国际妇产科学杂志

国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (2): 199-202.

• 论著 • 上一篇    下一篇

妊娠晚期贫血孕妇维生素A营养状况及网织红细胞参数分析

成丽虹，张淑仪，吴羽雷，张薇，张庆华，李仲均   

  1. 523001 广东省东莞市莞城医院（成丽虹，张淑仪，吴羽雷，张薇）；深圳和合医学检验实验室（张庆华）；南方医科大学附属东莞人民医院（李仲均）
  • 收稿日期:2019-04-22 修回日期:2019-05-20 出版日期:2020-04-15 发布日期:2020-04-15
  • 通讯作者: 李仲均，E-mail：dgrmlizj@163.com E-mail:dgrmlizj@163.com
  • 基金资助:
    国家卫生计生委医药卫生科技发展研究中心科研项目（W2016CWGD05）

Analysis of Vitamin A Status and Reticulocyte Parameters in Pregnant with Anemia in Late Pregnancy

CHENG Li-hong，ZHANG Shu-yi，WU Yu-lei，ZHANG Wei，ZHANG Qing-hua，LI Zhong-jun   

  1. Dongguan Guancheng Hospital，Donguan 523001，Guangdong Province，China （ＣＨENG Li-hong，ZHANG Shu-yi，WU Yu-lei，ZHANG Wｅｉ）；Shenzhen Harmony Medical Laboratory，Shenzhen 518101，Guangdong Province，Ｃｈｉｎａ （ＺＨＡNG Qing-hｕａ）；Ｄｏｎgguan People′s Hospital Affiliated to Southern Medical University，Donguan 523000，Guangdong Province，Cｈｉｎａ （ＬＩ Ｚhong-ｊｕｎ）
  • Received:2019-04-22 Revised:2019-05-20 Published:2020-04-15 Online:2020-04-15
  • Contact: LI Zhong-jun，E-mail：dgrmlizj@163.com E-mail:dgrmlizj@163.com
  • Supported by:
     

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摘要： 目的：探讨妊娠晚期贫血与维生素A缺乏的相关性，研究维生素A缺乏对红细胞及网织红细胞参数的影响。方法：回顾性分析2017年3月—2018年3月于东莞市莞城医院产检的妊娠晚期孕妇1 204例，其中贫血孕妇299例为贫血组，非贫血且无其他妊娠合并症的孕妇905例为对照组，比较2组孕妇维生素A浓度及网织红细胞参数的差异。另外，根据维生素A浓度，以0.3 mg/L为界值，将入选孕妇分为维生素A缺乏组及维生素A正常组，比较2组孕妇贫血发生率、红细胞参数及网织红细胞参数的差异。结果：妊娠晚期贫血和维生素A缺乏的比例分别为24.83%（299/1 204）和16.45%（198/1 204）。维生素A缺乏组孕妇贫血的发生率明显高于维生素A正常组（34.85% vs. 22.86%，χ2=12.732，P=0.000）。维生素A与妊娠晚期贫血的受试者工作特征（ROC）曲线下面积为0.604（95%CI：0.568～0.640），维生素A的临界值为0.36 mg/L。与正常组相比，维生素A缺乏可导致红细胞平均血红蛋白浓度（MCHC）降低[（332.91±14.50） g/L vs. （337.95±14.19） g/L]，红细胞分布宽度变异系数（RDW-CV，14.61±2.08 vs. 13.93±1.79）、网织红细胞百分比[RET%，（1.77±0.76）% vs. （1.60±0.66）%]和未成熟网织红细胞指数[IRF，（11.19±6.05）% vs. （9.36±5.82）%]均升高（P＜0.05），而2组平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）和网织红细胞绝对值（RET#）的差异无统计学意义（均P＞0.05）。结论：维生素A缺乏与妊娠期贫血可能存在相关性，并可出现相应的红细胞及网织红细胞参数改变。临床上需要监测孕妇血浆维生素A浓度，并通过膳食或药物补充，使其维持偏高于正常值下限的水平，以减少妊娠期贫血的发生率，保证母婴健康。

关键词: 维生素A；, 贫血；, 孕妇；, 红细胞计数；, 网状细胞

Abstract: Objective：To study the correlation between anemia in late pregnancy and vitamin A deficiency, and the effects of vitamin A deficiency on erythrocyte and reticulocyte parameters. Methods: A retrospective analysis of 1 204 pregnant women in late pregnancy who came to Dongguan Guancheng Hospital from March 2017 to March 2018 was carried out. Among them, 299 pregnant women with anemia were in anemia group, 905 pregnant women without anemia and other pregnancy complications were in control group. The differences of vitamin A concentration and reticulocyte parameters between the two groups were compared. In addition, pregnant women were divided into vitamin A deficient group and vitamin A normal group according to vitamin A concentration，which used 0.3 mg/L as the boundary value. The incidence of anemia, erythrocyte parameters and reticulocyte parameters were compared between the two groups. Results: The incidences of anemia and vitamin A deficiency in late pregnancy were 24.83% (299/1 204) and 16.45% (198/1 204), respectively. The incidence of anemia in the vitamin A deficiency group was significantly higher than that in the vitamin A normal group (34.85% vs. 22.86%, χ2=12.732, P=0.000). The area under the ROC curve (AUC) of vitamin A and anemia in late pregnancy was 0.604 (95%CI: 0.568-0.640), and the cut-off value of vitamin A was 0.36 mg/L. Vitamin A deficiency was associated with decreased MCHC [(332.91±14.50)g/L vs. (337.95±14.19)g/L], increased RDW-CV (14.61±2.08 vs. 13.93±1.79), RET% [(1.77±0.76)% vs. (1.60±0.66)%] and IRF [(11.19±6.05)% vs. (9.36±5.82)%] compared with the normal group (P＜0.05). While there was no statistical significance in the changes of MCV, MCH and RET# (P＞0.05). Conclusions: Vitamin A deficiency may be associated with anemia during pregnancy, and the parameters of red blood cells and reticulocytes can be changed accordingly. In order to reduce the incidence of anemia during pregnancy and ensure the health of mother and baby, it is necessary to monitor the plasma vitamin A concentration of pregnant women, and maintain the level higher than the lower limit of normal value through diet or drug supplement.

Key words: Vitamin A；, Anemia；, Pregnant women；, Erythrocyte count；, Reticulocytes

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