Hepcidin-25、HbA2、PON1表达水平在预测妊娠期缺铁性贫血中的价值

Clinical value of Hepcidin-25,HbA2 and PON1 expression levels in predicting the occurrence of iron deficiency anemia during pregnancy

目的探讨血清铁调素-25(Hepcidin-25)、血红蛋白A2(HbA2)、氧磷酶1(PON1)水平在预测妊娠期缺铁性贫血中的价值。方法将60例妊娠期缺铁性贫血患者纳入观察组,60例孕检正常的孕妇纳入对照组。比较两组研究对象血清Hepcidin-25、HbA2、PON1水平,采用受试者工作特征(ROC)曲线分析3项指标诊断妊娠期缺铁性贫血的效能,采用多因素Logistic回归分析Hepcidin-25、HbA2、PON1对妊娠期缺铁性贫血的影响,构建预测妊娠期缺铁性贫血的Nomogram模型,并进行Nomogram模型曲线校正及临床净收益分析。结果观察组的Hepcidin-25、HbA2、PON1水平明显低于对照组,差异有统计学意义(P<0.05)。Hepcidin-25、HbA2、PON1诊断妊娠期缺铁性贫血的曲线下面积(AUC)分别为0.973、0.915、0.993,cut-off值分别为103.22 ng/mL、2.21%、556.89 U/L。多因素Logistic回归分析结果显示Hepcidin-25≤103.22 ng/mL、HbA2≤2.21%、PON1≤556.89 U/L是妊娠期缺铁性贫血发生的独立危险因素(P<0.05)。以独立危险因素构建Nomogram模型,并进行内部检验,Nomogram预测模型的临床应用价值较高,净收益均高于Hepcidin-25、HbA2、PON1。结论Hepcidin-25、HbA2、PON1可用于妊娠期缺铁性贫血的预测。

Objective To explore the value of serum Hepcidin-25,hemoglobin A2(HbA2)and paraoxonase 1(PON1)levels in predicting iron deficiency anemia during pregnancy.Methods A total of 60 patients with iron deficiency anemia during pregnancy were included in the observation group,and 60 healthy pregnant women were included in the control group.The serum levels of Hepcidin-25,HbA2 and PON1 were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of the three indicators in the diagnosis of iron deficiency anemia during pregnancy,and multiple Logistic regression was used to analyze the effects of Hepcidin-25,HbA2 and PON1 on iron deficiency anemia during pregnancy.To construct a Nomogram model to predict iron deficiency anemia in pregnancy,and to conduct a Nomogram model curve correction and clinical net benefit analysis.Results The levels of Hepcidin-25,HbA2 and PON1 in the observation group were significantly lower than those in the control group(P<0.05).The area under the curve(AUC)of Hepcidin-25,HbA2 and PON1 in the diagnosis of iron deficiency anemia during pregnancy were 0.973,0.915 and 0.993 respectively,and the cut-off values were 103.22 ng/mL,2.21%and 556.89 U/L respectively.Mutiple Logistic regression showed that Hepcidin-25≤103.22 ng/mL,HbA2≤2.21%and PON1≤556.89 U/L were the risk factors of iron deficiency anemia during pregnancy(P<0.05).The Nomogram model constructed with independent risk factors had been internally tested.Nomogram prediction model had high clinical application value,and the net income was higher than Hepcidin-25,HbA2 and PON1.Conclusion Hepcidin-25,HbA2 and PON1 could be used to predict iron deficiency anemia during pregnancy.