IRF、Ret-He和IPF等相关参数在三系减低巨幼红细胞性贫血中的动态观察

摘要

目的 通过观察未成熟网织红细胞比率(IRF)、网织红细胞血红蛋白含量(Ret-He)、未成熟血小板比率(IPF)及其他相关参数在三系减低巨幼红细胞性贫血(MA)患者治疗过程中的变化,探索对维生素B12(VitB12)、叶酸(FA)治疗反应的早期指标.方法 用Sysmex XE-5000全自动血细胞分析仪对11例三系减低MA患者治疗过程中IRF、Ret-He、IPF及其相关参数的变化进行了动态观察.结果 三系减低MA患者经VitB12和(或)FA治疗后第3天,IRF、IPF、WBC及Ret首先上升(P<0.01);第4天Ret-He明显下降(P <0.01),PLT明显上升(P<0.01);第5天WBC恢复正常;第6天PLT恢复正常;第7天Ret%达到峰值(P<0.01),HGB明显上升(P<0.01);两周时MCH、MCHC明显下降(P <0.01);4周时MCV明显下降(P <0.01),HGB开始恢复正常;6周后MCV、MCH、MCHC恢复或接近正常.结论 IRF、Ret-He及IPF新型参数联合检测可作为评价三系减低MA患者骨髓生成活性、预示贫血改善的早期指标.%Objective To obtain the early indicators in VitB12 and FA therapy of MA by observing the change of IRF,Ret-He and IPF from patients with MA. Methods IRF,Ret-He,IPF and other indices in 11 patients with MA were obtained from Sysmex XE-500 hematology analyzer during follow-up therapy. Results After the therapy, IRF, IPF, WBC and Ret% significantly increased (P<0. 01) at the 3rd day;Ret-He significantly decreased(P<0. 01) and PLT significantly increased(P<0. 01) at the 4th day; WBC returned to the normal at the 5th day;PLT return to the normal at the 6th day;Ret% reached to the peak at the 7th day,while HGB significantly increased (P<0. 01) ;MCH and MCHC significantly decreased(P<0. 001,P<0. 01) at the 14th day;MCV significantly decreased(P<0. 01)and HGB returned to the normal at the 28th day;MCV,MCH and MCHC all began to return to the normal at the 42th day. Conclusion lRF,Ret-He,IPF and other indices may be the early indicators to evaluate marrow generation activity and improvement of three series decreased megaloblastic anemia.