Skikne B S, Flowers C H, Cook J D
Department of Medicine, University of Kansas Medical Center, Kansas City 66103.
Blood. 1990 May 1;75(9):1870-6.
This study was undertaken to evaluate the role of serum transferrin receptor measurements in the assessment of iron status. Repeated phlebotomies were performed in 14 normal volunteer subjects to obtain varying degrees of iron deficiency. Serial measurements of serum iron, total iron-binding capacity, mean cell volume (MCV), free erythrocyte protoporphyrin (FEP), red cell mean index, serum ferritin, and serum transferrin receptor were performed throughout the phlebotomy program. There was no change in receptor levels during the phase of storage iron depletion. When the serum ferritin level reached subnormal values there was an increase in serum receptor levels, which continued throughout the phlebotomy program. Functional iron deficiency was defined as a reduction in body iron beyond the point of depleted iron stores. The serum receptor level was a more sensitive and reliable guide to the degree of functional iron deficiency than either the FEP or MCV. Our studies indicate that the serum receptor measurement is of particular value in identifying mild iron deficiency of recent onset. The iron status of a population can be fully assessed by using serum ferritin as a measure of iron stores, serum receptor as a measure of mild tissue iron deficiency, and hemoglobin concentration as a measure of advanced iron deficiency.
本研究旨在评估血清转铁蛋白受体检测在铁状态评估中的作用。对14名正常志愿者进行反复静脉穿刺采血，以造成不同程度的缺铁。在整个采血过程中，连续检测血清铁、总铁结合力、平均红细胞体积（MCV）、游离红细胞原卟啉（FEP）、红细胞平均指数、血清铁蛋白和血清转铁蛋白受体。在储存铁耗竭阶段，受体水平无变化。当血清铁蛋白水平降至正常以下时，血清受体水平升高，且在整个采血过程中持续上升。功能性缺铁定义为体内铁减少超过铁储存耗竭点。血清受体水平比FEP或MCV更能敏感、可靠地反映功能性缺铁的程度。我们的研究表明，血清受体检测在识别近期发生的轻度缺铁方面具有特殊价值。通过使用血清铁蛋白作为铁储存的指标、血清受体作为轻度组织缺铁的指标以及血红蛋白浓度作为重度缺铁的指标，可以全面评估人群的铁状态。
