缺铁性贫血患者红细胞内游离原卟啉、血浆铁和转运铁蛋白饱和度检测水平及临床意义  

Detection levels and clinical significance of free erythrocyte protoporphyrin,plasma iron,and transferrin saturation in patients with iron deficiency anemia

作　　者：相莲 李卓[1] 王蓓[2] 高琳 XIANG Lian;LI Zhuo;WANG Bei;GAO Lin(Department of Laboratory Medicine,the First Affiliated Hospital of Xi'an Medical University,Xi'an 710061,Shaanxi,CHINA;Central Laboratory,Xi'an Children's Hospital,Xi'an 710003,Shaanxi,CHINA;Department of Pediatrics,the First Affiliated Hospital of Xi'an Medical University,Xi'an 710061,Shaanxi,CHINA)

机构地区：[1]西安医学院第一附属医院检验科,陕西西安710061 [2]西安市儿童医院中心实验室,陕西西安710003 [3]西安医学院第一附属医院儿科,陕西西安710061

出　　处：《海南医学》2022年第22期2892-2895,共4页Hainan Medical Journal

基　　金：陕西省教育厅专项科研项目(编号:20JK0893)。

摘　　要：目的检测缺铁性贫血(IDA)患者红细胞内游离原卟啉(FEP)、血浆铁和转运铁蛋白饱和度(TSAT)水平,并探讨其临床意义。方法选取2019年12月至2022年1月西安医学院第一附属医院收治的205例IDA患者作为IDA组,另选取同期于我院体检中心体检的健康人群96例作为对照组,同时根据血红蛋白浓度将IDA组患者分为轻度贫血组(n=86)、中度贫血组(n=78)和重度贫血组(n=41),检测IDA组与对照组FEP、血浆铁、TSAT水平和血常规指标[血红蛋白浓度(HB)、红细胞计数(RBC)、平均血红蛋白量(MCH)、平均红细胞体积(MCV)、红细胞分布宽度(RDW)],采用Pearson检验分析IDA组FEP、血浆铁和TSAT水平与血常规指标的相关性,并采用受试者工作曲线(ROC)分析FEP、血浆铁和TSAT检测水平对IDA患者的诊断效能。结果IDA组患者的HB、RBC、MCH、MCV明显低于对照组,RDW明显高于对照组,差异均有统计学意义(P<0.05);IDA组患者的FEP水平明显高于对照组,血浆铁和TSAT水平明显低于对照组,差异均有统计学意义(P<0.05);重度贫血组患者的FEP水平明显高于轻、中度贫血组,血浆铁和TSAT水平明显低于轻、中度贫血组,而中度贫血组患者的FEP水平明显高于轻度贫血组,血浆铁和TSAT水平明显低于轻度贫血组,差异均有统计学意义(P<0.05);经Pearson分析结果显示,IDA患者FEP水平与HB、RBC、MCH、MCV水平呈负相关(P<0.05),与RDW水平呈正相关(P<0.05);血浆铁、TSAT水平与HB、RBC、MCH、MCV水平呈正相关(P<0.05),与RDW水平负相关(P<0.05);经ROC分析结果显示,FEP、血浆铁和TSAT水平单独及联合诊断IDA的曲线下面积(AUC)分别为0.749、0.798和0.890、0.947,三者联合诊断价值最高。结论IDA患者FEP、血浆铁和TSAT水平与患者贫血程度密切相关,可作为IDA早期诊断的参考指标,三者联合诊断的效能较高,可为临床诊断IDA提供新思路。Objective To detect the levels of free erythrocyte protoporphyrin(FEP),plasma iron,and transferrin saturation(TSAT)in patients with iron deficiency anemia(IDA),and explore their clinical significance.Methods A total of 205 patients with IDA treated in the First Affiliated Hospital of Xi'an Medical University between December 2019 and January 2022 were selected as IDA group,and 96 healthy people who underwent physical examination in the Physical Examination Center of the hospital during the same period were enrolled as control group.The patients in IDA group were divided into mild anemia group(n=86),moderate anemia group(n=78),and severe anemia group(n=41)based on the hemoglobin concentration.The levels of FEP,plasma iron,TSAT,and blood routine indicators[hemoglobin concentration(HB),red blood cell count(RBC),mean corpuscular hemoglobin(MCH),mean corpuscular volume(MCV),red blood cell distribution width(RDW)]were detected in IDA group and control group.The correlation between levels of FEP,plasma iron,TSAT,and blood routine indicators in IDA group was analyzed by Pearson test,and receiver operator characteristic curve(ROC)was adopted to analyze the diagnostic efficiency of the detection levels of FEP,plasma iron,and TSAT on patients with IDA.Results The HB,RBC,MCH,and MCV of patients in IDA group were significantly lower than those in control group,while RDW was significantly higher than that in control group(P<0.05).The FEP level in IDA group was significantly higher than that in control group,while plasma iron and TSAT levels were significantly lower than those in control group(P<0.05).The FEP level of patients in severe anemia group was significantly higher,while the levels of plasma iron and TSAT were significantly lower compared to those in mild anemia group and moderate anemia group;the FEP level in moderate anemia group was significantly higher than that in mild anemia group,while plasma iron and TSAT levels were significantly lower than those in mild anemia group(P<0.05).Pearson analysis showed that FEP le

关 键 词：缺铁性贫血 红细胞内游离原卟啉 血浆铁 转运铁蛋白饱和度 贫血 血红蛋白 

分 类 号：R556.3[医药卫生—血液循环系统疾病]