Application value of blood routine detection combined with capillary hemoglobin electrophoresis in differential diagnosis between iron deficiency anemia and mild type beta-Thalassemia

doi:10.3969/j.issn.1002-7386.2018.05.009

Abstract：Objective To investigate the application value of blood routine detection combined with capillary hemoglobin electrophoresis in differential diagnosis between iron deficiency anemia and mild type beta-Thalassemia.Methods Twenty-six pregnant women with mild β-thalassemia were enrolled as β-thalassemia group,and the other 83 patients with iron deficiency anemia (IDA) were enrolled as IDA group,meanwhile, 60 healthy pregnant women were served as normal control group.The broutine test,iron metabolism and capillary hemoglobin electrophoresis were observed and compared among the three groups.Results The levels of Hb,MCV and MCH in IDA group were obviously lower than those in normal control group,however,the levels of RDW were significantly higher than those in normal control group(P<0.05). The levels of Hb, MCV and MCH inβ-thalassemia group were significantly lower than those in normal control group (P<0.05),however,there were no significant differences in the levels of RDW betweenβ-thalassemia group and normal control group (P>0.05). The levels of Hb in β-thalassemia group were obviously higher than those in IDA group,however,the levels of MCV, MCH and RDW were significantly lower than those in IDA group (P <0.05).As compared with those in normal control group, the serum levels of ferritin and iron in IDA group were significantly decreased,but the total iron binding capacity was significantly increased (P<0.05). As compared with those in IDA group, the levels of serum ferritin were significantly increased in β-thalassemia group (P<0.05),however,there were no significant differences in serum iron and total iron binding capacity between the two groups (P>0.05). As compared with those in normal control group,the levels of HbA1c in IDA group were increased,but the levels of HbA2 were significantly decreased (P<0.05). Moreover the levels of HbA1c in β-thalassemia group were obviously lower than those in normal control group,however,the levels of HbA2 were significantly higher than those in normal control group (P<0.05).As compared with those in IDA group, the levels HbA1c were decreased and levels of HbA2 were significantly increased in β-thalassemia group(P<0.05).There were significant differnces in the levels of MCH,MCV,RDW and HbA2 betweenβ-thalassemia group and IDA group (P<0.05). The sensitivity of differential diagnosis of RDW was the highest among the four indexes (P<0.05),but specificity and accuracy were the worst among the four indexes (P<0.05).The sensitivity,specificity and accuracy of combined detection of MCH + MCV + HbA2 were higher,which were 93.66%,98.71%,96.54%,respectively.Conclusion The MCH, MCV and HbA have important reference value in differential diagnosis between iron deficiency anemia and mild type beta-Thalassemia in pregnant women,moreover, the combined detection of multiple indexes is of great significance.