轻型地中海贫血患者妊娠期血红蛋白、铁蛋白水平变化及妊娠结局分析

摘要

Objective To investigate the hemoglobin ( HGB) and serum ferritin ( SF) changes during pregnancy of women with thalassemia minor and pregnancy outcome , and to provide theoretical evidence for increasing HGB of pregnant women with minor thalassemia .Methods HGB, SF and pregnancy outcomes at different gestational weeks of 50 pregnant women with thalassemia minor ( thalassemia group ) were analyzed and were compared with the data of 50 healthy pregnant women ( normal group ) .Results HGB at different gestational weeks in the normal group was all higher than that of the thalassemia group (P<0.05 or P<0.01), SF in early pregnancy of the normal group was lower than that of the thalasse-mia group (P<0.05), but significant difference was not found after 24 weeks between the two groups (P>0.05).HGB and SF decreased with the increased gestational weeks in both groups , but the decrease in the thalassemia group was greater than the normal group and the difference was significant (P<0.05 or P<0.01).The amount of bleeding during cesarean section or 2 hours after eutocia in the thalassemia group was more than that of the normal group (all P<0.05), but there were no significant differences in percentage of cesarean section , neonates weight, and 1′Apgar score (all P>0.05). Conclusions The HGB and SF decreases with the increased gestational weeks of women with thalassemia minor , which is similar with that of the normal pregnant women , and most are in iron deficiency at the end of pregnancy .Iron supplement based on SF is suggested for pregnant women from the 24 weeks of pregnancy , so that the adverse pregnancy outcomes re-sulted from iron deficiency and anemia can be avoided .%目的：探讨轻型地中海贫血患者妊娠期血红蛋白（ HGB）及铁蛋白（ SF）水平变化及妊娠结局。方法分析50例轻型地中海贫血患者（地贫组）不同孕周的HGB、SF 值及妊娠结局，并与同期的50例健康孕产妇（正常组）进行对比。结果正常组不同孕周的HGB 均比地贫组高（P ＜0．05或P ＜0．01）。正常组早孕时SF 低于地贫组（P ＜0．05），孕24周后两组SF 值比较无统计学差异（P ＞0．05）。两组HGB 和SF 均随孕周增大而逐步下降，其中地贫组下降幅度比正常组大，差异有统计学意义（P ＜0．05或P ＜0．01）。地贫组剖宫产术中、顺产后2 h 出血量均大于正常组（P 均＜0．05），两组剖宫产率、新生儿体质量及1 min Apgar 评分无统计学差异（P 均＞0．05）。结论与正常孕妇一样，轻型地中海贫血患者妊娠期HGB 及SF 随孕周增加逐渐下降，至妊娠末期大多处于明显缺铁的状态，且产中、产后出血量明显增多，对胎儿影响不明显。