Discrimination formulas for the differential diagnosis of iron deficiency anemia and beta thalassemia trait in Sichuan

doi:10.3969/j.issn.1673-8640.2017.09.011

Abstract

Abstract:

Objective To evaluate discrimination formulas for the differential diagnosis of iron deficiency anemia（IDA） and beta thalassemia trait（β-TT） in Sichuan Zigong. Methods A total of 760 patients from Zigong were enrolled,including 255 cases of β-TT and 505 cases of IDA. Red blood cell（RBC） indices were used to calculate the sensitivities(SEN),specificities(SPE),positive predictive values(PPV),negative predictive values(NPV),and Youden's indices(YI) of 10 discrimination formulas,including Shine and Lal,Green and King,Mentzer,RDWI,Srivastava,Ricerca,England and Fraser,Ehsani,Sirdah and Huber-Herklotz. Receiver operating characteristic（ROC） curve was drawn. Results Mentzer was the most reliable index,as it had the highest YI（80.1%）,the SEN was 97.0%,the SPE was 83.1%,and area under curve（AUC） was 0.971. The YI,SEN,SPE and AUC for RDWI were 72.8%,95.2%,77.6% and 0.961,respectively.Conclusions Mentzer and RDWI can be used for the differential diagnosis fo IDA and β-TT.

Key words: Iron deficiency anemia, Beta thalassemia trait, Discrimination formula

CLC Number:

R446.1

Zigong ZHANG Liangjun, CHEN Zhangxin, ZHONG Huixiu. Discrimination formulas for the differential diagnosis of iron deficiency anemia and beta thalassemia trait in Sichuan[J]. Laboratory Medicine, 2017, 32(9): 796-800.

Figures/Tables 4

References 23

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名称	公式	判定标准
Shine and Lal 公式^[6]	MCV×MCV×MCH/100	β-TT<1 530 IDA >1 530
Green and King 公式^[7]	MCV×MCV×RDW／ Hb×l00	β-TT<72 IDA >72
Mentzer公式^[8]	MCV／RBC	β-TT<13 IDA >13
RDWI公式^[9]	MCV×RDW／RBC	β-TT<220 IDA >220
Srivastava公式^[10]	MCH／RBC	β-TT<3.8 IDA >3.8
Ricerca公式^[11]	RDW／RBC	β-TT<4.4 IDA >4.4
England and Fraser公式^[12]	MCV-5×Hb-RBC	β-TT<0 IDA >0
Ehsani公式^[13]	MCV-10×RBC	β-TT<15 IDA >15
Sirdah公式^[14]	MCV-RBC-3×Hb	β-TT<27 IDA >27
Huber-Herklotz 公式^[15]	MCH×RDW×0.1/ RBC+RDW	β-TT <21 IDA >21

名称	公式	判定标准
Shine and Lal 公式^[6]	MCV×MCV×MCH/100	β-TT<1 530 IDA >1 530
Green and King 公式^[7]	MCV×MCV×RDW／ Hb×l00	β-TT<72 IDA >72
Mentzer公式^[8]	MCV／RBC	β-TT<13 IDA >13
RDWI公式^[9]	MCV×RDW／RBC	β-TT<220 IDA >220
Srivastava公式^[10]	MCH／RBC	β-TT<3.8 IDA >3.8
Ricerca公式^[11]	RDW／RBC	β-TT<4.4 IDA >4.4
England and Fraser公式^[12]	MCV-5×Hb-RBC	β-TT<0 IDA >0
Ehsani公式^[13]	MCV-10×RBC	β-TT<15 IDA >15
Sirdah公式^[14]	MCV-RBC-3×Hb	β-TT<27 IDA >27
Huber-Herklotz 公式^[15]	MCH×RDW×0.1/ RBC+RDW	β-TT <21 IDA >21

组别	例数	RBC（×10¹²/L）	Hb（g/L）	HCT（%）	MCV（fL）	MCH（pg）	MCHC（g/L）	RDW（%）
IDA组	505	3.50±0.95	8.03±2.74	26.67±7.37	75.05±5.93	22.64±4.57	291.64±24.13	18.40±3.22
β-TT组	255	5.94±0.78	10.58±1.72	40.98±5.31	68.91±3.68	21.18±1.45	306.71±11.62	16.76±1.55
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	RBC（×10¹²/L）	Hb（g/L）	HCT（%）	MCV（fL）	MCH（pg）	MCHC（g/L）	RDW（%）
IDA组	505	3.50±0.95	8.03±2.74	26.67±7.37	75.05±5.93	22.64±4.57	291.64±24.13	18.40±3.22
β-TT组	255	5.94±0.78	10.58±1.72	40.98±5.31	68.91±3.68	21.18±1.45	306.71±11.62	16.76±1.55
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

公式	SEN（%）	SPE（%）	PPV（%）	NPV（%）	YI（%）	AUC
Shine and Lal
IDA	38.4	100.0	100.0	45.0	38.4	0.677
β-TT	100.0	38.4	45.0	100.0	38.4	0.677
Green and King
IDA	97.4	67.1	85.4	92.9	64.5	0.958
β-TT	67.1	97.4	92.9	85.4	64.5	0.958
Mentzer
IDA	97.0	83.1	91.9	93.3	80.1	0.971
β-TT	83.1	97.0	93.3	91.9	80.1	0.971
RDWI
IDA	95.2	77.6	89.4	89.1	72.8	0.961
β-TT	77.6	95.2	89.1	89.4	72.8	0.961
Srivastava
IDA	92.9	69.0	85.6	83.1	61.9	0.935
β-TT	69.0	92.9	83.1	85.6	61.9	0.935
Ricerca
IDA	72.5	98.0	98.6	64.3	70.5	0.953
β-TT	98.0	72.5	64.3	98.6	70.5	0.953
England and Fraser
IDA	98.4	50.2	79.6	94.1	48.6	0.965
β-TT	50.2	98.4	94.1	79.6	48.6	0.965
Ehsani
IDA	95.4	74.9	88.3	89.2	70.3	0.955
β-TT	74.9	95.4	89.2	88.3	70.3	0.955
Sirdah
IDA	97.8	65.9	85.0	93.8	63.9	0.962
β-TT	65.9	97.8	93.8	85.0	63.9	0.962
Huber-Herklotz
IDA	97.0	19.2	70.4	76.4	16.2	0.908
β-TT	19.2	97.0	76.4	70.4	16.2	0.908