摘要
目的评估血清可溶性转铁蛋白受体(sTFR)及其复合参数sTFR/LogSF在炎症性肠病(IBD)合并缺铁性贫血(IDA)中的诊断效能。方法收集IBD患者161例,其中克罗恩病(CD)81例,溃疡性结肠炎(UC)80例。入院次日清晨空腹抽取静脉血完善血常规、铁代谢、C反应蛋白(CRP)、叶酸及维生素B12(Vit B12)。根据世界卫生组织(WHO)贫血诊断标准分为贫血组和非贫血组。分析IBD贫血的发生率及病因。根据SF将IBD分成缺铁性贫血(IDA)组和非IDA组,利用受试者工作特征曲线(ROC曲线)评估sTFR及sTFR/LogSF在IBD合并IDA中的诊断效能。所有病例随访至研究终点,随访时间≥12个月。结果 IBD合并贫血的发生率62.1%(100/161),其中IDA 40.0%(40/100),慢性病性贫血(ACD)14.0%(14/100),ACD与IDA混合26.0%(26/100),叶酸和Vit B12缺乏10.0%(10/100)。IDA组的血清sTFR浓度和sTFR/LogSF值明显高于非IDA组,差异有统计学意义(U=655.5、306.0,P<0.001)。血清sTFR/LogSF的AUC值(0.937)大于sTFR的AUC值(0.865);sTFR/LogSF临界值(2.8)处的特异度(90.9%)、敏感度(87.5%)高于sTFR的临界值(4.7 mg/L)处特异度(86.0%)、敏感度(77.5%)。sTFR、sTFR/LogSF与CRP无相关关系(r=0.042、-0.958,P>0.05)。结论 IBD合并贫血发生率高,其中以IDA为常见,检测血清sTFR/LogSF和sTFR可以更准确地诊断IBD合并IDA情况。
Objective To evaluate the value of serum soluble transferrin receptor（sTFR） and sTFR-ferritin index（sTFR/LogSF） in diagnosing iron deficiency anemia（IDA） with inflammatory bowel disease（IBD）.Methods161 patients with diagnosis of IBD was continuous collected,including 81 cases of Crohn＇s disease（CD） and 80 cases of ulcerative colitis（UC）.Drawing venous blood to check complete blood count,iron metabolism,CRP,folic acid and vitamin B12（Vit B12） in the next morning with an empty stomach.According to the WHO anemia diagnostic criterion,patients were divided into anemia group and non anemia group.The incidence and etiology of IBD were analysed.All patients with IBD were divided into iron deficiency anemia group and non iron deficiency group based on SF.Receiver-operating characteristic curve（ROC curve） were applied to evaluate the value of sTFR and sTFR/LogSF in diagnosis of IDA with IBD.All the cases were followed till the endpoint of the study,lasted for 12 months at least.Results The incidence of IBD combined with anemia was 62.1%（100/161）,among which IDA and ACD hold up to 40.0 %（40/100） and 14.0%（14/100） respectively,while the mix of IDA and ACD account for 26.0%（26/100）,and 10.0%（10/100） was taken by lack of folic acid and Vit B12.The level of sTFR and sTFR/LogSF in IDA group were obviously higher than those in non IDA group,and this difference was statistically significant（U=655.5,306.0,P0.001）.The AUC of sTFR/LogSF（0.937） was higher than the AUC（0.865） of sTFR.High s TfR levels（ 4.7 mg/L） had a sensitivity of 77.5% and a specificity of 86.0%,whereas high s TfR/LogSF（ 2.8） had a sensitivity of 87.5% and a specificity of 90.9% for the diagnosis of IDA.Both sTFR and sTFR/LogSF index were not correlated with CRP levels（r=0.042,0.958,P 0.05）.Conclusion The incidence of IBD combined anemia is high,among which IDA is common.By detecting serum sTFR/LogSF and s TfR,the diagnosis of IBD combined IDA may be more accurate.
作者
徐帆
胡乃中
梅俏
Xu Fan;Hu Naizhong;Mei Qiao(Dept of Gastroenterology,The First Affiliated Hospital of Anhui Medical University,Hefei 23002)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第7期1110-1114,共5页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81470809)
