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目的探讨哈萨克族妇女妊娠期缺铁性贫血对新生儿血清铁水平的影响及干预措施分析。方法选取2014年5月至2015年12月阿勒泰地区人民医院产科的196例哈萨克族妊娠期缺铁性贫血患者为研究对象,分别在孕早中晚期测定相关指标,全程测定研究对象怀孕期间的血红蛋白(Hb)、网织红细胞(Ret)、网织红细胞成熟指数(RMI)、血清铁(SI)、血清铁蛋白(SF)和血清转铁蛋白受体(s TfR)。分析三组患者孕早中晚期不同时间段缺铁性贫血与新生儿血清铁水平,并研究分析相关干预措施。结果缺铁性贫血(IDA)、隐性铁缺乏症(LID)和正常组的患病率在不同孕周组有显著性差异(χ2值分别为8.82、8.18、36.58,均P<0.05),其患病率随着孕周的增加而增加。SI与SF随着孕周的增加指数逐渐降低,s TfR,Ret及RM I随着孕周的增加逐渐上升,Hb、SI、SF、s TfR、Ret和RMI在不同孕周中有显著性差异(F值分别为5.17、9.49、7.49、4.81、5.19、6.28,均P<0.05),SI、SF在不同孕周中有显著性差异(F值分别为7.16、3.48,均P<0.05),进一步两两比较显示,LDA组、LID组与正常组SI和SF相比有显著性差异(t值3.48~7.16,均P<0.05),其余指标无显著性差异(P>0.05)。Hb在孕中期达到最低(112.49±2.95g/L),孕晚期有所回升(115.72±0.09g/L),而SI与SF随着孕周的增加逐渐降低,孕晚期分别为(75.82±0.85g/L和15.45±0.08g/L),各孕期相比较,F值分别为9.49和7.49。结论妊娠期妇女随着孕期的不断增加,缺铁现象不断加重,但是孕早期的缺铁现象对新生儿血清铁的影响最大,应该受到极大重视。妇女在备孕或妊娠期应遵医嘱,按时产检,并进行血清铁化验,医生要对早中晚期孕妇采取合理的治疗措施。
Objective To investigate the effects of iron deficiency anemia during pregnancy on the level of serum iron in neonates and the intervention measures. Methods A total of 196 Kazakh patients with pregnancy-threatening iron deficiency anemia in the obstetrics department of Altay Prefecture People’s Hospital from May 2014 to December 2015 were enrolled in this study. Relevant indexes were determined in the early and late pregnancy respectively. The hemoglobin Hb, Ret, RMI, SI, SF and s TfR were measured. Iron deficiency anemia and neonatal serum iron levels were analyzed in three groups at early, middle and late stages of pregnancy, and the related interventions were analyzed. Results The prevalence of iron deficiency anemia (IDA), latent iron deficiency (LID) and normal group were significantly different in different gestational age groups (χ2 = 8.82,8.18,36.58, all P <0.05) The prevalence increases with gestational age. SI and SF gradually decreased with the increase of gestational age, s TfR, Ret and RM I increased gradually with the increase of gestational age, and there were significant differences in Hb, SI, SF, s TfR, Ret and RMI between different gestational weeks (F = 5.17,9.49,7.49,4.81,5.19,6.28, all P <0.05). There were significant differences in SI and SF between different gestation weeks (F = 7.16 and 3.48, P <0.05, respectively) Further comparison showed that LDA group, LID group and normal group SI and SF were significantly different (t value 3.48 ~ 7.16, both P <0.05), the other indicators no significant difference (P> 0.05). The lowest level of Hb in the second trimester (112.49 ± 2.95g / L) and the third trimester in the third trimester (115.72 ± 0.09g / L), while the levels of SI and SF decreased gradually with the increase of gestational age. The third trimester of pregnancy was (75.82 ± 0.85 g / L and 15.45 ± 0.08g / L). Compared with each pregnancy, the F values were 9.49 and 7.49, respectively. Conclusion During pregnancy, the number of women with pregnancy continues to increase and iron deficiency continues to worsen. However, iron deficiency in early pregnancy has the greatest impact on neonatal serum iron and deserves great attention. Women in preparation for pregnancy or pregnancy should be prescribed by the doctor, on time seizure, and serum iron test, the doctor should take early and middle-aged pregnant women to take reasonable treatment.