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发育医学电子杂志  2024, Vol. 12 Issue (1): 30-35    DOI: 10.3969/j.issn.2095-5340.2024.01.006
  围产医学   论著 |产科 |
贫血孕妇血清铁及可溶性血清转铁蛋白受体检测对妊娠结局的预测价值
李丹 杨小倩 曹雪萍
1. 同济大学附属第一妇婴保健院 检验科,上海200040;2. 同济大学附属第一妇婴保健院 妇产科,上海 200040
Predictive value of serum iron and soluble serum transferrin receptor detection for pregnancy outcome in pregnant women with anemia
Li Dan, Yang Xiaoqian, Cao Xueping
1. Department of Clinical Laboratory, the First Maternal and InfantHealth Hospital Affiliated to Tongji University, Shanghai 200040, China; 2.Department of Obstetrics and Gynecology, the First Maternal and Infant Health Hospital Affiliated to Tongji University, Shanghai 200040, China
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摘要 【摘要】 目的  探究妊娠期贫血孕妇血清铁(serum iron,SI)及可溶性血清转铁蛋白受体(soluble serum transferrin receptor,sTfR)检测与妊娠结局的关系及临床意义。 方法 选取2020 年1 月至2021 年6 月同济大学附属第一妇婴保健院收治的1 000 例孕妇作为研究对象,根据有无贫血分为贫血组(n=195)和
无贫血组(n=805),比较两组孕妇的一般资料、SI、sTfR 水平。随访至妊娠结束,比较两组孕妇不良妊娠
结局发生情况。比较不同妊娠结局贫血孕妇的SI、sTfR 水平,采用受试者操作特征(receiver operating
characteristic,ROC)曲线和曲线下面积(area under the curve,AUC)评估SI、sTfR 水平对贫血孕妇妊娠
结局的预测价值。统计学方法采用独立样本t 检验和χ2 检验。 结果 妊娠期贫血的发生率为19.50%
(195/1 000)。贫血组孕妇SI 水平低于无贫血组[(5.5±1.0)与(18.2±6.0)μmol/L,t=29.370,P<0.001] ;sTfR 水平高于无贫血组[(3.8±1.3)与(1.9±0.6)mg/L,t=31.638,P<0.001]。贫血组孕妇不良妊娠结局总发生率高于无贫血组[23.59%(46/195)与4.10%(33/805),χ2=81.957,P<0.05]。发生与未发生不良妊娠结局贫血孕妇的SI 水平分别为[(4.6±0.8)与(5.7±0.8)μmol/L,t=15.366,P<0.001],发生较未发生不良妊娠结局贫血孕妇低;sTfR 水平分别为[(4.6±1.2)与(3.6±1.0)mg/L,t=8.985,P<0.001],发生较未发生不良妊娠结局贫血孕妇高。SI、sTfR 单独预测的AUC 分别为0.743、0.770,联合预测的AUC 最大,为0.924,最佳诊断敏感度、特异性分别为80.43%、87.92%。 结论 SI、sTfR 水平变化与妊娠期贫血的发生密切相关,联合检测对于妊娠期贫血孕妇的妊娠结局具有较高预测价值,可作为临床早期评估预测的辅助指标。
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关键词:  妊娠期贫血  血清铁  可溶性血清转铁蛋白受体  妊娠结局  受试者操作特征曲线    
Abstract: 【Abstract】 Objective To explore the relationship and clinical significance of serum iron (SI) and
soluble serum transferrin receptor (sTfR) detection in pregnant women with anemia during pregnancy and
pregnancy outcome. Method A total of 1 000 pregnant women from the First Maternal and Infant Health Hospital Affiliated to Tongji University from January 2020 to June 2021 were selected as the research objects.They were divided into anemia group (n=195) and non-anemia group (n=805) according to anemia or not.The general data, SI and sTfR levels of pregnant women in the two groups were compared. Follow-up was conducted until the end of pregnancy, and adverse pregnancy outcomes were compared between the two groups. SI and sTfR levels were compared among pregnant women with anemia for different pregnancy outcomes. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the predictive value of SI and sTfR levels for pregnancy outcomes in anemic pregnant women.Statistical methods performed by independent sample t-test and χ2 test. Result The incidence of anemia during pregnancy was 19.50% (195/1 000). The level of SI in the anemia group was lower than that in the non-anemia group [(5.5±1.0) vs (18.2±6.0) μmol/L, t=29.370, P<0.001]. The level of sTfR was higher than that in the non-anemia group [(3.8±1.3) vs (1.9±0.6) mg/L, t=31.638, P<0.001]. The overall incidence of adverse pregnancy outcomes in the anemia group was higher than that in the non-anemia group [23.59%(46/195) vs 4.10% (33/805), χ2=81.957, P<0.05]. The level of SI of anemic pregnant women with and without adverse pregnancy outcome was [(4.6±0.8) vs (5.7±0.8) μmol/L, t=15.366, P<0.001], and the level of SI for anemic pregnant women with adverse pregnancy outcome was lower than that of anemic pregnant women without adverse pregnancy outcome. The level of sTfR was [(4.6±1.2) vs (3.6±1.0) mg/L, t=8.985, P<0.001], which was higher in the anemic pregnant women than that without adverse pregnancy outcomes.The AUC predicted by SI and sTfR alone was 0.743 and 0.770, respectively. The AUC predicted by SI and sTfR together was the largest (0.924), and the best diagnostic sensitivity and specificity were 80.43% and 87.92%, respectively.  Conclusion The changes of SI and sTfR levels are closely related to the occurrence of anemia in pregnancy. Combined detection has a high predictive value for pregnancy outcomes in pregnant women with anemia, and can be used as an auxiliary index for early clinical evaluation and prediction.
Key words:  Anemia during pregnancy    Serum iron    Soluble serum transferrin receptor    Pregnancy outcome    Receiver operating characteristic curve
收稿日期:  2022-11-14                     发布日期:  2024-01-31     
基金资助: 上海市卫生系统优秀青年医学人才培养项目(PWRq2019-48)
通讯作者:  李丹    E-mail:  teasheauph3611@21cn.com
引用本文:    
李丹 杨小倩 曹雪萍. 贫血孕妇血清铁及可溶性血清转铁蛋白受体检测对妊娠结局的预测价值[J]. 发育医学电子杂志, 2024, 12(1): 30-35.
Li Dan, Yang Xiaoqian, Cao Xueping. Predictive value of serum iron and soluble serum transferrin receptor detection for pregnancy outcome in pregnant women with anemia. Journal of Developmental Medicine(Electronic Version), 2024, 12(1): 30-35.
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