育龄人群不孕不育影响因素分析

目的:探讨影响育龄人群不孕不育的因素。方法:使用问卷调查的方法,对山东省1 842对20～44岁育龄夫妇进行不孕不育影响因素调查。结果:①单因素分析结果显示,影响不孕不育的女性因素包括年龄、结婚年龄、民族、职业、文化程度、人均收入、身高、体重、月经规律情况、月经周期情况、月经量、痛经、继发性闭经情况、子宫疾病、卵巢疾病、输卵管疾病、宫颈疾病、阴道分泌物、阴道分泌物异味、盆腔感染情况、流引产次数、清宫术次数、药物流产次数、有无宫外孕、腹腔手术次数、精神病史、下腹疼痛史、长期服药史、两地分居、曾用避孕药、曾用IUD、有害物质接触史、重大不良生活史、精神压力等。影响不孕不育的男性因素包括职业、文化程度、人均收入、身高、体重、染色体情况、睾丸疾病、附睾疾病、输精管疾病、射精异常、高热史、精索静脉曲张、有害物质接触史、工作强度、高温作业、接触噪音、精神压力等。②多因素分析结果显示,育龄人群不孕不育的影响因素包括月经量、痛经、子宫疾病、输卵管疾病、清宫次数、分居、女方精神压力、男方职业、男方体重、男方睾丸情况等。结论:加强宣传,提高育龄群众自身素质;加强管理,为广大育龄群众提供优质服务;加强生殖健康教育,可降低不孕症的发病率。     

Factors affecting acceptance of immunization among children in rural Bangladesh

This paper uses the Bangladesh Fertility Survey 1989 data to identify the factors affecting acceptance of immunization among children in rural Bangladesh. Acceptance of DPT, measles and BCG vaccinations were the dependent variables. The independent variables included proximity to health facilities, frequency of visit by health worker, respondent's mobility, media exposure, education, age, economic status of household, region of residence, and gender of child. Logistic regression analysis was performed to assess the net effects of the variables in addition to univariate analysis. Among the independent variables, proximity to health facility, frequency of health worker's visit, mother's mobility, education, age, gender of child, ownership of radio, economic condition of household, and region of residence showed statistically significant association with acceptance of immunization. The effect of frequency of health worker's visit was dependent on region of residence, possession of radio, and mother's education. The effect of mother's ability to visit health centre alone was also dependent on ownership of radio, economic condition of household, and mother's education.     

单纯性肥胖儿童血清氨基酸水平分析

【目的】 研究单纯性肥胖患儿血清17种氨基酸水平的分布情况,探讨血清氨基酸水平与胰岛素抵抗之间的关系,为临床制定综合治疗干预方案提供科学依据。 【方法】 用高效液相色谱法对78例单纯性肥胖儿童和40例正常儿童的血清17种氨基酸水平进行检测;用化学发光法检测空腹胰岛素(FINS)、全自动生化仪检测空腹血糖(FPG),计算稳态模型的胰岛素抵抗指数(HOMA-IR),并对氨基酸与FINS、FPG 和HOMA-IR之间的相关性进行分析。 【结果】 实验组患儿的血清氨基酸水平严重失衡,其蛋氨酸Met,半胱氨酸Cys和甘氨酸Gly显著的低于对照组(P<0.05),其余14种氨基酸[苏氨酸(Thr)、缬氨酸(Val)、异亮氨酸(Ile)、亮氨酸(Leu)、苯丙氨酸(Phe)、赖氨酸(Lys)、组氨酸(His)、精氨酸(Arg)、天冬氨酸(Asp)、谷氨酸(Glu)、丙氨酸(Ala)、脯氨酸(Pro)、丝氨酸(Ser)、酪氨酸(Tyr)]显著高于对照组(P<0.05);患儿存在着血清Thr、His、Arg、Gly和Ala水平分布高、低极不均的情况;实验组患儿虽空腹血糖正常,但普遍存在胰岛素抵抗;其FINS 及HOMA-IR与 Lys、Ile、Leu、Val呈正比。 【结论】 在对单纯性肥胖患儿治疗干预的过程中,动态监测血清氨基酸水平,可以帮助临床医生了解肥胖儿童体内氨基酸水平失衡的情况,为制定针对性的综合治疗方案,提供科学依据。     

