Serum ferritin and the iron status of Canadians.

Serum ferritin concentration was determined in 1105 Canadians aged 1 to 90 years. Geometric mean values (ng/ml) were as follows: children 1 to 4 years old, 12; children 5 to 9 years old, 15; adolescent girls, 17; adolescent boys, 18; women 20 to 39 years, 23; women 65 years and older, 52; men 20 to 39 years, 93; and men 40 and older, 92. Ranges were side in all age groups, reflecting variations in size of body iron stores. From analysis of the ferritin values it is highly probably that iron stores were greatly reduced in approximately 25% of children, 30% of adolescents, 30% of menstruating women, 60% of pregnant women and 3% of men. Iron-deficiency anemia was noted in only 2% of subjects. If "normality" requires more than small amounts of storage iron to meet physiologic demands, the study results suggest a high probability of iron deficiency in 60% of the pregnant women and in 19% of the other subjects; but if normality is defined as maintenance of adequate iron stores for erythropoiesis, the prevalence of iron deficiency was zero in the pregnant women and 2% in the other subjects.     

血清铁、铁蛋白和铁染色对缺铁性贫血的诊断价值

①目的 探讨血清铁、铁蛋白和铁染色对缺铁性贫血的诊断价值.②方法 采用全自动生化分析法、化学发光法和普鲁兰反应法分别对65例缺铁性贫血组、158倒非缺铁性贫血组和38倒健康对照组患者进行血清铁、铁蛋白和细胞内外铁检测.③结果 缺铁性贫血患者血清铁、铁蛋白和骨髓细胞内、外铁明显减少,与非缺铁性贫血及健康对照组比较有非常显著性差异（P（0.01）;非缺铁性贫血组血清铁、铁蛋白和细胞内、外铁琦增高,与缺铁性贫血及健康对照组比较有非常显著性差异（P＜0.01）;④结论 血清铁、铁蛋白和骨髓细胞内外铁的多少能灵敏的反应机体对铁的贮存和利用水平,对缺铁性贫血的诊断和鉴别诊断具有非常重要的意义.     

定期无偿献血对献血者血清铁和铁蛋白的影响

目的：研究献血对血清铁含量的影响。方法收集76例无偿献血人员为献血组,83例健康人员（非献血人员）为对照组,采集空腹静脉血,进行血常规、血清铁和铁蛋白检查。结果献血组血清铁、红细胞和红细胞压积均在正常范围,血清铁蛋白和血红蛋白除1例外也在正常范围。献血组男性血清铁蛋白为（116．52±67．16）ng／mL,对照组男性为（186．39±103．15） ng／mL,两组比较差异有统计学意义（P ＜0．05）;献血组女性血清铁蛋白为（66．2±47．62）ng／mL,对照组女性为（101．1±73．89） ng／mL,两组比较差异有统计学意义（P ＜0．05）。献血组血清铁与对照组比较差异无统计学意义（P ＞0．05）。结论献血组血清铁蛋白降低,但是并没有造成贫血。因此,献血可以减少体内的铁贮存量。     

Serum ferritin, cobalt excretion and body iron status.

Serum ferritin concentration was measured by immunoradiometric assay in 64 subjects. It was closely related to the size of body iron stores measured by hemosiderin content of bone marrow in all subjects and by the deferoxamine test in 10 patients with iron overload. Urinary cobalt excretion, an indirect measure of iron absorption, was inversely related to hemosiderin content of bone marrow in 34 patients aged 18 to 72 with or without liver disease, but this relation did not hold in a group of 20 student volunteers aged 17 to 30, indicating that the test is unreliable in young people. A strong inverse correlation was demonstrated between values for cobalt excretion and serum ferritin in the 34 patients and between those for iron absorption and serum ferritin in the 20 students. Serum ferritin concentration appears to reflect accurately the iron status of the healthy individual but high values in liver disease must be interpreted with caution.     

血清铁、铁蛋白和骨髓铁染色对贫血的诊断价值

贫血不是一个独立的疾病,而是各系统许多疾病的一个共同症状.它是指单位容积循环血液中红细胞、血红蛋白和/或血细胞比容低于参考值下限.临床上常见的贫血有缺铁性贫血(IDA)、巨幼细胞性贫血(MeA)、溶血性贫血(HA)、再生障碍性贫血(AA)、白血病性贫血、铁粒幼细胞性贫血(SA)和继发性贫血(感染性贫血、肾性贫血、恶性肿瘤所致的贫血等).本文通过对293例贫血患者血清铁、铁蛋白和骨髓铁染色的结果分析并与健康对照组结果比较,旨在探讨这些指标对贫血的诊断和鉴别诊断价值.     

