标题：深圳光明新区健康成人低血红蛋白密度参考区间建立及其在缺铁性贫血诊疗中的应用价值

      作者：唐永华 1，刘小君 1，李阳华 2    (深圳市光明新区人民医院检验科 1、内科 2，广东 深圳 518106)

      卷次： 2017年28卷20期

      【摘要】 目的 了解深圳光明新区健康成人低血红蛋白密度(LHD%)情况，并建立其正常参考区间，同时探讨其在缺铁性贫血诊断、治疗及疗效判断中的临床应用。方法 选取2015年10月至2017年1月来深圳市光明新区人民医院体检的健康成人240人为对照组，采用Sysmex XE-5000全自动血液分析仪检测血常规，然后根据红细胞平均血红蛋白浓度(MCHC)计算LHD%，并选择同期经临床确诊为缺铁性贫血(IDA)患者75例为 IDA组，分别于治疗前和治疗 3个月后检测血常规和计算LHD%，并对计算结果进行统计分析。结果 对照组LHD%值为(2.61±0.93)%，95%参考区间为0.78%~4.44%，其中男性和女性LHD%分别为(2.89±0.76)%和(2.13±0.72)%，95%参考区间分别为1.40%~4.38%和0.72%~3.54%，男性高于女性，两者之间比较差异有统计学意义(P<0.05)；IDA组患者治疗前LHD%为(32.16±20.05)%，明显高于对照组，两者比较差异有显著统计学意义(P<0.01)，且与其血红蛋白(Hb)浓度呈负相关性(r=-0.431 3)；IDA组患者治疗后LHD%值均明显降低，但恢复速度比Hb和MCHC慢；通过ROC曲线分析，当LHD%的cut-off值为4.50%时，LHD%用于 IDA早期诊断的敏感性为95.07%，特异性为100%。结论 建立了深圳光明新区健康成人LHD%水平正常参考区间，LHD%对 IDA早期诊断有很高的敏感性，是 IDA的早期诊断和疗效动态监测的良好指标，具有重要的临床应用价值，值得推广应用。
      【关键词】 低血红蛋白密度；参考区间；缺铁性贫血；价值
      【中图分类号】 R556.3 【文献标识码】 A 【文章编号】 1003—6350（2017）20—3334—03

Establishment of the reference range of low hemoglobin density of healthy adult and its application value indiagnosis and treatment of iron deficiency anemia in Guangming new district of Shenzhen.
TANG Yong-hua 1, LIUXiao-jun 1, LI Yang-hua 2. Department of Clinical Laboratory 1, Department of Internal Medicine 2, Shenzhen GuangmingNew District People’s Hospital, Shenzhen 518106, Guangdong, CHINA
【Abstract】 Objective To understand the situation of healthy adult's low hemoglobin density (LHD%) and es-tablish the level of normal reference range, at the same time, to explore clinical application in the diagnosis, treatmentand curative effect judgment of iron deficiency anemia (IDA) in Shenzhen Guangming New District. Methods A totalof 240 cases of healthy adults, who underwent physical examination in Shenzhen Guangming New District People's Hos-pital from October 2015 to January 2017, were selected as the control group. Routine blood test was measured by Sys-mex XE-5000 automatic blood analyzer, and then LHD% was calculated according to mean corpuscular haemoglobinconcentration (MCHC). At the same period, 75 cases of patients with IDA were selected as the IDA group, and routineblood test and LHD% were measured and calculated before the treatment and 3 months after the treatment. The resultswere statistically analyzed. Results The LHD% value of the control group was (2.61±0.93)% (95% reference range of0.78%-4.44%), in which male and female LHD% were (2.89±0.76)% and (2.13±0.72)%, respectively (95% referencerange of 1.40%-4.38% and 0.72%-3.54%, respectively) (P<0.05); Before the treatment, LHD% in the IDA patients was(32.16±20.05)%, which was significantly higher than that in the control group (P<0.01), and instead of hemoglobin (Hb)concentration showed a negative correlation (r=-0.4313). After the treatment, the LHD% values in patients with IDAwere significantly decreased, but the recovery speed was slower than the Hb and MCHC. ROC curve analysis showedthat when the cut-off of LHD% value was 4.50%, the sensitivity of the LHD % for IDA early diagnostic was 95.07%,and the specificity was 100%. Conclusion The LHD% normal reference interval of Shenzhen Guangming new ditricthealthy adults was established. LHD% has the high sensitivity for the early diagnosis of IDA and is a good indicator ofearly diagnosis and curative effect of dynamic monitoring of IDA. It has important clinical application value and is wor-thy of popularization and application.
      【Key words】 Low hemoglobin density (LHD); Reference range; Iron deficiency anemia (IDA); Value·论 著·doi:10.3969/j.issn.1003-6350.2017.20.022