孕晚期轻型地中海贫血孕妇的铁储备研究

The Study of Iron Storage of Thalassemia Minor Gravidas in Third Trimester

目的研究轻型地中海贫血(thalassemia minor,以下简称地贫)孕妇孕晚期铁储备,旨在为临床轻型地贫孕妇铁储备监测提供理论依据。方法按标准选取本院定期产检的28~36周孕妇108例为研究对象,分为:α-轻型地贫组(A组):45例,β-轻型地贫组(B组):32例(以上两组又总称为地贫组),缺铁性贫血组(iron-deficiency anemia,IDA)(C组):31例。所有病例同期检测血红蛋白(haemoglobin,Hb)、血清铁蛋白(serum ferritin,SF)及可溶性转铁蛋白受体(soluble transferrin receptor,s-TfR),同时对各项指标进行统计学分析。结果三组相比较:SF:A组、B组、C组三组间差异有统计学意义(F=19.738,P<0.05),多重比较B组高于C组和A组(P<0.05)、C组高于A组(P=0.83)。sTfR:A组、B组、C组三组间差异有统计学意义(F=6.696,P=0.002),多重比较A组高于B组和C组(P=0.209、P<0.05)、B组高于C组(P=0.029)。Hb:A组、B组、C组三组间差异有统计学意义(F=17.469,P<0.05),多重比较C组高于A组和B组(P=0.019、P<0.05)、A组高于B组(P<0.05)。地贫组与C组相比较:SF、s-TfR:地贫组均明显高于C组(t=2.414,3.424,P=0.018,0.001),差异有统计学意义。Hb:地贫组及C组分别为:(91.36±8.43)g/L、(98.44±7.12)g/L,地贫组低于C组,差异有统计学意义(t=-4.118,P<0.05)。结论孕晚期轻型地贫患者的铁储备高于IDA,轻型地贫较IDA贫血情况更为严重,且β-轻型地贫较α-轻型地贫更易出现贫血。轻型地贫较IDA其组织缺铁程度更严重,且α-轻型地贫较β-轻型地贫程度更重。

Objective To study the iron reserve of pregnant women with thalassemia minor in late pregnancy,in order to provide theoretical basis for the monitoring of iron reserve of pregnant women with thalassemia minor.Methods According to the standard,108 pregnant women who underwent regular antenatal examination in the hospital were divided into three groups:α-mild thalassemia minor group(group A,n=45),β-mild thalassemia minor group(group B,n=32)and iron deficiency anemia group(iron-deficiency anemia,IDA)(C group,n=31).Hemoglobin(haemoglobin,Hb),serum ferritin(serum ferritin,SF)and soluble transferrin receptor(soluble transferrin receptor,s-TfR),were detected in all cases at the same time.Results Compared with the three groups:SF:group A,group B and group C,the difference was statistically significant(F=19.738,P<0.05),multiple comparison group B was higher than group C and group A(P<0.05),group C was higher than group A(P=0.83).s-TfR:there was significant difference among three groups(F=6.696,P=0.002),multiple comparison group A was higher than group B and group C(P=0.209,P<0.05),group B was higher than group C(P=0.029).Hb:there was significant difference among three groups(F=17.469,P<0.05),multiple comparison group C was higher than group A and group B(P=0.019,P<0.05),group A was higher than group B(P<0.05).Compared with group C,SF and sTfR in group C were significantly higher(t=2.414,3.424,P=0.018,0.001).Hb:the difference between the group of poverty and the group C was(91.36±8.43)g/L and(98.44±7.12)g/L,respectively.The difference was statistically significant(t=-4.118,P<0.05).Conclusion The iron reserve of patients with mild thalassemia minor in late pregnancy was higher than that of IDA,and the anemia of mild thalassemia minor was more serious than that of IDA,andβ-mild thalassemia minor was more prone to anemia thanα-mild thalassemia minor.The degree of iron deficiency in mild thalassemia minor was more serious than that in IDA,and the degree ofα-mild thalassemia minor was more severe than that inβ-mild thalassemia minor.