引言缺铁性贫血和β-地中海贫血性状是小细胞低色素性贫血的两个常见且重要的区别。自1973年以来,使用两个或更多个常见的全血细胞计数(CBC)参数的各种区分指数已用于区分这两者。最近,一个新的判别指数,CRUISE指数,是在2019年提出的。对我们地理区域的患者评估了各种旧指标以及CRUISE指数的疗效。材料和方法我们是以实验室为基础的,横断面研究,其中100名患者,根据纳入和排除标准,对小细胞性低色素性贫血患者的CBC参数以及血清铁蛋白和血红蛋白-高效液相色谱(HbHPLC)进行了评估。共有八个歧视指数,Mentzer,Srivastava,Shine&Lal,绿色与国王,RDWI,英格兰&弗雷泽,使用KermanI和CRUISE指数,并使用不同的统计参数评估其诊断功效。获得了ROC曲线,并为我们的种群提出了新的临界值。使用MicrosoftExcel(Microsoft®Corp.,雷德蒙德,WA,美国)和SPSSv29.0.2.0(20)(IBM公司,Armonk,NY,美国)。结果100例患者中,β-地中海贫血性状39例,缺铁性贫血61例。平均年龄为36.7(±12.7SD)岁。在73名女性中,43例诊断为缺铁性贫血(IDA),30例诊断为β-地中海贫血(BTT)。在27名男性中,18例诊断为IDA,9例诊断为BTT。IDA患者的平均红细胞体积(MCV)的平均值显着降低(p=.008),平均红细胞血红蛋白(MCH)(p=0.003),和平均红细胞血红蛋白浓度(MCHC)(p=.003),并且红细胞分布宽度(RDW)(p=.020)明显更高。IDA患者的平均铁蛋白水平为7.61(±3.75)mcg/L,BTT患者的平均铁蛋白水平为87.09(±66.77SD)mcg/L。IDA患者的平均HbA2水平为2.75%(±0.41%SD),BTT患者的平均HbA2水平为5.57%(±0.73%SD)。CRUISE指数显示出最高的AUC(0.934),YI(76.21)和准确性(90%),其次是Mentzer指数,诊断准确性为81%。Shine&Lal指数显示AUC最低(0.710),YI(3.28)和准确度(41%)。结论CRUISE指数,这是最近提出的,在AUC方面排名第一,YI,和准确性,在鉴别诊断这两种疾病的敏感性方面被认为是第二好的。Mentzer指数,常用的索引,在我们的研究中,BTT和IDA的诊断准确性也很高。CRUISE指数是一个新颖的指数,需要在其他各种地理设置中进行更多的研究工作,以评估该指数的有效性。
Introduction Iron deficiency anemia and beta-thalassemia trait are two common and important differentials of microcytic hypochromic anemia. Various discrimination indices using two or more common complete blood cell count (CBC) parameters have been used to distinguish between the two since 1973. Recently, a new discriminant index, the CRUISE index, was proposed in the year 2019. The efficacy of various older indices along with the CRUISE index was evaluated for patients in our geographical area. Materials and method Ours was a laboratory-based, cross-sectional study where 100 patients, based on inclusion and exclusion criteria, with microcytic hypochromic anemia were evaluated for CBC parameters along with serum ferritin and hemoglobin-high performance liquid chromatography (Hb HPLC). A total of eight discrimination indices namely, Mentzer, Srivastava, Shine & Lal, Green & King, RDWI, England & Fraser, Kerman I and CRUISE index were used and evaluated for their diagnostic efficacy using different statistical parameters. ROC curves were obtained and a new cut-off value was proposed for our population. Data was analysed using Microsoft Excel (Microsoft® Corp., Redmond, WA, USA) and SPSS v29.0.2.0 (20) (IBM Corp., Armonk, NY, USA). Results Out of the total 100 cases, 39 were beta-thalassemia trait and 61 were iron deficiency anemia cases. The average age was 36.7 (±12.7 SD) years. Among the 73 females, 43 were diagnosed as iron deficiency anemia (IDA) and 30 as beta-thalassemia trait (BTT) cases. Among the 27 males, 18 were diagnosed as IDA and nine as BTT cases. The mean values were significantly lower in IDA patients for mean corpuscular volume (MCV) (p=.008), mean corpuscular haemoglobin (MCH) (p=.003), and mean corpuscular haemoglobin concentration (MCHC) (p=.003) and significantly higher for red cell distribution width (RDW) (p=.020). The mean ferritin levels in cases of IDA were 7.61 (±3.75) mcg/L and in BTT were 87.09 (±66.77 SD) mcg/L. The mean HbA2 levels in IDA cases were 2.75% (±0.41% SD) and BTT cases were 5.57% (±0.73% SD). CRUISE index revealed the highest AUC (0.934), YI (76.21) and accuracy (90%) followed by the Mentzer index with a diagnostic accuracy of 81%. Shine & Lal index revealed the lowest AUC (0.710), YI (3.28) and accuracy (41%). Conclusion CRUISE index, which was recently proposed, was ranked 1st in terms of AUC, YI, and accuracy and was considered 2nd best in terms of sensitivity for differentially diagnosing the two conditions. Mentzer index, a commonly used index, also revealed a high diagnostic accuracy in our study for differentiating BTT from IDA. CRUISE index being a novel index, more research work needs to be carried out in various other geographical setups to evaluate the efficacy of this index.