铁代谢相关生化指标在缺铁性贫血诊断中的应用  

Application of commonly used indexes of iron metabolism in laboratory in diagnosis of iron deficiency anemia

作　　者：侯立安[1] 徐二木[1] 夏良裕[1] 梁小悦 邱玲[1] 程歆琦[1] HOU Lian;XU Er-mu;XIA Liang-yu(Departmant of Laboratory Mdeicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730 China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院检验科,北京100730

出　　处：《中国实验诊断学》2022年第6期881-886,共6页Chinese Journal of Laboratory Diagnosis

摘　　要：目的 探讨常见的铁代谢指标在缺铁性贫血诊断中的应用价值。方法 选取缺铁性贫血(iron deficiency anemia,IDA)、慢性病贫血(anemia of chronic disease,ACD)和慢性病合并缺铁性贫血(chronic diseases with iron deficiency anemia,CIDA)以及健康对照(heathly,HS)4组标本,同时检测4组标本的常用铁代谢指标:可溶性转铁蛋白受体(soluble transferrin receptor,sTfR)、血清铁蛋白(serum ferritin,SF)、血清铁(serum Iron,SI)、不饱和铁结合力(unsaturated iron binding capacity,UIBC)和转铁蛋白(serum transferring,TRF),进行独立样本非参数检验并做ROC曲线,判断不同指标的诊断价值。结果 4组标本中,缺铁性贫血(IDA)和慢性病合并缺铁性贫血组(CIDA)的sTfR平均含量明显高于其他两组(P<0.05),分别为4.77和3.27mg/L。4个研究组中仅IDA组的SF平均含量低于WHO规定的IDA诊断标准,为5.30μg/L。sTfR/lgSF在ACD和健康对照组差异不明显(P=1.00),机体存在缺铁性贫血时sTfR/SF及sTfR/lgSF的值较高。IDA与ACD和健康对照组比较,各指标的ROC曲线下面积均大于0.9,其中SF、sTfR/SF和sTfR/lgSF的曲线下面积最大,为0.99。结论 研究发现不同的铁代谢指标在缺铁性贫血中有不同程度的改变,SF、sTfR/SF和sTfR/lgSF在缺铁性贫血的诊断中有较大价值。Objective Study on the Application value of Common related Indexes of Iron Metabolism in diagnosis and differential diagnosis of Iron deficiency anemia.Methods Four groups of IDA,ACD,CIDA and healthy control were selected,and the indexes of iron metabolism in the four groups were detected at the same time:soluble transferrin receptor(sTfR),Serum ferritin(SF),serum ferritin(SI),unsaturated iron binding capacity(UIBC)and serum transferring(TRF).The nonparametric test of independent samples and the ROC curve were performed to judge the diagnostic value of different indexes.Results The average content of sTfR in IDA and CIDA was significantly higher than that in the other two groups(P<0.05),which were 4.77and 3.27mg/L,respectively.The average SF content of the IDA group in the four study groups was lower than the WHO-defined IDA diagnostic criteria,which was 5.30μg/L.sTfR/lgSF was not significantly different between ACD and Healthy control(P=1.00),and the values of sTfR/SF and sTfR/lgSF were higher when there was iron deficiency anemia in the body.IDA compared with ACD and healthy controls,the AUC of of each index is greater than 0.9.The AUC of SF、sTfR/SF and sTfR/lgSF is the largest,that is0.99.Conclusion The study found that different iron metabolism related indicators have different degrees of changes in iron deficiency anemia.SF,sTfR/SF and sTfR/lgSF have great value in the diagnosis of IDA.

关 键 词：缺铁性贫血 慢性病贫血 慢性病合并缺铁性贫血 可溶性转铁蛋白受体 铁蛋白 血清铁 

分 类 号：R556.3[医药卫生—血液循环系统疾病]