转铁蛋白受体指数对儿童贮存铁减少的诊断价值

The value of serum transferrin receptor ratio to serum ferritin in the diagnosis of children′s iron deficiency store

目的探讨转铁蛋白受体指数[血清转铁蛋白受体(sTfR)/Log血清铁蛋白(SF)]对儿童贫血早期贮存铁减少(IDS)诊断的有效性。方法检测568例武汉地区来我院的就诊儿童和96名健康儿童的锌原卟啉(ZPP)、血红蛋白(Hb)、血清铁蛋白(SF)、血清转铁蛋白受体(sTfR)水平。依评价标准,分为铁正常、IDS、红细胞生成缺铁(IDE)与缺铁性贫血(IDA)4组。统计IDS儿童数量,并计算其sTfR/LogSF。采用受试者工作特征(ROC)曲线分析sTfR、sTfR/LogSF诊断儿童IPS的效率。结果筛查出的102例IDS儿童与健康儿童相比,血清sTfR和sTfR/LogSF均显著增加(P<0.05)。但对贫血早期儿童IDS的诊断而言,sTfR/LogSF的灵敏度、特异性、阳性预测值和阴性预测值均高于sTfR。经ROC曲线分析,sTfR诊断IDS的效率为0.79,而sTfR/LogSF诊断IDS的效率达0.93。结论sTfR/LogSF能有效反映儿童早期贮存铁的情况,可作为筛查儿童IDS的可靠指标。

Objective To study the diagnostic value of serum transferrin receptor （sTfR） ratio to serum ferritin （SF） for children＇ s iron deficiency store （ IDS ）. Methods The levels of zinc protoporphyrin （ ZPP ） , hemoglobin （Hb） , SF and sTfR in 568 health check children and 96 healthy children in WuHan area were determined and 568 children were divided into four groups according to the current criteria for assessing iron status ： iron normal, iron deficiency store （IDS） , iron deficiency erythropoiesis （IDE） and iron deficiency anemia （IDA）. The IDS children ratio of sTfR/ LogSF was calculated. The IDS children＇s iron deficiency was evaluated with receiver operating characteristics（ ROC ） curve. Results The levels of sTfR and sTfR/LogSF increased significantly in IDS children（P 〈 0.05 ）. The sensitivity, specificity, positive prediction and negative prediction of sTfR/LogSF were higer than sTfR in IDS children. The efficacy of sTfR in identifying IDS reached 79%, and the sTfR/LogSF reached 93 %. Conclusions sTfR/LogSF is promising for assessing iron store and screening IDS of children.