缺铁性贫血患者sTfR、SF、SI、UIBC、TRF检测的临床意义研究

Clinical significance of detection of sTfR,SF,SI,UIBC,TRF in patients with iron deficiency anemia

目的研究缺铁性贫血患者可溶性转铁蛋白受体(sTfR)、血清铁蛋白(SF)、血清铁(SI)、不饱和铁结合力(UIBC)和转铁蛋白(TRF)检测的临床意义。方法选择2021年1月至2023年2月济源市人民医院收治的30例单纯缺铁性贫血患者作为缺铁性贫血组,30例单纯慢性病贫血患者作为慢性病贫血组,同期选择30例健康体检人群为健康对照组。对比三组患者的sTfR、SF、SI、UIBC、TRF水平,分析sTfR、SF、SI、UIBC、TRF在不同程度缺铁性贫血中的表达,并采用Pearson相关性分析不同贫血程度与sTfR、SF、SI、UIBC、TRF的相关性;受试者工作特征(ROC)曲线评估sTfR、SF、SI、UIBC、TRF对缺铁性贫血的诊断效能。结果缺铁性贫血组、慢性病贫血组与健康对照组的sTfR、SF、SI、UIBC和TRF水平差异均有统计学意义(P<0.05)。sTfR、UIBC、TRF:轻度患者低于中度患者,而中度患者低于重度患者(P<0.05);SF、SI:轻度患者高于中度患者,而中度患者高于重度患者(P<0.05)。Pearson相关性显示,缺铁性贫血患者的Hb与SF、SI呈正相关,与sTfR、UIBC、TRF呈负相关(P<0.05)。ROC曲线显示,sTfR的曲线下面积(AUC)为0.857(0.771~0.943),SF的AUC为0.779(0.683~0.876),SI的AUC为0.745(0.643~0.847),UIBC的AUC为0.708(0.580~0.836),TRF的AUC为0.761(0.662~0.861),联合检测的AUC为0.968(0.771~0.943)(P<0.05)。结论sTfR、SF、SI、UIBC、TRF在缺铁性贫血、慢性病贫血和健康人群中的表达均有明显差异,同时各指标受生理或病理因素影响,不能单独用于缺铁性贫血的诊断。故应综合多项指标检测,以便为缺铁性贫血患者的早期筛查和诊断提供参考依据。

【Objective】To study the clinical significance of the detection of soluble transferrin receptor(sTfR),serum ferritin(SF),serum iron(SI),unsaturated iron binding capacity(UIBC),and transferrin(TRF)in patients with iron deficiency anemia.【Methods】From January 2021 to February 2023,30 patients with simple iron deficiency anemia admitted to the hospital were selected as the iron deficiency anemia group,and 30 patients with simple chronic disease anemia were selected as the chronic disease anemia group.During the same period,30 healthy individuals undergoing physical examination were selected as the healthy control group.The levels of sTfR,SF,SI,UIBC,and TRF in three groups of patients were compared,the expression of sTfR,SF,SI,UIBC,and TRF in different degrees of iron deficiency anemia was analyzed,and Pearson correlation was used to analyze the correlation between different degrees of anemia and sTfR,SF,SI,UIBC,and TRF.The reciever operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of sTfR,SF,SI,UIBC,and TRF in iron deficiency anemia.【Results】There were significant differences in the levels of sTfR,SF,SI,UIBC,and TRF between the iron deficiency anemia group,the chronic disease anemia group,and the healthy control group(P<0.05).sTfR,UIBC,TRF:Mild patients were lower than moderate patients,while moderate patients were lower than severe patients(P<0.05);SF,SI:Mild patients were higher than moderate patients,while moderate patients were higher than severe patients(P<0.05).Pearson correlation showed that Hb in patients with iron deficiency anemia was positively correlated with SF,SI,and negatively correlated with sTfR,UIBC,and TRF(P<0.05).The ROC curve shows that the area under curve(AUC)of sTfR is 0.857(0.771 to 0.943),the AUC of SF is 0.779(0.683 to 0.876),the AUC of SI is 0.745(0.643 to 0.847),the AUC of UIBC is 0.708(0.580 to 0.836),the AUC of TRF is 0.761(0.662 to 0.861),and the AUC of joint detection is 0.968(0.771 to 0.943)(P<0.05).【Conclusion】The expressions of sTfR,SF,SI,UIBC,and TRF are significantly different in iron deficiency anemia,chronic disease anemia,and healthy individuals.However,due to physiological or pathological factors,these indicators cannot be used solely for the diagnosis of iron deficiency anemia.Therefore,multiple indicator tests should be integrated to provide a reference basis for early screening and diagnosis of iron deficiency anemia patients.