血清铁蛋白在缺铁性贫血并感染中的诊断价值

Diagnosis value of serum ferritin on iron deficiency in anemic children with infectious diseases

目的 研究血清铁蛋白(SF)在并感染的缺铁性贫血(IDA)患儿中的诊断价值。方法 采用酶联免疫吸附试验,检测60例感染性疾病IDA患儿SF,其中38例骨髓铁染色显示铁缺乏患儿为A组[Hb(62.9±21.3)g／L],22例未做骨穿检查患儿为B组[Hb(83.3±16.4)g／L];同时检测20例患同类感染性疾病Hb正常患儿为对照组。结果 对照组SF为(170±150)μg／L,A组和B组分别为(40±32)μg／L、(53±37)μg/L,A、B组均明显低于对照组(P均<0.01)。在有骨髓铁染色作为金标准A组中,若分别以SF<14μg／L、<60μg／L、<100μg／L作为诊断界点,诊断缺铁敏感度分别为15.8％、73.7％、92.1％,约登指数分别为0.26、0.52、0.57,以SF<100μg／L为诊断界值准确性最好;在B组中若以同样几个界点作为判断缺铁标准,其敏感度分别为18.2％、63.6％、95.5％,约登指数为0.18、0.43、0.61,与A组相似。结论 在并感染性疾病的贫血患儿中,建议可将SF<100μg／L作为判断IDA的依据。

Objective To evaluate the cutoffs of serum ferritin(SF) in diagnosing iron deficiency in anemic children with infectious diseases. Methods SF was measured by enzyme-linked immunosorbent assay(EIA). Sixty children with iron deficiency anemia and common infectious diseases were included. Among them, 38 with no stainable iron in bom marrow were in group A [Hb (62.9±21.3) g/L],22 with no born marrow examination were in group B [Hb (83.3±16.4) g/L]. In group C there were 20 children who had the similar infectious diseases but with normal hemoglobin. Results SF in group A,B,C was (170±150)μg/L,(40±32)μg/L and (53±37)μg/L, respectively, with was significantly lower than that in group C (t=3. 83,3. 39 P = 0. 0010, 0.0027). When the cutoffs of ferritin were<14μg/L,<60μg/L,<100μg/L, in group A with no stainable iron in bone marrow, the sensitivity of SF in diagnosing iron deficiency were 15.8 % , 73.7 % , 92.1 % , Youden index were 0.26, 0 52, 0.57,respectively; and the sensitivity of group B were 18.2 %,63.6 %, 95.5 %, Youden index were 0.18, 0.43, 0.61, respectively, very similar to group A. Conclusion In anemic children with common infectious diseases,SF< 100μg/L can be a indicator for diagnosing iron deficiency