低血红蛋白密度对血液透析贫血患者缺铁性贫血和铁缺乏的诊断价值分析*

doi:10.3969/j.issn.1671-2587.2023.05.013

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (5): 654-661.DOI: 10.3969/j.issn.1671-2587.2023.05.013

低血红蛋白密度对血液透析贫血患者缺铁性贫血和铁缺乏的诊断价值分析^*

钟馨¹, 邱浩川¹, 陈斯亮¹, 李朝晖¹, 毛怀东³, 章俊²

¹深圳市龙岗中心医院,广东深圳 518116;
²南方医科大学附属珠江医院,广东广州 510220;
³清远市中医院 ,广东清远 511500

收稿日期:2023-07-06 出版日期:2023-10-20 发布日期:2023-11-20
通讯作者: 章俊,主要从事终末期肾脏病研究,（E-mail）zxueli063@163.com。
作者简介:钟馨,主要从事血液透析、肾性贫血、铁代谢方面研究,（E-mail）zhongx1982@163.com。
基金资助:
*本课题受深圳龙岗区科技创新计划项目（No.LGKCYLWS2020022）资助

Analysis of the Diagnostic Value of Low Hemoglobin Density in Iron Deficiency Anemia and Iron Deficiency in Hemodialysis Anemia Patients

ZHONG Xin, QIU Haochuan, CHEN Siliang, et al

Shenzhen Longgang Central Hospital, Shenzhen 518116

Received:2023-07-06 Online:2023-10-20 Published:2023-11-20

摘要/Abstract

摘要： 目的观察低血红蛋白密度（low hemoglobin density,LHD）对血液透析贫血患者缺铁性贫血（iron deficiency anemia,IDA）和铁缺乏（iron deficiency,ID）的诊断价值,明确LHD在血液透析患者不同病因贫血鉴别诊断的临床应用价值。方法选取 2020年1月—2022年1月龙岗中心医院维持性血液透析患者375人,依据是否贫血及缺铁分为：血透非贫血组、肾性贫血并缺铁性贫血组、肾性贫血并铁正常组、肾性贫血并绝对性铁缺乏组、肾性贫血并功能性铁缺乏组。同时选取龙岗中心医院健康体检人群157人、缺铁性贫血人群65人分别作为健康对照组（阴性对照组）与缺铁性贫血组（阳性对照组）。分析各组间红细胞参数指标LHD及铁代谢指标在各组间的差异。ROC曲线分析LHD在血液透析贫血人群中IDA和ID的诊断效能。结果 LHD指标在血透贫血人群的IDA筛查中,诊断值>23.05（P<0.05）,灵敏度100%,特异度99.49%。在血透贫血人群功能性铁缺乏的筛查中,诊断值>7.705（P<0.05）,灵敏度61.11%,特异度58.67%。结论 LHD在血液透析贫血患者中对IDA的诊断具有较好的诊断效能,诊断阈值>23.05。LHD对血液透析贫血患者的ID的诊断能力较弱。 LHD对肾性贫血并功能性铁缺乏与绝对性铁缺乏并未见明显的鉴别诊断价值。

关键词: 低血红蛋白密度, 缺铁性贫血, 铁缺乏, 血液透析

Abstract: Objective To observe the diagnostic value of low hemoglobin density (low hemoglobin density, LHD) for iron deficiency anemia (iron deficiency anemia, IDA) and iron deficiency (iron deficiency, ID) in hemodialysis anemia patients, and to clarify the clinical application value of LHD in the differential diagnosis of anemia of different causes in hemodialysis patients. Methods 375 maintenance hemodialysis patients in Longgang Central Hospital from January 2020 to January 2022 were divided into: hemodialysis non-anemia group, renal anemia, renal anemia and iron normal group, renal anemia and absolute iron deficiency group, renal anemia and functional iron deficiency group. At the same time, 157 people from health examination and 65 people with iron deficiency anemia in Longgang Central Hospital were selected as healthy control group (negative control group) and iron deficiency anemia group (positive control group) respectively. The differences in red blood cell parameters LHD and iron metabolism were analyzed among the groups. ROC curve analysis of the diagnostic power of LHD in IDA and ID was tested in the hemodialysis anemia population. Results In IDA screening, the diagnostic value of LHD was> 23.05 (P<0.05), sensitivity 100% and specificity 99.49%. For screening of functional iron deficiency in the hemodialysis anemia population,, its the diagnostic value> 7.705 (P<0.05), sensitivity 61.11% and specificity 58.67%. Conclusion sLHD has high diagnostic efficacy for IDA in hemodialysis anemia patients with diagnostic threshold> 23.05. LHD is weak in diagnose ID in patients with hemodialysis anemia.LHD has no obvious differential diagnosis value for renal anemia combined with functional iron deficiency and absolute iron deficiency.

Key words: Low hemoglobin density, Iron deficiency anemia, Iron deficiency Hemodialysis

中图分类号:

R556.3R446.1

钟馨, 邱浩川, 陈斯亮, 李朝晖, 毛怀东, 章俊. 低血红蛋白密度对血液透析贫血患者缺铁性贫血和铁缺乏的诊断价值分析^*[J]. 临床输血与检验, 2023, 25(5): 654-661.

ZHONG Xin, QIU Haochuan, CHEN Siliang, et al. Analysis of the Diagnostic Value of Low Hemoglobin Density in Iron Deficiency Anemia and Iron Deficiency in Hemodialysis Anemia Patients[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(5): 654-661.

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低血红蛋白密度对血液透析贫血患者缺铁性贫血和铁缺乏的诊断价值分析^*

Analysis of the Diagnostic Value of Low Hemoglobin Density in Iron Deficiency Anemia and Iron Deficiency in Hemodialysis Anemia Patients

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