【摘要】目的探讨缺铁性贫血(iron deficiency anemia，IDA)青少年女性维生素D 缺乏症(Vitamin D deficiency，VDD)发生率及其与铁代谢指标的相关性。方法选择2019 年1 月至2019 年12 月来连云港市第一人民医院门诊就诊的80 例青少年女性作为研究对象。其中，IDA 确诊50 例(IDA 组，n=50)，另外30 例为健康女性(对照组，n=30)。分析IDA 青少年女性中VDD 的发生率。比较IDA 组和对照组患者血清铁、血清铁蛋白、总铁结合力(total iron binding capacity，TIBC)等铁代谢指标以及维生素D 水平差异；比较IDA 患者中不同维生素D 水平下铁代谢指标水平差异；采用Pearson's 相关性分析IDA 患者中维生素D 水平与铁代谢指标的相关性。结果IDA 组和对照组患者在体质量指数(Body mass index，BMI)、血红蛋白、平均红细胞体积(mean corpuscular volume，MCV)、红细胞比容、血清铁、血清铁蛋白、TIBC、血清维生素D 方面差异有统计学意义(t=2.096，P=0.039；t=11.856，P＜0.001；t=7.591，P＜0.001；t=4.194，P＜0.001；t=12.492，P＜0.001；t=12.572，P＜0.001；t=3.152，P=0.002；t=3.626，P=0.001)。IDA 组VDD 患者21 例(42% )，对照组VDD 患者5 例(16.67% )，两组比较差异有统计学意义(χ2=5.485，P=0.019)。Pearson's 相关性分析结果显示，IDA 患者中维生素D 水平与血清铁、血清铁蛋白、TIBC 无相关性(r=-0.081，P=0.658；r=0.029，P=0.883；r=0.141，P=0.394)。IDA 患者中维生素D＜30nmol/L 组和维生素D＞30nmol/L 组在TIBC、血清维生素D 方面差异有统计学意义(t=2.244，P=0.029；t=12.993，P＜0.001)。结论VDD 在患有IDA 的青少年女性中的发生率高于健康对照组。然而，维生素D 水平与铁代谢指标无显著相关性。
【Abstract】Objective To investigate the incidence of vitamin D deficiency (VDD) in female adolescents with iron deficiency anemia (IDA) and the correlation of VDD with iron metabolism. Methods A total of 80 female adolescents admitted to the Outpatient Department of Lianyungang First People's Hospital in the period from Jan. 2019 to Dec. 2019 were enrolled in this study. Among them, 50 IDA cases were assigned as the IDA group, and 30 healthy women were recruited as the control group. The incidence of VDD was analyzed in IDA group. The iron metabolism indexes including serum iron, serum ferritin and total iron binding capacity (TIBC) as well as serum vitamin D levels were compared between the two groups. The iron metabolism indexes were also compared in IDA group with different serum vitamin D levels. The correlation between serum vitamin D level and iron metabolism indexes in IDA group was analyzed by Pearson's correlation. Results There were significant differences in body mass index (BMI), hemoglobin, mean corpuscular volume (MCV), hematocrit, serum iron, serum ferritin, TIBC and serum vitamin D between IDA group and control group (t=2.096, P=0.039; t=11.856, P＜0.001; t=7.591, P＜0.001; t=4.194, P＜0.001; t=12.492, P＜0.001; t=12.572, P＜0.001; t=3.152, P=0.002; t=3.626, P=0.001). There were 21 cases (42%) and 5 cases (16.67%) of VDD in IDA group and control group respectively (χ2=5.485, P=0.019). Pearson's correlation analysis showed that there were no correlations between serum vitamin D level and serum ferritin, TIBC(r=-0.081, P=0.658; r=0.029, P=0.883; r=0.141, P=0.394). In IDA group, TIBC and serum vitamin D were significantly different between patients with vitamin D＜30 nmol/L and those with vitamin D＞30 nmol/L (t=2.244, P=0.029; t=12.993, P＜0.001). Conclusion The incidence of VDD in female adolescents with IDA was higher than that in healthy controls. However, serum vitamin D level had no significant correlation with iron metabolism indexes.
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