Response of hemoglobin, serum ferritin, and serum transferrin receptor during iron supplementation in pregnancy: a prospective study

OBJECTIVE: We evaluated the effect of iron supplementation on biochemical indicators of iron status, namely hemoglobin (Hb), serum ferritin (SF), and serum transferrin receptor (sTfR), during pregnancy. METHODS: A prospective study was conducted in 73 pregnant women who received daily supplements of 60 mg of iron and 500 microg of folic acid for 100 d from 19 wk of gestation. The indicators of iron status (Hb, SF, and sTfR) at 19, 27, and 35 wk of gestation were analyzed. The response of iron status indicators to iron supplementation was assessed in the cohort and in pregnant women who were anemic (n = 35) and non-anemic (n = 38) at 19 wk. RESULTS: All three indicators of iron status during supplementation (27 and 35 wk) were similar to the presupplementation status. The sTfR as an indicator correlated negatively with presupplementation Hb levels (r = -0.417). Based on sTfR level in iron-adequate pregnant women, a cutoff value of at least 12.0 mg/L was derived to define iron deficiency in pregnancy. When the response was tested in anemic pregnant women, iron supplementation improved mean Hb (P < 0.05) at the end of 35 wk (96 +/- 8.8 to 110 +/- 20.2 g/L) of gestation, with no change in SF. Conversely, non-anemic pregnant women showed a significant increase in SF and a decrease in Hb (122 +/- 11.6 to 112 +/- 15.2 g/L) at 35 wk of gestation. A significant effect of iron intake on sTfR was seen only among iron-deficient anemic women. CONCLUSIONS: These observations suggest that, during pregnancy, sTfR responds to iron supplementation when there is iron-deficiency anemia and therefore can be used as an indicator.     

铁缺乏育龄妇女血清转铁蛋白受体的变化及其诊断铁缺乏效率分析

目的:探讨血清转铁蛋白受体(sTfR)与血清转铁蛋白受体/血清铁蛋白(sTfR/SF)筛检铁缺乏的特异性和灵敏性及其鉴定铁缺乏的效率。方法:初筛北京郊区与河北地区18-45岁非孕育龄妇女941名,检测血清铁蛋白(SF)、锌原卟啉(ZPP)、血红蛋白(Hb),依评价标准,分为铁正常、贮存铁减少(IDS)、红细胞生成缺铁(IDE)与缺铁性贫血(IDA)四组,测定其sTfR值并计算sTfR/SF即sTfR/LogSF、Log(sTfR/SF),观察不同铁状况育龄妇女sTfR、sTfR/SF水平及变化,并采用ROC曲线分析其诊断铁缺乏效率。结果:IDS、IDE、IDA各期sTfR水平随铁缺乏程度显著增加,sTfR/SF在各期增加幅度均较大。sTfR与SF、Hb显著负相关,与ZPP显著正相关。经ROC曲线分析,sTfR鉴定功能铁缺乏的效率可达83%,Log(sTfR/SF)鉴定贮存铁缺乏的效率可达99%。结论:sTfR与sTfR/SF可灵敏反映人体铁状况,可作为筛检育龄妇女铁缺乏的可靠指标。     

