Abstract: Objective To investigate the changes and significance of serum iron (SI),total iron binding capacity (TIBC),transferrin (Tf) and ferritin (SF) in children with iron deficiency anemia (IDA) and to provide evidence for clinical treatment. Methods From January 2014 to February 2016,101 cases of anemia children were selected in Maternal and Child Health Hospital of Hainan Province,including 67 cases of IDA (IDA group),anemia of chronic disease (ACD) in 34 cases (ACD group),At the same time,100 healthy children were selected as control group.Serum levels of SI,TIBC,Tf and SF of each group were measured. Results Levels of SI and SF were (4.70±1.30) mol/L and (59.43±18.84) g/L in IDA group,significantly lower than those in control group and ACD group (P<0.05);Level of TIBC was (74.60±6.52) mol/L in IDA group,significantly higher than that in control group and ACD group (P<0.05);Level of Tf were (3.30±0.52) g/L and (3.35±0.60) g/L in IDA group and ACD group,significantly higher than that in control group (P<0.05);The areas of ROC curve of SI,TIBC and SF in the diagnosis of IDA were 0.837,0.822 and 0.755(P<0.05),Tf area under the ROC curve was 0.515(P>0.05); SI,TIBC and SF cut-off values were 6.99 mol/L,61.90 mol/L and 71.92 g/L,and the sensitivity were 73.50%,97.00% and 73.50%,the specificity were 94%,64.70% and 70.10% respectively. Conclusion SI,TIBC and SF are of certain value in the diagnosis of children iron deficiency anemia,and can be used as differential diagnosis index between iron deficiency anemia and anemia of chronic disease.

Key words: serum iron, total iron binding capacity, transferrin, ferritin, iron deficiency anemia, children

摘要： 目的 分析血清铁(SI)、总铁结合力(TIBC)、转铁蛋白(Tf)和铁蛋白(SF)在缺铁性贫血(IDA)患儿中的变化及意义,为临床诊治提供参考依据。方法 选取2014年1月-2016年2月在海南省妇幼保健院治疗的贫血患儿101例,其中IDA患儿67例(IDA组),慢性疾病性贫血(ACD)34例(ACD组),同时选取健康儿童100例作为对照组,检测各组血清SI、TIBC、Tf和SF水平。结果 IDA组患儿SI和SF分别为(4.70±1.30) mol/L和(59.43±18.84) g/L,明显低于对照组和ACD组(P＜0.05);IDA组患儿TIBC为(74.60±6.52) mol/L,明显高于对照组和ACD组(P＜0.05);IDA组和ACD组Tf分别为(3.30±0.52)g/L和(3.35±0.60)g/L,均明显高于对照组(P＜0.05);SI、TIBC和SF 诊断IDA的受试者工作特征(ROC)曲线下面积分别为0.837、0.822和0.755(P＜0.05),Tf ROC曲线下面积为0.515(P＞0.05);SI、TIBC和SF截断值分别为6.99 mol/L、61.90 mol/L和71.92 g/L,诊断IDA的灵敏度分别为73.50%、97.00%和73.50%,特异度分别为94.00%、64.70%和70.10%。结论 SI、TIBC和SF在小儿缺铁性贫血诊断中有一定的价值,可作为缺铁性贫血和慢性疾病性贫血鉴别诊断指标。

关键词: 血清铁, 总铁结合力, 转铁蛋白, 铁蛋白, 缺铁性贫血, 儿童