对重度不适感的大学生进行团体发展性心理健康教育研究

目的 探讨适用于有重度不适感的大学生的心理健康教育模式。方法 通过讲授、讨论、角色扮演等方式，对15名有重度不适感的师范专科学校学生(6男9女)进行分三阶段(准备、实施、总结)包括6个主题(主动与人交往、赞扬与感谢他人、赞美自己、选择成熟的交往方式、自我控制情绪、完善个性)的团体发展性心理健康教育，教育前后以ATQ，SAD，SDS，SCI--90进行问卷调查。结果 开展教育后，SCL-90中躯体化、强迫、人际敏感、抑郁、焦虑等分数以及ATQ，SAD，SDS分数均显降低。结论 团体发展性心理健康教育将矫治与教育相结合，是针对有重度不适感的大学生的有效的模式。     

早产儿支气管肺发育不良的危险因素分析

目的探讨早产儿支气管肺发育不良（BPD）的危险因素,为BPD的临床防治提供理论参考。方法回顾分析2011年1月-2014年1月在成都市妇女儿童中心医院新生儿科住院、胎龄在34周以内、生存28d以上的621例早产儿资料。以BPD的发生与否分为BPD组与非BPD组,并对多种危险因素与BPD的发生进行统计学分析。结果早产儿BPD发生率为15.9%。胎龄、低出生体质量及并发出生5min窒息、肺炎、肺出血、呼吸机相关性肺炎、呼吸急性窘迫综合征、呼吸机治疗、肺动脉高压、贫血、宫内发育迟缓、败血症、产前感染、高浓度吸氧、其母有产前感染性疾病与BPD发生有关,其中胎龄、低出生体质量、高浓度吸氧、呼吸机治疗、呼吸机相关性肺炎、败血症、产前感染、发育迟缓是BPD的独立危险因素。结论保证胎儿宫内正常生长发育、尽可能避免早产、减少感染、合理应用机械通气以减少肺部并发症是预防早产儿发生BPD的重要措施。     

阵发性室上性心动过速急诊治疗临床分析

目的探讨阵发性室上性心动过速的急诊治疗方法。方法以2009年1月至2011年6月期间本院收治的128例阵发性室上性心动过速的患者为研究对象,根据患者年龄、病情不同分ABCD4个治疗组,分别给予ATP、异搏定、心律平、西地兰治疗,观察4组患者的有效复律例数、复律时间、不良反应。结果 ATP的有效转复率为96.43%,无效率为3.57%,复律时间为0.31～1min;发生不良反应1例;异搏定组的有效转复率为91.43%,无效率为8.57%,复律时间为2.5～37min,未发生不良反应;心律平组的有效转复率为93.55%,无效率为6.45%,复律时间为1.8～32min,未发生不良反应;西地兰组的有效转复率为94.12%,无效率为5.88%,复律时间为35～115min,未发生不良反应;转复率ATP组最高,异搏定组最低,复律时间ATP组最短,西地兰组最长,仅ATP组发生1例,4组患者的有效转复率、平均复律时间、不良反应发生率之间无统计学差异。结论 ATP适用于年龄较小、血压低、无窦房结和传导系统病变、无哮喘病史的患者,起效较快;心律平和异搏定的使用禁忌证是年龄较大、心肌病变严重、心功能较差、逆传性房室折返性心动过速、严重心力衰竭、慢性阻塞性肺疾病、窦房结病变及心源性休克的患者,临床用药时注意避免;西地兰发挥作用时间较长,见效慢,适用于有心功能障碍但无预激综合征的患者。     

