转铁蛋白饱和度联合铁调素对小儿缺铁性贫血的诊断效能研究  

Diagnostic efficiency of transferrin saturation combined with hepcidin in children with iron deficiency anemia

作　　者：谭永红[1] 余洽超[1] 余剑佩[1] 方艳莹 TAN Yong-hong(Department of Pediatrics,Kaiping central hospital,Kaiping,Guangdong,529300,China)

机构地区：[1]开平市中心医院内儿科,广东开平529300

出　　处：《齐齐哈尔医学院学报》2020年第24期3088-3091,共4页Journal of Qiqihar Medical University

摘　　要：目的分析转铁蛋白饱和度(TS)联合铁调素(Hepc)对小儿缺铁性贫血(IDA)的诊断效能。方法选择2017年1月—2019年9月本院接诊的166例缺铁性贫血(IDA)患儿作为研究对象,根据骨髓铁染色是否消失分为IDA组(86例)和非IDA组(80例)两组。比较两组患儿铁参数、红细胞参数检测结果及血清TS、Hepc水平,分别进行多因素和相关性分析,使用受试者工作特征曲线(ROC)下面积(AUC)评价转铁蛋白饱和度联合铁调素对小儿IDA的诊断效能,获取最佳诊断截值。结果IDA组患儿总铁结合力(TIBC)、转铁蛋白受体(sTFR)、红细胞体积分布宽度(RDW)水平均明显高于非IDA组,血清铁(SI)、转铁蛋白饱和度(TS)、铁蛋白(SF)、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、铁调素(Hepc)水平均明显低于非IDA组,差异均有统计学意义(P<0.05);多因素分析显示,SI、TIBC、TS、MCHC、SF、Hepc均是IDA组患儿独立影响因素(P<0.05);IDA组患儿TIBC与TS及Hepc均呈负相关(P<0.05),SI、MCHC、SF均与TS及Hepc呈正相关(P<0.05);ROC分析显示,TS和Hepc预测小儿IDA的最佳截值分别为12.92%、58.97ng/mL,联合诊断的灵敏度和特异度均较单一指标提高,AUC为0.914明显大于TS的0.638和Hepc的0.701,差异均有统计学意义(P<0.05)。结论IDA组患儿血清TS及Hepc水平降低均可能与铁代谢稳态失衡有关,两者联合诊断的效能较高,在临床诊治中应予以重视。Objective To analyze the diagnostic efficiency of transferrin saturation(TS)combined with hepcidin(Hepc)in children with iron deficiency anemia(IDA).Methods A total of 166 children with IDA who were admitted to our hospital from January 2017 to September 2019 were selected as the research subjects,according to whether the bone marrow iron staining disappeared,they were divided into IDA group(86 cases)and non-IDA group(80 cases).Test results of iron parameters,erythrocyte parameters,serum TS and Hepc levels in the two groups were analyzed by multiple factors analysis and correlation analysis,the area under the receiver operating characteristic curve(ROC)was used to evaluatethe diagnosis efficiency of pediatric IDA of transferrin saturation combined with hepcidin,in order to obtain the best diagnostic cutoff value.Results The levels of total iron binding(TIBC),serum transferrin receptor(sTFR),and red blood cell volume distribution(RDW)in the IDA group were significantly higher than those in the non-IDA group,serum iron(SI),TS,serum ferritin(SF);the average red blood cell volume(MCV),average red blood cell hemoglobin content(MCH),average red blood cell hemoglobin concentration(MCHC),and Hepc levels were significantly lower than those in the non-IDA group(P<0.05).Multivariate analysis showed that SI,TIBC,TS,MCHC,SF,and Hepc were independent influencing factors of IDA in children(P<0.001).TIBC was negatively correlated with TS and Hepc in children with IDA(P<0.05).SI,MCHC and SF were positively correlated with TS and Hepc(P<0.05).ROC analysis showed that the best cutoff valuesof TS and Hepc for pediatric IDA were 12.92% and 58.97 ng/mL,the sensitivity and specificity of the combined diagnosis were higher than a single indicator,the AUC was 0.914,which was significantly higher than the 0.638 of TS and 0.701 of Hepc(P<0.05).Conclusions The decrease of serum TS and Hepc levels in children with IDA may be related to the imbalance of iron metabolism homeostasis,the combined diagnosis of these two indicators have higher eff

关 键 词：缺铁性贫血 转铁蛋白饱和度 铁调素 诊断效能 

分 类 号：R725.5[医药卫生—儿科]