血清NRF2，HO-1联合铁代谢指标检测在诊断慢性病贫血及缺铁性贫血中的临床应用

任梅; 谢静; 季国; 李娟; 叶春美; 许荟; 石培民

血清NRF2，HO-1联合铁代谢指标检测在诊断慢性病贫血及缺铁性贫血中的临床应用

The clinical application value of serum NRF2, HO-1 combined with iron metabolism indicators in the diagnosis of chronic disease anemia and iron deficiency anemia

摘要

摘要:
目的： 探究血清核因子E2相关因子2（NRF2）、血红素加氧酶-1（HO-1）联合铁代谢指标检测在诊断慢性病贫血（ACD）及缺铁性贫血（IDA）中的临床应用。
方法： 选取2019年1月至2022年12月45例ACD病人（ACD组）及45例IDA病人（IDA组）作为研究对象，另选取同期体检健康者45名为对照组。采用酶联免疫吸附法（ELISA）测定血清NRF2、HO-1、SI、SF、TRF、sTfR水平；采用Pearson分析血清NRF2、HO-1与SI、SF、Hb以及NRF2与HO-1的相关性；采用受试者工作特征曲线（ROC）评价血清NRF2、HO-1和铁代谢指标SI、SF水平在诊断ACD和IDA发生中的价值。
结果： ACD组和IDA组Hb、NRF2、HO-1、SI水平较对照组均降低（P ＜ 0.05），SF水平升高（P ＜ 0.05）；Pearson分析显示，ACD组和IDA组的血清NRF2、HO-1水平与SI、Hb均呈正相关关系（P ＜ 0.01），与SF呈负相关关系（P ＜ 0.01），且血清NRF2与HO-1水平呈正相关关系（P ＜ 0.01）；血清NRF2、HO-1、SI、SF诊断ACD的曲线下面积（AUC）分别为0.822、0.831、0.813、0.888，四者联合诊断ACD的AUC为0.977，均优于四者单独诊断（P ＜ 0.05）；血清NRF2、HO-1、SI、SF诊断IDA的曲线下面积（AUC）分别为0.829、0.883、0.834、0.856，四者联合诊断IDA的AUC为0.974，均优于四者单独诊断（P ＜ 0.05），且NRF2、HO-1联合SI、SF诊断IDA的效能优于诊断ACD效能。
结论： 与健康人比较，ACD和IDA病人血清NRF2、HO-1和铁代谢指标SI降低，血清SF升高；四者联合在诊断ACD和IDA中具有一定价值。

Abstract:
Objective To explore the clinical application value of serum nuclear factor erythrocyte 2-related factor 2 (NRF2), heme oxygenase-1 (HO-1) combined with iron metabolism indicators in the diagnosis of anemia of chronic disease (ACD) and iron deficiency anemia (IDA).
Methods From January 2019 to December 2022, 45 ACD patients (ACD group) and 45 IDA patients (IDA group) were collected as the study subjects, and 45 healthy examiners in our hospital were collected as the control group. The enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of NRF2, HO-1, SI, SF, TRF, and sTfR. The Pearson was used to analyze the correlation between serum NRF2, HO-1 and SI, SF, Hb, and correlation between NRF2 and HO-1. The receiver operating characteristic curve (ROC) was used to evaluate the value of serum NRF2, HO-1 and iron metabolism indicators SI, SF levels in the diagnosis of ACD and IDA.
Results The levels of Hb, NRF2, HO-1 and SI in the ACD and IDA groups were obviously lower than those in control group (P ＜ 0.05), and the SF levels in the ACD and IDA groups were significantly higher than that in control group (P ＜ 0.05). The results of Pearson analysis showed that the serum levels of NRF2 and HO-1 levels were positively correlated with SI and Hb, and negatively correlated with SF (P ＜ 0.01), and the serum level of NRF2 was positively correlated with HO-1 levels in the ACD and IDA groups (P ＜ 0.05). The area under the curve (AUC) of serum NRF2, HO-1, SI, and SF in the diagnosis of ACD were 0.822, 0.831, 0.813, and 0.888, respectively, the AUC of the four combination in the diagnosis of ACD was 0.977, which was better than the single diagnosis of four (P ＜ 0.05). The area under the curve (AUC) of serum NRF2, HO-1, SI, and SF in the diagnosing IDA was 0.829, 0.883, 0.834, and 0.856, respectively, the AUC of the four combination in the diagnosis of IDA was 0.974, which was better than the single diagnosis of four (P ＜ 0.05), moreover, the efficacy of NRF2 and HO-1 combined with SI and SF in the diagnosing IDA was better than that of ACD (P ＜ 0.05).
Conclusions Compared with healthy people, the serum levels of NRF2 and HO-1 and iron metabolism index SI decrease, and the serum levels of SF increase in ACD and IDA patients. The combination of the four has certain value in the diagnosis of ACD and IDA.

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