慢性病贫血的铁代谢研究  

Investigation of iron metabolism in anemia of chronic disease

作　　者：张文龙[1] 王曼萍[1] 张骥[1] 杨昕[1] 李莉[1] 刘德琮[1] 闫杰[1] 

机构地区：[1]上海市普陀区人民医院血液内科,上海200060

出　　处：《临床血液学杂志》2008年第6期588-589,共2页Journal of Clinical Hematology

摘　　要：目的:探讨慢性病贫血(ACD)的铁代谢,有利于临床医师提高对该病的诊治水平。方法:对21例ACD和15例缺铁性贫血(IDA)患者进行Hb、血清铁(SI)、总铁结合力(TIBC)、血清铁蛋白(SF)、可溶性转铁蛋白受体(sTfR)、骨髓涂片铁染色、EPO、白细胞介素(IL)-1、IL-6、IL-8和肿瘤坏死因子-浕(TNF-浕)进行检测,并对结果进行分析。结果:①SI、TIBC、SF和骨髓涂片铁染色对区别ACD和单纯性IDA有很大帮助,2组数据比较差异有统计学意义,P<0.05;②ACD组中存在缺铁(占19.01);③ACD组和IDA组的sTfR水平分别为(2.41±1.20)mg/L和(6.38±3.24)mg/L,2组比较差异有统计学意义,P<0.05;④ACD组EPO水平低于IDA组,而IL-6、IL-8、TNF-浕水平高于IDA组,2组间数据比较除IL-1外,其他细胞因子差异有统计学意义,P<0.05。结论:sTfR是一种新的铁参数,有助于临床医师对ACD与IDA鉴别及合理用药,初步结果显示一些细胞因子在ACD疾病的致病因素中占重要地位。Objective：To investigate iron metabolism in anemia of chronic disease （ACD） and help clinicians to prove the diagnosis and treatment of the disease. Method： Hb, SI, TIBC, SF, sTfR, EPO, IL-1, IL-6, IL-8 and TNF-α were measured. Iron staining in bone marrow slides was performed in 21 ACD patients and 15 iron deft ciency anemia （IDA） patients. Result： （1）The level of SI, TIBC, SF, sTfR and iron staining in bone marrow slides were obviously different between ACD and IDA patients（ P 〈0.05） ; （2）Qhe level of EPO in ACD was lower than that in IDA, but the levels of IL-6, IL-8 and TNF-α were higher than that in IDA （ P 〈0.05） ; （3）Iron deficiency existed in 19.01 % ACD patients. Conclusion： sTfR was a new iron parameter to favor differential diagnosis between ACD and IDA and rational use of drugs. Some cytokines played an important role in the mechanism of ACD.

关 键 词：贫血 慢性病 铁代谢 

分 类 号：R556[医药卫生—血液循环系统疾病]