轻度和重度子痫前期女性血清铁蛋白浓度的评估。

Yesmin F, Islam M S, Ferdoushi S, Faisal F M, Rehena Z, Afroza F, Sarkar S, Rahman M Q, Ahmed A N

Dr Farzana Yesmin, Medical Officer, 500 Bed General Hospital, Mugda, Khilgaon, Dhaka, Bangladesh.

Mymensingh Med J. 2016 Jan;25(1):119-25.

Pre-eclampsia is one of the most important complications of pregnancy. About 16% of maternal death is associated with pre-eclampsia in Bangladesh. It is necessary to diagnose or to predict pre-eclampsia for minimizing maternal morbidity and mortality. This case control study was carried out in the department of Clinical Pathology, in collaboration with department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from March 2011 to February 2012 which included 20 mild pre-eclamptic and 20 severe pre-eclamptic patients and 30 gestation matched normotensive pregnant women within 28-40 weeks of gestation. Serum iron profile was measured and PBF was done to observe the association of higher concentration of serum ferritin, serum iron, percent saturation of total iron binding capacity, hemoglobin and lower level of total iron binding capacity, increased neutrophil count and decreased platelet count with pre-eclampsia. The mean serum ferritin concentration of mild pre-eclamptic group 99.91±7.84 ng/ml was 5 times and severe pre-eclamptic group 149.59±13.75 ng/ml was 8 times higher than that of control group 18.47±2.03 ng/ml. The mean serum iron level of mild pre-eclamptic group was (114.45±8.72 μg/dl) and in severe pre-eclamptic group was (174.35±13.59 μg/dl) and control group was (72.64±4.72 μg/dl) (p<0.05). The mean TIBC was higher and percent saturation was lower in control group than mild and severe pre-eclamptic group. The mean differences of iron parameters were statistically significant (p<0.05) among the three groups in ANOVA test. Both hemoglobin (gm/dl), total count of WBC and percentage of neutrophil were significantly higher (p<0.05) but platelet count was significantly lower in mild and severe pre-eclamptic group than normal control group. So higher concentration of serum ferritin, serum iron, percent saturation of total iron binding capacity and hemoglobin level increased and total iron binding capacity decreased in mild and severe pre-eclampsia than those of uncomplicated normal pregnancy. Pre-eclampsia is one of the most important complications of pregnancy. About 16% of maternal death is associated with pre-eclampsia in Bangladesh. It is necessary to diagnose or to predict pre-eclampsia for minimizing maternal morbidity and mortality. This case control study was carried out in the department of Clinical Pathology, in collaboration with department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from March 2011 to February 2012 which included 20 mild pre-eclamptic and 20 severe pre-eclamptic patients and 30 gestation matched normotensive pregnant women within 28-40 weeks of gestation. Serum iron profile was measured and PBF was done to observe the association of higher concentration of serum ferritin, serum iron, percent saturation of total iron binding capacity, hemoglobin and lower level of total iron binding capacity, increased neutrophil count and decreased platelet count with pre-eclampsia. The mean serum ferritin concentration of mild pre-eclamptic group 99.91±7.84 ng/ml was 5 times and severe pre-eclamptic group 149.59±13.75 ng/ml was 8 times higher than that of control group 18.47±2.03 ng/ml. The mean serum iron level of mild pre-eclamptic group was (114.45±8.72 μg/dl) and in severe pre-eclamptic group was (174.35±13.59 μg/dl) and control group was (72.64±4.72 μg/dl) (p<0.05). The mean TIBC was higher and percent saturation was lower in control group than mild and severe pre-eclamptic group. The mean differences of iron parameters were statistically significant (p<0.05) among the three groups in ANOVA test. Both hemoglobin (gm/dl), total count of WBC and percentage of neutrophil were significantly higher (p<0.05) but platelet count was significantly lower in mild and severe pre-eclamptic group than normal control group. So higher concentration of serum ferritin, serum iron, percent saturation of total iron binding capacity and hemoglobin level increased and total iron binding capacity decreased in mild and severe pre-eclampsia than those of uncomplicated normal pregnancy.

