检验医学 ›› 2022, Vol. 37 ›› Issue (11): 1039-1043.DOI: 10.3969/j.issn.1673-8640.2022.011.008

• 临床应用研究·论著 • 上一篇    下一篇

缺铁性贫血患儿Flt-3L、TF、25(OH)D检测的临床意义

赵晓敏, 江晓宇, 单凯莉, 单铁英, 刘秀珍()   

  1. 邯郸市中心医院儿科,河北 邯郸 056000
  • 收稿日期:2021-05-20 修回日期:2022-05-20 出版日期:2022-11-30 发布日期:2022-12-26
  • 通讯作者: 刘秀珍
  • 作者简介:刘秀珍,E-mail:handan.lxz.2009@163.com
    赵晓敏,女,1975年生,硕士,主治医师,主要从事小儿急救及重症诊治工作。
  • 基金资助:
    河北省医学科学研究课题计划(20191835)

Roles of Flt-3L,TF and 25(OH)D in iron deficiency anemia among infants and children

ZHAO Xiaomin, JIANG Xiaoyu, SHAN Kaili, SHAN Tieying, LIU Xiuzhen()   

  1. Department of Pediatrics,Handan Central Hospital,Handan 056000,Hebei,China
  • Received:2021-05-20 Revised:2022-05-20 Online:2022-11-30 Published:2022-12-26
  • Contact: LIU Xiuzhen

摘要:

目的 探讨FMS样酪氨酸激酶3配体(Flt-3L)、转铁蛋白(TF)、25-羟基维生素D[25(OH)D]对婴幼儿缺铁性贫血的辅助诊断价值。方法 选取缺铁性贫血患儿128例(缺铁性贫血组)、非缺铁性贫血患儿68例(非缺铁性贫血组)、体检健康婴幼儿100名(正常对照组)。检测所有对象血红蛋白(Hb)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、Flt-3L、TF、25(OH)D和血清铁(SI)水平。根据病情严重程度将缺铁性贫血患儿分为轻度贫血组(61例)、中度贫血组(55例)、重度贫血组(12例)。采用Logistic回归分析评估婴幼儿发生缺铁性贫血的危险因素。采用受试者工作特征(ROC)曲线评价各项指标辅助诊断婴幼儿缺铁性贫血的效能。结果 缺铁性贫血组和非缺铁性贫血组Hb、MCV、MCH、MCHC均低于正常对照组(P<0.05)。缺铁性贫血组血清Flt-3L、TF水平均高于正常对照组和非缺铁性贫血组(P<0.05),SI、25(OH)D水平均低于正常对照组和非缺铁性贫血组(P<0.05)。Flt-3L、TF水平随缺铁性贫血程度的加重而升高(P<0.05);Hb、MCV、MCH、MCHC、25(OH)D、SI水平均随缺铁性贫血程度的加重而降低(P<0.05)。血清Flt-3L、TF、25(OH)D均是婴幼儿发生缺铁性贫血的危险因素(P<0.05)。ROC曲线分析结果显示,Flt-3L、TF、25(OH)D联合检测诊断缺铁性贫血的曲线下面积(AUC)为0.983,鉴别诊断缺铁性贫血和非缺铁性贫血的AUC为0.981。结论 Flt-3L、TF、25(OH)D对婴幼儿缺铁性贫血有较高的辅助诊断价值,且与贫血的严重程度有关。

关键词: FMS样酪氨酸激酶3配体, 转铁蛋白, 25-羟基维生素D, 缺铁性贫血, 婴幼儿

Abstract:

Objective To investigate the values of FMS-like tyrosine kinase 3 ligand(Flt-3L),transferrin(TF) and 25-hydroxyvitamin D [25(OH)D] in the auxiliary diagnosis of iron deficiency anemia among infants and children. Methods Totally,128 children with iron deficiency anemia(iron deficiency anemia group),68 children with non-iron deficiency anemia(non-iron deficiency anemia group) and 100 infants and children undergoing healthy physical examination(healthy control group) were enrolled. Hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),Flt-3L,TF,25(OH)D and serum iron(SI) levels were determined. The children with iron deficiency anemia were classified into mild anemia group(61 cases),moderate anemia group(55 cases) and severe anemia group(12 cases). Risk factor analysis was performed using Logistic regression analysis,and receiver operating characteristic(ROC)curve was used to evaluate the efficiency of each index in the diagnosis of iron deficiency anemia in infants and children. Results Hb,MCV,MCH and MCHC were lower in iron deficiency anemia group and non-iron deficiency anemia group than those in healthy control group(P<0.05). Serum Flt-3L and TF levels were higher in iron deficiency anemia group than those in healthy control and non-iron deficiency anemia groups(P<0.05),and SI and 25(OH)D levels were lower than those in healthy control and non-iron deficiency anemia groups(P<0.05). Flt-3L and TF levels were increased with the severity of iron deficiency anemia(P<0.05). Hb,MCV,MCH,MCHC,25(OH)D and SI levels were decreased with the severity of iron deficiency anemia(P<0.05). Serum Flt-3L,TF and 25(OH)D were independent risk factors for iron deficiency anemia(P<0.05). The area under curve(AUC) of the combination of Flt-3L,TF and 25(OH)D for the diagnosis of iron deficiency anemia was 0.983. The AUC for the differential diagnosis of iron deficiency anemia and non-iron deficiency anemia was 0.981. Conclusions Flt-3L,TF and 25(OH)D have diagnostic values in the auxiliary diagnosis of iron deficiency anemia in infants and children,and the diagnostic efficiency of the combined determination is better.

Key words: FMS-like tyrosine kinase 3 ligand, Transferrin, 25-Hydroxyvitamin D, Iron deficiency anemia, Infants and children

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