网织红细胞血红蛋白含量作为缺铁的标志物。

Reticulocyte haemoglobin content as a marker of iron deficiency.

作者信息

Lorenz Laila, Arand Jörg, Büchner Katja, Wacker-Gussmann Annette, Peter Andreas, Poets Christian F, Franz Axel R

机构信息

Department of Neonatology, University Children's Hospital of Tübingen, University of Tübingen, Tübingen, Germany.

Department of Internal Medicine, Division of Endocrinology, Metabolism, Pathobiochemistry and Clinical Chemistry, University of Tübingen, Tübingen, Germany.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2015 May;100(3):F198-202. doi: 10.1136/archdischild-2014-306076. Epub 2014 Dec 9.

DOI:10.1136/archdischild-2014-306076

PMID:25491423

Abstract

OBJECTIVE

To evaluate reticulocyte haemoglobin content (CHr), compared with ferritin, transferrin saturation (TS) and mean corpuscular volume (MCV), as a marker of iron deficiency (ID).

DESIGN

Retrospective analysis of clinically indicated blood samples taken between February 2010 and October 2012.

SETTING

Single-centre neonatal care unit.

PATIENTS

210 very preterm (gestational age <32 weeks) or very low birthweight infants (birth weight <1500 g) at 3-4 months corrected age.

MAIN OUTCOME MEASURES

Complete blood count, CHr, ferritin and TS determined as part of a standard follow-up examination. To detect the optimal CHr cut-off, ID was defined by the presence of more than two of the following three criteria: MCV <75 fL, TS <10%, ferritin <30 µg/L.

RESULTS

210 preterm infants were included at a corrected age of (median (IQR)) 3.5 (3.0-4.0) months and with a CHr of 29.7 (28.6-30.7) pg. There were correlations between CHr and MCV (r=0.54, p <0.0001) and between CHr and TS (r=0.44, p <0.0001). There were 27 (13.4%) iron-deficient infants, and two infants (1%) fulfilled criteria of ID-anaemia. CHr was lower in infants with ID (26.4 (23.8-28.7) pg) than in those without (29.9 (29.0-30.8) pg, p <0.0001). The optimal CHr cut-off for detecting ID was 29 pg (sensitivity 85%, specificity 73%). Areas under the receiver operating characteristic curve for detection of ID tended to be higher for CHr compared with ferritin (0.92 vs 0.75), TS (0.90 vs 0.82) and MCV (0.81 vs 0.72).

CONCLUSIONS

CHr seems to be a suitable marker for latent ID in preterm infants at 3-4 months corrected age and may be superior to ferritin, TS and MCV.

摘要

目的

评估网织红细胞血红蛋白含量（CHr）与铁蛋白、转铁蛋白饱和度（TS）和平均红细胞体积（MCV）相比，作为缺铁（ID）标志物的情况。

设计

对2010年2月至2012年10月期间采集的临床指示血样进行回顾性分析。

设置

单中心新生儿重症监护病房。

患者

210名极早产儿（胎龄<32周）或极低出生体重儿（出生体重<1500g），矫正年龄为3 - 4个月。

主要观察指标

作为标准随访检查的一部分，测定全血细胞计数、CHr、铁蛋白和TS。为检测CHr的最佳临界值，ID定义为符合以下三项标准中的两项以上：MCV<75fL、TS<10%、铁蛋白<30μg/L。

结果

210名早产儿纳入研究，矫正年龄中位数（四分位间距）为3.5（3.0 - 4.0）个月，CHr为29.7（28.6 - 30.7）pg。CHr与MCV之间存在相关性（r = 0.54，p<0.0001），CHr与TS之间也存在相关性（r = 0.44，p<0.0001）。有27名（13.4%）缺铁婴儿，2名婴儿（1%）符合缺铁性贫血标准。ID婴儿的CHr（26.4（23.8 - 28.7）pg）低于无ID婴儿（29.9（29.0 - 30.8）pg，p<0.0001）。检测ID的最佳CHr临界值为29pg（敏感性85%，特异性73%）。与铁蛋白（0.92对0.75）、TS（0.90对0.82）和MCV（0.81对0.72）相比，CHr检测ID的受试者工作特征曲线下面积更高。