血清铁和铁蛋白与肝病患者肝纤维化指标的关系

目的研究血清铁和铁蛋白与肝脏疾病患者血清肝纤维化指标(透明质酸、层粘蛋白、人Ⅲ型前胶原、Ⅳ型胶原)的关系。方法采用1s快速肝穿刺法对41例肝病患者取肝组织标本,行HE和铁染色后镜检;同时分别应用原子吸收光谱法、放射免疫法和酶联免疫法检测患者的血清铁、血清铁蛋白、肝纤维化指标。结果良性肝病患者与肝细胞癌患者比较,血清铁测定值无显著性差异(P>0.05),血清铁蛋白差异显著(P<0.05);良性肝病患者、早期肝细胞癌患者肝纤维化指标测定值与正常对照组间有显著性差异(P<0.05),晚期肝癌患者的肝纤维化指标与正常对照组间的差异无统计学意义(P>0.05)。血清铁及血清铁蛋白与层粘蛋白具有统计学上的相关性(血清铁r=0.439,P=0.031;血清铁蛋白r=0.476,P=0.016)。肝癌组织没有发现铁颗粒沉积。结论肝细胞癌患者多出现血清铁蛋白升高;血清铁、血清铁蛋白测定值和层粘蛋白测定值具有相关性;与良性肝病相比,肝癌组织的铁含量明显降低。晚期肝癌患者纤维化指标下降,可能与肿瘤组织抑制了胶原合成有关。酒精性脂肪肝多合并肝铁过载;对于良性肝脏疾病血清铁和铁蛋白测定值可以作为肝铁过载的重要指标。     

依据孕期血清铁蛋白及血红蛋白水平预防性补铁的效果观察

目的:探讨根据血清铁蛋白及血红蛋白水平给予孕妇预防性补铁对妊娠期铁缺乏、贫血、妊娠并发症及妊娠结局的影响。方法:选择300例单胎孕妇为研究对象,分为试验组和对照组,试验组同时监测血红蛋白及血清铁蛋白,当血清铁蛋白<30μg/L时给予预防性口服补铁73. 6 mg/d,对照组监测血红蛋白,当血红蛋白<110 g/L时给予治疗性口服补铁220. 8 mg/d,比较两组孕妇产前血清铁蛋白、血红蛋白水平,铁缺乏、贫血发生率、补铁后不良反应发生率、妊娠期糖尿病、妊娠期高血压疾病发生率、早产、低出生体重儿、产后出血、产后贫血发生率。结果:截至分娩前,试验组孕妇的血清铁蛋白、血红蛋白水平显著高于对照组,差异有统计学意义(P <0. 05),试验组孕妇的铁缺乏、贫血发生率显著低于对照组,差异有统计学意义(P <0. 05),试验组补铁后不良反应发生率显著低于对照组,差异有统计学意义(P<0. 05)。两组孕妇妊娠期糖尿病、妊娠期高血压疾病、早产、低出生体重儿、产后出血的发生率差异无统计学意义(P>0. 05),试验组孕妇产后贫血的发生率显著低于对照组,差异有统计学意义(P <0. 05)。结论:孕期根据血清铁蛋白及血红蛋白水平给予孕妇预防性补铁对增强孕妇补铁依从性、降低孕期铁缺乏、产前产后贫血发生率有明显效果。     

血浆铁蛋白、铁代谢基因与冠心病的相关性分析

目的:分析总结冠心病与血浆铁蛋白(FT)及铁代谢基因(HFE)的相关性。方法:以30例健康者为对照组,以30例稳定性心绞痛(SAP)患者为SAP组,以30例患不稳定心绞痛(UA)患者为UA组,以30例急性心肌梗塞(AMI)患者为AMI组。分析4组患者间FT含量及HFE阳性表达率的差异,并对各组患者的FT含量及HFE阳性表达率与冠心病相关性进行分析。结果:4组研究对象间,AMI组患者的FT含量最高(P<0.05);4组研究对象间HFE阳性表达率比较无统计学差异(P>0.05);FT含量与冠心病存在相关性(P<0.05),HFE阳性表达率与冠心病无相关性(P>0.05)。结论:FT含量与冠心病存在相关性。     

