摘要
目的探讨血清铁调素、平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)等红细胞参数在不同严重程度缺铁性贫血(IDA)患者中的差异及与疾病严重程度的相关性。方法回顾性分析2021年10月—2023年3月新疆维吾尔自治区妇幼保健院内科诊治的IDA患者102例的临床资料。根据患者病情严重程度分为轻中度IDA组(n=64)和重度IDA组(n=38)。收集2组临床资料,检测并比较血清铁调素、血清铁蛋白(SF)及总铁结合力(TIBC)等铁代谢指标;MCV、MCH及红细胞分布宽度(RDW)等红细胞参数;网织红细胞(RET)计数、RET百分比及RET血红蛋白含量(RET-He)等网织红细胞参数。分析不同预后患者间各指标的差异,通过Spearman相关性分析及多因素Logistic回归分析筛选IDA患者病情严重的危险因素。结果重度IDA组患者的血清铁调素、SF、MCV、MCH、RET百分比及RET-He均低于轻中度IDA组患者(t/P=5.091/<0.001,5.513/<0.001,3.191/0.002,5.338/<0.001,5.244/<0.001,5.745/<0.001),血清TIBC水平、RDW、RET计数均高于轻中度IDA组患者(t/P=4.215/<0.001,5.770/<0.001,3.874/<0.001);IDA患者严重程度与患者血清TIBC、RDW及RET计数呈正相关(r/P=0.390/<0.001,0.496/<0.001,0.386/<0.001),与血清铁调素、SF、MCV、MCH、RET百分比及RET-He呈负相关(r/P=-0.477/<0.001,-0.506/<0.001,-0.302/0.002,-0.475/<0.001,-0.466/<0.001,-0.500/<0.001);多因素Logistic回归分析表明,IDA患者铁调素升高、MCH水平升高均是病情严重的保护因素[OR(95%CI)=0.780(0.631~0.965),0.556(0.328~0.941)]。结论不同严重程度的IDA患者铁代谢、红细胞参数及网织红细胞参数存在较大差异,其中铁调素、MCH水平降低可能提示IDA患者病情较严重,监测相关指标有助于更准确地评估IDA患者病情。
Objective To explore the difference of erythrocyte parameters such as serum ferritin,mean corpuscular volume(MCV)and mean corpuscular hemoglobin(MCH)in patients with iron deficiency anemia(IDA)and their correlation with disease severity.Methods Clinical data of 102 IDA patients treated in the Internal Medicine Department of Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region from October 2021 to March 2023 were Retrospective analyzed.According to the severity of the disease,the patients were divided into mild to moderate IDA group(n=64)and severe IDA group(n=38).The general clinical data,iron metabolism indexes such as ferritin,serum ferritin(SF)and total iron binding capacity(TIBC),erythrocyte parameters such as mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH)and erythrocyte distribution width(RDW),reticulocyte(RET)count,RET percentage and hemoglobin content of reticulocyte(RET-He)were compared between the two groups.The differences of various indexes among patients with different prognosis were analyzed,and the risk factors of serious condition in IDA patients were screened by Spearman correlation analysis and multivariate Logistic regression analysis.Results Serum ferritin,SF,MCV,MCH,RET percentage and RET-He in severe IDA group were significantly lower than those in mild to moderate IDA group(t/P=5.091/<0.001,5.513/<0.001,3.191/0.002,5.338/<0.001,5.244/<0.001,5.745/<0.001),while serum TIBC level,RDW and RET count were significantly higher than those in mild to moderate IDA group(t/P=4.215/<0.001,5.770/<0.001,3.874/<0.001).The severity of IDA patients was positively correlated with serum TIBC,RDW and RET count,and negatively correlated with serum ferritin(r/P=0.390/<0.001,0.496/<0.001,0.386/<0.001),SF,MCV,MCH,RET percentage and RET-He(r/P=-0.477/<0.001,-0.506/<0.001,-0.302/0.002,-0.475/<0.001,-0.466/<0.001,-0.500/<0.001).Multivariate Logistic regr ession analysis showed that the increase of ferritin and the level of MCH in patients with IDA were the protective factors of severe illness[OR(95%CI)=0.780(0.631-0.965),0.556(0.328-0.941)].Conclusi on There are great differences in iron metabolism,erythrocyte parameters and reticulocyte parameters in IDA patients with different severity,in which the decrease of ferritin and MCH levels may indicate that the condition of IDA patients is more serious.Monitoring related indicators will more accurately evaluate the condition of IDA patients and provide a certain guiding value for clinical treatment.
作者
李丽
邓茜
李海荣
孙蕾
鄢萍
Li Li;Deng Qian;Li Hairong;Sun Lei;Yan Ping(Department of Laboratory,Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Province,Urumqi 830000,China;不详)
出处
《疑难病杂志》
CAS
2024年第5期585-589,共5页
Chinese Journal of Difficult and Complicated Cases
基金
新疆维吾尔自治区自然科学基金资助项目(2022D01C608)。
关键词
缺铁性贫血
铁调素
红细胞参数
严重程度
Iron deficiency anemia
Ferritin
Erythrocyte parameters
Severity
