拉萨地区孕期妇女血红蛋白水平研究

Levels of hemoglobin concentration and anemia during pregnancy in Lhasa

目的 了解拉萨地区孕期妇女的血红蛋白（Hb）水平及高海拔下贫血患病情况。方法 随机抽样选择拉萨地区孕妇，采用B—Hemoglobin血红蛋白仪，取指末梢血10ul测量Hb含量，分别运用CDC法、Dirren法和Dallman法对Hb进行海拔调整，计算贫血患病率；采用KX-21N血液自动分析仪测量红细胞各参数，分析细胞特征。结果 共检测孕妇380名，Hb平均浓度为127．6g／L。藏族孕妇Hb为126．6g／L，低于其他民族134．6g／L；农村为130．4g/L，高于城市125．9g／L。以孕周作为协变量进行协方差分析后，藏族孕妇Hb浓度仍较低，城市和农村孕妇间差异无统计学意义。不同方法校正Hb与海拔关系后得出不同的贫血患病率：CDC法70．0％，Dirren法77．9％，Dallman法41．3％。分析红细胞参数发现，拉萨孕妇并未出现缺铁性贫血的特异性变化。结论 海拔因素对Hb有显著影响；拉萨孕期妇女Hb浓度较平原地区高；日前应用较为广泛的Hb同海拔间关系的校正方法可能会高估世居高原的藏族妇女人群贫血患病率。

Objective To investigate the distribution of hemoglobin（Hb） and prevalence of anemia in pregnant women living in the Tibetan Plateau area. Methods Random sampling method was used and fingertip blood sample was tested. Related soeiodemographic information was collected. We adjusted the hemoglobin measurements based on the different levles of altitude, using three different methods from CDC, Dirren＇s and Dallman＇s to estimate the prevalence rates of anemia. Results Three hundred and eighty pregnant women were included. The mean Hb was 127.6 g/L. Tibetan had a lower Hb （126.6 g/L） than people from other ethnlcities （134.6 g/L） with rural pregnant women having a higher Hb （130.4 g/L） than that of urban ones （125.9 g/L）. After controlling the gestational age, results remained the same. Different method used for correction of hemoglobin would cause different prevalence rates of anemia which were all higher than the pre-adjusted prevalence rates： 70.0% for CDC method, 77.9% for Dirren＇ s method and 41.3% for Dallman＇s method respectively. After analyzing the erythrocyte arameters, we could not conclude that population in our study was under the early stage of the iron deficiency anemia. Conclusion Higher altitude could affect the levels of hemoglobin concentration significantly. Currently adopted hemoglobin correction methods might not be suitable for Tibetan pregnant women. We suggested that it was imperative to establish a relationship between altitude and hemoglobin of Tibetan women during pregnancy in order to correctly evaluate the prevalence of anemia.