Clinical Study On The Recovery Of Whole Blood Cell Count And Iron Metabolism Index In Patients With Iron Deficiency Anemia Who Have Responded To Treatment

Objective:Dynamically observe the changes of whole blood cell count and iron metabolism indexes and the correlation between them in patients with iron deficiency anemia(IDA)who have responded to treatment;to provide beneficial help for monitoring the curative effect of iron therapy more accurately in the future.Methods:The clinical data and laboratory examination results of 230 patients with iron deficiency anemia who were regularly treated in the outpatient department of Northern Jianfsu People’s Hospital from June 1,2016 to September 1,2020 were collected,including gender,age,complete blood count and iron metabolism index,Another 110 healthy people in the same period were selected as control group.230 IDA patients were followed up for an average of 5 months.The regularity of changes of whole blood cell count and iron metabolism index parameters of patients with iron deficiency anemia after iron treatment and the correlation between them were observed,to evaluate its guiding significance for clinical treatment and curative effect monitoring.Result:1.A total of 230 IDA patients with complete clinical data were enrolled,including52 males and 178 females,with a median age of 44 years(14-93 years);In etiological analysis,menstruation increased(47.19%)、uterine fibroids(9.55%)and chronic gastritis(4.49%)were common in female,while peptic ulcer(28.85%)、hemorrhoids(19.23%)and malignant tumors of digestive tract(9.62%)were common in male;IDA patients are prone to abnormal platelets and leukocytes,with 84 cases(36.52%)of elevated platelets and 52 cases(22.17%)of decreased leukocytes,respectively.2.Changes of whole blood cell count and iron metabolism indexes in IDA patients before and after treatment:2.1Change rule of whole blood cell count:The research of this subject found that,except the white blood cell count(5.54±2.13 *10^9/L vs 5.73±1.71 *10^9/L,P >0.05),the other indexes all changed after treatment,which were as follows: red blood cell count,hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,hematocrit,mean corpuscular hemoglobin concentration after treatment were higher than those before treatment(P<0.05).;The red blood cell distribution width(RDW-CV)and platelet count after treatment were lower than those before treatment(P<0.05).2.2Change rule of iron metabolism indexes:The levels of serum iron and ferritin after treatment were significantly higher than those before treatment(P<0.05);The levels of total iron binding capacity and soluble transferrin receptor after treatment were significantly lower than those before treatment(P<0.05).3.Dynamic observation of changes of whole blood cell count in IDA patients during treatment:3.1Erythrocyte parameters:When the treatment with iron is effective,the order of red blood cell parameters returning to normal is red blood cell,hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,hematocrit,mean corpuscular hemoglobin concentration and red blood cell distribution width.3.2Platelet count in IDA patients with thrombocytosis:The platelet count returned to the normal value within a month and reached the lowest value within two month.After that,the platelet count increased slowly,but the change trend was not obvious and there was no obvious difference.4.Correlation between RDW-CV,platelet parameters and iron metabolism indexes:4.1Correlation between RDW-CV and iron metabolism indexes:There was no significant correlation between RDW-CV and hemoglobin level,mean corpuscular volume and iron metabolism index in healthy control group(P>0.05).In IDA group,RDW-CV was negatively correlated with hemoglobin level,mean corpuscular volume and iron metabolism index(P<0.05).Further multivariate linear regression analysis showed that hemoglobin,transferrin saturation and mean corpuscular volume were independent influencing factors of RDW-CV.4.2Correlation between platelet count and iron metabolism index in IDA patients with thrombocytosis:Platelet count was negatively correlated with serum iron and transferrin saturation(r=-0.469,P<0.05;r=-0.400,P<0.05),there was no obvious correlation between platelet count with ferritin,total iron binding capacity and soluble transferrin receptor(P>0.05),suggesting that the more serious iron deficiency,the higher the platelet count.Conclusion:1.To observe the whole blood cell count and iron metabolism index of IDA patients before and after iron treatment can reflect the precision degree of iron treatment.2.Dynamic follow-up of whole blood cell count of IDA patients during treatment and platelet count of some patients with thrombocytosis at first diagnosis showed that the recovery of red blood cell parameters and platelet count had its own regularity.3.At first diagnosis,RDW-CV and platelet count have their own independent negative correlation factors: the important iron metabolism indexes affecting platelet count are serum iron and transferrin saturation;Important indexes affecting RDW-CV are hemoglobin,transferrin saturation,and mean corpuscular volume.