铁缺乏致网织红细胞参数及血清转铁蛋白受体的变化

目的研究早期铁缺乏的敏感指标。方法根据铁蛋白(SF)、血红蛋白(Hb)、血清铁(SI),将12～15岁289位女性分组:铁耗竭期(SID期),红细胞生成缺铁期(IDE期),缺铁性贫血期(IDA期)和对照组。检测各组网织红细胞参数[包括网织红细胞百分比(Ret%)、低荧光强度网织红细胞(LFR)、中荧光强度网织红细胞(MFR)、高荧光强度网织红细胞(HFR)和网织红细胞成熟指数(RMI)、血清转铁蛋白受体(sTfR)和红细胞参数[(包括红细胞分布宽度(RDW%)和红细胞平均容积(CMV)),比较各组的指标,以及sTfR同其他指标的相关关系。结果 HFR和sTfR在SID期、IDE期、IDA期均显著高于对照组(P<0.01),并且呈数倍增长;MFR、RMI、RDW%和MCV在SID期与正常对照组无显著性差异(P>0.05),而IDE期和IDA期均与对照组有显著性差异(P<0.01或P<0.05),其中MFR和RMI呈数倍改变。sTfR和HFR、MFR以及RMI呈明显正相关(r=0.51,0.57,0.64,P<0.05),同Hb呈明显负相关(r=-0.54,,P<0.01);同SF、SI相关性微弱(r=-0.30,-0.31,P<0.05)。结论 HFR、sTfR、MFR、RMI可作为早期铁缺乏的诊断指标,尤其是前二者,可在铁缺乏患者的筛查中推广应用。[营养学报,2013,35(2):150-153]     

铁缺乏儿童血清转铁蛋白受体的变化及对铁干预的反应

目的观察血清转铁蛋白受体(sTfR)在铁状况正常和不同程度缺铁儿童体内的水平和铁干预后的变化,评价sTfR在筛检人群铁缺乏和补铁效果中的价值.方法初筛北京房山区6～14岁儿童1006名,检测其铁生化指标,从中筛选铁正常、贮存铁减少(ID)、红细胞生成缺铁(IDE)和缺铁性贫血(IDA)儿童239名,采用双抗体夹心ELISA法测定sTfR含量,计算sTfR/log血清铁蛋白(SF).对铁缺乏儿童给予口服乙二胺四乙酸钠铁胶囊(60mg元素铁/粒),每次1粒,ID与IDE儿童,每周1次,IDA儿童每周3次,连续9周.补铁后重复测定铁生化指标与sTfR,比较补铁前后sTfR的变化.结果ID、IDE、IDA期儿童sTfR含量分别为(20.03±2.33)nmol/L、(24.52±1.07)nmol/L和(33.28±6.09)nmol/L,sTfR/logSF值分别为18.15±5.31、20.98±8.88和29.08±8.57,均显著高于正常对照组的sTfR(18.74±3.06)nmol/L与sTfR/logSF值9.89±1.74.sTfR与红细胞游离原卟啉(FEP)、血红蛋白(Hb)显著相关.正常儿童sTfR为12.5～23.5nmol/L.补铁后,ID、IDE与IDA期儿童sTfR含量为(16.37±3.10)nmol/L,明显低于补铁前水平,但在IDE与IDA期没有变化;ID期儿童sTfR/logSF值分别为11.42±3.12、16.54±4.70和23.59±9.93,与补铁前相比均显著降低.结论sTfR为鉴定铁缺乏IDE与IDA期的特异指标,sTfR/logSF为观察补铁效果的敏感指标.     

补铁对人体血清转铁蛋白受体水平的影响

目的研究补铁过程血清转铁蛋白受体(sTfR)值的时相动态变化趋势,为sTfR是否可作为观察补铁效果的指标提供依据.方法 2002年4～10月,从河北省廊坊市和北京顺义区初筛942名18～45岁育龄妇女,检测其铁生化指标,依现行铁状况评价标准,筛检红细胞生成缺铁(IDE)和缺铁性贫血(IDA)妇女,经知情同意后,共有59名妇女完成了自始至终的补铁效果动态观察.采用L-苏糖酸亚铁胶囊(7 mg元素铁/粒),IDE妇女隔日服4粒,IDA妇女每日服4粒,补铁12周,分别测定补铁过程中0、3、6、9和12周的铁生化指标和sTfR值,观察sTfR时相动态变化.结果 IDE和IDA育龄妇女sTfR含量分别为(26.62±10.57)nmol/L和(41.25±21.96)nmol/L,均显著高于健康者的水平;在补铁过程中,sTfR呈现以下变化特点在IDE期,sTfR在补铁后3周内趋于平稳,3周后渐进性降低,至12周时接近和达到健康者的水平,检测值为(17.86±5.57)nmol/L;在IDA期,补铁后3周内sTfR迅速下降,3周后缓慢下降,至第9周趋于平稳,至12周时接近和达到健康者的水平,检测值为(19.54±5.94)nmol/L;sTfR/血清铁蛋白在补铁过程中的变化趋势与sTfR基本平行;补铁过程中sTfR与血红蛋白、血清铁蛋白呈负相关,与锌卟啉呈正相关.结论在补铁过程,sTfR随机体铁状况的恢复而逐渐下降至正常水平,sTfR可作为观察补铁效果的特异指标.     

