Abstract:

Objective To investigate the clinical application role of reticulocyte hemoglobin content（Ret-He）in children with thalassemia. Methods From March 2018 to September 2024，300 children without iron deficiency thalassemia（TT0 group）[104 cases of α-thalassemia（A0 group），188 cases of β-thalassemia（B0 group）and 8 cases of α-+β-thalassemia]，110 children with iron deficiency thalassemia （TT1 group） [40 cases of α-thalassemia（A1 group）and 70 cases of β-thalassemia（B1 group）]，90 children with iron deficiency anemia（IDA）（IDA group）and 80 healthy subjects（control group）were enrolled from the Third Hospital of Mianyang. The data on thalassemia genotypes and red blood cell（RBC）count，hemoglobin（Hb），mean corpuscular volume（MCV），mean corpuscular hemoglobin（MCH），mean corpuscular hemoglobin concentration（MCHC），the percentages of reticulocytes（RET%），Ret-He and serum ferritin（SF）determination results were collected. The differences in related indicators among the groups were compared. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of Ret-He in diagnosing thalassemia in children and differentiating thalassemia with iron deficiency. Results Among the 410 children with thalassemia，the determination rates of α-，β- and α-+β-thalassemia were 37.56%，60.49% and 1.95%，respectively，and the main types of α- and β-thalassemia were --SEA（70.78%）and CD17（35.08%），respectively. The levels of Hb，MCV，MCH，MCHC，Ret-He and SF in TT0 group，TT1 group and IDA group were lower than those in control group，while RBC count and RET% were higher than those in control group（P<0.05）. The levels of RBC count，Hb and MCHC in TT0 group and TT1 group were higher than those in IDA group，while MCV，MCH and Ret-He were lower than those in IDA group（P<0.05）. The levels of Hb，MCV，MCH and MCHC in A0 group were higher than those in B0 group and B1 group，and the levels of MCV，MCH and MCHC in A0 group were higher than those in A1 group. The levels of MCHC in A1 and B1 groups were lower than that in B0 group（P<0.05）. The optimal cut-off values of Ret-He for diagnosing thalassemia in children and differentiating IDA from thalassemia with iron deficiency were 28.1 pg and 24.4 pg，respectively，with the sensitivities of 84.9% and 80.0%，the specificities of 81.2% and 70.0%，and the areas under curves（AUC）of 0.873 and 0.744，respectively. Conclusions Ret-He can be used as a screening indicator for thalassemia in children，and it also plays a role in differentiating IDA from thalassemia with iron deficiency in children.

Key words: Reticulocyte hemoglobin content, Thalassemia, Iron deficiency anemia, Children