锌对大鼠生长发育及组织核酸和蛋白质代谢的影响

通过大鼠缺锌（ＺＤ）、高锌（ＺＨ）模型，研究对生长发育及组织核酸和蛋白质代谢的影响。结果：（１）ＺＤ、ＺＨ组的体重、体重增长值、饲料效价均低于自由喂养（ＡＬ）组，Ｐ＜０．０１；（２）ＺＤ、ＺＨ组的胸脖、脾脏重量低于ＡＬ组，Ｐ＜０．０１。但其它内脏的重量，组间无显著差异；（３）ＺＤ、ＺＨ组的心、肝、脑、肺、肾、睾丸的内脏指教大于ＡＬ组，但胸脖、脾脏指数则小于ＡＬ组；（４）ＺＤ组的胸腺、脾脏、睾丸、脑细胞小于ＡＬ组，Ｐ＜０．０５或Ｐ＜０．０１；（５）ＺＤ，ＺＨ组的胸腺、脾脏、骨髓细胞增殖指数低于ＡＬ组，Ｐ＜０．０１；ＺＤ组的肝脏、睾丸、脑细胞的增殖指数低于ＡＬ组，Ｐ＜０．０５或Ｐ＜０．０１。（６）ＺＤ组的胸腺、脾脏、睾丸、脑细胞的ＤＮＡ和蛋白质含量低于ＡＬ组，Ｐ＜０．０５或Ｐ＜０．０１；胸腺、脾脏、脑细胞的蛋白质含量低于ＡＬ组，Ｐ＜０．０５或Ｐ＜０．０１；（７）ＺＤ组的血清总蛋白、白蛋白低于ＡＬ组，Ｐ＜０．０１。提示缺锌或高锌均可抑制生长发育及组织核酸和蛋白质代谢     

空腹血糖与糖化血红蛋白在2型糖尿病诊断中的应用

目的评估空腹血糖（FPG）和糖化血红蛋白（HbAlc）诊断2型糖尿病（T2DM）的敏感性和特异性。探讨FPG、HbAlc及联合指标诊断T2DM的最佳切点。方法采用WHO糖尿病诊断标准,将423例研究对象分为T2DM组（n=60）和非T2DM组（n=363）,所有受试者均行口服葡萄糖耐量试验（OGTT）,同时测定其FPG及HbAlc。绘制FPG和HbAlc诊断糖尿病的受试者工作曲线（ROC曲线）。结果①HbAlc诊断T2DM的切点为6．1％,此时灵敏度为91．7％,特异度为78．5％,曲线下面积0．910（95％CI,0．873～0．946）,阳性预测值（＋PV）为41．4％,阴性预测值（-PV）为98．3％,You＆n指数为O．702,正确率为80．4％,Kappa值为0．465。HbAlc≥6．5％时,灵敏度为61．7％,特异度为93．7％,＋PV为61．7％、-Py为93．7％,Youden指数为0．553,正确率为89．1％,Kappa值为O．553。②FPG诊断T2DM的切点为6．09mmol／L,此时灵敏度83．3％,特异度89．3％,曲线下面积0．898（95％CI,0．885-0,957）,＋PV50．5％,一州96．9％。Youden指数0．726,正确率86．1％,Kappa值0．549。当FPG≥7．00mmol／L时,灵敏度33．3％,特异度99．2％,＋w87．0％、-PV90．0％、Youden指数0．325、正确率89．8％、Kappa值0．438。③HbAlc≥6．1％和FPG≥6．09mmol／L联合指标具有较好的诊断性能。且优于单个指标,此时的灵敏度83．3％．特异度93．7％,＋PV68．5％,-PV97．1％,Youden指数0．770,正确率92．2％,Kappa值0．706。结论HbAlc≥6．1％和FPG≥6．09mmol／L联合指标具有很好的灵敏度和特异度,且Youden指数、正确率、Kappa值都高于其他指标,与OGTT有很好的一致性,对T2DM的诊断有较好应用价值。     

中国中小学生早餐营养素摄入量

目的：了解中国中小学生早餐营养素摄入量。方法：早用1992年全国营养调查中的住户调查及连续3d24h回顾法膳食调查资料，对中国17719名中小学生早餐能量和营养素摄入量进行分析。结果：中国中小学生早餐蛋白质、钙、锌、硒、视黄醇当量、硫胺素、核黄素等营养素摄入量均未达到RDA的25％，其中钙、视黄醇当量和核黄素等摄入量严重不足，仅为RDA的10％左右，中小学生早餐来自蛋白质、脂肪和碳水化合物的能量比例不当。比较来看，小学生早餐蛋白质、脂肪、钙、铁、锌、硒、硫胺素、核黄素和烟酸等摄入量占RDA百分比明显高于中学生。男生早餐蛋白质、铁、锌、硒、视黄醇当量和烟酸等摄入量占RDA百分比稍高于女生。乡村学生早餐能量、蛋白质、碳水化合物、钙、铁、锌、视黄醇当量、硫胺素、烟酸及抗坏血酸等摄入量占RDA百分比高于城市学生，脂肪、硒和核黄素摄入量低于城市学生。结论：乡村中小学生早餐平均能量和营养素摄入量好于城市中小学生，但城乡中小学生早餐营养素摄入状况均有待改善。     

