贫血红细胞

1.3 统计方法 各标本RDW值用(±s)表示，组与组之间结果比较采用t检验。

　　1.2 方法采取患者入院后未经治疗的首次清晨，用美国BD公司生产的EDTA-K2真空采集管采空腹静脉血2.0 ml，门诊体检健康者同样真空采集静脉血，用Sysmex SF-3000全自动血细胞分析仪及原装配套试剂严格按照操作程序测定RDW值，并做好记录。仪器每天用Sysmex全血质控物进行室内质控检测，均在控。
　　1 材料与方法1.1 贫血红细胞 病例来源收集的145例慢性系统疾病性贫血患者均为2003年1月至2005年7月来自我院和当地其他医院的住院病人。其中肝性贫血患者45例，男28例，女17例；年龄30岁~70岁；肾性贫血患者45例，男26例，女19例；年龄29岁~80岁；糖尿病贫血患者55例，男29例，女26例；年龄36岁~80岁；另有45例门诊体检健康者作为正常对照，男25例，女20例；年龄30岁~65岁。所有病例血清铁蛋白检测结果均在正常范围内，排除缺铁性贫血的存在。对慢性系统疾病性贫血程度分为轻、中和重度。
　　Key words：Anemia of chronic systemic disease；Hepatic anemia；Renal anemia；Diabetic anemia；Red cell distribution width(RDW)慢性系统疾病性贫血临床上较为常见，包括肝病、肾病、内分泌疾病引起的贫血，以往与慢性病贫血(anemia of chronic disease，ACD)一起统称为ACD。目前认为ACD不再包括此类疾病引起的贫血，而另称为慢性系统疾病性贫血［1］，红细胞分布宽度(red blood cell distribution width，RDW)是反映红细胞不均一性的客观指标，也是反映红细胞体积异质性的一个重要参数［2］。上述慢性系统疾病性贫血RDW是否存在差异的研究报道甚少［3］。本文通过对肝性贫血、肾性贫血、糖尿病性贫血三种疾病RDW的比较，旨在探讨三者RDW的差异及其临床实验室辅助诊断价值。
　　［关键词］ 慢性系统疾病性贫血；肝性贫血；肾性贫血；糖尿病性贫血；红细胞分布宽度To Analyse Red Blood Cell Distribution Width of Anemia of Chronic Systemic DiseaseAbstract：Objective To explore the differences of red cell distribution width(RDW)among patients with anemia of chronic systemic disease involving hepatic anemia，renal anemia and diabetic anemia，and to determine the diagnosis value of RDW.Methods RDW values of 45 hepatic anemia，45 renal anemia and 55 diabetic anemia patients were measured by Sysmex SF3000 hemocyte analyzer and were compared with each other.45 healthy examiners were used as normal controls.Results The RDW values of hepatic anemia and renal anemia patients were obviously higher than those of normal controls(P＜0.01，P＜0.05 respectively)，but the RDW values of diabetic anemia patients had not significant difference with those of normal controls(P＞0.05).No significant differences could be found in the RDW values between male and female patients with the three different kinds of anemia(P＞0.05).The RDW values of patients with mild hepatic anemia or diabetic anemia were significantly lower than those of the patients with moderate and severe patients(P＜0.01，P＜0.05).Conclusion Detection of RDW value appeared a certain reference value to clinically identify the three different types of anemia of chronic systemic disease.For the patients with moderate diabetic anemia or above，RDW value determination was clinically significant.

　　慢性系统疾病性贫血红细胞分布宽度分析关键词】 慢性系统疾病性贫血红细胞［摘 要］ 目的：了解慢性系统疾病性贫血中肝性贫血、肾性贫血、糖尿病性贫血患者的红细胞分布宽度(RDW)的差异，探讨RDW的临床实验室辅助鉴别诊断价值。方法：用Sysmex SF-3000全自动血细胞分析仪测定45例肝性贫血、45例肾性贫血和55例糖尿病性贫血患者的RDW值，比较三者RDW值的差异。同时设置45例门诊体检健康者作为正常对照。结果：肝性贫血患者的RDW值较正常对照组明显升高(P＜0.01)，肾性贫血患者的RDW值也较正常对照组高(P＜0.05)，糖尿病性贫血患者的RDW值与正常对照组差异无显着性(P＞0.05)。不同慢性系统疾病性贫血男、女患者之间RDW值差异均无显着性(P＞0.05)。中重度肝性贫血和糖尿病贫血患者RDW值高于轻度患者(P＜0.01，P＜0.05)。结论：RDW值的测定对临床鉴别此三种不同类别慢性系统疾病性贫血有一定的参考价值，对中度贫血以上糖尿病患者测定RDW值有临床意义。