Hepcidin在老年缺铁性贫血和慢性病贫血中的诊断价值

Diagnostic Value of Hepcidin in Elderly Patients with Iron Deficiency Anemia and Anemia of Chronic Disease

目的:通过检测患者血清Hepcidin(铁调素)水平,探讨Hepcidin在老年人群缺铁性贫血(IDA)和慢性病贫血(ACD)中的应用价值。方法:选取老年IDA患者28例、ACD患者21例、健康对照组25例。应用ELISA法检测Hepcidin,血细胞分析仪检测WBC、RBC计数,放射免疫法检测血清铁蛋白(SF)水平,生化分析仪检测C-反应蛋白(CRP)、血清铁(SI)水平。结果:血清Hepcidin在IDA组、ACD组及对照组之间具有显著统计学意义(P<0.01);ACD组SF、WBC计数、CRP明显比IDA组高(P<0.01);根据受试者工作特征(ROC)曲线,当Hepcidin临界值取93.31μg/L时,诊断老年IDA敏感性为88%,特异性为89%;当Hepcidin临界值取130.05μg/L时,诊断ACD敏感性为72%,特异性为96%。结论:血清Hepcidin水平的检测有助于鉴别老年缺铁性贫血与慢性病贫血,具有一定的临床应用价值。

Objective： This study was to evaluate the differential diagnostic value of serum Hepcidin in elderly patients with iron deficiency anemia （ IDA ） and anemia of chronic disease （ ACD ）. Methods： The group of IDA consisted of 28 elderly patients, and the group of ACD consisted of 21 elderly patients, the control group included 25 healthy elderly people. Hepcidin was measured by ELISA; WBC, RBC counts were assayed by haematology analyzer; the serum ferritin level was measured by using radioimmunoassay; C-reaction protein（CRP） and serum iron levels were assayed by a biochemical analyzer. Results： Hepcidin level between the three groups was significantly different （P 〈 0.01）; serum ferritin,WBC and CRP levels in ACD patients were significantly higher than that in IDA patients（P 〈 0. 01 ） ; according to the receivers operating characteristic （ROC） curve, the best threshold in diagnosis of IDA was 93. 31 μg/L with the sensitivity of 88% and the specificity of 89% ; the best threshold diagnosis of ACD was 130.05 μg/L with the sensitivity of 72% and the specificity of 96%. Conclusions： serum Hepcidin has a certain value in the differential diaznosis of IDA and ACD in elderly patients.