均明显高于微量元素五项和红细胞四项(P0.05)。结论:IDA患儿微量元素镁、铁、锌含量以及Hb、MCV、MCH及MCHC水平较低,微量元素五项联合红细胞四项检测可以提高小儿IDA的检出率。     

血液检验在贫血诊断与鉴别诊断中的价值分析

目的:分析血液检验在贫血诊断和鉴别诊断中的价值。方法:选取血常规检测的贫血患者122例,按照患者的贫血类型分为缺铁性贫血组和地中海贫血组,另选取健康成人作为对照组。对三组进行血细胞进行检测,对三组患者血液中的RDW、RBC/MCV、MCH、Hb、MCV、RBC指标的差异进行观察。结果:缺铁性贫血组患者的RBC、Hb指标低于地中海贫血组和对照组,而RDW高于其他两组,具有统计学意义,P0.05。地中海贫血组患者的RBC、RBC/MCV高于其他两组,有统计学意义,P0.05。缺铁性贫血组患者和地中海贫血组患者的MCH、MCV低于对照组,有统计学意义,P0.05。结论:血液检测中的RDW、RBC/MCV、MCH、Hb、MCV、RBC指标可以帮助贫血疾病的诊断,并且能够对不同类型的贫血进行鉴别,具有十分重要的意义。     

MCH、MCV、RDW-CV、HbA_2和红细胞脆性试验在地中海贫血和缺铁性贫血鉴别诊断中的应用

目的:探讨平均红细胞血红蛋白量(MCH)、平均红细胞体积(MCV)、红细胞分布宽度变异系数(RDW-CV)、血红蛋白A_2(Hb A_2)和红细胞脆性试验在地中海贫血和缺铁性贫血鉴别中的价值。方法:以地中海贫血基因诊断和血清铁蛋白测定作为确诊地中海贫血和缺铁性贫血的分组依据,选择2012年1月1日至2014年12月31日广州军区总医院经分子生物学和血清铁蛋白检测的156例患者为研究对象,将其分为地中海贫血组115例(其中α地中海贫血77例,β地中海贫血37例,α地中海贫血复合β地中海贫血1例)和缺铁性贫血组41例;比较患者的MCH、MCV、RDW-CV、Hb A_2和红细胞脆性等血液学指标,采用ROC曲线评价鉴别地中海贫血和缺铁性贫血的血液学指标,试找出最适合鉴别这2种贫血的截断值(cut-off值),以截断值计算上述血液学指标鉴别这2种贫血的灵敏度、特异性、预测值与准确率。结果:地中海贫血患者与缺铁性贫血患者的MCH、MCV和红细胞脆性差异有统计学意义(P0.05),RDW-CV差异无统计学意义(P0.05)。MCH、MCV和红细胞脆性的ROC曲线下面积依次为0.641、0.654、0.778,其最佳截断值分别为23.65 pg、72.8 f L、43.5%;MCH、MCV和红细胞脆性试验在鉴别地中海贫血和缺铁性贫血中的灵敏度分别为89.84%、83.94%、80.42%。Hb A_2在α地中海贫血患者与缺铁性贫血患者间差异无统计学意义(P0.05);Hb A_2在β地中海贫血患者与缺铁性贫血患者间差异有统计学意义(P0.001),Hb A_2在ROC曲线下面积为0.925,最佳截断值为2.93%,鉴别β地中海贫血和缺铁性贫血的灵敏度为92.50%。结论:用MCH、MCV、Hb A_2、红细胞脆性试验最佳截断值对鉴别地中海贫血和缺铁性贫血有一定的价值;Hb A_2在鉴别α地中海贫血和缺铁性贫血中无意义;Hb A2鉴别β地中海贫血和缺铁性贫血的灵敏度高。     

贫血浅谈

<正>贫血是血液系统疾病病人最常见的症状,指的是单位容积周围血液中血红蛋白浓度、红细胞计数和(或)血细胞比容低于相同年龄、性别和地区的正常标准。以血红蛋白浓度的降低为最重要标准。我国成人血红蛋白测定,男性低于120克/升、女性低于110克/升、妊娠妇女低于100克/升时可诊断为贫血。引起贫血的常见原因为红细胞生成减少、破坏过多及失血。常见的类型有缺铁性贫血、巨幼细胞贫血、     

