| Research objects: To analyze the value of RET-He and serum Hepc in the diagnosis and treatment of iron deficiency anemia and chronic disease anemia,and discuss the role of both RET-He and serum Hepcidin in the process of IDA and ACD anemia occurred.Methods: Collected in Jilin University First Hospital Outpatient and inpatient in May to August 2015 for 150 cases, Among them 120 cases of patients with anaemia,which were divided into IDA for 30 cases and ACD for 90 cases. According to the clinical diagnosis, ACD group were further divided into inflammatory anemia group 30 cases, tumor group 30 cases, renal anemia group 30 cases; Unanemia patients 30 cases as the control group. Groups of red blood cells related parameters,including RET-He、serum Hepc、RBC、HGB、HCT、MCV、MCH、MCHC, and Iron metabolism related parameters including serum hepcidin、Fe、Ferr were measured respectively. Use SPSS software to analyze and compare the variance between groups. The Pearson correlation analysis and ROC curve analysis were used,to evaluate the diagnostic value of RET-He and serum Hepc in iron deficiency anemia and chronic disease anemia,to discuss the role of both RET-He and serum Hepcidin in the process of IDA and ACD anemia occurred.Results:(1)IDA, ACD,and the control group RET-He detection result: IDA group for 19.73±5.19 pg; Among ACD group, inflammatory anemia group、umor anemia group、nephropathy anemia group for 25.57±3.86 pg、28.82±5.84pg、32.33±3.35 pg, and control group 33.36±1.28 pg. Compared with the control group, IDA group、 inflammatory anemia group、 tumor anemia group had significant difference with the control group(P<0.01); nephropathy anemia group and the control group had no significant difference(P>0.05). Comparing RET-He between IDA group and ACD group, IDA group RET-He had significant difference with inflammatory anemia group、 tumor anemia group、nephropathy anemia group(P<0.01).Comparison RET-He With in ACD group,inflammation anemia group had difference with tumor group(P<0.05), tumor group had difference with nephropathy anemia group(P <0.05).(2)IDA, ACD, and the control group serum Hepcidin detection result: IDA group for 13.88±3.57 ng/ml; Among ACD group, inflammatory anemia group 、 tumor anemia group 、 nephropathy anemia group for 32.75 ±7.06ng/ml、28.46±10.06ng/ml、18.56±8.77ng/ml, and the control group 17.38 ± 6.54ng/ml. Compared with the control group, IDA group had difference with the control group(P<0.05); inflammatory anemia group、tumor anemia group had significant difference with the control group(P<0.01); nephropathy anemia group and the control group had no significant difference(P>0.05).Comparing serum Hepcidin between IDA group and ACD group, IDA group had significant difference with inflammatory anemia group、 tumor anemia group、nephropathy anemia group(P<0.01). Comparison serum Hepc With in ACD group, nephropathy anemia group had difference with inflammatory anemia group、 tumor anemia group(P<0.05); inflammatory anemia group and tumor anemia group had no significant difference(P>0.05).(3)The area under the ROC curve of RET-He for diagnosis of IDA、inflammatory anemia、tumor anemia、nephropathy anemia respectively were 0.983、0.971、0.773、0.585;when the critical value respectively were 29.85pg/ml、31.45pg/ml、32.00pg/ml、32.45pg/ml, the sensitivity respectively were96.7%、93.3%、70%、50%; and the specificity respectively 100%、93.3%、80%、80%.The area under the ROC curve of serum Hepcidin for diagnosis of IDA、inflammatory anemia、tumor anemia、n ephropathy anemia respectively were 0.679、0.939、0.821、0.527;when the critical value respectively were 15.51ng/ml、21.62ng/ml、20.50ng/ml、15.96ng/ml, the sensitivity respectively were 73.3%、90%、86.7%、63.30%,and the specificity respectively 60%、80%、66.7%、56.7%. The area under the ROC curve of RET-He combined with serum Hepcidin for diagnosis of IDA is 0.986,and sensitivity 96.7%,specificity 96.7%. The area under the ROC curve of RET-He combined with surem Hepcidin for diagnosis of inflammatory anemia is 0.998,and sensitivity 96.7%,specificity100%.(4)In IDA group, RET-He level and the level of serum iron were decreased and positively correlated, the correlation coefficient for 0.614, P<0.05. Inflammatory anemia group、 tumor anemia group RET-He level and the level of serum Fe had a certain degree of relevance, but renal anemia group RET-He level and the level of serum Fe had no correlation.Conclusions:(1)In IDA,RET-He and serum hepcidin both decrease at the same time,which can be used as one of the effective laboratory diagnosis indicators of IDA, but it must be pointed ont that there are 16.67% patiens with RET-He and hepecidin no decreasing at the same time.(2) In IDA, RET-He decrease, serum Fe and Ferritin decrease; RET-He was positively correlated with serum Fe reduction, so RET-He reduction is one of indicator to judge the lack of iron.(3)In inflammatory and tumor anemia, Serum hepcidin increase, in renal anemia serum hepcidin have no change,but in IDA serum hepcidin decrease,so serum hepcidin is an effective indicator for the identification diagnosis of IDA and inflammatory、tumor anemia. |
PDF Full Text Request