几种红细胞和铁参数在儿童缺铁性贫血和溶血性贫血中的比较

目的:研究多种红细胞和铁参数在缺铁性贫血和溶血性贫血中的不同变化,了解它们在二者中有无鉴别意义。方法:采用全自动血细胞分析仪做血常规及红细胞分析,血液荧光测定仪测定锌原卟啉,EIA法测定血清转铁蛋白受体,检测了40例缺铁性贫血患儿(Hb 62.6±20.8 g/L)和33例溶血性贫血患儿(Hb 58.5±21.6 g/L),包括15例β-地中海贫血(仅1例为轻型)。结果:缺铁性贫血和各种溶血性贫血的红细胞分布宽度(RDW)、锌原卟啉(ZPP)、血清转铁蛋白受体(sTfR)均增高。RDW-SD在各种溶血性贫血均显著高于缺铁性贫血,P均<0.01;RDW-CV只在β-地中海贫血明显高于缺铁性贫血,P<0.01,而其他溶血性贫血的RDW-CV值却和缺铁性贫血非常相似(P=0.998)。缺铁性贫血的ZPP明显高于溶血性贫血,P<0.01。sTfR在β-地中海贫血高于缺铁性贫血和其他类型溶血性贫血,P均<0.05;不同的溶血性贫血sTfR升高的程度不同。结论:虽然缺铁性贫血和溶血性贫血的红细胞分布宽度、ZPP、sTfR均增高,但程度并不一致,可根据以上变化将二者区别开来。在评价溶血性贫血的sTfR水平时,应首先考虑溶血性贫血的类型。     

补中益气颗粒联合多糖铁复合物治疗妊娠期缺铁性贫血疗效和安全性分析

目的：探讨补中益气颗粒联合多糖铁复合物治疗妊娠期缺铁性贫血（IDA）的临床疗效。方法：将120例妊娠期IDA患者按照随机数字表法分为2组，每组60例。对照组给予多糖铁复合物治疗，研究组给予补中益气颗粒联合多糖铁复合物治疗，均用药4周。比较2组治疗前后红细胞（RBC）计数、血红蛋白（Hb）含量、平均红细胞血红蛋白含量（MCH）、血清铁（SI）、血清铁蛋白（SF）、铁调素和可溶性转铁蛋白受体（sTfR），以及2组治疗总有效率、不良反应和不良妊娠结局发生率。结果：治疗后研究组RBC、Hb、MCH、SI和SF均高于对照组，铁调素和sTfR低于对照组，治疗总有效率高于对照组，差异均有统计学意义（均P＜0.05）。2组不良反应发生率和不良妊娠结局发生率差异无统计学意义（P＞0.05）。结论：补中益气颗粒联合多糖铁复合物可有效改善铁代谢，治疗妊娠期IDA效果显著，安全性较好。     

Iron status of the free-living, elderly Framingham Heart Study cohort: an iron-replete population with a high prevalence of elevated iron stores

