Differential Diagnosis of Thalassemia and Iron Deficiency Anemia Using Routine Blood Parameters from an Automated Hematology Analyzer
全自动血细胞分析仪血常规检验对地中海贫血和缺铁性贫血诊断分析

摘要

目的 探讨基于全自动血细胞分析仪的血常规检验参数在鉴别诊断地中海贫血（地贫）与缺铁性贫血（IDA）中的临床价值。方法 选取确诊的地贫患者50例（地贫组）、IDA患者50例（IDA组）及同期健康体检者50例（对照组）。所有受试者均使用同一全自动血细胞分析仪检测血常规，比较三组间及两组贫血患者间红细胞参数的差异，并计算关键参数的诊断比值。结果 地贫组红细胞计数（RBC）高于IDA组，而平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）低于IDA组，红细胞分布宽度（RDW）低于IDA组。联合参数（MCV、MCH、RDW）鉴别两种贫血的效能优于单一指标。结论 全自动血细胞分析仪提供的多项红细胞参数，尤其是MCV、MCH和RDW的组合分析，对地贫与IDA的快速、初步鉴别诊断具有重要参考价值。

Abstract

Objective To investigate the clinical value of routine blood test parameters based on automated hematology analyzers in the differential diagnosis of thalassemia and iron deficiency anemia (IDA).
Methods Fifty patients with confirmed thalassemia (thalassemia group), fifty patients with IDA (IDA group), and fifty healthy individuals (control group) were selected. All subjects underwent routine blood tests using the same automated hematology analyzer. Differences in erythrocyte parameters among the three groups and between the two anemia groups were compared, and the diagnostic ratios of key parameters were calculated.
Results The red blood cell count (RBC) was higher in the thalassemia group than in the IDA group, while the mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were lower in the thalassemia group. The red blood cell distribution width (RDW) was also lower in the thalassemia group compared to the IDA group. The combination of parameters (MCV, MCH, RDW) demonstrated superior diagnostic efficacy in differentiating the two types of anemia compared to any single parameter.
Conclusion   Multiple erythrocyte parameters provided by automated hematology analyzers, especially the combined analysis of MCV, MCH, and RDW, offer valuable reference for the rapid and preliminary differential diagnosis of thalassemia and IDA.