摘要
目的探讨多参数分析方法在缺铁性贫血（IDA）和慢性病性贫血（ACD）中的鉴别诊断价值。方法采用生化和酶联免疫吸附法（ELISA）方法检测IDA和ACD二组患者的铁参数血清铁（sI）、总铁结合力（TIBC）、转铁蛋白（TF）、血清铁蛋白（SF）、血清可溶性转铁蛋白受体（sTfR）以及炎性指标白介素-1（IL-1）、白介素-6（IL-6）、肿瘤坏死因子-β（TNF-13）和C反应蛋白（CRP）和铁调素（Hepcidin）血清含量。结果在IDA和ACD鉴别诊断中，铁参数中的SF（98．6比6．0，P=0）和STfR／logSF（13．1±4．4比27．6±16．5，P=0．002）有临床鉴别诊断价值；二组贫血患者炎性因子皆增高，只有CRP差异有统计学意义。不论在IDA和ACD单病种诊断还是在二者鉴别诊断中，Hepcidin（144．6±1．9比86．5士3．1，P〈0．05）都有临床鉴别诊断价值。相关性分析显示，sTfR／logSF与SI呈负相关（P=0．002），与TIBC和TRF呈正相关，而与炎性指标无显著性相关；Hepcidin与炎性因子IL-6、TNF-β呈正相关，与sI呈负相关，sTfR／logSF与Hepcidin之间也具有正相关性（r=0．376，P=0．005）。结论多参数分析方法可对老年性ACD作出鉴别诊断。
Objectives To clarify the differential diagnostic value for iron deficiency anemia （IDA）and anemia of chronic disease（ACD）with analysis method of multiple parameters. Methods The serum concentrations of iron parameters （SI, TIBC, TF, SF and sTfR）, inflammatory index （ IL-1, IL-6 ,TNF-13）,CRP and hepcidin were detected in patients with IDA and ACD by biochemical method and ELISA respectively. Results In the differential diagnosis of IDA versus ACD, the SF （98.6 versus 6.0,P=0）and sTfR/logSF[（13.1±4.4） versus （27.6± 16.5）,P=0. 002]had clinical value for the differential diagnosis. Inflammatory factors level was increased in two groups, only the difference in CRP between IDA and ACD showed a statistical significance. The hepcidin had the clinical value in differential diagnosis for single disease diagnosis of IDA and ACD and for differential diagnosis between IDA and ACD[（144.6±1.9 ） versus （86.5±3.1 ）, P〈0.053. Correlation analysis showed that the sTfR/logSF had a significantly negative correlation with SI（P=0. 002） ,a significantly positive correlation with TIBC and TRF,and no significant correlation with inflammatory factors. The hepcidin had significantly positive correlation with IL-6 and TNF-β,and a significantly negative correlation with SI. The positive correlation was observed between sTfR/logSF and Hepcidin（r= 0. 376,P= 0. 005）. Conclusions Analysis method of multiple parameters could make a differential diagnosis of ACD in the elderly.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2017年第1期53-56,共4页
Chinese Journal of Geriatrics
基金
南京市卫生局课题（2012YKK12095）
作者简介
通信作者：薛军，Email：xuejun64@sina．com
