轻型地贫孕妇不同孕期SF、Hb、Ret-He及Ret％水平变化的临床观察

目的探讨血清铁蛋白(SF)、血红蛋白(Hb)、网织红细胞血红蛋白含量(Ret-He)以及网织红细胞百分率(Ret%)水平在轻型珠蛋白生成障碍性贫血(简称地贫)孕妇不同孕期补铁治疗前的变化特点及临床意义。方法选取不同孕期的轻型地贫孕妇245例(α-地贫149例,β-地贫96例)、铁缺乏(ID)孕妇155例、缺铁性贫血(IDA)孕妇117例及同期健康孕妇316例作为研究对象,并将ID组、IDA组、HC组统一归为非地贫组,分析5组孕妇的SF、Hb、Ret-He及Ret%水平随孕周的变化趋势,并比较α-地贫、β-地贫和非地贫孕妇不同孕期的ID和IDA发生率。结果与健康孕妇相同,随孕周增加,α-地贫和β-地贫孕妇SF水平呈下降趋势(P<0.05),β-地贫孕妇Hb水平为先下降后升高(P <0.05),Ret%水平除β-地贫组外,其余各组则逐渐增高(P <0.05)。α-地贫孕妇IDA主要发生于中孕期(61.5%)和晚孕期(60.3%),β-地贫孕妇IDA主要发生于晚孕期(61.9%),均高于同期非地贫组(P均<0.01);但ID更易发生在非地贫孕妇中孕期(29.0%)和晚孕期(39.9%)。结论α-地贫相对于β-地贫更早出现缺铁,但β-地贫比α-地贫贫血程度更重。SF、Hb、Ret-He以及Ret%水平检测用于轻型地贫患者妊娠期铁缺乏筛查及病情评估可提高准确性,其中Ret-He可作为地贫孕妇铁储备水平监测指标。

Clinical observation on the level of SF,Hb,Ret-He and Ret% in different period pregnant women with minor thalassemia

Objective To observe the characteristics and clinical significance of serum ferritin(SF),hemoglobin(Hb),reticulocyte hemoglobin content(Ret-He)and percentage of reticulocytes(Ret%)before iron supplementation in different period pregnant women with minor thalassemia.Methods A total of 245 cases of pregnant women with minor thalassemia(149 cases wereα-thalassemia,96 cases wereβ-thalassemia),155 pregnant women with iron deficiency(ID),117 pregnant women with iron deficiency anemia(IDA)and 316 healthy pregnant women in the same period were enrolled.The ID group,IDA group and HC group were all classified as non thalassemia group.The change trend of SF,Hb,Ret-He and Ret% were analyzed in the five groups of pregnant women,and compared the occurrence rate of ID and IDA in different pregnancy women withα-thalassemia,β-thalassemia and non-thalassemia.Results Compared with healthy pregnant women,with the increase of gestational weeks,the SF level in the pregnant women withα-thalassemia and the pregnant women withβ-thalassemia showed a downward trend(P<0.05),and the Hb level of the pregnant women withβ-thalassemia decreased firstly and then increased(P<0.05).The Ret%level increased gradually in all groups except theβ-thalassemia group(P<0.05).There was no significant diffidence in Ret-He levels among groups at different gestational weeks.IDA in pregnant women withα-thalassemia mainly occurred in the middle pregnancy(61.5%)and late pregnancy(60.3%),and that mainly occurred in the late pregnancy(61.9%)in pregnant women withβ-thalassemia,which both higher than that in non-thalassemia(P<0.01).However,ID was more likely to occur in the middle pregnancy(29.0%)and late pregnancy(39.9%)of non thalassemia.Conclusion Iron deficiency might occur earlier inα-thalassemia than that inβ-thalassemia,butβ-thalassemia were even more anaemic thanα-thalassemia.SF,Hb,Ret-He and Ret%levels could improve the accuracy of screening and disease assessment of pregnant women with thalassemia minor.Among them,Ret-He could be used as the monitoring index of iron reserve level in pregnant women.