BACKGROUND: Although iron deficiency occurs commonly in vulnerable groups of women of reproductive age, infants, and children, less is known about the iron nutriture of the elderly. OBJECTIVE: Our objective was to evaluate the iron status of a noninstitutionalized, elderly US population, with a particular focus on 2 concerns unique to the elderly: 1) potential confounding effects of chronic disease on iron measures and 2) increased occurrence of elevated iron stores. DESIGN: Multiple iron measures, including serum ferritin (SF), transferrin saturation, mean cell volume, and hemoglobin, were used to evaluate the prevalence of iron deficiency (ID), iron deficiency anemia (IDA), and other measures of iron nutriture in 1016 elderly white Americans aged 67-96 y from the Framingham Heart Study. "Diseased" subjects were defined as those with possible pathologically altered iron measures due to inflammation, infection, elevated liver enzymes, hereditary hemochromatosis, or cancer. The effect of altered iron status on various prevalence estimates was assessed. RESULTS: The elderly subjects had a low prevalence of ID (2.7%), IDA (1.2%), and depleted iron stores (3%; SF < 12 microg/L). In contrast, 12.9% had elevated iron stores (SF > 300 microg/L in men and SF > 200 microg/L in women), of which only 1% was attributable to chronic disease. The prevalence of ID, IDA, and depleted iron stores was unaffected by the presence of chronic disease. CONCLUSIONS: The Framingham Heart Study cohort is an iron-replete elderly population with a high prevalence of elevated iron stores in contrast with a low prevalence of iron deficiency, with insignificant effects of chronic disease on these iron status estimates. The likely liability in iron nutriture in free-living, elderly white Americans eating a Western diet is high iron stores, not iron deficiency.     

sTfR与孕妇、新生儿、婴儿亚临床缺铁及缺铁性贫血前瞻性纵向研究

【目的】 通过前瞻性纵向监测贫血孕妇及其新生儿、婴儿的Hb,sTfR,分析孕妇贫血对婴儿6月龄时铁代谢的影响。 【方法】 随机抽取Hb<100 g/L的56例临产孕妇作为研究组,选取56例Hb>110 g/L的同孕周临产孕妇作为对照组,两组孕妇所生各56例新生儿、婴儿为子代研究组、子代对照组,婴儿于出生时、42 d、4个月、6个月进行定期体检,孕妇、新生儿、6月龄婴儿抽血检测Hb、sTfR。 【结果】 与对照组比较,贫血孕妇及其所生婴儿6月龄时的Hb、sTfR值差异有统计学意义(P<0.01),新生儿Hb、sTfR值差异无统计学意义(P>0.05)。贫血孕妇所生婴儿6月龄时IDA检出率为60.8%%,正常孕妇所生婴儿为21.6%,差异有统计学意义(P<0.01)。 【结论】 孕妇贫血是导致6月龄婴儿SID及IDA的主要危险因素。     

Iron deficiency is unacceptably high in refugee children from Burma

Iron-deficiency anemia (IDA) in refugees is reported to be among the major medical problems worldwide. Because food rations are typically inadequate in iron, long-term reliance is a key predictor of anemia among displaced people. Comprehensive nutritional assessments of refugee children from Burma have not previously been completed. Refugee children aged 6-59 mo were studied to determine 1) the prevalences of anemia, iron deficiency (ID) and IDA and 2) the factors associated with anemia and ID. Cluster sampling in three camps and convenience sampling in two additional camps were used. Hemoglobin (Hb) levels were measured and micro mol zinc protoporphyrin/mol heme were determined in 975 children. Logistic regression analyses (95% CI) determined predictors of anemia and ID. The prevalences of IDA, anemia and ID in these refugee children were 64.9, 72.0 and 85.4%, respectively. Predictors of anemia included young age (P < 0.001), food ration lasting <1 mo (P = 0.001), daily consumption of dietary iron inhibitors (P < 0.05), weight-for-height Z-score of <-2 (P < 0.05), male gender (P < 0.05) and uneducated father (P < 0.001). Predictors of ID were young age (P < 0.001) and recently reported illness (P < 0.05). Laboratory tests confirmed that anemia and ID are major health problems among these refugee children and that ID is the leading cause of anemia. A comprehensive nutrition and public health-focused approach to combating anemia and ID is essential. Following the presentation of results to policy makers, the improvement of the micronutrient content of rations has been initiated.     

