| Objective To study the the changes and clinical significance of erythrocyte related parameters and serology indexes in patients with Myelodysplastic Syndrome(myelodysplastic syndrome,MDS).Methods Select the records of 90 patients with MDS admitted by Kailuan Hospital between January 2014 and December 2018 as the research object,and randomly select 30 patients from MA(megaloblastic anemia)group,30 patients from IDA(iron-deficiency anemia)group,30 patients from AA(aplastic anemia)group and 90 Normal controls group admitted in the same period.According to the World Health Organization(WHO)classification(2008),MDS can be divided into RA(Refractory anemia),RARS(Refractory anemia with ringed sideroblasts)groups,RCMD(Refractory anemia with multilineage dysplasia)group,RAEB-1(the Refractory anemia with excess blasts-1)group and RAEB-2(Refractory anemia with excess blasts-2)group.According to the IPSS(The International Prognostic Scoring),patients with MDS can be divided into low risk group,the moderate group-1,the morderate group-2 and high-risk groups.Compare the basic data of MDS group and control group and explore the significance of Hb(hemoglobin),MCV(mean corpuscular volume),MCH(mean corpuscular hemoglobin),mean corpuscular hemoglobin concentration(MCHC)and RDW(red cell distribution width)in the diagnosis and treatment of MDS,as well as the significance of the serum indexes of SF(serum ferritin),FA(folic acid),VitB12(vitamin B12),LDH and ?-HBDH in the diagnosis and treatment of MDS.SPSS 22.0 was used to collate and analyze the data,normal test and variance homogeneity test were carried out for all measurement data,mean ± standard deviation(x± s)was used to describe the data consistent with normal independent variance homogeneity,and variance analysis was used to compare the differences among three groups and above.The counting data and grade data were described with(percentage)[n(%)].The chi square test was used to compare the difference between groups.The LSD method was used to make further comparison between the two groups.The test level ?=0.05,P<0.05 showed that the difference was statistically significant.Results 1.The IDA group level of MCV(75.16±10.85fl)and MCH(75.16±10.85pg)are the lowest,and the level of MCV(100.42±16.90fl)and MCH(32.89±4.52pg)in MDS group,AA group(108.41±16.48fl,35.57±5.08pg)and MA group(121.26±10.34fl,41.61±4.65pg)increased in turn.The levels of RDW-CVand RDW-SD in IDA group(19.44±4.09%,50.68±9.16fl),AA group(15.85±2.37%,58.14±11.06fl),MDS group(17.46±3.80%,60.64±13.13fl)and MA group(19.17±4.87%,74.41 ± 14.68fl)were higher than those in the normal control group,and increased in turn.The difference of MCV,MCH and RDW between MDS group and control group was statistically significant(p<0.05),which is important to distinguish patients with MDS,MA,IDA and AA.According to the international prognosis score system(IPSS),the Hb of moderate group 1(67.73±26.21g/L)and 2(80.50±20.11g/L)was lower than that of low risk group(P<0.05),and the MCV(94.86±13.56fl)and MCH(31.14±5.15pg)of low risk group were lower than the group 1(106.61±13.51fl,34.36±4.37pg)and group 2(95.56±11.11fl,31.88±3.72pg)(P<0.05),both of which were statistically significant.According to WHO(2008)classification,there was no significant difference in erythrocyte parameters between groups(P>0.05)2.The levels of SF(730.97±630.15ng/ml),FA(36.60±11.76nmol/L),VitB12(443.21±348.02pmol/L),LDH(356.03±150.69U/L)and ?-HBDH(239.58±149.13U/L)in MDS group were significantly higher than those in normal control group.According to the prognosis classification of IPSS,there was no significant difference in SF,FA,VitB12,LDH and ?-HBDH among the four groups(P>0.05).According to WHO(2008)classification,the SF levels RAEB-2 group(744.48±301.03ng/ml),RA and RAS group(404.76±246.30ng/ml)were significantly different(P<0.05),and SF level in each group increased in turn.The levels of VitB12,LDH and ?-HBDH in RAEB-1 group(467.63±90.95 pmol/L,265.00±633.92U/L,221.75±34.73U/L)and RAEB-2(401.82±80.14pmol/L,288.80±76.46U/L,255.00±35.17U/L)group were notably higher than those in RA,RABs group(325.72±50.75pmol/L,246.00±46.25U/L,205.75±44.01U/L)and RCMD group(371.98±60.32pmol/L,228.71±33.27 U/L,210.00±49.44 U/L).Conclusion 1.Hb,MCV,MCH and RDW in the parameters of erythrocyte can reflect the morphological changes of red blood system,abnormal hematopoiesis and anemia in MDS.The elevation of MCV,MCH and RDW in MDS is significantly higher than that in the normal group,and is significantly different from that in MA group,AA group and IDA group,which provides an important laboratory basis for the differential diagnosis of MDS.2.There was no significance of erythrocyte parameters for MDS typing,and Hb,MCV and MCH in erythrocyte parameters had certain significance for prognosis evaluation of newly diagnosed MDS patients.3.The serum levels of SF,FA,VitB12,LDH and ?-HBDH in MDS patients were higher than those in the normal group,and were significantly higher in RAEB-1 and RAEB-2 groups with more primordial cells.The combined detection is helpful for the judgment of MDS patients and provides an effective laboratory basis for clinical practice.But they have no clinical significance for the prognosis evaluation of MDS patients.Figure 3;Table 10;Reference 105... |
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