【摘要】 目的　观察血清转铁蛋白受体 (sTfR)在铁状况正常和不同程度缺铁儿童体内的水平和铁干预后的变化 ,评价sTfR在筛检人群铁缺乏和补铁效果中的价值。方法　初筛北京房山区 6～ 14岁儿童 10 0 6名 ,检测其铁生化指标 ,从中筛选铁正常、贮存铁减少 (ID)、红细胞生成缺铁 (IDE)和缺铁性贫血 (IDA)儿童 2 39名 ,采用双抗体夹心ELISA法测定sTfR含量 ,计算sTfR log血清铁蛋白 (SF)。对铁缺乏儿童给予口服乙二胺四乙酸钠铁胶囊 (6 0mg元素铁 粒 ) ,每次 1粒 ,ID与IDE儿童 ,每周 1次 ,IDA儿童每周 3次 ,连续 9周。补铁后重复测定铁生化指标与sTfR ,比较补铁前后sTfR的变化。结果　ID、IDE、IDA期儿童sTfR含量分别为 (2 0 0 3± 2 33)nmol L、(2 4 5 2± 1 0 7)nmol L和 (33 2 8± 6 0 9)nmol L ,sTfR logSF值分别为 18 15± 5 31、2 0 98± 8 88和 2 9 0 8± 8 5 7,均显著高于正常对照组的sTfR(18 74± 3 0 6 )nmol L与sTfR logSF值 9 89± 1 74。sTfR与红细胞游离原卟啉 (FEP)、血红蛋白 (Hb)显著相关。正常儿童sTfR为 12 5～ 2 3 5nmol L。补铁后 ,ID、IDE与IDA期儿童sTfR含量为 (16 37±3 10 )nmol L ,明显低于补铁前水平 ,但在IDE与IDA期没有变化 ;ID期儿童sTfR logSF值分别为11 42± 3 12、16 5 4±更多还原

【Abstract】 Objectives To study the level of serum transferrin receptor (sTfR) in children with different stages of iron deficiency, as well as in the normal children, to observe its response to iron supplementation, and to explore the role of sTfR in surveillance of iron status and assessment of iron supplementation in population.Methods By determining iron status index, 1 006 children aged 6-14 years in Fangshan District, Beijing were divided into four groups, control group, iron depletion (ID) group, iron deficiency erythropoiesis (IDE) group and iron deficiency anemia (IDA) group, and 239 of them were measured for sTfR with Quintikine enzyme immunoassay (R&D system, Minneapolis, MN) and sTfR/logserum ferratin (SF)was estimated. Iron supplementation (NaFeEDTA capsules, containing 60 mg iron element per capsule) was administered for the children with ID and IDE per capsule once weekly and for the children with IDA per capsule thrice weekly for nine weeks. Iron status index and sTfR were measured before and after iron supplementation. Results The levels of sTfR and sTfR/log SF in children with ID, IDE and IDA were (20.03±2.33) nmol/L, (24.52±1.07) nmol/L, (33.28±6.09) nmol/L and (18.15±5.31), (20.98±8.88), (29.08±8.57), respectively, significantly higher than those in the control group [sTfR(18.74±3.06) nmol/L and sTfR/log SF(9.89±1.74)]. Statistical analysis showed that sTfR correlated to free erythrocyte protoporphyrin and hemoglobin. sTfR levels in normal children was (12.5-23.5) nmol/L. After iron supplementation, sTfR levels in children with ID was(16.37±3.10) nmol/L, significantly decreased than those before iron supplementation, but no change in sTfR was observed in children with IDE and IDA. sTfR/log SF were decreased significantly in all children with ID group(11.42±3.12), IDE (16.54±4.70)and IDA (23.59±9.93).Conclusion sTfR is a specific indicator for identifying IDE and IDA, and sTfR/log SF is a sensitive index for assessing the effects of iron supplementation.更多还原