摘要
目的探讨血清铁调素(Hepcidin)-25水平对妊娠期缺铁性贫血诊治的意义及与围产结局的关系。方法选择2011年8月至2013年9月在产科门诊建立分娩档案的孕妇230例为研究对象,其中134例妊娠期缺铁性贫血孕妇为病例组,96例健康孕妇为对照组,测定两组孕妇血清Hepcidin-25水平以及贫血、铁代谢相关指标;分析血清Hepcidin-25水平与围产结局的关系。结果病例组Hepcidin-25水平为(89.69±18.69)ng/ml,低于对照组的(139.87±23.65)ng/ml(P<0.01)。随着缺铁性贫血严重程度的增加(轻度→中度→重度),Hepcidin-25水平逐渐降低[(135.15±22.45)ng/ml→(80.43±13.21)ng/ml→(62.69±10.32)ng/ml],差异有统计学意义(F=216.073,P<0.05)。病例组血红蛋白(Hb)、铁蛋白(Fer)、血清铁(Fe)、红细胞计数(RBC)、红细胞压积(HCT)、叶酸(FA)、网织红细胞计数(RET)、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均血红蛋白浓度(MCHC)低于对照组(P<0.05)。Hepcidin-25与RBC、Hb、HCT、Fer、MCV、MCH、MCHC、FA、Fe、RET呈正相关关系(P<0.05);与转铁蛋白(TRF)、血清转铁蛋白受体(sTfR)呈负相关关系(P<0.05)。低水平的Hepcidin-25、Fer、Fe均为妊娠期妇女发生缺铁性贫血的危险因素(P<0.05);Hepcidin-25低水平组围产不良结局发生率高于Hepcidin-25高水平组(P<0.01);Fer、Hepcidin-25诊断妊娠期缺铁性贫血的灵敏度、特异度和曲线下面积(AUC)相近,皆小于Fe。结论妊娠期缺铁性贫血孕妇血清Hepcidin-25浓度降低,低水平的Hepcidin-25为妊娠期妇女发生缺铁性贫血的危险因素,且与围产不良结局相关;Hepcidin-25诊断妊娠期缺铁性贫血灵敏度、特异度较高。
Objective To investigate the significance of serum Hepcidin-25 level in diagnosis and treatment of iron deficiency anemia during pregnancy and its relationship with perinatal outcome.Methods Out of 230 pregnant women who set up production files in obstetric clinic from August 2011 to September 2013,134 pregnant women with iron deficiency anemia were selected as case group,and 96 healthy pregnant women were served as control group.The serum Hepcidin-25 level and related indexes of anemia and iron metabolism were measured in two groups,and the relationship between serum level of Hepcidin-25 and perinatal outcomes was analyzed.Results The level of Hepcidin-25 in case group was significantly lower than that in control group[(89.69±18.69)ng/ml vs(139.87±23.65)ng/ml,P<0.01].With the increase of the severity of iron deficiency anemia(mild to moderate to severe),the level of Hepcidin-25 gradually decreased [(135.15±22.45)ng/ml to(80.43±13.21)ng/ml to(62.69±10.32)ng/ml],with a statistical difference(F=216.073,P<0.05).The level of hemoglobin(Hb),ferritin(Fer),iron(Fe),red blood cell count(RBC),hematocrit(HCT),folic acid(FA),reticulocyte count(RET),mean corpuscular volume(MCV),mean cellular haemoglobin(MCH) and mean corpuscular hemoglobin concentration(MCHC) in case group was significantly lower than those in control group(P<0.05).Hepcidin-25 level was positively correlated with RBC,Hb,HCT,Fer,MCV,MCH,MCHC,FA,Fe,RET,and was negatively correlated with transferrin(TRF) and serum transferrin receptor(sTfR)(P<0.05).Hepcidin-25,Fer and Fe in low levels were the risk factors of iron deficiency anemia in pregnant women(P<0.05);the rate of adverse perinatal outcome in patients with low level Hepcidin-25 was higher than that in patients with high level Hepcidin-25(P<0.01).In the diagnosis of iron deficiency anemia in pregnancy,the sensitivity specificity and AUC of Fer and Hepcidin-25 were similar and were lower than that of Fe.Conclusions In pregnant women with iron deficiency anemia during pregnancy,the serum concentration of
作者
齐亮
邱辉
付玉
QI Liang;QIU Hui;FU Yu(Department of Obstetrics,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110004,China)
出处
《中国临床研究》
CAS
2019年第11期1471-1475,共5页
Chinese Journal of Clinical Research
关键词
铁调素-25
妊娠期缺铁性贫血
铁代谢
铁蛋白
转铁蛋白
围产结局
Hepcidin-25
Iron-deficiency anemia during pregnancy
Iron metabolism
Ferritin
Transferrin
Perinatal outcome
