血清FEP及尿液hepcidin-25检测在儿童铁缺乏早期诊断的初步研究

发布时间：2018-08-05 09:40

【摘要】：目的：初步研究血清游离红细胞原卟啉(FEP)及尿液hepcidin-25水平在儿童铁缺乏症早期诊断的诊断性能。方法：采用ELISA方法,对25名贮存铁耗尽阶段患儿、25名缺铁性红细胞生成阶段患儿、25名缺铁性贫血阶段患儿和25名健康儿童进行血清游离红细胞原卟啉及尿液hepcidin-25检测。用受试者工作特征曲线(ROC)确定血清FEP及尿液hepcidin-25诊断贮存铁耗尽、缺铁性红细胞生成、缺铁性贫血阶段的临界值及其相应的诊断性能。结果：FEP对鉴别对照组与贮存铁耗尽组、对照组与缺铁性红细胞生成组、对照组与缺铁性贫血组、缺铁性红细胞生成组与缺铁性贫血组、贮存铁耗尽组与缺铁性红细胞生成组、对照及贮存铁耗尽混合组与缺铁性红细胞生成组的ROC曲线下的面积分别是：0.683、0.927、0.997、0.865、0.882、0.905,最佳临界值条件下相应的诊断灵敏度/诊断特异度分别是：52%/68%、84%/88%、99.9%/92%、88%/72%、68%/92%、80%/84%。hepcidin-25对鉴别对照组与贮存铁耗尽组、对照组与缺铁性红细胞生成组、对照组与缺铁性贫血组、缺铁性红细胞生成组与缺铁性贫血组、贮存铁耗尽组与缺铁性红细胞生成组、对照及贮存铁耗尽混合组与缺铁性红细胞生成组的ROC曲线下面积分别是：0.865、0.974、0.998、0.872、0.870、0.922,最佳临界值条件下的诊断灵敏度／诊断特异度分别是：96%/60%、96%/88%、99.9%/88%、82%/74%、70%/95%、98%/57%。结论：血清FEP对铁缺乏症的缺铁性红细胞生成阶段及缺铁性贫血阶段有诊断能力,对贮存铁耗尽阶段无诊断能力；hepcidin-25对贮存铁耗尽阶段、缺铁性红细胞生成阶段、缺铁性贫血阶段均有诊断能力,能比FEP更早地诊断铁缺乏症。检测尿液hepcidin-25是一个简单而没有创伤的试验,而且可以很早地在血液学改变之前预测铁缺乏。
[Abstract]:Objective: to study the diagnostic performance of serum free erythrocyte protoporphyrin (FEP) and urine hepcidin-25 in early diagnosis of iron deficiency in children. Methods: serum free erythrocyte protoporphyrin and urine hepcidin-25 were detected by ELISA method in 25 children with iron deficiency erythropoiesis and 25 children with iron deficiency anemia and 25 healthy children. The critical value of serum FEP and urine hepcidin-25 in the diagnosis of iron depletion, iron deficiency erythropoiesis, iron deficiency anemia and their corresponding diagnostic performance were determined by using the operating characteristic curve (ROC) of the subjects. Results FEP differentiated the control group from the iron depletion group, the control group from the iron deficiency erythropoiesis group, the control group from the iron deficiency anemia group, the iron deficiency erythropoiesis group from the iron deficiency anemia group, the iron storage depletion group from the iron deficiency erythropoiesis group, and the iron deficiency erythropoiesis group from the iron deficiency anemia group. The area under the ROC curve of the control and storage iron-depletion mixed group and the iron deficiency erythropoiesis group was: 0.6830.9270.9970.8650.8650.8820.905.The diagnostic sensitivity / diagnostic specificity under the optimum critical value was 0.905, respectively. The corresponding diagnostic sensitivity / diagnostic specificity of the control group and the iron deficiency erythropoiesis group were respectively: 52268% / 8899.9 / 8899.9 / 8899.9 / 8899.9 / 888872N / 8888 / 92N / 888084 / 84.hepcidin-25, which distinguished the control group from the storage iron depletion group. Control group and iron deficiency erythropoiesis group, control group and iron deficiency anemia group, iron deficiency erythropoiesis group and iron deficiency anemia group, iron storage depletion group and iron deficiency erythropoiesis group. The area under the ROC curve for the control and storage iron depletion mixed group and the iron deficiency erythropoiesis group was: 0.9980.9740.9980.8720.8720.872and 0.922, respectively. The diagnostic sensitivity / diagnostic specificity at the best critical value was 99.96 / 60,60,60,8888 / 88 / 88 / 99 / 99 / 89 / 99 / 88 / 88 / 98 / 98 / 98 / 57 / 98, respectively.The area under the ROC curve of the iron depletion mixed group and the iron deficiency erythropoiesis group was: Conclusion: serum FEP has the ability to diagnose iron deficiency erythropoiesis and iron deficiency anemia, but can not diagnose iron storage depletion stage and iron deficiency erythrocytogenesis stage. Iron deficiency anemia has the ability to diagnose iron deficiency earlier than FEP. Urine hepcidin-25 detection is a simple, non-invasive test and can predict iron deficiency well before hematological changes.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R723.2

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