呼和浩特地区普通健康人群血清铁蛋白增高的临床分析

Clinical analysis of serum SF increase in common healthy population in Huhehaote area

目的分析研究普通健康体检人群血清铁蛋白(SF)增高的临床特点,为当地SF增高人群的临床就诊提供指导依据。方法选择2008年1月至2012年12月于内蒙古医科大学附属医院体检中心进行健康体检中利用化学发光免疫方法检测发现SF增高的人群,并做进一步相关检查及随访检测,根据随访结果对血清SF增高原因进行临床分析。结果在600例SF增高的体检人群中良性和恶性病变的SF分别为(478.55±456.19)、(796.95±566.93)ng/mL,二者差异有统计学意义(P<0.05);在72例SF增高恶性病变中,肝癌、胰腺癌、肺癌、淋巴瘤、白血病、多发性骨髓瘤、宫颈癌SF分别为(996.35±599.93)、(746.35±544.67)、(556.72±448.61)、(438.62±488.43)、(516.11±422.68)、(477.42±379.25)、(468.34±422.99)ng/mL,肝癌组和胰腺癌组与其他各组比较,差异均有统计学意义(P<0.05),而肺癌、淋巴瘤、白血病、多发性骨髓瘤、宫颈癌组间比较,差异无统计学意义(P>0.05);在528例SF增高良性病变中消化、呼吸、内分泌、血液、神经、心血管、肾脏系统疾病SF分别为(789.33±446.49)、(488.70±414.28)、(361.53±299.79)、(300.72±147.58)、(556.74±458.71)、(467.74±345.56)、(263.45±168.45)ng/mL,消化与其他各系统比较,差异均有统计学意义(P<0.05);在265例SF增高的良性的消化系统病变中病毒性肝炎组、病毒性肝炎后肝硬化组、酒精性肝炎组、酒精性肝炎后肝硬化组SF分别为(656.33±346.56)、(780.33±446.21)、(456.34±278.96)、(660.12±403.69)ng/mL,病毒性肝炎组与酒精性肝炎组SF增高比较,差异有统计学意义(P<0.05)。结论 SF可以作为体检人群恶性肿瘤初筛的重要实验室参考指标之一,但特异性不高,可作为甲胎蛋白阴性肝癌患者的辅助诊断。

Objective To analyze the clinical characteristics of serum ferritin（SF）increase in common healthy people to provide better guidance suggestion for the clinical diagnosis and treatment of the SF increase crowd.Methods The cases with increased SF detected by the chemiluminescence immune method among the healthy individuals of physical examination in the physical examination center of this hospital from January 2008 to December 2012 were collected and performed the further related detection and follow up detection.According to follow up results,the causes of SF increase were clinically analyzed.Results In 600 cases of SF increase physical examination individuals,SF in benign and malignant lesions were（478.55±456.19）ng/mL and（796.95±566.93）ng/mL respectively,the difference between them had statistical significance（P〈0.05）.In 72 cases of increased SF malignant lesions,SF in liver cancer,pancreatic cancer,lung cancer,lymphoma,leukemia,multiple myeloma and cervical cancer were（996.35±599.93）,（746.35±544.67）,（556.72±448.61）,（438.62±488.43）,（516.11±422.68）,（477.42±379.25）,（468.34±422.99）ng/mL respectively,the differences between liver and pancreatic cancer groups with other groups had statistical significance（P〈0.05）,but the difference among lung cancer,lymphoma,leukemia,multiple myeloma and cervical cancer groups had no statistical significance（P〉0.05）;in 528 cases of SF increase benign lesions,SF in digestive,respiratory,endocrine,hematology,nervous,cardiovascular,renal system lesions were（789.33±446.49）,（488.70±414.28）,（61.53±299.79）,（300.72±147.58）,（556.74±458.71）,（467.74±345.56）,（263.45±168.45）ng/mL respectively,the differences between the digestive system group with other system groups had statistical significance（P〈0.05）.The increased levels of SF had difference among digestive and other systems（P〈0.05）;in 265 cases of SF increase digestive system lesions,SF in viral hepatitis,liver cirrhosis after viral hepatitis,alcoholic hepatitis,liver cirrhosis after alcoholic hepatitis group were（656.33±346.56）,（780.33±446.21）,（456.34±278.96）,（660.12±403.69）ng/mL respectively,the increased levels of SF had statistical difference between the viral hepatitis group and the alcoholic hepatitis group（P〈0.05）.Conclusion SF can be used as one of the important reference laboratory indexes of malignant tumor early screening,but the specificity is not high,SF can be used as the auxiliary diagnosis of hepatocellular carcinoma in the patients with AFP negative.