| 李芬,安文茜,贺杰,等.血清同型半胱氨酸、维生素 B12和可溶性转铁蛋白受体联合检测对妊娠期贫血早期诊断的价值分析[J].安徽医药,2022,26(7):1336-1340. |
| 血清同型半胱氨酸、维生素 B12和可溶性转铁蛋白受体联合检测对妊娠期贫血早期诊断的价值分析 |
| Value of combined detection of serum Hcy, VB12 and sTfRin early diagnosis of anemia in pregnancy |
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| DOI：10.3969/j.issn.1009-6469.2022.07.015 |
| 中文关键词: 妊娠并发症，血液 贫血 同型半胱氨酸 维生素 B12 可溶性转铁蛋白受体 |
| 英文关键词: Pregnancy complications, hematologic Anemia Homocysteine Vitamin B12 Soluble transferrin receptor |
| 基金项目:河北省 2015年度医学科学研究重点课题计划( 20150444) |
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| 中文摘要: |
| 目的检测血清同型半胱氨酸(Hcy)、维生素 B12(VB12)和可溶性转铁蛋白受体(sTfR)联合检测对妊娠期贫血早期诊断的价值。方法选取 2017年 3月至 2019年 3月邯郸市妇幼保健院收治的孕 12周前发生妊娠期贫血病人 150例作为研究对象(贫血组)根据发生贫血的严重程度分为轻度组( 84例)、中度组(45例)和重度组(21例)。另选取同期在进行围产保健检测的健康孕妇20，0例作为对照组。收集受试者一般资料；酶联免疫吸附法( ELISA)法检测受试者血清 Hcy、VB12、sTfR水平； Pearson法分析血清 Hcy、VB12、sTfR的相关性； logistic回归分析妊娠期发生贫血的影响因素；受试者工作特征曲线( ROC)分析血清 Hcy、VB12、sTfR水平对妊娠期发生贫血的预测价值。结果对照组、轻度组、中度组、重度组病人血清 Hcy［(9.42±2.74) μmol/L、(25.75±9.41)μmol/L、(38.47±13.26)μmol/L、(46.21±15.83)μmol/L］、 sTfR［( 4.41±1.36)mg/L、(7.34±2.85)mg/L、(9.65± 3.13)mg/L、(14.98±4.26)mg/L］水平均依次升高( P<0.05)，VB12［( 285.69±66.11)ng/L、(145.46±41.56)ng/L、(105.35±30.54)ng/ L、(66.73±22.37)ng/L］、 Hb［( 125.54±15.23)g/L、(102.36±10.37)g/L、(76.49±14.81)g/L、(51.74±13.68)g/L］水平均依次降低( P< 0.05)，且轻度组、中度组和重度组病人血清 Hcy、VB12、sTfR、Hb水平差异有统计学意义( P<0.05)。 Pearson法分析显示，血清 Hcy水平与 VB12呈负相关，与 sTfR呈正相关(r=.0.62、0.65，P<0.05)，VB12与 sTfR呈负相关( r=.0.64，P<0.05)，与 Hb呈正相关(r=0.59，P<0.05)； sTfR与 Hb呈负相关( r=.0.62，P<0.05)。logistic回归分析显示， Hcy、sTfR水平偏高及 VB12、Hb水平偏低是妊娠期发生贫血的危险因素( P<0.05)。 ROC分析结果显示， Hcy、VB12、sTfR预测妊娠期发生贫血的曲线下面积( AUC)分别为 0.768、0.761、0.769；灵敏度为 77.7%、70.3%、75.3%，特异度为 75.3%、85.5%、77.6%。联合检测预测妊娠期发生贫血的 AUC为 0.851，灵敏度为 80.4%，特异度为 84.1%。结论 Hcy、sTfR在妊娠期贫血孕妇血清中水平升高， VB12水平降低，与孕妇贫血严重程度有关，可能作为潜在的预测妊娠期贫血的标志物。 |
| 英文摘要: |
| Objective To detect the value of combined detection of serum homocysteine (Hcy), vitamin B12 (VB12) and solubletransferrin receptor (sTfR) in the early diagnosis of anemia in pregnancy.Methods A total of 150 patients with gestational anemia be-fore 12 weeks of pregnancy who were admitted to Handan Maternal and Child Health Hospital from March 2017 to March 2019 were se-lected as the research objects (observation group). According to the severity of anemia, they were assigned into mild group (84 cases),moderate group (45 cases) and severe group (21 cases). Another 200 cases of healthy pregnant women with perinatal health examinationin the hospital at the same time were selected as the control group. General data of subjects were collected; enzyme linked immunosor-bent assay (ELISA) was used to detect the levels of Hcy, VB12 and sTfR; Pearson method was used to analyze the correlation of serumHcy, VB12 and sTfR; Logistic regression analysis was used to analyze the influencing factors of anemia in pregnancy, and receiver oper-ating characteristic curve (ROC) was used to analyze the predictive value of serum Hcy, VB12 and sTfR levels on anemia in pregnancy.Results The levels of Hcy [(9.42±2.74) μmol/L, (25.75±9.41) μmol/L, (38.47±13.26) μmol/L, (46.21±15.83) μmol/L] and sTfR[(4.41±1.36) mg/L, (7.34±2.85) mg/L, (9.65±3.13) mg/L, (14.98±4.26) mg/L] in the control group, mild group, moderate group and se-vere group increased in turn (P < 0.05), and the level of VB12 [(285.69±66.11) ng/L, (145.46±41.56) ng/L, (105.35±30.54) ng/L,(66.73±22.37) ng/L] and Hb [(125.54±15.23) g/L, (102.36±10.37)g/L, (76.49±14.81) g/L, (51.74±13.68) g/L] decreased in turn (P < 0.05), the levels of Hcy, VB12, sTfR and Hbin mild, moderate and severe groups were significantly different (P<0.05). Pearson analysis showed that level of serum Hcy was negatively correlated with VB12, positively correlated with sTfR (r =.0.62,0.65, P<0.05), VB12 was negatively correlated with sTfR (r=.0.64, P<0.05), STfR was positively correlated with HB (r=0.59, P<0.05); sTfR was negatively correlated with HB (r=.0.62,P<0.05). Logistic regression analysis showed that the high levels of Hcy and sTfR and the low level ofVB12 and Hb were the risk factors of anemia during pregnancy (P<0.05). ROC analysis showed that the area under the curve (AUC) ofHcy, VB12 and sTfR in predicting anemia in pregnancy was 0.768, 0.761 and 0.769, respectively. The sensitivity was 77.7%, 70.3%,75.3%, and the specificity was 75.3%, 85.5%, 77.6%. The AUC of combined detection in predicting anemia in pregnancy was 0.851,the sensitivity was 80.4%, and the specificity was 84.1%.Conclusions The levels of Hcy and sTfR in serum of pregnant women withanemia in pregnancy are increased, and the level of VB12 is decreased. They are related to the severity of anemia in pregnant women,and may be a potential marker for predicting anemia in pregnancy. |
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