血清铁蛋白、转铁蛋白联合25-羟基维生素D指标检测对婴幼儿缺铁性贫血的预测价值

Predictive Value of Serum SF and TF Combined with 25(OH)D in Infants and Children with Iron Deficiency Anemia

目的:探究血清铁蛋白(serum ferritin,SF)、转铁蛋白(transferrin,TF)联合25-羟基维生素D[25-hydroxyvitamin D,25(OH)D]指标对婴幼儿缺铁性贫血的预测价值。方法:选取2020年10月—2023年9月在上海市浦东新区南汇新城镇社区卫生服务中心就诊的缺铁性贫血婴幼儿60例,并按病例对照1∶4的比例选取具有可比性的240例非缺铁性贫血婴幼儿作为非缺铁性贫血组,另选取同期健康体检儿童100例作为健康对照组,收集3组受试儿童的临床资料,并检测其血清SF、TF、25(OH)D等水平。结果:3组受试儿童SF、25(OH)D、TF水平比较,差异均有统计学意义(Z/F值分别为296.290、408.959、1008.023,P<0.05),其中,非缺铁性贫血组与缺铁性贫血组SF、25(OH)D水平明显低于健康对照组,缺铁性贫血组TF水平高于非缺铁性贫血组和健康对照组。logistic回归分析结果显示,SF、25(OH)D、TF水平与婴幼儿缺铁性贫血发生风险因素呈正相关。以SF、25(OH)D、TF指标作为检验变量,将缺铁性贫血组和非缺铁性贫血组作为参考标准,制作ROC曲线,其中,SF、25(OH)D、TF的AUC分别为0.613,0.713,0.628,而3个指标联合预测概率AUC为0.848,相较于每个指标均显著提升。结论:SF、25(OH)D、TF联合检测对婴幼儿缺铁性贫血诊断有较高的价值,能够为婴幼儿缺铁性贫血的临床诊断及预后提供借鉴。

OBJECTIVE To investigate the predictive value of serum ferritin(SF)and transferrin(TF)combined with 25-hy-droxyvitamin D[25(OH)D]in infants and children with iron deficiency anemia.METHODS 60 cases of infants and children with iron-deficiency anemia were selected from October 2020 to September 2023 in Luchaogang community,and 240 cases of infants and children with non-iron-deficiency anemia were selected as the non-iron-deficiency anemia group according to the case-control ratio of 1∶4 with comparable characteristics.In addition,100 children were selected as the control group for the same period of health checkup.Clinical data of the three groups of children were collected and serum SF,TF and 25(OH)D levels were measured.RE-SULTS The SF,25(OH)D,indexes of infants and children in the non-iron deficiency anemia group and the iron deficiency ane-mia group were significantly lower than those of the healthy control group(Z/F=296.290,408.959,1008.023,P<0.05);the TF in-dexes of the children in the iron deficiency anemia group were higher than those of the children in the non-iron deficiency anemia group and the healthy control group(P<0.05);SF,25(OH)D,and TF indexes were the risk factors for the children with iron defi-ciency anemia(P<0.05);the ROC curve SF,25(OH)D,and TF indexes as the test variables were made to determine whether or not the anemic children were iron deficiency anemia as the reference standard;using SF,25(OH)D,and TF indicators as test vari-ables,and whether the anemic children were iron deficient as reference criteria,the AUC of SF,25(OH)D,and TF were 0.613,0.713,and 0.628,respectively,and the AUC of the joint predictive probability of the three indicators was 0.848,which was signifi-cantly higher compared to each indicator.CONCLUSION The combination of SF,25(OH)D,and TF indexes has high value for the diagnosis of iron deficiency anemia in infants and children,and improves the reference for clinical diagnosis and prognosis.