目的 建立武汉地区表观健康成人血清可溶性转铁蛋白受体(soluble transferrin receptor，sTfR)和可溶性转铁蛋白受体与血清铁蛋白常用对数的比值(sTfR/log serum ferritin index，sTfR/lgSF)参考区间，为临床对铁缺乏和缺铁性贫血诊治提供依据。方法 选取武汉亚心总医院表观健康体检者和献血屋献血者 273 名，检测sTfR、其他铁代谢指标以及超敏C-反应蛋白(high sensitivity C-reactive protein，hsCRP)，并计算sTfR/lgSF值，采用百分位数法(P2。5～P97。5)建立sTfR和sTfR/lgSF参考区间。采用Spearman相关分析评价sTfR、sTfR/lgSF与其他铁代谢指标、hsCPR相关性。结果 sTfR水平(M，mg/L)男女(1。01 vs 1。07)间差异不具统计学意义(P＞0。05)，但男性sTfR/lgSF水平明显低于女性(0。45 vs 0。62)，差异有统计学意义(P＜0。05);各年龄组间sTfR(M，mg/L)、sTfR/lgSF(M)比较，分别为(1。07 vs 1。02 vs 1。00)、(0。52 vs 0。53 vs 0。51)，差异均不具统计学意义(P＞0。05);sTfR参考区间为(0。72～1。68)mg/L，根据性别建立sTfR/lgSF参考区间为男性(0。31～0。88)、女性(0。37～1。19);相关性分析结果显示:sTfR、sTfR/lgSF与hsCRP无相关性(r=0。043，P＞0。05)、(r=-0。064，P＞0。05)，而血清铁蛋白(serum ferritin，SF)、血清铁(serum iron，SI)、转铁蛋白饱和度(transferrin saturation，TSAT)与 hsCRP 均有相关性(r=0。128，P＜0。05)、(r=-0。195，P＜0。01)、(r=-0。173，P＜0。01);sTfR与SF无相关性(r=-0。115，P＞0。05)，而sTfR/lgSF与SF有显著性相关(r=-0。685，P＜0。01)。结论 初步建立了武汉地区表观健康成人血清sTfR及sTfR/lgSF的参考区间。sTfR和sTfR/lgSF不受炎性因子影响，对在炎症作用下血清铁蛋白升高的贫血患者，鉴别是否存在铁缺乏方面有着重大意义。
Establishment of reference intervals for serum sTfR and sTfR/lgSF in apparently healthy adults in Wuhan
Objective To establish reference intervals for serum soluble transferrin receptor(sTfR)and sTfR/log ser-um ferritin index(sTfR/lgSF)in apparently healthy adults in the Wuhan area,so as to provide reference for clinical diagno-sis and treatment of iron deficiency and iron-deficiency anemia.Methods A total of 273 individuals from the Wuhan Aisa General Hospital,including health examination participants and blood donors,were selected to measure sTfR,other iron metabolism indicators and high sensitivity C-reactive protein(hsCRP).The sTfR/lgSF values were calculated and reference intervals for sTfR and sTfR/lgSF were established using the percentile method(P2.5 to P97.5).Spearman correlation anal-ysis was used to evaluate the relationships between sTfR,sTfR/lgSF,and other iron metabolism indicators,as well as hsCRP.Results The sTfR levels(M,mg/L)between males and females(1.01 vs 1.07)were not statistically significant(P＞0.05),but the sTfR/lgSF levels if males were significantly lower than those in females(0.45 vs 0.62)(P＜0.05).There was no significant difference in sTfR(M,mg/L)and sTfR/lgSF(M)among different age groups,with values of 1.07 vs 1.02 vs 1.00 and 0.52 vs 0.53 vs 0.51,respectively(P＞0.05).The reference interval for STfR was(0.72-1.68)mg/L,the sTfR/lgSF reference interval was(0.31-0.88)for males,and(0.37-1.19)for females.Correlation analysis showed no correlation between sTfR,sTfR/lgSF and hsCRP(r=0.043,P＞0.05;r=-0.064,P＞0.05),while serum ferritin(SF),serum iron(SI),transferrin saturation(TSAT)were correlated with hsCRP(r=0.128,P＜0.05;r=-0.195,P＜0.01;r=-0.173,P＜0.01).There was no correlation between sTfR and SF(r=-0.115,P＞0.05),while sTfR/lgSF was significantly correlated with and SF(r=-0.685,P＜0.01).Conclusion Preliminary reference intervals for serum sTfR and sTfR/lgSF in apparently healthy adults in the Wuhan has been established.sTfR and sTfR/lgSF are not affected by inflammatory factors and are significant for identifying iron deficiency in anemia patients with elevated serum ferritin caused by inflammation.
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