炎症性贫血的病因、诊断与治疗研究进展

感染、自身免疫紊乱、慢性疾病和年龄等很多原因都会导致炎症发生并发展为贫血。炎症性贫血(anemia of inflammation AI)通常为正细胞正色素性贫血,临床表现温和。系统性的铁利用、红细胞生成、红细胞生存期特征的变化导致了炎症性贫血。最佳治疗是纠正病因,然而当病因不清或难以诊断时,治疗炎症性贫血的办法就非常有限了。铁调素(Hepcidin)是近年研究铁利用调节的中心。由于铁调素定量分析技术的发展,人们逐渐认识到其在各种疾病中的作用。最近研究集中在铁调素表达调节通路,并发现了药物治疗的靶点。由于治疗上的巨大进步,分析正常血红蛋白对疾病预后的影响,就可以明确炎性疾病发生和死亡过程中贫血是否具有可逆性。     

基于儿童缺铁性贫血预防办法的研究

缺铁性贫血在临床上作在比较常见世界性一种儿童营养类疾病,影响了儿童的身心健康发展。如果儿童发生缺铁性贫血,常常会导致其身体发迟缓、智力变弱等,给患病儿童和家长带来了身心上的痛苦和经济负担。本文内容从儿童缺铁性贫血产生的原因来分析,同时结合儿童缺铁性贫血的现状,关于如何通过补充乳铁蛋白来预防儿童缺铁性贫血提出了相关措施与办法。     

缺铁性贫血中肠道菌群作用的研究进展

缺铁性贫血是临床最常见的贫血类型之一,已知缺铁性贫血会导致机体免疫力下降,影响心血管系统,对儿童和青少年的智力发育造成损害。然而越来越多的学者发现缺铁还会引起肠道菌群结构发生改变,影响肠道菌群的代谢。短链脂肪酸作为肠道菌群代谢的主要产物,受铁的制约最大。短链脂肪酸对机体肠道健康起着至关重要的作用,因此缺铁是有害的。另外临床工作中发现益生菌联合铁剂治疗缺铁性贫血,疗效更显著；铁剂联合抗菌药物对细菌相关疾病的治疗效果大大提高,说明铁与肠道菌群关系密切。本文就缺铁性贫血与肠道菌群关系的研究进展作一综述。     

高铁酵母的研究初报

铁是人体必需的微量元素之一。铁离子是红细胞中血红蛋白的组成成分,缺铁会引致缺铁性贫血。据世界卫生组织(WHO)报导,缺铁性贫血是遍及全球的营养缺乏症,特别是发展中国家更为严重。我国儿童缺铁性贫血患病率约占50％以上。如果用硫酸亚铁和乳酸亚铁等制剂作     

贫血的几种类型

贫血(anemia)是临床上常见的由多种不同原因或疾病引起的一种症状,是指外周血中单位容积内血红蛋白浓度(Hb)、红细胞计数(RBC)和(或)血细胞比容(HCT)低于相同年龄、性别和地区的正常标准.一般认为在平原地区,成年男性Hb＜120 g/L、RBC＜4.5×1012/L及(或)HCT＜0.42,女性Hb＜110 g/L、RBC＜4.0×1012/L及(或)HCT＜0.37就可诊断为贫血.其中以Hb浓度降低最为重要,因为红细胞计数不一定能准确地反映贫血的存在及贫血的程度.贫血通常是根据红细胞形态或引起贫血的原因和发生贫血的病理生理综合进行分类的.主要有以下几种类型.     