乳腺癌患者发病的影响因素分析

目的 探讨基本情况、遗传、生育、疾病和饮食等因素与乳腺癌发生的关系,分析乳腺癌的影响因素.方法 选取2015年1月至2015年9月在中国福利会国际和平妇幼保健医院收治的168例术后病理确诊的乳腺癌患者为观察组,选取168例在体检门诊进行乳腺检查并排除乳腺癌者为对照组,比较两组研究对象的临床资料.结果 两组受试者在年龄、BMI、婚姻情况、医疗保险、高血压病史及患病时间、糖尿病病史及患病时间组间比较差异均无统计学意义(t/χ2值分别为1.317、1.511、0.203、1.080、0.056、0.828、0.000、0.020,均P>0.05).两组患者在文化程度及职业资料比较上,差异具有统计学意义(χ2值分别为23.875、21.212,均P<0.05).两组患者在受挫折后情绪、自觉健康状况、与12个月之前相比的体重变化、采取措施控制体重、初潮年龄、是否绝经、避孕药物使用及乳腺癌家族史比较上,差异具有统计学意义(χ2值分别为18.900、14.915、29.031、10.826、11.664、18.185、4.626、14.696,均P<0.05).饮食方面两组患者在食用杂粮、猪肉、羊肉、虾、禽类、海产品、奶及奶制品、黄豆及其制品、新鲜蔬菜、水果、腌制食品、蛋类比较上,差异均具有统计学意义(χ2值4.189~46.672,均P<0.05),两组患者在食用大米、牛肉、鱼类、酒类、抽烟差异均无统计学意义(χ2值0.412~3.178,均P>0.05).近两年内遭受过比较大的挫折情绪不佳、采取措施控制体重、初潮年龄早、绝经晚、服用过避孕药物、乳腺癌家族史、食用猪肉和羊肉均是乳腺癌发病的危险因素(OR值1.642~7.471,均P<0.05),母乳喂养、食用杂粮、食用奶及奶制品、食用黄豆及其制品、食用新鲜蔬菜和水果均是乳腺癌发病的保护因素(OR值0.627~0.862,均P<0.05).结论 近两年内遭受过比较大的挫折情绪不佳、采取措施控制体重、初潮年龄早、绝经晚、服用过避孕药物、乳腺癌家族史、食用猪肉和羊肉均是乳腺癌发病的危险因素,母乳喂养、食用杂粮、食用奶及奶制品、食用黄豆及其制品、食用新鲜蔬菜和水果均是乳腺癌发病的保护因素.     

联合检测VEGF、TSGF、CA153及CA125在乳腺癌诊断中的临床意义

目的:探讨血管内皮细胞生长因子(VEGF)、肿瘤特异性生长因子(TSGF)、CA153和CA125联合检测在乳腺癌诊断中的应用价值。方法:采取62例乳腺癌患者血浆标本为实验组,112例乳腺良性疾病及50例健康人群血浆标本作对照组。用酶联法检测VEGF、TSGF,用免疫放射法检测CA153及CA125。结果:VEGF、TSGF、CA153及CA125对乳腺癌的敏感性分别为82.2%、85.4%、74.2%及40.3%;特异性分别为68.5%、66.0%、91.3%,及72.0%,VEGF、TSGF、CA153及CA125联合检测乳腺癌的敏感性为93.5%,特异性为89.6%。结论:联合检测与单项指标检测相比,提高了对乳腺癌早期诊断的敏感性,同时又有较好的特异性,具有一定的临床应用价值。     

Biomagnification of Trace Elements in the Aquatic Food Web in the Mekong Delta,South Vietnam Using Stable Carbon and Nitrogen Isotope Analysis

