地中海贫血与缺铁性贫血怎样鉴别 葛晓燕 山西医科大学第二医院 скачать в хорошем качестве

地中海贫血与缺铁性贫血怎样鉴别 葛晓燕 山西医科大学第二医院

地中海贫血与缺铁性贫血怎样鉴别 葛晓燕 山西医科大学第二医院 我想提出这个问题，主要是因为我们做血常规检查的时候，地中海贫血和缺铁性贫血都是表现为小细胞低色素性的贫血，所以才有这个问题，那么地中海贫血和缺铁性贫血，它是有明显的区别的，首先缺铁性贫血的发病人群，主要是育龄的妇女，或者是生长发育期的儿童，而地中海贫血一般都是自幼，都会出现贫血的表现;第二点不同，就是缺铁性贫血的患者，一般是脾脏不大，或者是轻度的肿大，而地中海贫血的患儿，如果是静止型和轻型，脾脏不大或者是轻度肿大，如果是中间型或者是重型，有临床贫血症状的，会有中到重度的脾大，这个是一个鉴别点;第三个如果我们做血液血检查的话，那么缺铁性贫血的患者的铁蛋白、血清铁都是明显减低的，而地中海贫血的患者的铁是不低的，如果是经常输血的话，铁甚至会是增高的，第四个鉴别点就是地中海贫血和缺铁贫血，它的发病机理是不一样的，那么地中海贫血的患者做血红蛋白电泳，可以发现异常的血红蛋白，缺铁性贫血的患者是正常的，此外还可以做基因检测，可以发现地中海贫血的基因突变异常。 How to distinguish thalassemia from iron deficiency anemia I want to raise this question, It's mainly because when we do blood tests, Thalassemia and iron deficiency anemia are small cell and low pigment anemia, That's why we have this problem, So thalassemia and iron deficiency anemia, There are obvious differences, First, the incidence of iron deficiency anemia, Mainly women of childbearing age, Or growing children, And thalassemia is usually from childhood, Will appear anemic performance; The second is different, Iron deficiency anemia, Generally, the spleen is not big, Or a mild swelling, And children with thalassemia, In the case of static and light duty, The spleen is not large or slightly swollen, If it's intermediate or heavy, With clinical anemia symptoms, There will be moderate to severe splenomegaly, This is an identification point; Third, if we do a blood test, So the ferritin and serum iron of the patients with iron deficiency anemia are obviously reduced, Iron is not low in thalassemia patients, If it's a regular transfusion, Iron will even increase, The fourth distinguishing point is thalassemia and iron deficiency anemia, Its pathogenesis is different, So the thalassemia patients do hemoglobin electrophoresis, Abnormal hemoglobin can be found, Iron deficiency anemia is normal, In addition, gene testing can be done, It can be found that the gene mutation of thalassemia is abnormal.