Abstract: Objective To evaluate the clinical significance of different hematology parameters on microcytic anemia patients. Methods Blood samples from patients in PUMCH with different microcytic anemia from October 2017 to September 2018 were tested for routine blood tests, cellular hemoglobin of reticulocytes (CHr), serum ferritin (SF), soluble transferrin receptor (sTfR), hepcidin and other iron metabolism parameters. Data from different diseases were analyzed and compared. Results Twenty-six iron deficiency anemia (IDA), 12 anemia of chronic disease (ACD), 12 thalassemia (TA), 12 refractory anemia with ring sideroblast (RARS) and 17 normal controls (NC) were tested. The level of MCV (mean corpuscular volume) in IDA and TA group were lower than that of control(P＜0.01). MCV level in TA group was even lower than that in IDA. The concentrations of mean corpuscular hemoglobin concentration(MCHC) in ACD, IDA, TA, RARS groups were lower than that in NC (P＜0.01), among which IDA had the lowest level. All types of anemia, except RARS, had higher level of reticulocyte counts than NC(P＜0.01), among them, TA group had the highest level. The level of CHr in ACD, IDA and TA groups was lower than that of NC(P＜0.01). SF concentration in IDA group was significantly lower than NC (P＜0.01), and was also lower than other 3 groups. ACD and RARS had higher concentrations of SF than NC(P＜0.01). As for the levels of transferrin saturation (TS), ACD, IDA, and TA groups were lower than NC (P＜0.01), while RARS was significantly higher than NC(P＜0.01) and also higher than the other 3 types of anemia. The level of sTfR and sTfR index(sTfR/log SF) in IDA group was significant higher than that in NC(P＜0.01), also higher than ACD, TA and RARS groups.ROC curve showed that SF and sTfR index facilitated differentiating IDA from other types of microcytic anemia. Conclusions Routine tests and iron metabolism related parameters from the peripheral blood tests may support the preliminary identification of different kinds of microcytic anemia and further differential diagnosis.

Key words: microcytic anemia, routine test, iron metabolism parameters, differential diagnosis