Expression of the infectious salmon anemia virus receptor on atlantic salmon endothelial cells correlates with the cell tropism of the virus

Infectious salmon anemia (ISA) is a World Organization for Animal Health (OIE)-listed disease of farmed Atlantic salmon, characterized by slowly developing anemia and circulatory disturbances. The disease is caused by ISA virus (ISAV) in the Orthomyxoviridae family; hence, it is related to influenza. Here we explore the pathogenesis of ISA by focusing on virus tropism, receptor tissue distribution, and pathological changes in experimentally and naturally infected Atlantic salmon. Using immunohistochemistry on ISAV-infected Atlantic salmon tissues with antibody to viral nucleoprotein, endotheliotropism was demonstrated. Endothelial cells lining the circulatory system were found to be infected, seemingly noncytolytic, and without vasculitis. No virus could be found in necrotic parenchymal cells. From endothelium, the virus budded apically and adsorbed to red blood cells (RBCs). No infection or replication within RBCs was detected, but hemophagocytosis was observed, possibly contributing to the severe anemia in fish with this disease. Similarly to what has been done in studies of influenza, we examined the pattern of virus attachment by using ISAV as a probe. Here we detected the preferred receptor of ISAV, 4-O-acetylated sialic acid (Neu4,5Ac(2)). To our knowledge, this is the first report demonstrating the in situ distribution of this sialic acid derivate. The pattern of virus attachment mirrored closely the distribution of infection, showing that the virus receptor is important for cell tropism, as well as for adsorption to RBCs.     

Cytoskeleton alterations of erythrocytes from patients with Fanconi's anemia

Fanconi's anemia (FA) is a very rare genetically heterogeneous disease which has been hypothesized to be defective in the detoxification of reactive oxygen species. In this work we report the results obtained by morphometric and biochemical analyses on the red blood cells (RBCs) from FA patients. With respect to RBCs from healthy donors the following changes have been detected: (i) a variety of ultrastructural alterations, mainly surface blebbing typical of acanthocytes and stomatocytes; (ii) a significant quantitative increase of these altered forms; (iii) modifications of spectrin cytoskeleton network; (iv) an altered redox balance, e.g. a decreased catalase activity and significant variations in the GSSG/GSH ratio. We hypothesize that remodeling of the redox state occurring in FA patients results in cytoskeleton-associated alterations of red blood cell integrity and function.     

Transcriptional activity of paired homeobox Pax6 is enhanced by histone acetyltransferase Tip60 during mouse retina development

The pathophysiology of oxidative hemolytic anemia is closely associated with hemoglobin (Hb) stability; however, the mechanism of how Hb maintains its stability under oxidative stress conditions of red blood cells (RBCs) carrying high levels of oxygen is unknown. Here, we investigated the potential role of peroxiredoxin II (Prx II) in preventing Hb aggregation induced by reactive oxygen species (ROS) using Prx II knockout mice and RBCs of patients with hemolytic anemia. Upon oxidative stress, ROS and Heinz body formation were significantly increased in Prx II knockout RBCs compared to wild-type (WT), which ultimately accelerated the accumulation of hemosiderin and heme-oxygenase 1 in the Prx II knock-out livers. In addition, ROS-dependent Hb aggregation was significantly increased in Prx II knockout RBCs. Interestingly, Prx II interacted with Hb in mouse RBCs, and their interaction, in particular, was severely impaired in RBCs of patients with thalassemia (THAL) and sickle cell anemia (SCA). Hb was bound to the decameric structure of Prx II, by which Hb was protected from oxidative stress. These findings suggest that Prx II plays an important role in preventing hemolytic anemia from oxidative stress by binding to Hb as a decameric structure to stabilize it.     

Detection of two-component mixtures of lognormal distributions in grouped, doubly truncated data: analysis of red blood cell volume distributions

