Also Known As
ZPP
ZP
游离红细胞原卟啉
FEP
正式名称
锌原卟啉
本文最后审核 时间
本文 最后修改 时间 2018/01/15.
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为何检测?

用于筛查和检测慢性铅暴露;检测儿童缺铁症。

何时检测?

当您长期接触铅,或者医生怀疑您铅中毒时,可作为监测铅暴露情况的一个指标,;作为儿童和青少年缺铁情况筛查的一个指标。

何种样本?

手臂静脉或手指采血的标本。

是否需要作试验前准备?

不需要。

检测什么?

锌原卟啉(ZPP)试验是用来鉴定血中亚铁血红素的形成是否中断的试验。亚铁血红素是血红素的重要成分,它作为红细胞(RBC)中的蛋白能将氧气从肺部运输到机体组织和细胞中。经过一系列的酶促反应,最后在原卟啉分子中心插入一个铁原子后形成亚铁血红素。如果铁缺乏,那么锌就会取代铁与原卟啉结合形成锌原卟啉。由于其不能输送氧气,ZPP在红细胞中不发挥任何作用。

有两种方法可以检测ZPP。游离红细胞原卟啉(FEP)试验同时检测ZPP(代表了红细胞中90%的原卟啉)和游离原卟啉(未与锌结合)。ZPP与亚铁血红素比率代表了红细胞中ZPP相对于亚铁血红素的百分比。

测试样本如何采集?

用手臂静脉采血的标本来测量FEP。将一滴手指血放到血液荧光计上检测ZPP与亚铁血红素比率。这种仪器能测量ZPP的荧光量并报告每单位亚铁血红素分子中ZPP的数量。由于样本只需一滴血,这试验非常适合筛查儿童。

是否需要进行任何试验前准备以保证样本的质量?

不需要。

Accordion Title
常见问题
  • 有何用途?

    锌原卟啉主要用于辅助检测儿童缺铁症,也用于检测并监测成人的慢性铅暴露。

    ZPP同铅水平一起检测,可用于评估慢性铅暴露。铅制产品爱好者和那些居住在老房子里的人患铅中毒的风险更高。这是因为他们常常接触或吸入铅。那些吸入含铅粉尘的、通过手部接触食入铅的,或者儿童误食含铅的油漆碎片的(常发生在建于1960年前的住宅),其体内铅水平和ZPP会升高。美国职业安全和健康组织(OSHA)规定工业部门员工要做ZPP试验,并且强烈建议每次接触过铅的员工都需做ZPP试验来监测其铅水平。由于ZPP不能反映最近或急性铅暴露,所以这两者都是必需的,而且去除铅接触源后,人体内铅含量不会很快改变。ZPP是反映人体3-4个月前平均铅暴露情况最好的指标。

    ZPP的灵敏度不能够满足儿童筛查的需求,因为直到铅浓度超过可接受范围后,ZPP值才上升。美国疾病预防控制中心(CDC)将儿童铅安全浓度最大值设的非常低以便将铅暴露对他们成长的负面影响最小化。

    在儿童中,ZPP与亚铁血红素比率作为铁缺乏的早期指标。ZPP与亚铁血红素比率增加是铁储量不足的首发征象之一,在大多数青年人出现贫血体征和症状之前其值会升高。要确诊为缺铁症还需要做更多能反映铁贮存情况的特异性试验。

  • 何时检测?

    当怀疑成人有慢性铅暴露;当作为职业性铅监控程序的参与者时;当某人有制作有色玻璃的爱好,会经常接触铅时,需要做ZPP和铅试验。当怀疑铁缺乏症时,ZPP与亚铁血红素比率可作为儿童和青少年铁缺乏的筛查试验。

  • 试验结果的含义?

    血中ZPP浓度通常较低。ZPP的增加提示亚铁血红素的正常制造中断了,但对于其起因没有特异性。ZPP增加的主要原因是缺铁症和铅中毒。除了病人的病史、临床表现和其他试验如铁蛋白、铅浓度和全血细胞计数(CBC),检测ZPP水平也是很重要的。病人也可能同时患有缺铁症和铅中毒。

    慢性铅暴露时,ZPP能反映3-4个月前的平均铅水平。然而,ZPP试验不能检测当前血中铅的量和机体含铅负荷(器官和骨中的量)。发生铅暴露后ZPP值升高远慢于血铅浓度,而在铅接触终止后ZPP需要更长的时间才能使数值下降。

    儿童ZPP与亚铁血红素比率增加通常是因为缺铁症。随着时间推移,经铁补充疗法后ZPP与亚铁血红素比率降低提示有效铁有所增加。

  • 还有什么我需要了解的吗?

    在红细胞生成性卟啉症中也能看到ZPP的增加,但这些遗传性疾病不像缺铁症或铅中毒那样常见。

    在炎症、慢性贫血、感染和几种血液疾病中,ZPP可能会升高,但一般不用于监测或诊断这些疾病。

    鉴于ZPP试验使用的方法,血中其他带荧光的物质,如胆红素和核黄素,可能会导致假阳性结果。如果在测试前标本没有避光,则会产生假性低值。

  • 除了ZPP和铅试验,医生还会做哪些试验来监测铅暴露?

      如果您处于一个常常接触到铅的工作环境中,您的医生会要求做以下试验来评价您的肾功能和红细胞生成:

    • BUN 
    • 肌酐
    • 尿常规
    • CBC或血红蛋白和红细胞压积
    • 外周血涂片
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