轻型β地中海贫血合并缺铁性贫血与单纯缺铁性贫血孕妇补铁治疗前后铁代谢参数变化的特点  

Characteristics of iron metabolism parameters after iron supplementation in pregnant women with beta thalassemia minor combined with IDA and those with simple IDA

作　　者：陈年坤 李仲均[3] 黄莺莺[1] 肖超群[1] 沈歆旸 潘淑敏 谢利嘉 黄镇钦 王志坚[1] CHEN Niankun;LI Zhongjun;HUANG Yingying;XIAO Chaoqun;SHEN Xinyang;PAN Shumin;XIE Lijia;HUANG Zhenqin;WANG Zhijian(不详;Depart-ment of Obstetrics and Gynecology,Nanfang Hospital of Southern Medical University,Guangzhou 510445,China;Department of Obstetrics and Gynecology,The Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518107,China)

机构地区：[1]南方医科大学南方医院妇产科,广州510445 [2]中山大学附属第七医院妇产科,广东深圳518107 [3]南方医科大学附属东莞人民医院妇产科,广东东莞523059

出　　处：《实用医学杂志》2022年第3期340-343,共4页The Journal of Practical Medicine

基　　金：广东省自然科学基金项目(编号:2015A030313307)。

摘　　要：目的探讨轻型β地中海贫血(简称地贫)合并缺铁性贫血孕妇与单纯缺铁性贫血孕妇补铁治疗过程中的补铁效果与铁代谢特点的异同以及监测手段。方法纳入定期产检的孕妇214例,其中轻型β地贫合并缺铁性贫血孕妇52例,单纯轻型β地贫孕妇53例,单纯缺铁性贫血孕妇50例,正常孕妇59例。检测血常规参数、铁代谢参数并进行对比分析,其中地贫缺铁孕妇与单纯缺铁孕妇需口服铁剂补铁治疗4周。结果(1)地贫合并缺铁孕妇中可溶性转铁蛋白受体(soluble transferrin receptor,sTfR)含量明显高于单纯地贫孕妇与单纯缺铁孕妇(P<0.05);(2)补铁治疗后,地贫缺铁孕妇与单纯缺铁孕妇中血红蛋白、平均红细胞体积(MCV)及所有铁代谢参数水平均有明显改善(P<0.05);(3)地贫缺铁孕妇补铁治疗后,铁蛋白增长幅度大于单纯缺铁孕妇(P<0.05)。结论轻型地贫孕妇补铁治疗有效且铁过载风险低,结合检测铁蛋白与sTfR有助于准确反映该类孕妇机体铁状况,及时筛查出铁缺乏,对补铁治疗具有临床指导意义。Objective To study the similarities and differences in iron supplementation effect between pregnant women with beta thalassemia minor combined with iron deficiency anemia(IDA)and those with simple IDA,and explore monitoring methods for iron supplementation.Methods A total of 214 pregnant women visiting for regular pregnancy check-ups were enrolled in the study,including 52 cases of beta thalassemia minor combined with IDA,53 cases of simple beta thalassemia minor,50 cases of simple IDA,and 59 cases of healthy pregnant women.Those in the beta thalassemia minor combined with IDA group and the simple IDA group were managed with oral iron supplementation for 4 weeks.The blood parameters and iron metabolism parameters of each pregnant woman were examined and compared across the groups.Results(1)The sTfR content in the beta thalassemia minor combined with IDA group was significantly higher than that in the simple beta thalassemia minor and the simple IDA groups(P<0.05).(2)After iron supplementation,the levels of Hb,MCV and all iron metabolism parameters were significantly improved in the groups of the beta thalassemia minor combined with IDA and the simple IDA(P<0.05).(3)After iron supplementation,the increase of ferritin in the beta thalassemia minor combined with IDA group was significantly greater than that in the simple IDA group(P<0.05).Conclusion Iron supplementation for pregnant women with mild thalassemia is effective,with a lower risk of iron overload.The ferritin and sTfR detections are helpful for accurate understanding of the iron status and timely screening of iron deficiency in those pregnant women.It is meaningful for the clinical guidance for iron supplementation.

关 键 词：轻型β地中海贫血 缺铁性贫血 妊娠 补铁治疗 铁代谢参数 

分 类 号：R714.2[医药卫生—妇产科学]