In the present study, we report the concentrations of 21 trace elements (V, Cr, Mn, Co, Cu, Zn, As, Se, Rb, Sr, Mo, Ag, Cd, Sn, Sb, Cs, Ba, Hg, Tl, Pb, and Bi), as well as the results of the analysis of stable carbon and nitrogen isotopes, of the various biota that make up the food web in the main stream of the Mekong Delta near Can Tho, South Vietnam. A significant trophic level-dependent increase was found in concentrations of Se, Rb, and Hg with increasing δ¹⁵N, indicating that an overall biomagnification of these elements occurred. However, the increase of Hg concentration per trophic level was lower than in previous studies. In contrast, the concentration of Mn showed an opposite trend in the food web of the Mekong Delta. In addition to these overall trends, the present study revealed that the biomagnification profiles of trace metals differ between crustaceans and fishes; concentrations of Mn, Cu, Zn, As, Sr, Mo, Ag, Cd, Sb, Cs, Ba, Tl, and Pb were significantly higher in crustaceans, whereas fishes showed higher concentrations of Cr, Rb, and Hg (trophic level determined by δ¹⁵N). The differences in the biomagnification profile between the major taxa might be attributed to differences in metal accumulation and in detoxification abilities such as possessing a metal-binding protein, e.g., metallothionein (MT).     

我院病历全面质量管理的构想与实践

从全面质量管理理念出发,对实施病历全面质量管理进行了初步构想,进一步明确了病历质量控制的功能定位及拓展,贯彻全程、全员、全面质控的理念,重视病历质量控制中的反馈和交流环节,强化质量文化的建设和传承.同时在病历质量控制实践中,从组织体系的完善、评价指标体系的调整、质控关键点的确定、环节质控与终末质控的结合、质控培训体系的建设等方面,加强了病历质量控制的综合管理力度.     

Elemental and nutritional analysis of Punica granatum from Turkey

Twenty different varieties of pomegranate (Punica granatum) from Turkey were analyzed for vitamin C level, lipid content, sterol determination, anthocyanin content, and elemental analysis (Ca, Mg, P, Fe, Na, and K studies). Vitamin C content range of 1,050-312 mg/100 g, oil content range of 2.41-3.73%, sterol content range of 5.78-8.43%, anthocyanin content range of 2,100-4,400 mg/L, potassium range of 250-1,200 ppm, calcium range of 35-326 ppm, magnesium range of 176-427 ppm, iron range of 21-46 ppm, sodium range of 35-76 ppm, and phosphorus range of 12-43 ppm were observed in these varieties.     

故纸堆里的新大陆

在那些传承千年的故纸堆里，赵家路找到了一个更广阔的世界，她如得水的鱼一般，遨游其中。     

Self-instructional teaching of biostatistics for medical students

A growing body of literature deals with the use of self-instructional methods for teaching biostatistics to medical students. The University of Tennessee Department of Community Medicine tested the hypothesis that, in controlled, randomized situations, learning of statistical material by self-instruction is equivalent to learning identical material by the lecture method. An analysis of student performance, in terms of the grades obtained on two separate examinations, showed that students learning by self-instruction did as well or better than their colleagues taking lectures. On the basis of these results, self-instructional biostatistics for medical students at the University of Tennessee has been selected as the major teaching method of that subject.Dr. Robinson is Professor and Chief of Biostatistics in the Department of Community Medicine, University of Tennessee College of Medicine, 800 Madison Avenue, Memphis, Tennessee 38163. Mr. Burke is Instructor in the Department of Community Medicine, University of Tennessee, and Director of Statistical Services in the Memphis and Shelby County Health Department. Dr. Stahl was Assistant Professor of Community Health and Medical Practice, Section of Health Care Studies, University of Missouri, Columbia, Missouri, during this study. He is currently Assistant Professor of Sociology, Purdue University, School of Humanities, Social Science and Education, Lafayette, Indiana. Requests for reprints should be addressed to Dr. Robinson. John W. Runyan, Jr., M.D., and Stephen T. Miller, M.D., of the Department of Community Medicine, University of Tennessee, made valuable suggestions during the preparation of this paper.     

两种类型老年高血压病因差异的研究

通过对现况调查中诊断的９４例老年单纯收缩期高血压和６７例非单纯收缩期高血压，与１３５例血压正常者进行病例对照研究，筛选出各自的危险因素。然后，对它们作比较分析，探讨是否存在着差异。在研究的年龄、性别、婚姻状况、吸烟、饮酒、精神创伤、高血压家族史、身高、体重、体重指数、血糖水平、血清胆固醇、甘油三脂和高密度脂蛋白胆固醇等１８个变量中，经单因素非条件Ｌｏｇｉｓｔｉｃ回归分析。结果表明：老年ＩＳＨ的发病与高血压家族史、精神创伤、年龄、血糖水平有关，体重指数、体重、吸烟、饮酒、精神创伤、血清总胆固醇水平是ＮＩ５Ｈ发病的危险因素。进一步多因素非条件Ｌｏｇｉｓｔｉｃ回归分析显示：高血压家族史、精神创伤、血糖水平先后进入ＩＳＨ方程，体重指数、吸烟、精神创伤、血清总胆固醇水平依次入选ＮＩＳＨ的方程。研究揭示ＩＳＨ和ＮＩＳＨ的病因存在差异，从病因学的角度支持ＩＳＨ是不同于ＮＩＳＨ的独特综合症。     

