应用不同血红蛋白标准对高海拔地区孕晚期妇女贫血诊断的影响

Effects of applying different hemoglobin standards on the anemia diagnosis of pregnancy in the third trimester in high-altitude areas

目的探讨应用不同血红蛋白(Hb)标准对高原地区孕晚期妇女贫血诊断的影响。方法测定居住在海拔2200米和4000米地区、妊娠>28周的孕妇Hb;评估应用不同Hb标准对高原地区孕晚期妇女贫血诊断的影响。结果采用现用国家标准作为贫血诊断标准(Hb<110 g/L),2200米地区的孕晚期妇女检出率为19.77%;4000米地区检出率为26.63%,轻度贫血多见。以国际卫生组织(WHO)海拔矫正后标准作为贫血诊断标准,2200米地区以Hb<120 g/L为贫血诊断标准检出率为47.81%;4000米地区以Hb<145 g/L为贫血诊断标准检出率为92.39%,中度及以上贫血多见。结论现用国家标准会导致高原地区孕晚期妇女贫血患者漏诊,WHO海拔矫正后标准是否适宜高海拔地区孕晚期妇女相关诊断还有待商榷。

Objective To investigate the effects of applying different hemoglobin(Hb)standards on the anaemia diagnosis of pregnant women in the third trimester in plateau areas.Methods The Hbs of pregnant women living in the areas with altitudes of 2200 m and 4000 m and gestational age>28 weeks were determined.Different Hb standards were used to assess their effects on the anaemia diagnosis of pregnant women in the third trimester in plateau areas.Results Using the current national standard as the diagnostic criteria for anemia(Hb<110 g/L),it can be found that the detection rate of pregnant women in the third trimester in the area of 2200m was 19.77%and the detection rate in the area of 4000 m was 26.63%,respectively.Mild anaemia was more common.Taking the corrected standard altitude of World Health Organization(WHO)as the diagnostic criteria for anemia,it can be found that the detection rate taking Hb<120 g/L as the standard in the area of 2200 m was 47.81%and the detection rate taking Hb<145 g/L as the standard in the area of 4000 m was 92.39%,respectively.Moderate and severe anemia was more common.Conclusions The current national standard may lead to missed anemia diagnosis of pregnant women in the third trimester in plateau areas.It remains to be discussed whether the WHO altitude corrected standards are suitable for the diagnosis of pregnant women in the third trimester in high-altitude areas.