血清转铁蛋白受体在小儿缺铁性贫血诊断及分度中的研究

目的:探讨血清转铁蛋白受体(sTfR)在儿童缺铁性贫血(IDA)诊断及其分度中的意义。方法:6月-12岁IDA儿童50例及正常儿童20例均进行血红蛋白(Hb)、sTfR、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)测定,并将受测对象分为正常对照组(C组)、轻度IDA组(IDA1组)、中一重度IDA组(IDA2组),计算C组、IDA1组、IDA2组3组间sTfR均数并将其进行统计学分析比较。结果:C组、IDA1组、IDA2组sTfR浓度分别为27.6±9.3 nmol／L、44.3±8.5 nmol／L、63.4±12.6 nmol／L,将其3组间进行方差分析及两两比较,均有显著差异(P<0.01)。结论:sTfR在诊断IDA及判断IDA的严重程度中有着重要的意义。     

Iron status of pregnant Indian women from an area of active iron supplementation

ObjectiveThe aim of this study was to investigate the iron status of pregnant tribal women from Ramtek, Nagpur, Maharashtra, India using a combination of indices.MethodsA community-based observational study was conducted to assess iron status using a convenience sample of pregnant Indian tribal women from Ramtek. Pregnant women were recruited at 13 to 22 wk gestation (first visit; n = 211) and followed to 29 to 42 wk gestation (second visit; n = 177) of pregnancy. Sociodemographic and anthropometric data; iron supplement intake; and blood samples for estimating hemoglobin (Hb), serum ferritin (SF), soluble transferrin receptor (sTfR), and C-reactive protein (CRP) were obtained.ResultsThe mean (SD) Hb concentration at recruitment was 106 (15) g/L and 106 (14) g/L at the second visit; 41% of the women at recruitment and 55% at second visit were anemic (14% higher, P < 0.001). No women at recruitment and 3.7% at second visit had SF concentration < 15 ng/mL; and 3.3% at recruitment and 3.9% at the second visit had sTfR > 4.4 ng/mL (0.6% higher, P = 0.179). Almost 62% and 71% of pregnant women used iron supplements at both visits, respectively. Iron supplement intake > 7 d in the preceding month improved the Hb concentration by 3.23 g/L and reduced sTfR concentration by 13%; women who were breastfeeding at the time of recruitment had 11% higher SF concentration.ConclusionsThe iron indices suggest that pregnant tribal women of central India, although anemic, had good iron status. Use of iron supplements > 7 d in the preceding month improved iron status; however, non–iron-deficiency anemia persisted in this group.     

Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores

Iron status, prevalence of iron deficiency and elevated iron stores, and the effect of gastrointestinal ulceration on iron status in free-living Taiwanese elderly persons were all assessed in a nationally representative, cross-sectional nutrition survey--the Elderly NAHSIT. The survey included blood measurements of iron indices. Data were collected from 1202 elderly men and 1152 elderly women aged 65 years and older. Multiple iron measures, including serum ferritin (SF), transferrin saturation (Tsat), and hemoglobin were used to evaluate the prevalence of iron deficient erythropoiesis (ID) and iron deficiency anemia (IDA). Despite no routine practice of iron fortification in Taiwan, elderly subjects had a low prevalence of ID and IDA. The prevalence of ID was 2.3% in men and 1.4% in women. The prevalence of IDA was 2.5% in men and 2.0% in women. In contrast, 15.7% of men and 9.8% of women had elevated iron stores as diagnosed by SF>300 microg/L. Subjects with a history of gastrointestinal ulceration had significantly lower serum ferritin than those without ulcers, but the prevalence of anemia, ID and IDA was unaffected. In conclusion, elderly people in Taiwan are an iron-replete population with a high prevalence of elevated iron stores and a low prevalence of iron deficiency.     

