中国育龄期妇女贫血筛查血红蛋白阈值探讨  

Study on the age-appropriate hemoglobin cut-offs for anemia screening of women of child-bearing age in China

作　　者：吴芹[1] 李娜[1] 王月娇[1] 李剑虹[1] 张巍[1] 刘捷[1] 杨晓光[1] 杨丽琛[1] 

机构地区：[1]中国疾病预防控制中心营养与食品安全所,北京100050

出　　处：《卫生研究》2012年第5期750-753,共4页Journal of Hygiene Research

基　　金：国家自然科学基金面上项目(No.30400351;No.30972483)

摘　　要：目的探讨适用于中国育龄期妇女贫血筛查的血红蛋白(Hb)阈值。方法从2002年中国居民营养与健康监测的资料中按一定的血红蛋白浓度梯度分层随机抽取619名育龄期妇女(20～45岁),运用分层分析的方法,根据其他铁营养状况指标和血红蛋白的相关性以及这些指标随血红蛋白浓度变化的趋势综合判断应用血红蛋白筛查贫血的适宜判定界值。结果 C反应蛋白(CRP)均在正常值范围内(≤8mg/L);血红蛋白与转铁蛋白受体、铁蛋白比值的对数lg(sTfR/SF)呈负相关,与血清铁(SI)、血清铁蛋白的对数(lgSF)和转铁蛋白饱和度TS(%)呈正相关;血红蛋白与其他铁营养状况指标的回归分析中,lgSF和sTfR/SF被纳入了回归方程(回归模型以及系数检验均有统计学意义,P<0.001),是解释血红蛋白浓度变化的两个最佳指标;SF和sTfR/SF两个指标在血红蛋白为110g/L这个拐点处变化最为显著。结论血红蛋白浓度110g/L可作为我国育龄期妇女贫血筛查的相对适宜判定界值。Abstract： Objective To discuss the age-appropriate hemoglobin cut-offs for anemia screening of women of child-bearing age in China. Methods The atlthors selected a stratified random sample of 619 women aged 20-45 which from the 2002 China National Nutrition and Health Survey （CNNHS） in 2002. According to a certain concentration gradient of hemoglobin, stratified analysis was used to define the critical value of hemoglobin according to the correlation between iron nutritional indexes and hemoglobin as well as these indices changes trend in the process of iron deficiency anemia. Results C- Reactive Protein values were all in normal range（≤8mg/L）. Hb concentrations correlated positively with lg （sTfR/SF） and negatively with serum iron , lgSF as well as TS, respectively（P 〈 0.05）. IgSF and sTfR/SF were selected in the regression analysis which were the best indicators to explain Hb. These two indices changed the most significantly at the point of 110 g/L of Hb concentration. Conclusion The age-appropriate cut-off values of Hb in anemia screening might be 110 g/L for women of child-bearing age in China.

关 键 词：血红蛋白阈值 贫血 铁营养状况指标 育龄期妇女 

分 类 号：R151.42[医药卫生—营养与食品卫生学] R556[医药卫生—公共卫生与预防医学]