子痫前期是妊娠期最重要的并发症之一。在孟加拉国，约16%的孕产妇死亡与子痫前期有关。为了将孕产妇的发病率和死亡率降至最低，有必要诊断或预测子痫前期。本病例对照研究于2011年3月至2012年2月在达卡班加班杜·谢赫·穆吉布医科大学（BSMMU）临床病理科与妇产科合作开展，研究对象包括20例轻度子痫前期患者、20例重度子痫前期患者以及30例妊娠28 - 40周的血压正常的匹配孕妇。检测了血清铁指标并进行了外周血涂片检查，以观察血清铁蛋白、血清铁、总铁结合力百分饱和度、血红蛋白浓度升高以及总铁结合力水平降低、中性粒细胞计数增加和血小板计数减少与子痫前期之间的关联。轻度子痫前期组血清铁蛋白平均浓度为99.91±7.84 ng/ml，是对照组18.47±2.03 ng/ml的5倍；重度子痫前期组血清铁蛋白平均浓度为149.59±13.75 ng/ml，是对照组的8倍。轻度子痫前期组血清铁平均水平为（114.45±8.72 μg/dl），重度子痫前期组为（174.35±13.59 μg/dl），对照组为（72.64±4.72 μg/dl）（p<0.05）。对照组的平均总铁结合力较高，百分饱和度较低，低于轻度和重度子痫前期组。方差分析显示，三组之间铁参数的平均差异具有统计学意义（p<0.05）。轻度和重度子痫前期组的血红蛋白（gm/dl）、白细胞总数和中性粒细胞百分比均显著高于（p<0.05）正常对照组，但血小板计数显著低于正常对照组。因此，与未合并症的正常妊娠相比，轻度和重度子痫前期患者的血清铁蛋白、血清铁、总铁结合力百分饱和度和血红蛋白水平升高，总铁结合力降低。子痫前期是妊娠期最重要的并发症之一。在孟加拉国，约16%的孕产妇死亡与子痫前期有关。为了将孕产妇的发病率和死亡率降至最低，有必要诊断或预测子痫前期。本病例对照研究于2011年3月至2012年2月在达卡班加班杜·谢赫·穆吉布医科大学（BSMMU）临床病理科与妇产科合作开展，研究对象包括20例轻度子痫前期患者、20例重度子痫前期患者以及30例妊娠28 - 40周的血压正常的匹配孕妇。检测了血清铁指标并进行了外周血涂片检查，以观察血清铁蛋白、血清铁、总铁结合力百分饱和度、血红蛋白浓度升高以及总铁结合力水平降低、中性粒细胞计数增加和血小板计数减少与子痫前期之间的关联。轻度子痫前期组血清铁蛋白平均浓度为99.91±7.84 ng/ml，是对照组18.47±2.03 ng/ml的5倍；重度子痫前期组血清铁蛋白平均浓度为149.59±13.75 ng/ml，是对照组的8倍。轻度子痫前期组血清铁平均水平为（114.45±8.72 μg/dl），重度子痫前期组为（174.35±13.59 μg/dl），对照组为（72.64±4.72 μg/dl）（p<0.05）。对照组的平均总铁结合力较高，百分饱和度较低，低于轻度和重度子痫前期组。方差分析显示，三组之间铁参数的平均差异具有统计学意义（p<0.05）。轻度和重度子痫前期组的血红蛋白（gm/dl）、白细胞总数和中性粒细胞百分比均显著高于（p<0.05）正常对照组，但血小板计数显著低于正常对照组。因此，与未合并症的正常妊娠相比，轻度和重度子痫前期患者的血清铁蛋白、血清铁、总铁结合力百分饱和度和血红蛋白水平升高，总铁结合力降低。