妊娠期地中海贫血产妇血清血红蛋白、铁蛋白、转铁蛋白受体水平变化及与母婴结局的关系  

Changes of serum hemoglobin, ferritin and transferrin receptor levels in puerperae with thalassemiaduring pregnancy and their relationship with maternal-infant outcomes

作　　者：苏艳芳[1,2] 毛婧霞 覃政[1,2] SU Yanfang;MAO Jingxia;QIN Zheng(Department of Obstetrics,the First People's Hospital of Nanning,Nanning 500022,Guangxi,China;Department of Laboratory Medicine,the First People's Hospital of Nanning,Nanning 500022,Guangxi,China)

机构地区：[1]南宁市第一人民医院产科,南宁500022 [2]南宁市第一人民医院检验科,南宁500022

出　　处：《中国性科学》2023年第6期66-70,共5页Chinese Journal of Human Sexuality

基　　金：广西壮族自治区卫生健康委员会自筹科研课题(Z20210802)。

摘　　要：目的探究妊娠期地中海贫血产妇血清血红蛋白(Hb)、铁蛋白(SF)、转铁蛋白受体(TfR)水平变化及与母婴结局的关系。方法以2019年1月至2022年1月南宁市第一人民医院收治的204例妊娠期地中海贫血产妇(地贫组)及72例体检产妇(对照组)作为研究对象,采用免疫比浊法检测受试者血清Hb、SF、TfR水平。分析各指标联合检查对病情严重程度的评估价值及与病情程度、不良妊娠结局的关系。结果重度组血清Hb、SF水平低于轻度组、中度组,TfR水平高于轻度组、中度组(P<0.05);中度组血清Hb、SF水平低于轻度组,TfR水平高于轻度组(P<0.05)。联合检查评估地中海贫血严重程度的曲线下面积(AUC)大于血清Hb、SF、TfR水平单独检测(P<0.05)。血清Hb、SF水平与妊娠期地中海贫血严重程度呈负相关,TfR水平与病情严重程度呈正相关(P<0.05)。地中海贫血患者随着妊娠进展,Hb、SF水平呈下降趋势,TFR水平呈上升趋势(P<0.05)。地贫组不良妊娠结局发生率为33.33%;不良妊娠结局组血清Hb、SF水平低于妊娠结局较好组,TfR水平高于妊娠结局较好组(P<0.05)。血清TfR升高是不良妊娠结局发生的危险因素,血清Hb、SF水平升高为保护因素(P<0.05)。结论妊娠期地中海贫血产妇血清Hb、SF、TfR水平变化与孕周及病情严重程度相关,并对病情严重程度具有评估价值,且各指标异常变化可影响患者妊娠结局。Objective To explore the changes of levels of serum hemoglobin(Hb),serum ferritin(SF)and transferrin receptor(TR)in puerperae with thalassemia during pregnancy and their relationship with maternal-infant outcomes.Methods 204 puerperae with thalassemia during pregnancy(thalassemia group)and 72 puerpene who underwent physical examination(control group)fom the First People's Hospital of Nanning from January 2019 to January 2022 were selected as the research subjects.Immunoturbidimetry was used to detect the levels of serum Hb,SF and TR of the subjects.The evaluated value of combined examination of various indicators on the severity of disease and the relationship with disease sevenity and adverse pregnancy outcomes were analyzed.Results Serum Hb and SF levels in sevene group were lower while TfR level was higher compared to mild group and moderate group(P<0.05).The levels of senum Hb and SF were lower while the TR level was higher in moderate group compared to mild group(P<0.05).The area under the curve(AUC)of combined examination in evaluating the severity of thalassemia was higher than that of serum Hb,SF or TfR alone(P<0.05).The levels of serum Hb and SF were negatively correlated with the severity of thalassemia during pregnancy,and the level of TR was positively corelated with the disease severity(P<0.05).With the progression of pregnaney,the Hb and SF levels in patients with thalassemia showed downward trends while'TfR level showed an upward trend(P<0.05).The incidence rate of poor pregnancy outcomes in thalassemia group was 33.33%。The levels of serum Hb and SF in adverse pregnancy outcome group were lower than those in good pregnancy outcome group while the level of TfR was higher than that in good pregnancy outcome group(P<0.05).Increased serum TR was a risk factor for poor pregnancy outcomes,and increased serum Hb and SF levels were protective factors(P<0.05).Conclusions The changes of serum Hb,SF and TfR levels in puerperae with thalassemia during pregnancy are related to the gestational age and disease

关 键 词：妊娠期地中海贫血 血红蛋白 铁蛋白 转铁蛋白受体 血清水平 母婴结局 

分 类 号：R714[医药卫生—妇产科学]