Mustafa KAPLAN, Nisbet YILMAZ, Gülsüm ÖZET

Yeni tanı demir eksikliği anemisi olan hastalarda bazal immatür retikulosit fraksiyonu (IRF) düzeyi ve demir tedavisine IRF yanıtının değerlendirilmesi

Amaç: Bu çalışmada immatür retikulosit fraksiyonu (IRF)’nun sağlıklı populasyondaki bazal değerini, demir eksikliği anemisi (DEA) olan hastalarda bazal IRF düzeyini ve oral demir replasman tedavisine IRF yanıtının değerlendirilmesini amaçladık.Gereç ve Yöntem: Bu çalışma Mart 2011-Eylül 2011 tarihleri arasında dahiliye polikliniğine başvuran ve yeni tanı DEA tanısı konulan 100 çalışma hastası ve 103 sağlıklı kontrol grubu ile yapılmıştır. Hastalardan tanı anında tam kan sayımı, retikulosit, IRF parametreleri çalışıldıktan sonra çalışma grubu hastalarına oral demir replasman tedavisi başlanmıştır. 7 gün sonra kontrole çağrılan hastalarda aynı parametreler prospektif olarak tekrar çalışılmıştır. Çalışma için Beckman-Coulter LH750/780 cihazı kullanılmıştır.Sonuçlar: Kontrol grubu ve çalışma grubununun cinsiyet dağılımı benzer olup çalışmaya katılanların ortalama yaşı 44’tü. Çalışma grubunda hastaların tedavi öncesi ortalama IRF değeri kontrol grubundaki hastalara göre düşük bulunmuştur (%0.22±0.05 / %0.24±0.05; p>0.05). 7 günlük tedavi sonrası kontrole çağrılan hastalarda hemoglobin değeri 9.75 ±1.52 g/dl’den 10.8±1.48 g/dl’ ye (p<0.05), IRF değerleri ise %0.22±0.05’ten %0.43±0.39’a yükselmiştir (p<0.05). Alt grup analizlerinde hemoglobin değeri düşük olanlarda, 45 yaşından genç olanlarda ve kadın cinsiyette IRF artışı daha belirgin olmakla beraber istatistiksel olarak anlamlı farklılık bulunmamıştır (p>0.05).Sonuç: Bu çalışmada sağlıklı populasyonda Beckman-Coulter LH750/780 cihazı ile ölçülen bazal IRF değeri %0.24±0.05 olarak bulunmuştur. Yeni tanı DEA olan hastalarda IRF düzeyinin düştüğü ve oral demir replasman tedavisi alan hastalarda IRF’nin retikulosit krizine korele bir şekilde arttığı gösterilmiştir.

Anahtar Kelimeler:

İmmatür retikulosit fraksiyonu, retikulosit, mikrositik anemi

Evaluation of basal immature reticulocyte fraction (IRF) level and IRF response to iron therapy in patients with newly diagnosed iron deficiency anemia

Aim: In this study, we aimed to evaluate the basal value of immature reticulocyte fraction (IRF) in healthy population, the baseline IRF level in patients with iron deficiency anemia (IDA), and the IRF response to oral iron replacement therapy.Material and Method: This study was conducted with 100 study patients diagnosed with IDA and 103 control group patients who were admitted to the internal medicine polyclinic between March 2011 and September 2011. At the time of diagnosis whole blood count, reticulocyte and IRF parameters were studied and then oral iron replacement therapy was started to the study group patients. The same parameters were prospectively restudied after 7 days of follow-up. Beckman-Coulter LH750 / 780 instrument was used for the study.Results: The gender distribution of the control and study group was similar and the average age of the participants was 44. In the study group, the mean pre-treatment IRF value of the patients was found to be lower than the mean IRF value of the control group (0.22 ± 0.05% / 0.24% ± 0.05%; p> 0.05). In patients who were referred for control in the seventh day of treatment, the mean hemoglobin value increased from 9.85 ± 1.52 g / dL to 10.8 ± 1.48 g / dL (p <0.05) and IRF values increased from 0.22 ± 0.05% to 0.43 ± 0.39% (p <0.05). Although the IRF increase was more obvious in patients with low hemoglobin levels, younger age and female sex in subgroup analysis, there was no statistically significant difference between groups.Conclusion: In this study, baseline IRF value of healthy population measured with Beckman-Coulter LH750 / 780 instrument was found 0.24 ± 0.05%. IRF levels decrease in patients with newly diagnosed IDA and increases in correlation with the reticulocyte crisis after oral iron replacement therapy

Keywords:

Immature reticulocyte fraction, reticulocyte, microcytic anemia,

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