不同灭蟑方法搭配使用对不同车型旅客列车灭蟑效果的研究

目的研究不同灭蟑方法的搭配使用对不同车型旅客列车的灭蟑效果,以找出高效、合理、科学、经济的灭蟑方案。方法对各新时速、25K型、25G型、22型的4个车底用A、B、C、D 4种灭蟑方案对应作业,用药激法调查作业前后蟑螂密度,计算杀灭率。结果新时速列车A方案的平均杀灭率为72.9%,B方案的平均杀灭率为96.3%,C方案的平均杀灭率为100%,D方案的平均杀灭率为100%,即灭蟑效果D=C>B>A;25K型列车A方案的平均杀灭率为82.2%,B方案的平均杀灭率为86.7%,C方案的平均杀灭率为88.3%,D方案的平均杀灭率为93.3%,即灭蟑效果D>C>B>A;25G型列车A方案的平均杀灭率为72.9%,B方案的平均杀灭率为80.9%,C方案的平均杀灭率为89.3%,D方案的平均杀灭率为93.9%,即灭蟑效果D>C>B>A;22型列车A方案的平均杀灭率为46.7%,B方案的平均杀灭率为71.4%,C方案的平均杀灭率为58.3%,D方案的平均杀灭率为78.8%,即灭蟑效果D>B>C>A。结论不管是哪种车型,D方案都起到最好效果,A方案相对其他方案都是最差效果,但从合理、科学、经济的角度考虑对新时速列车使用,C方案灭蟑较佳,25K型和25G型都是使用D方案最佳,其次是C和B,22型最好是D方案,而B方案优于C方案。     

Characteristics of Urban Sidewalks/Streets and Objectively Measured Physical Activity

Several studies have found significant relationships between environmental characteristics (e.g., number of destinations, aesthetics) and physical activity. While a few of these studies verified that the physical activities assessed were performed in the environments examined, none have done this in an urban, neighborhood setting. This information will help efforts to inform policy decisions regarding the design of more “physically active” communities. Fourteen environmental characteristics of 60, 305-m-long segments, located in an urban, residential setting, were directly measured using standardized procedures. The number of individuals walking, jogging, and biking in the segments was assessed using an observation technique. The segments were heterogeneous with regards to several of the environmental characteristics. A total of 473 individuals were seen walking, bicycling, or jogging in the segments during 3,600 min of observation (60 min/segment). Of the 473 seen, 315 were walking, 116 bicycling, and 42 jogging. A greater number of individuals were seen walking in segments with more traffic, sidewalk defects, graffiti, and litter and less desirable property aesthetics. Only one environmental characteristic was associated with bicycling and none were significantly related with jogging. This study provides further evidence that environmental characteristics and walking are related. It also adds new information regarding the importance of scale (e.g., micro, macro) and how some environmental characteristics of urban, residential sidewalks and streets relate to physical activity. Suminski and Hyder are with the Department of Physiology, Kansas City University of Medicine and Biosciences, Kansas, MO, USA; Heinrich is with the Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA; Poston is with the Department of Basic Medical Sciences, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA; Pyle is with the Department of Family Medicine, Kansas City University of Medicine and Biosciences, Kansas, MO, USA.     

中年女性铁缺乏的诊断

依照国际营养性贫血咨询委员会(INACG)制订的铁缺乏症诊断标准和权威学者COOK的诊断标准,对248名中年女性的铁缺乏状况进行诊断,发现:运用INACG标准,铁缺乏症的检出率偏低,应用COOK标准,铁缺乏症检出率较高。当运用COOK标准时,采用Hb、SF、EP、TS四项指标组合,IDA的检出率为16.9％;三项指标组合即Hb、SF、EP组合,Hb、EP、TS组合,Hb、SF、TS组合,对IDA的检出率分别为10.4％,7.2％,4.8％。单项指标对铁缺乏症的诊断价值的高低顺序为:EP>SF>TS。