We have examined the statistical requirements for the detection of mixtures of two lognormal distributions in doubly truncated data when the sample size is large. The expectation-maximization algorithm was used for parameter estimation. A bootstrap approach was used to test for a mixture of distributions using the likelihood ratio statistic. Analysis of computer simulated mixtures showed that as the ratio of the difference between the means to the minimum standard deviation increases, the power for detection also increases and the accuracy of parameter estimates improves. These procedures were used to examine the distribution of red blood cell volume in blood samples. Each distribution was doubly truncated to eliminate artifactual frequency counts and tested for best fit to a single lognormal distribution or a mixture of two lognormal distributions. A single population was found in samples obtained from 60 healthy individuals. Two subpopulations of cells were detected in 25 of 27 mixtures of blood prepared in vitro. Analyses of mixtures of blood from 40 patients treated for iron-deficiency anemia showed that subpopulations could be detected in all by 6 weeks after onset of treatment. To determine if two-component mixtures could be detected, distributions were examined from untransfused patients with refractory anemia. In two patients with inherited sideroblastic anemia a mixture of microcytic and normocytic cells was found, while in the third patient a single population of microcytic cells was identified. In two family members previously identified as carriers of inherited sideroblastic anemia, mixtures of microcytic and normocytic subpopulations were found. Twenty-five patients with acquired myelodysplastic anemia were examined. A good fit to a mixture of subpopulations containing abnormal microcytic or macrocytic cells was found in two. We have demonstrated that with large sample sizes, mixtures of distributions can be detected even when distributions appear to be unimodal. These statistical techniques provide a means to characterize and quantify alterations in erythrocyte subpopulations in anemia but could also be applied to any set of grouped, doubly truncated data to test for the presence of a mixture of two lognormal distributions.     

Quantitative exfoliative oral cytology in iron-deficiency and megaloblastic anemia

A study was undertaken to ascertain if there were any morphometric or morphologic changes in exfoliated oral squames in either iron-deficiency or vitamin B12-deficiency states. The results revealed a significant (P less than .05) increase in nuclear area and a significant alteration in nuclear/cytoplasmic ratio in vitamin B12 deficiency; both returned to normal following replacement therapy. No changes were seen with iron deficiency anemia or non-vitamin B12 megaloblastic anemia. Ultrastructurally, the surface morphology showed similar features in all groups, with the plasma membrane forming complex folds (microplications) in three patterns: branching, parallel and network. The microplication widths and interplication distances were remarkably constant in both control and study groups, regardless of pattern.     

Randomized Placebo-Controlled Trial of Helicobacter pylori Eradication for Iron-Deficiency Anemia in Preadolescent Children and Adolescents

Background. A few cases relating H. pylori infection to iron-deficiency anemia have been described recently. We investigated the role of H. pylori infection in iron-deficiency anemia in preadolescent children and adolescents.
Patients and Methods. We conducted a double-blind, placebo-controlled therapeutic trial in 43 subjects (mean age, 15.4 years) with iron-deficiency anemia. Endoscopy was performed, and biopsy specimens were examined by urease test and histological analysis. Twenty-two of 25 H. pylori –positive patients were assigned randomly to three groups. Group A patients were given oral ferrous sulfate and a 2-week course of bismuth subcitrate, amoxicillin, and metronidazole. Group B patients were given placebo for iron and a 2-week course of triple therapy. Group C patients were given oral ferrous sulfate and a 2-week course of placebo. Iron status was reassessed 4 weeks and 8 weeks after the 2-week regimen ended.
Results. Of the 43 subjects with iron-deficiency anemia, 25 (58.1%) had H. pylori in the antrum. Group A and B subjects, who received eradication therapy, showed a significant increase in hemoglobin level as compared with group C subjects at 8 weeks after therapy ( p = .0086).
Conclusions. Treatment of H. pylori infection was associated with more rapid response to oral iron therapy as compared with the use of iron therapy alone. Such treatment also led to enhanced iron absorption even in those subjects who did not receive oral iron therapy.     

Effects of r—HuEPO on the biophysical characteristics of erythrocyte membrane in patients with anemia of chronic renal failure

Using electron spin resonance (ESR) spin labeling technique,we have studied the conformation of sulfhydryl groups(-SH) binding sites in membrane proteins and mem brane fluidity of red blood cells(RBCs) from two groups of patients with anemia of chronic renal failure(ACRF).One of the groups is composed of patients who were untreated with recombinant human erythropoietin(r-HuEPO),and the other is composed of patients who were treated with r-HuEPO.The results indicated:1)the conformation of SH group binding site in RBC membrane proteins from former group was different from those of healty people.2)the fluidity in the region near the surface of RBC membrane from former group was lower than those of healthy people.3)However,the above biophysical properties of RBC membrane from later group were normal.We concluded that RBC membrane in patients with ACRF was abnormal,and the treatment of r-HuEPO may promote the production of normal RBCs,thus ameliorate the biophysical properties of RBCs from the patients with ACRF.     

