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]

IRON DEFICIENCY INDUCED CHANGES OF RETICULOCYTE PARAMETERS AND SERUM TRANSFERRIN RECEPTOR

Objective To investigate the early sensitive index of iron deficiency(ID).Methods A total of 279 females,aged 12–15 years,was divided into four groups: iron depletion phase(SID),iron-deficient erythropoiesis(IDE),iron-deficiency anemia(IDA) and controls group,on the basis of the measured values of serum ferritin(SF),hemoglobin(Hb) and serum iron(SI).The parameters of reticulocyte including reticulocyte count(Ret%),low fluorescence reticulocytes(LFR),middle fluorescence reticulocytes(MFR),high fluorescence reticulocytes(HFR) and reticulocyte maturity index(RMI),serum transferrin receptor(sTfR) and the parameters of erythrocyte including red cell distribution width(RDW%) and mean corpuscular volume(MCV) were assayed.The data of intervention groups were compared with healthy controls group.The relationship between the sTfR and other indexes of iron deficiency was analysed.Results The average HFR and sTfR in SID,IDE and IDA were significantly higher than those of the control(P<0.01).Moreover,they were several times increased in intervention groups as compared with control group.The average MFR,RMI,RDW% and MCV were insignificantly different between SID and control groups(P>0.05),and they were significantly different in IDE and IDA as compared with the control(P<0.01 or P<0.05),Among the total,the MFR and RMI were several times changed in IDA when compared with the control.The concentration of sTfR was positively correlated significantly with HFR,MFR and RMI(r=0.51,0.57,0.64,P<0.05,respectively),and negatively correlated significantly with Hb(r = ?0.54,P<0.01).However,the concentration of sTfR was only weakly correlated with SF and SI(r =?0.30,-0.31,P<0.05).Conclusion HFR,sTfR,MFR and RMI are sensitive indexes of the early iron deficiency,especially the first two.They could be applied in screening of iron deficiency.ACTA NUTRIMENTA SINICA,2013,35(2):150-153]