缺铁性贫血对孕妇免疫功能及感染性疾病的影响

目的探讨妊娠期缺铁性贫血(IDA)特别是边缘性铁缺乏对妇女免疫功能和感染易感性的影响。方法从孕检的280名孕30～38周第一胎妇女中,通过测定血红蛋白、红细胞内游离原卟啉和血清铁蛋白诊断出69名IDA孕妇、随机抽取52名正常孕妇和50名婚检非孕妇女作为研究对象,检测其细胞免疫的T淋巴细胞亚群CD+3、CD+4、CD+8和自然杀伤(NK)细胞CD16活性及IL2水平,以及体液免疫的IgA、IgG、IgM和补体C3水平;记录妇女妊娠期和分娩1周内感染性疾病的患病情况,SAS软件进行统计分析。结果本调查IDA孕妇Hb值均数为(102.00±6.00)gL,其CD+3、CD+4细胞的百分比、CD+4CD+8比值及IL2水平低于正常孕妇(P<0.01,P<0.05,P<0.05,P<0.01),IDA孕妇IgG水平低于正常孕妇(P<0.01),且随孕妇Hb值的下降,这些指标水平呈下降趋势;孕中期开始IDA孕妇感染性疾病的总发病率高于正常孕妇(P<0.05)。结论IDA孕妇T细胞亚群数量及因子水平和部分免疫球蛋白水平改变,感染性疾病发病率增高;对NK细胞活性和产褥期感染易感性的影响,尚需增加样本数进一步观察。

Effects of iron deficiency anemia on immunity and infectious disease in pregnant women

OBJECTIVE: To review the changes in immune function and incidence of infectious diseases in pregnant women with iron deficiency anemia (IDA), especially marginalde-ficiency of iron. METHODS: T lymphocyte subsets level (CD3+, CD4+ and CD8+), nature kill cells activity (CD16), interleukin-2 (IL-2) and serum IgA, IgG, IgM and complement C3 were determined in 3 different wormen groups, including 69 IDA pregnant women who were diagnosed by Hemoglobin, concentrations of free erythocyte porphrin and serum ferritin from 280 pregnant women during 30-38weeka of gestation, 52 random sampling normal pregnant women and 50 no pregnant women examined before marriage. RESULTS: The prevalenoe of IDA for pregnant women is 24.6%. The average concentration of Hb for pregnant women of IDA is 102.00(6.00 g/L The level of CD3+ and CD4+ cells, the ratio of CD4+/CD8+ cells, serum IL-2 as well as IgG levels in the pregnant women were significantly lower than that of those normal pregnant women (P < 0.01, P < 0.05, P < 0.05, P < 0.01). With the decreasing extent of Hb, these significant immunological indices of pregnant women will degrease. The incidence of infectious diseases in IDA pregnant women was significantly higher than that in normal pregnant women (P < 0.05). CONCLUSION: There are significantly effects of IDA on cellular immune function and infectious disease during pregnancy. The study on effects of IDA during pregnancy on nature kill cells activity (CD16) and incidence of infectious diseases during puerperium should be continued by increasing sample's number.