Abstract:

Objective To discuss the change of reticulocyte hemoglobin （RET-He） level of the anemic patients with different degrees and different types of anemia， and to analyze its auxiliary diagnostic value in microcytic hypochromic anemia. Methods The clinical data of 369 anemic patients and 40 healthy physical examination individuals were collected. The patients were divided into mild anemia group （125 cases）， moderate anemia group （163 cases）， and severe anemia group （81 cases） based on the hemoglobin （Hb） level，and 40 healthy physical examination individuals were regarded as control group. The patients were also divided into macrocytic anemia group （91 cases）， normocytic anemia group （108 cases）， simple microcytic anemia group （23 cases）， and microcytic hypochromic anemia group （147 cases） based on the morphological types of anemia. The red blood cell count， Hb level， blood cell specific volume （HCT）， mean red blood cell volume （MCV）， mean red blood cell Hb level （MCH），mean red blood cell Hb concentration （MCHC）， and RET-He level of the subjects in various groups were detected；the receiver operating characteristic （ROC） curve was drawn to obtain the diagnostic cutoff value for the disease； the area under curve （AUC）， sensitivity， and specificity were calculated. Results Compared with control group， the RET-He levels of the patients in moderate and severe anemia groups were significantly decreased （P<0.01）； compared with mild anemia group， the RET-He levels of the patients in moderate and severe anemia groups were significantly decreased（P<0.01）. The RET-He levels of the patients in macrocytic anemia， normocytic anemia， simple microcytic anemia， and microcytic hypochromic anemia groups showed a decreasing trend （P<0.01）； compared with control group， the RET-He levels of the patients in simple microcytic anemia and microcytic hypochromic anemia groups were significantly decreased （P<0.01）； compared with mild macrocytic anemia group， the RET-He levels of the patients in mild normocytic anemia， mild simple microcytic anemia， and mild microcytic hypochromic anemia groups were significantly decreased （P<0.01）. Compared with mild normocytic anemia group， the RET-He levels of the patients in mild simple microcytic anemia group and mild microcytic hypochromic anemia group were significantly decreased （P<0.01）. Compared with moderate macrocytic anemia group， the RET-He levels of the patients in moderate normocytic anemia group， moderate microcytic anemia group， and moderate microcytic hypochromic anemia group were significantly decreased （P<0.05 or P<0.01）；compared with moderate normocytic anemia group， the RET-He level of the patients in moderate microcytic hypochromic anemia group was significantly decreased （P<0.01）； compared with severe macrocytic anemia group and severe normocytic anemia group， the RET-He level of the patients in severe microcytic hypochromic anemia group was significantly decreased （P<0.01）；compared with moderate simple microcytic anemia group， the RET-He level of the patients in severe simple microcytic anemia group was significantly increased （P<0.01）； compared with mild microcytic hypochromic anemia group， the RET-He levels of the patients in moderate microcytic hypochromic anemia group and severe microcytic hypochromic anemia group were significantly decreased （P<0.01）；compared with moderate microcytic hypochromic anemia group， the RET-He level of the patients in severe microcytic hypochromic anemia was significantly decreased （P<0.01）.The cutoff value of RET-He level for diagnosing microcytic hypochromic anemia was 27.25 pg， and the sensitivity was 91.2%， the specificity was 90.5%， and the AUC was 0.968［95% confidence interval （CI）：0.952—0.984］， suggesting that the RET-He level could make an auxiliary diagnosis for microcytic hypochromic anemia. Conclusion The RET-He level can assist in the diagnosis of anemia with different morphological types and degrees， and has certain clinical application value for the diagnosis of microcytic hypochromic anemia.

Key words: Reticulocyte hemoglobin, Anemia, Hematocrit, Receiver operating characteristic curve, Hemoglobin