血红蛋白筛查孕妇缺铁性贫血界限值的研究

由于国内评价铁营养状况的检测方法尚未普及，目前一般只能依据血红蛋白（Ｈｂ）的检测结果来判断孕妇是否贫血和是否需要补铁。为了找出一合理的Ｈｂ界限值，以平衡由此带来的缺铁诊断的假阳性和假阴性偏性，笔者对２５６名孕妇的Ｈｂ、血清铁蛋白（ＳＦ）和红细胞原卟啉（ＦＥＰ）三项指标检测的基础上，探讨了Ｈｂ的三个不同界限值（国内定界限值：Ｈｂ＝１００ｇ／Ｌ；世界卫生组织定界限值；Ｈｂ＝１１０ｇ／Ｌ；和二者均值：Ｈｂ＝１０５ｇ／Ｌ）时，孕妇缺铁诊断假阳性和假阴性的程度，借用流行病学筛查的指标，提出了与ＳＦ和ＦＥＰ检测结果相符合为标准，以两项约登指数（ＹＩ）之和最大为原则的衡量方法，以此选出Ｈｂ＝１０５ｇ／Ｌ为粗判孕妇缺铁性贫血的界限值为最佳。

A study on the Boundary Value of Hemoglobin Concentration for Screening Iron Deficiency Anemia in Pregnant Women

o evaluate Whether a pregnant woman is inanemia or there exist the needs to replenish ironis usually based on the measurement of hemo-globin ( HB)concentration,because the evaluationof iron nutritional status has not yet been usedWidely in onr country.Blood specimens were collected from 258 preg- nant women,and concentrations of Hb,serumferritin(SF)and free erythrocyte protoporphyrin(FEP) were determined to find out a reasonablyboundary value of Hb concentration from the two different ones set by out country and WHO,respectively,and the one averaged the formertwo,i.e,100g/L,110g/L and 105g/L.Falsepositivity and false negativity in diagnosis ofiron d ficiency anemia(IDA)for pregnantwomen were evaluated baseden on the measurement of SF and FEP concentrations as gold standards.Results showed that the optimal Hb concentration for preliminary diagnosis of IDA was 105g/L with maximizing Youden index.