低频交变磁场刺激对缺铁性贫血大鼠贫血改善的作用研究

目的:明确低频正弦波交变电磁场对缺铁性贫血大鼠贫血改善的作用效果,为其未来的临床应用提供实验依据。方法:雄性断乳的SPF级Sprague-Dawley(SD)大鼠,共36只,随机的等分为空白对照组(n=12)、缺铁性贫血组(n=12)和缺铁性贫血+电磁场刺激组(n=12)。缺铁性贫血组和缺铁性贫血+电磁场刺激组的大鼠饲养以低铁饲料和去离子水,每周尾静脉放血1 m L。空白对照组大鼠饲养以常规饲料和普通蒸馏水,且不予尾静脉放血。对缺铁性贫血+电磁场刺激组的12只大鼠施加全身低频交变电磁场刺激,每天刺激2小时,连续刺激10周。实验结束后提取大鼠血液样本,使用氰化高铁血红蛋白法进行测定全血血红蛋白含量,使用专用试剂盒测定血清铁和总铁结合力;提取肝脏和脾脏组织,对肝脏铁和脾脏铁含量进行测定。结果:全身暴露低频交变电磁场刺激显著提高了缺铁性贫血大鼠体重(P0.05),提升了其血清铁含量(P0.05),显著提高全血血红蛋白含量(P0.05),并显著降低了缺铁性贫血大鼠血清总铁结合力(P0.05);同时,电磁刺激也显著提高了缺铁性贫血大鼠肝脏铁和脾脏铁含量(P0.05)。结论:交变电磁场作为一种经济、安全、无创的物理作用方式,具有较为显著的缺铁性贫血的改善效果。     

Prevalence and etiology of acquired anemia in Medieval York, England

This paper presents three distinct models for the development of acquired anemia: iron-deficiency anemia produced by the inadequate intake and/or absorption of iron, the anemia of chronic disease (ACD) caused by the body's natural iron-withholding defense against microbial invaders, and megaloblastic anemia caused by insufficient intake and/or absorption of vitamin B(12) or folic acid. These etiological models are used to interpret the distribution and etiology of anemia among adult individuals interred at the Medieval Gilbertine Priory of St. Andrew, Fishergate, York (n = 147). This bioarchaeological analysis uncovered not only a strong relationship between decreasing status and increasing prevalence of anemia for both men and women, but also identified clear sex-based differences at this site. Within the high-status group, blood and iron loss as a result of rampant parasitism likely produced an environment ripe for the development of iron-deficiency anemia, while the parasitic consumption of vitamin B(12) may have caused occasional cases of megaloblastic anemia. As status decreases, the interpretation of anemia becomes more complex, with megaloblastic anemia and ACD emerging as viable, potentially heavy contributors to the anemia experiences of low-status people at St. Andrew's. Apart from status effects, women (especially young women) are disproportionately affected by anemia when compared to men within their own status group and, on average, are also more likely to have experienced anemia than their male peers from other status groups. This suggests that high iron-demand reproductive functions helped to make iron-deficiency anemia a chronic condition in many women's lives irrespective of their status affiliation.     

Iron-Deficiency Anemia is Associated with Altered Characteristics of Sleep Spindles in NREM Sleep in Infancy

Objective To determine the effects of iron-deficiency anemia on the development of non-rapid-eye-movement (NREM) sleep stages, as indexed by sleep spindles. Study design Patterns of sleep spindles during NREM sleep stages 2 and 3–4 (slow-wave-sleep, SWS) were compared in 26 otherwise healthy 6-month-old Chilean infants with iron-deficiency anemia and 18 non-anemic control infants. From polygraphic recordings, EEG activity was analyzed for sleep spindles to assess their number (density), duration, frequency, and inter-spindle interval. Results Iron-deficient anemic infants differed from the control group by having sleep spindles with reduced density, lower frequency, and longer inter-spindle intervals in NREM sleep stage 2 and SWS. Conclusions These results provide evidence of delayed sleep spindle patterns in iron-deficient anemic infants, suggesting that iron is an essential micronutrient for the normal progression of NREM sleep pattern development in the human. Special issue dedicated to Dr. Moussa Youdim.