Kuvibidila S, Mark J A, Warrier R P, Yu L, Ode D, Tshefu K A
Louisiana State University Medical Center, Pediatrics, Division of Hematology/Oncology, New Orleans 70112, USA.
J Trop Med Hyg. 1995 Dec;98(6):373-8.
This study was designed to evaluate soluble transferrin receptor (sTfR) as an index of iron status in 0.5-16-year-old Zaïrian children: 17 with symptomatic malaria, 8 with asymptomatic malaria, and 15 controls. sTfR was also measured in 20 plasma samples obtained from iron sufficient laboratory employees. sTfR, haemoglobin and ferritin were measured by enzyme-immunoassay, cyanmethaemoglobin method, and radioimmunoassay respectively. Mean haemoglobin levels were lower and ferritin higher (P < 0.001) in children with clinical symptoms of malaria than in those without malaria, and they were intermediate in those with asymptomatic malaria. Mean sTfR concentrations were similar among the three groups of children and laboratory controls. There was a considerable overlap in sTfR concentrations between the three groups of children (1.8-10.2, 2.9-11.6 and 2.97-8.95 mg 1(-1) in symptomatic malaria, asymptomatic malaria and control groups, respectively) as well as laboratory controls (1.2-7.30 mg l-1). Despite the overlap, 6 children with malaria (24%) and one control child (6.7%) had sTfR concentrations above the highest concentration found in laboratory controls. No child had serum ferritin < 12 micrograms l-1 (suggestive of iron deficiency). As expected, sTfR negatively correlated with ferritin (r = -0.230) in the overall study population of children, and with haemoglobin in children with asymptomatic malaria (r = -0.943, P < 0.05), as well as in control children (r = -0.363). All children with sTfR above normal were also anaemic. Although the upper limit of normal sTfR concentration in healthy children is unknown, using the cut-off value of adults, we conclude that sTfR might be a more sensitive index of iron deficiency than serum ferritin in patients with malaria.
本研究旨在评估可溶性转铁蛋白受体（sTfR）作为扎伊尔0.5至16岁儿童铁状态指标的情况：17名有症状疟疾患儿、8名无症状疟疾患儿以及15名对照儿童。还对从铁充足的实验室工作人员处获得的20份血浆样本进行了sTfR检测。sTfR、血红蛋白和铁蛋白分别采用酶免疫测定法、氰化高铁血红蛋白法和放射免疫测定法进行检测。有疟疾临床症状的儿童平均血红蛋白水平较低，铁蛋白水平较高（P < 0.001），高于无疟疾的儿童，而无症状疟疾儿童的水平处于中间。三组儿童和实验室对照的平均sTfR浓度相似。三组儿童（有症状疟疾组、无症状疟疾组和对照组的sTfR浓度分别为1.8 - 10.2、2.9 - 11.6和2.97 - 8.95 mg l⁻¹）以及实验室对照（1.2 - 7.30 mg l⁻¹）的sTfR浓度有相当大的重叠。尽管存在重叠，但6名疟疾患儿（24%）和1名对照儿童（6.7%）的sTfR浓度高于实验室对照中发现的最高浓度。没有儿童血清铁蛋白< 12微克l⁻¹（提示缺铁）。正如预期的那样，在整个儿童研究人群中，sTfR与铁蛋白呈负相关（r = -0.230），在无症状疟疾儿童中与血红蛋白呈负相关（r = -0.943，P < 0.05），在对照儿童中也是如此（r = -0.363）。所有sTfR高于正常水平的儿童也都贫血。尽管健康儿童正常sTfR浓度的上限未知，但使用成人的临界值，我们得出结论，在疟疾患者中，sTfR可能是比血清铁蛋白更敏感的缺铁指标。
