Choi J W, Pai S H
Department of Clinical Pathology, Inha University Hospital, Jung-gu, Inchon, Korea.
Ann Hematol. 2001 Jan;80(1):26-31. doi: 10.1007/s002770000229.
To investigate the changes in erythropoiesis during pregnancy, 342 pregnant and postpartum women were examined for reticulocyte subpopulations, reticulocyte maturity index (RMI), and serum transferrin receptor (sTfR) levels. The reticulocyte subpopulations were analyzed by flow cytometry, and the sTfR concentration was measured by an immunoenzymometric method. There were no significant differences in the values of reticulocyte subpopulations, RMI, and sTfR between first trimester and non-pregnant women. However, the RMI and sTfR concentration increased gradually from the second trimester of pregnancy, during which time values were twofold higher than those in the first trimester, and peaked in the third trimester. Then the RMI and sTfR values decreased abruptly 1-4 weeks postpartum and finally dropped to the levels of non-pregnant women 5 weeks after delivery. The maternal sTfR concentration correlated significantly with the corrected reticulocyte count (r = 0.52, P < 0.01), RMI (r = 0.67, P < 0.01), and high fluorescence reticulocytes (HFR) (r = 0.62, P < 0.01); however, the serum ferritin level correlated poorly with the reticulocyte subpopulations during pregnancy. In conclusion, erythropoiesis increases with gestational age during pregnancy and returns to normal 5 weeks after delivery. Measurement of sTfR in combination with RMI may improve the assessment of erythropoietic activity during pregnancy.
为研究孕期红细胞生成的变化，对342名孕妇及产后妇女进行了网织红细胞亚群、网织红细胞成熟指数（RMI）及血清转铁蛋白受体（sTfR）水平检测。采用流式细胞术分析网织红细胞亚群，用免疫酶法测定sTfR浓度。孕早期妇女与非孕妇女的网织红细胞亚群、RMI及sTfR值无显著差异。然而，从妊娠中期开始，RMI和sTfR浓度逐渐升高，在此期间其值比孕早期高出两倍，并在孕晚期达到峰值。然后，产后1 - 4周RMI和sTfR值突然下降，产后5周最终降至非孕妇女水平。母体sTfR浓度与校正网织红细胞计数（r = 0.52，P < 0.01）、RMI（r = 0.67，P < 0.01）及高荧光网织红细胞（HFR）（r = 0.62，P < 0.01）显著相关；然而，孕期血清铁蛋白水平与网织红细胞亚群的相关性较差。总之，孕期红细胞生成随孕周增加而增加，产后5周恢复正常。联合检测sTfR和RMI可能有助于改善孕期红细胞生成活性的评估。
