多参数分析在缺铁性贫血和慢性病性贫血鉴别诊断中的应用价值  

Value of multi-parameter analysis in differential diagnosis of iron deficiency anemia and chronic anemia

作　　者：赵宏伟[1] 刘春霞[1] 权学莲[1] ZHAO Hong-wei;LIU Chun-xia;QUAN Xue-lian(Department of Hematology,Langfang People's Hospital,Langfang Hebei 065000,China)

机构地区：[1]廊坊市人民医院血液科,河北廊坊065000

出　　处：《临床和实验医学杂志》2021年第8期876-879,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省重点研发计划指导项目(编号:18ZF264)。

摘　　要：目的研究缺铁性贫血(IDA)和慢性病性贫血(ACD)鉴别诊断中多参数分析方法的应用价值。方法回顾性分析2017年10月至2020年10月廊坊市人民医院收治的70例贫血患者,根据贫血类型分为ACD组(37例)与IDA组(33例);选取同期入院进行体检的35例健康志愿者作为对照组。采用生化与酶联免疫吸附试验法检测铁调素血清(Hepcidin)含量、血清可溶性转铁蛋白受体(sTfR)、肿瘤坏死因子-β(TNF-β)、白细胞介素-6(IL-6)、白细胞介素1(IL-1)、C反应蛋白(CRP)、血清铁蛋白(SF)、转铁蛋白(TF)、总铁结合力(TIBC)、血清铁(SI)水平与sTfR/logSF比值,并分析Hepcidin、sTfR/logSF比值与其他因素相关性;同时比较3组胃窦组织内膜铁转运蛋白表达水平。结果ACD组的Hepcidin、CRP、SF、SI水平明显高于IDA组,TF、TIBC水平与sTfR/logSF明显低于IDA组,差异均有统计学意义(P<0.05);ACD组Hepcidin、sTfR、TNF-β、IL-6、IL-1、CRP、SF水平与sTfR/logSF比值明显高于对照组,TF、TIBC、SI水平明显低于对照组,差异均有统计学意义(P<0.05);IDA组的sTfR、TNF-β、IL-6、IL-1、CRP、TF、TIBC水平与sTfR/logSF比值明显高于对照组,Hepcidin、SF、SI水平明显低于对照组,差异均有统计学意义(P<0.05)。sTfR/logSF比值与TRF、TIBC呈正相关,与SI呈负相关(P<0.05);Hepcidin与SI呈负相关,与TNF-β、IL-6呈正相关,且Hepcidin与sTfR/logSF比值呈正相关(P<0.05)。与对照组比较,IDA组膜铁转运蛋白水平呈高表达,而ACD组膜铁转运蛋白水平呈低表达,差异均有统计学意义(P<0.05)。结论多参数分析方法可为IDA和ACD的鉴别诊断提供重要依据。Objective To study the application value of the multi-parameter analysis method in the differential diagnosis of Iron deficiency anemia(IDA)and chronic disease(ACD).Methods From October 2017 to October 2020,70 patients with anemia admitted to Langfang City People's Hospital were retrospectively analyzed and divided into ACD group(37 cases)and IDA group(33 cases)according to the type of anemia.At the same time,35 healthy volunteers who were admitted to Langfang City People's Hospital for physical examination during the same period were selected as the control group.Hepcidin serum(Hepcidin)content,serum soluble transferrin receptor(sTfR),and tumor necrosis factor-β(TNF-β),interleukin-6(IL-6),interleukin-1(IL-1),C-reactive protein(CRP),serum ferritin(SF),transferrin(TF),total iron binding capacity(TIBC),serum iron(SI)level and sTfR/logSF ratio,and the correlation between Hepcidin,sTfR/logSF ratio and other factors were detected by biochemical and enzyme-linked immunosorbent assays in the three groups.Results The levels of Hepcidin,CRP,SF,and SI in the ACD group were significantly higher than those in the IDA group,and the levels of TF,TIBC and sTfR/logSF were significantly lower than those in the IDA group,with significant differences(P<0.05);Hepcidin,sTfR,and TNF-β,IL-6,IL-1,CRP,SF levels and sTfR/logSF ratio in the ACD group were significantly higher than those in the control group,TF,TIBC,SI levels were significantly lower than those in the control group,the differences were significant(P<0.05);IDA group's levels of sTfR,TNF-β,IL-6,IL-1,CRP,TF,TIBC and the ratio of sTfR/logSF were significantly higher than those in the control group.The levels of Hepcidin,SF,and SI were significantly lower than those of the control group,and the differences were significant(P<0.05).The sTfR/logSF ratio was positively correlated with TRF and TIBC,and negatively correlated with SI(P<0.05);Hepcidin was negatively correlated with SI,and positively correlated with TNF-βand IL-6,and Hepcidin was correlated with sTfR/logSF ratio(P<

关 键 词：缺铁性贫血 慢性病性贫血 多参数分析 诊断价值 

分 类 号：R556[医药卫生—血液循环系统疾病] R446.1[医药卫生—内科学]