Survey of anaemia and Helicobacter pylori infection in adolescent girls in Suihua, China and enhancement of iron intervention effects by H. pylori eradication

In the present study, we investigated the prevalence of anaemia and Fe deficiency anaemia (IDA) and explored the relationship between Helicobacter pylori infection and IDA in adolescent girls. A total of 1037 adolescent girls from Suihua, China were enrolled. Hb, serum ferritin (SF), serum transferrin receptor (sTfR) and serum IgG antibodies to H. pylori were measured. Participants with IDA and co-existing H. pylori infection (n 80) who had an intake of >25 mg/d of Fe were assigned randomly to the intervention and control groups. Patients in the intervention group were administered a 12-week course of oral EDTA-Na-Fe (60 mg Fe/dose, three times a week) and a 2-week course of colloidal bismuth subcitrate, amoxicillin and metronidazole. Subjects in the control group were administered EDTA-Na-Fe alone. Hb, SF and sTfR were reassessed 3 months after the 12-week regimen ended. Prevalence of anaemia, Fe deficiency (defined as SF < 12·0 μg/l), IDA and H. pylori infection in the population of 1037 was 19.5, 40.4, 17.1 and 31.2 %, respectively. The prevalence of H. pylori infection in the IDA group was 46.9 %, while the non-anaemic group had 28.1 % prevalence. A significant increase in Hb and SF and a decrease in sTfR value were found in the intervention group and the H. pylori-negative group. Findings suggest that IDA is still one of the prominent problems in adolescent girls. There is an association between H. pylori infection and IDA. Treatment of H. pylori infection is associated with a more rapid response to oral Fe therapy.     

Iron deficiency anemia is highly prevalent among human immunodeficiency virus-infected and uninfected infants in Uganda

Although anemia is a common finding among human immunodeficiency (HIV)-infected infants in sub-Saharan Africa, the factors contributing to the pathogenesis of anemia have not been well characterized. We sought to characterize the relative contribution of iron deficiency and chronic disease to the anemia among infants. Hemoglobin, ferritin, erythropoietin, tumor necrosis factor-alpha (TNF-alpha), neopterin, CD4(+) lymphocyte count and plasma HIV load were measured in 165 HIV-infected and 39 uninfected 9-mo-old infants seen in an outpatient pediatric clinic in Kampala, Uganda. Among HIV-infected and uninfected infants, the prevalence of anemia (hemoglobin < 110 g/L) was 90.9 and 76.9%, respectively (P = 0.015), and the prevalence of iron deficiency anemia (hemoglobin < 110 g/L and ferritin < 12 microg/L) was 44.3 and 45.4%, respectively (P = 0.92). The relatively higher prevalence of anemia among HIV-infected infants was attributed to the anemia of chronic disease. Among infants with and without iron deficiency, the fitted regression line was log(10) plasma erythropoietin = 2.86 - 0.016.hemoglobin, and log(10) plasma erythropoietin = 4.11 - 0.028.hemoglobin, respectively, with a difference in the slope of the regression lines between log(10) erythropoietin and hemoglobin among infants with and without iron deficiency (P = 0.049). Infants in Uganda have an extremely high prevalence of anemia, and nearly half of the anemia is due to iron deficiency. The erythropoietin response to anemia appears to be upregulated among infants with iron deficiency.     

铁状态标记物诊断铁缺失的效能评价

目的:评价铁状态标记物血红蛋白(Hb)、平均红细胞体积(MCV)、血清铁(SI)、血清铁蛋白(Fer)、转铁蛋白(TF)和可溶性转铁蛋白受体(sTfR)诊断铁缺乏的有效性。方法:贫血患者69例,有21例缺铁性贫血(IDA),32例慢性病贫血(ACD)和16例其他病因所致贫血(ACOD)均进行骨髓铁染色检查。测定其Hb,MCV,Fer,TF和TfR水平,并计算了各诊断效能参数。结果:方差分析(ANOVA)显示所有铁状态标记物在3个观察组之间均存在明显差异(P≤0.001),但Hb、MCV、Fer和SI结果有明显重叠,不能作为鉴别铁缺乏指标。IDA(P=0.000)和ACOD(P=0.000)患者血清sTfR水平明显高于ACD患者。sTfR与铁蛋白对数比(TfR指数,TfRI)为区分铁缺乏提供了一个可靠的指标(AUC=1.00,Se、Sp、PVpos和PVneg均为100%,YI和Ef均为1.00)。用ROC曲线区分ACD和IDA的优劣程度依次是TfRI=TF>TfR>MCV>TFS>Fer>SI>Hb,区分ACD和ACOD的优劣程度依次是TfRI=TFS>TfR>MCV>TF>Fer>SI>Hb,区分ACD和(IDA+ACOD)的优劣程度依次是TfRI>TfR>TFS>MCV>TF>Fer>SI>Hb。结论:血清sTfR是诊断铁缺乏极具价值的非创伤性标记物。TfRI是理想的鉴别患者铁贮存情况指标。     

