血清游离红细胞原卟啉和尿液铁调素-25诊断铁缺乏的临床意义

Application of serum FEP and urine hepcidin-25 in the diagnosis of iron deficiency and its clinical significance

目的:探讨血清游离红细胞原卟啉(FEP)、尿液铁调素-25(hepcidin-25)诊断铁缺乏的临床意义。方法:以2016年5月—2019年7月收治的30例贮存铁耗尽期患儿为A组,30例缺铁性红细胞生成期患儿为B组,30例缺铁性贫血期患儿为C组,30例健康体检儿童为对照组。所有研究对象均接受血清FEP、尿液hepcidin-25检测。结果:(1)A、B、C 3组血清FEP水平分别与对照组比较,差异有统计学意义(P<0.05);A组与B组、A组与C组、B组与C组血清FEP水平相互比较差异有统计学意义(P<0.05)。(2)A、B、C 3组尿液hepcidin-25水平分别与对照组比较,差异有统计学意义(P<0.05);A组与B组、A组与C组尿液hepcidin-25水平比较差异有统计学意义(P<0.05),B组与C组比较差异无统计学意义(P>0.05)。(3)血清FEP对A组诊断的灵敏度为0.867,特异度为0.967,约登指数为0.833;对B组诊断的灵敏度为0.800,特异度为0.800,约登指数为0.600;对C组诊断的灵敏度为0.767,特异度为0.767,约登指数为0.533。尿液hepcidin-25对A组诊断的灵敏度为0.900、特异度为0.367,约登指数为0.267;对B组诊断的灵敏度为0.800,特异度为0.700,约登指数为0.500;对C组诊断的灵敏度为1.000,特异度为0.833,约登指数为0.833。结论:血清FEP和尿液hepcidin-25对所有铁缺乏的患儿都表现出一定的诊断能力,对缺铁性红细胞生成期及缺铁性贫血期患儿的诊断能力较强,对贮存铁耗尽期患儿的诊断能力相对较弱,血清FEP和尿液hepcidin-25可作为铁缺乏患儿进行早期诊断的实验室指标,值得临床推广使用。

Objective: To investigate the clinical significance of serum free erythrocyte protoporphyrin(FER) and urine hepcidin-25 in the diagnosis of iron deficiency. Methods: From May 2016 to July 2019, 30 children with iron depletion stage were selected as group A, 30 children with iron deficiency erythropoiesis stage as group B, and 30 children with iron deficiency iron deficiency anemia as group C, 30 healthy children were taken as control group. All subjects were tested for serum FEP and urine hepcidin-25. Results:(1) The levels of serum FEP in group A, group B and group C were significantly higher than those in the control group(P<0.05);There were significant differences in the serum FEP levels between group A and group B, group A and group C, group B and group C(P<0.05).(2)The levels of hepcidin-25 in urine of group A, group B and group C were significantly higher than those of the control group(P<0.05), and the levels of hepcidin-25 in urine of group A and group B, group A and group C were significantly higher than those of the control group(P<0.05), there was no significant difference between group B and group C(P>0.05).(3)The sensitivity, specificity and yoden index of serum FEP in group A were 0.867, 0.967 and 0.833 respectively;The sensitivity, specificity and yoden index of group B were 0.800, 0.800 and 0.600 respectively;The sensitivity, specificity and yoden index of group C were 0.767, 0.767 and 0.533 respectively. The sensitivity, specificity and yoden index of urinary hepcidin-25 in group A were 0.900, 0.367 and 0.267 respectively;The sensitivity, specificity and yoden index of group B were 0.800, 0.700 and 0.500 respectively;The sensitivity, specificity and yoden index of group C were 1.000, 0.833 and 0.833,respectively. Conclusion: Both serum FEP and urine hepcidin-25 are capable of diagnosing iron deficiency in all patients, and are better for iron deficiency in erythropoiesis and iron deficiency anemia, FEP in serum and hepcidin-25 in urine can be used as laboratory indexes for early diagnosis of patients with iron deficiency.