轻型地中海贫血孕妇全血微量元素的影响因素

The influencing factors of whole blood trace elements in pregnant women with mild thalassemia

目的:探讨轻型轻型地中海贫血(简称"地贫")孕妇全血微量元素浓度的影响因素.方法:基因诊断318例地贫孕妇,其中静止型α地贫32例、标准型α地贫171例,β地贫杂合子(β+地贫)104例,α,β混合型地贫11例,对照组120例,统计分析全血微量元素与红细胞参数及全血微量元素相互之间关系.结果:1轻型地贫孕妇与对照组相比,全血铁(Fe)、镁(Mg)明显降低(P<0.01);除静止型α地贫外,全血锌(Zn)均升高(P<0.01).Fe含量α地贫组高于β+地贫(P<0.01);Zn浓度由高到低依次为α,β混合型地贫和标准型α地贫[(113.33±21.74)、(111.94±17.06)μmol/L]>β+地贫(98.71±15.04)μmol/L>静止型α地贫(89.93±17.19)μmol/L(P<0.01).2轻型地贫孕妇与对照组相比,血红蛋白(Hb)、红细胞比积(HCT)、红细胞平均容积(MCV)、红细胞平均血红蛋白量(MCH)、红细胞平均血红蛋白浓度(MCHC)降低,红细胞(RBC)(除静止型α地贫)升高(均P<0.01);标准型α地贫RBC高于β+地贫(P<0.01);β+地贫Hb低于其他地贫组(P<0.05或P<0.01).3与健康孕妇相比,轻型地贫孕妇Ca与红细胞参数呈负相关,且相关性减低,而Fe、Zn、Mg与红细胞参数呈正相关,且相关性升高;各微量元素之间的相关性,除Zn和Mg之间明显升高外,其他相关性减低或无明显差异.结论:特殊贫血状态(RBC升高,HB减低)、微量元素之间的相互影响是导致地贫孕妇微量元素改变的重要原因.

Aim：To explore the influencing factors of whole blood elements in pregnant women with mild thalassema. Methods： Three hundred and eighteen pregnant women with various genotypes of mild thalassemia were classified into four groups： silent α-thalassemia group （31 cases）, standard α -thalassemia （171 cases）, β^＋ thalassemia （104 cases）, α-compounding β-thalassemia （11 cases）, and control group were 120 cases. The Red Blood Cell Parameters and whole blood elements： Ca, Cu, Fe, Zn, Mg, Pb, Cd were determined from all the samples, and the results were statistically analyzed. Results： ①The levels of iron and magnesium in all groups of pregnant women with mild thalassemia were lower than those of the control group （P〈0.01）,and the level of zinc was higher except silent α-thalassemia （P〈0.01）.The level of Fe in standard α-thalassemiawere was higher than that of β^＋ thalassemia （P〈0.01）. The level of zinc in α-compounding β-thalassemia and standard α-thalassemia was decreasing [（113.33±21.74）、（111.94±17.06）μmol/L] 〉β^＋thalassemia （98.71±15.04） μmol/L〉silent α-thalassemia （89.93±17.19） μmol/L （P〈0.01）. ② For pregnant women with thalassemia minor, the levels of Hb, HCT, MCV, MCH and MCHC were decreasing, while, the level of RBC was higher than that of control group with the value of P〈0.01 （except for the silent α-thalassemia）. Moreover, standard α-thalassemia has higher level of RBC than that of β^＋ thalassemia [（4.49±0.44）×1012/L, 4.34±0.50×1012/L] （P〈0.01）; and for β^＋ thalassemia, its level of Hb was lower than that of the other thalassemia groups （P〈0.05 or P〈0.01）. ③ Compared with the healthy pregnant women, Ca and red blood cell parameter showed a negative correlation and the correlation decreased, while Fe, Zn, Mg and red blood cell parameter showed a positive correlation and the correlation increased. The correlation between each of the trace elements, except for Zn and Mg increased significantly, reduced or had no significant difference. Conclusion：The influencing factors of whole blood elements in pregnant women with mild thalassema were very complicated, including anemia caused by thalassemia, the change of red blood cell parameters, the different levels of elements inside and outside red blood cell, the interrelationship of elements between each other and oxidative stress caused by thalassemia.