中国育龄期妇女贫血筛查血红蛋白阈值探讨

目的探讨适用于中国育龄期妇女贫血筛查的血红蛋白(Hb)阈值。方法从2002年中国居民营养与健康监测的资料中按一定的血红蛋白浓度梯度分层随机抽取619名育龄期妇女(20～45岁),运用分层分析的方法,根据其他铁营养状况指标和血红蛋白的相关性以及这些指标随血红蛋白浓度变化的趋势综合判断应用血红蛋白筛查贫血的适宜判定界值。结果 C反应蛋白(CRP)均在正常值范围内(≤8mg/L);血红蛋白与转铁蛋白受体、铁蛋白比值的对数lg(sTfR/SF)呈负相关,与血清铁(SI)、血清铁蛋白的对数(lgSF)和转铁蛋白饱和度TS(%)呈正相关;血红蛋白与其他铁营养状况指标的回归分析中,lgSF和sTfR/SF被纳入了回归方程(回归模型以及系数检验均有统计学意义,P<0.001),是解释血红蛋白浓度变化的两个最佳指标;SF和sTfR/SF两个指标在血红蛋白为110g/L这个拐点处变化最为显著。结论血红蛋白浓度110g/L可作为我国育龄期妇女贫血筛查的相对适宜判定界值。     

铁剂对缺铁孕妇和新生儿干预作用的研究

目的 :　研究孕妇缺铁导致新生儿缺铁的发病情况和补充铁剂的干预作用。方法 :　 44例孕妇分为对照组和铁剂组 ,孕中期开始分别服用安慰剂或铁剂。分别测定孕妇在服药前、服药后及新生儿的各项铁指标 :血清铁 (serum iron,SI)、总铁结合力 (total iron binding capacity,TIBC) ,转铁蛋白饱和度 (transferrin saturation,TS) ;血清铁蛋白 (serum ferritin,SF)。血红蛋白(Hb)值为临床资料。结果 :　对照组新生儿 Hb、SI、TS、SF平均值均低于铁剂组新生儿 ;对照组新生儿贫血发病率和贮铁不足率达 80 %、54.5% ,明显高于铁剂组。除母血 SF与新生儿 SI以外 ,孕妇与新生儿的 SI、TS、SF之间呈不同程度的显著正相关。孕末期铁剂组孕妇缺铁性贫血人数明显少于对照组 ;对照组孕妇孕末期 Hb、SI、TS、SF较孕中期进一步降低或维持原来的低水平 ,而铁剂组孕妇孕末期 Hb、SI、TS较孕中期有增加 ,SF未进一步降低。结论 :　孕妇与新生儿的铁营养状况密切相关 ,孕妇缺铁会导致新生儿缺铁。补充铁剂能减少孕妇及其新生儿缺铁     

周日补铁治疗儿童缺铁性贫血疗效观察

〖目的〗 观察每周一次补铁治疗缺铁性贫血（ＩＤＡ）的疗效。〖方法〗 采用设未治疗的病例对照组和正常对照组的方法,对５０例ＩＤＡ患儿每周一次性补充元素铁２ｍｇ／ｋｇ,共１２周。在治疗前、中、后观察Ｈｂ,ＺＰＰ,ＳＦ三项指标的变化。〖结果〗 治疗组治疗１２周后Ｈｂ、ＳＦ均极显著性升高（Ｐ〈０．０１）,ＺＰＰ极显著性降低（Ｐ〈０．０１）,病例对照组各指标各有改善,不能达到正常水平。〖结论〗 ７日补铁法对