血清铁和铁蛋白与肝病患者肝纤维化指标的关系

OBJECTIVE: To study the relationship of serum iron and ferritin with the indicators for hepatic fibrosis and hepatic iron overload. METHODS: Liver tissue specimens were obtained from 41 patients with benign (16) or malignant (25) liver diseases by 1 second liver biopsy, and routine microscopic examination was performed after haematoxylin-eosin (HE) and Perl's Prussian staining. Atomic absorption spectrum, radioimmunoassay and enzyme-linked immunosorbent assay were respectively employed to examine the serum levels of iron, ferritin, hyaluronic acid, laminin, human procollagen type , and collagen type . RESULTS: Between patients with benign and malignant liver diseases, significant differences were found in the serum ferritin levels (P < 0.05), but not in serum iron levels (P > 0.05). It was also noted that the levels of the indicators for hepatic fibrosis in patients with benign and early-stage malignant diseases varied significantly from the levels in normal subjects, but these differences were not observed between normal subjects and patients with end-stage hepatic malignancies. Serum iron and ferritin were found to be associated with serum laminin levels (serum iron: r=0.439, P=0.031; serum ferritin: r=0.476, P=0.016), and no iron granules detected in the tissue specimens of hepatocellular carcinoma. CONCLUSIONS: Most of the patients with hepatocellular carcinoma have elevated serum ferritin levels. The serum levels of iron and ferritin are statistically correlated with serum laminin level. Obvious reduction of iron content is typical of hepatic malignant tissues in comparison with the benign tissues, and the reduction in the levels of the indicators for hepatic fibrosis might involve the inhibition of collagen synthesis in the tumor tissues from patients with end-stage hepatocellular carcinoma. Most of the cases of alcoholic fatty liver are complicated by liver iron overload, often marked by serum iron and ferritin levels.     

Serum ferritin level. Determinant of iron requirement in hemodialysis patients

Seventeen patients without renal failure and 14 patients receiving long-term hemodialysis were studied. Serum and bone marrow ferritin determinations were made at the time of bone marrow aspiration. A good correlation was found between serum ferritin levels and bone marrow iron stores, as well as between bone marrow ferritin levels and iron stores. Serum ferritin determinations appear to give an accurate estimation of bone marrow iron stores, thereby providing a reliable guide for iron replacement therapy and reducing the need for repeated bone marrow aspirations. Serum ferritin levels of less than 105 ng/ml suggest decreased iron stores, and values greater than 120 ng/ml indicate adequate or increased iron stores. Preliminary data also suggest that bone marrow ferritin determinations may be useful in quantitating bone marrow iron stores.     

新生儿窒息HIE患儿SI SF水平的变化

目的探讨新生儿窒息、轻度新生儿缺氧缺血性脑病（HIE）患儿血清铁（SI）、血清铁蛋白（SF）水平的变化及意义。方法分别测定30例足月单纯窒息儿、30例足月轻度HIE新生儿入院时（日龄12 h~48 h）、日龄4 d及日龄7 d（恢复期）时血SI及SF含量,并与20例健康新生儿（对照组）进行比较。结果轻度HIE急性期SI、SF水平与对照组及恢复期比较,先降低（日龄12 h~48 h）,后升高（日龄4 d）（P均〈0.05）;单纯窒息组急性期SI、SF水平仅在日龄4 d时明显高于对照组及恢复期（P〈0.05）;HIE及新生儿窒息恢复期SI、SF水平与对照组比较,差异无显著性（P〉0.05）。结论 SI、SF可能参与HIE的发生、发展过程,并可作为临床早期诊断HIE的观察指标。     

非酒精性脂肪肝病与血清铁及铁蛋白的相关性研究

目的 探讨超声影像学诊断非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)与血清铁离子和血清铁蛋白浓度的相关性。方法 应用经超声影像学方法诊断的40例非酒精性脂肪肝病者作为病例组及40例健康体检的非酒精性脂肪肝病者作为正常对照组,分别用原子吸收光谱法和放射免疫法检测血清铁和血清铁蛋白浓度。结果 病例组的血清铁、铁蛋白测定值[(105.17±24.52)μg/dL,(146.57±68.28) ng/dL]与对照组[(85.45±26.84) μg/dL,(90.58±49.71) ng/dL]比较,差异有统计学意义(P<0.01)。应用血清铁诊断NAFLD的受试者工作特征(receiver operating characteristic, ROC)曲线下面积、最佳阈值及敏感度、特异度、误诊率、漏诊率分别为0.69(P<0.01)、123.5 (μg/dL)、82.5%、60%、40 %、17.5%。应用铁蛋白诊断NAFLD的ROC曲线下面积、最佳阈值及敏感度、特异度、误诊率、漏诊率分别为0.73(P<0.01)、134.9 (ng/dL)、75.0%、72.5%、27.5%、25.0%。结论 NAFLD患者血清铁和铁蛋白水平均出现升高,与超声诊断结果具有明显相关性。     

Assessment of iron stores in inflammation by assay of serum ferritin concentrations

A serum ferritin concentration of below 15 microgram/l is accepted as indicating diminished iron reserves in an otherwise normal person. In patients with inflammatory disease this lower limit of normality may be inappropriate as inflammation may directly stimulate the production of ferritin protein. Results obtained in a survey of 150 patients with early inflammatory joint disease suggest that a ferritin concentration of 55 microgram/l is a more appropriate lower limit of normality.