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诊断缺铁性贫血常用铁参数的临床意义 被引量:18

The clinical significence of common iron parameters in iron deficiency anemia
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摘要 目的:对缺铁性贫血(IDA)常用铁参数:血清铁(SI)、总铁结合力(TIBC)、血清转铁蛋白饱和度(TS)、血清铁蛋白(SF)、血清转铁蛋白受体(sTFR)以及红细胞平均体积(MCV)、红细胞体积分布宽度(RDW)的诊断价值进行评价;确定ELISA法测定SF的最佳临界点。方法:选取同期门诊或住院的贫血患者252例,以骨髓可染铁消失作为诊断缺铁的金标准将其分为IDA组和非IDA组。测定血常规各项参数[红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、MCV、红细胞平均血红蛋白量(MCH)、红细胞平均血红蛋白浓度(MCHC)、RDW]、SI、TIBC、TS、SF、sTFR、骨髓铁染色。用ROC曲线比较各参数优劣及确定最佳临界点。结果:各项铁参数ROC曲线下面积(AUC)分别为:SI 0.54(95%CI:0.36~0.71),TIBC 0.89(95%CI:0.75~1.03),TS 0.68 (95%CI:0.58~0.78),SF 0.87(95%CI:0.77~0.97),sTFR 0.92(95%CI:0.84~1.00),MCV 0.82(95%CI: 0.70~0.94),RDW 0.81(95 % CI:0.68~0.94)。以sTFR的ROC AUC最大,由大到小依次为AUC sTFR> AUC TIBC>AUC SF>AUC MCV>AUC RDW>AUC TS>AUC SI。ELISA法测定SF的最佳临界点为50μg/L,此时的灵敏度为0.85,特异度为0.96。结论:各参数的诊断价值由大到小依次为:sTFR>TIBC>SF> MCV>RDW>TS>SI,以sTFR诊断缺铁的价值最大。②ELISA法测定SF的最佳临界值宜提高至50μg/L。 Objective: To evaluate the clinical significance of iron parameters composed of Serum iron (SI), Total iron-binding capacity (TIBC), Transferrin saturation (TS), Serum ferrin (SF), Soluble transferrin receptor (sTFR), Mean corpuscular volume (MCV) and Erythrocyte hemoglobin distribution width (RDW) in dignosis of Iron deficiency anemia(IDA). To identify the optimal cutoff point of SF measured with ELISA. Method: Two hundred and fifty-two patients with anemia from out-patient clinic or inpatient department entered the study. Based on the iron staining result of bone marrow smear as the gold standard for iron deficiency, patients were classified into two groups: IDA group and Non-IDA group. Iron parameters are SI, TIBC, TS, SF, sTFR, blood routine, bone marrow iron staining, ROC curve were used to evaluate iron parameters and to identify their optimal critical point. Result:The values of area under the curve (AUC) of each iron parameter are as followings: SI 0. 54(95%CI:0. 36 -0. 71), TIBC 0. 89(95%CI:0. 75- 1.03), TS 0. 68(95%CI:0. 58-0. 78), SF 0. 87(95%CI:0. 77-0. 97), sTFR0.92(95%CI:0.84-1.00), MCV0.82(95%CI:0.70-0.94), RDW0.81(95%CI:0.68-0.94). sTFR has the highest value of AUC, and the order from high to low is AUCsTFR, AUCTIBC, AUCSF, AUCMCV, AUCRDW, AUCTS, AUCSI. The optimal critical point of SF assayed with ELISA is 50 ug/L. At that point, the sensitivity is 0. 85 and the specificity is 0. 96. Conclusion:①Among the parameters of SI, TIBC, TS, SF, sTFR, MCV and RDW, sTFR is the best for diagnosis of iron deficiency. The order of diadynamic value of these parameters is sTFR〉TIBC〉SF〉MCV〉RDW〉TS〉SI. ②The optimal critical point of SF assayed with ELISA is 50 ug/L.
出处 《临床血液学杂志》 CAS 2007年第2期99-101,共3页 Journal of Clinical Hematology
关键词 贫血 缺铁性 血清铁 总铁结合力 转铁蛋白饱和度 铁蛋白 转铁蛋白受体 可溶性 平均红细胞体积 红细胞分布宽度 Iron deficiency anemia Serum iron Total iron-binding capacity Transferrin saturation, Serum ferrin, Soluble transferrin receptor Mean corpuscular volume Erythrocyte hemoglobin distribution width
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参考文献7

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二级参考文献9

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