妊娠期妇女缺铁性贫血诊断指标一致性的探讨

Evaluation on consistency of diagnostic indexes for iron deficiency anemia in pregnant women

目的 评价以血红蛋白为指标诊断孕妇缺铁性贫血(IDA)与血清铁蛋白和红细胞游离原卟啉变化的符合程度。方法 对506名不同孕周孕妇的血红蛋白、血清铁蛋白和红细胞游离原卟啉进行检测,分别以血红蛋白<100g/L、<105g/L和<110g/L作为诊断IDA的界限值,应用Kappa分析方法分别分析了血红蛋白与血清铁蛋白和红细胞游离原卟啉检测的一致性。结果 21孕周前,血红蛋白的3种界限值与血清铁蛋白、红细胞游离原卟啉诊断的一致性普遍较差;21孕周后,以血红蛋白<105g/L和<110g/L为界值,血红蛋白与血清铁蛋白和红细胞游离原卟啉诊断的一致性普遍较好,但以血红蛋白<100g/L为界限值与血清铁蛋白、红细胞游离原卟啉诊断的一致性相对较差。结论 血红蛋白与血清铁蛋白和红细胞游离原卟啉检测孕妇IDA的一致性,与孕周以及血红蛋白的界限值有关。

Objective To evaluate the consistency of hemoglobin (Hb) as an diagnostic index for iron deficiency anemia (IDA) in pregnant women with serum ferritin (SF) and free erythrocyte protoporphyrin (FEP).Methods Hb,SF and FEP were assayed for 506 pregnant women with various gestational weeks for the diagnosis of IDA with Hb<100 g/L,<105 g/L and<110 g/L as cut-off values,respectively.Kappa was calculated to estimate their consistency.Results Diagnosis for IDA in women with less than 21 gestational weeks,Hb was not consistent well with SF or FEP,regardless the cut-off values for Hb.That in women with 21 or more gestational weeks,Hb,with cut-off values of 105 g/L or 110 g/L,was quite consistent with SF and FEP,while a cut-off value of 100 g/L Hb was not so well consistent with SF or FEP.Conclusions The consistency between Hb and SF or FEP in the diagnosis for IDA in pregnant women was associated with their length of gestational weeks and the cut-off value of Hb.