广西桂林市77例重型地中海贫血内分泌检测结果分析  

Clinical Analysis of A Endocrine Detection in 77 Cases of Thalassemia Major in Guilin City of Guangxi

作　　者：杨潍嘉 王珂 巫玉峰 唐仕强 莫畅游 匡小凤 

机构地区：[1]广西桂林市妇女儿童医院,桂林市541001

出　　处：《广西医学》2013年第9期1138-1141,共4页Guangxi Medical Journal

基　　金：广西卫生厅科研立项课题(Ζ2011512)

摘　　要：目的探讨重型β地中海贫血(地贫)伴铁过载患者甲状腺、甲状旁腺、性腺等内分泌情况。方法重型地贫患者77例(病例组),健康对照组75例,检测两组空腹血糖、空腹胰岛素、血钙、无机磷、铁蛋白及甲状旁腺激素、促甲状腺激素(TSH)、游离三碘甲状腺原氨(FT3)、游离甲状腺素(FT4)、骨钙素。结果病例组检出亚临床甲低18例、甲状旁腺激素低下8例,对照组75例FT3、FT4、TSH均在正常范围。病例组检出胰岛素抵抗4例,对照组无胰岛素抵抗。两组空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)比较差异无统计学意义(P>0.05)。病例组血钙、甲状旁腺激素均低于对照组(P<0.05);血磷、骨钙素、铁蛋白高于对照组(P<0.05)。病例组骨龄落后、骨质疏松、身高落后、体重低下发生率均高于对照组(P均<0.05)。结论重型地贫伴铁过载患者内分泌功能损害是多方面的,以身材矮小和性发育迟缓、性激素水平低下最常见,其次是甲状腺和甲状旁腺激素功能低下。Objective To explore the endocrine of thyroid,parathyroid,gonad in β-thalassemia major patients with iron overload.Methods Seventy-seven patients with thalassemia major（case group） and 75 cases of healthy controls（control group） were enrolled in the study.Fasting blood glucose,fasting insulin,serum calcium,phosphorus and ferritin were detected in both groups as well as parathyroid hormone,TSH,FT3,FT4 and osteocalcin.Results There were 18 cases of subclinical hypothyroidism and 8 cases of low parathyroid hormone in the case group.FT3,FT4 and TSH of 75 cases in the control group were normal.There were 4 insulin resistance cases in the case group while no insulin resistance case in the control group.Fasting blood glucose,fasting insulin,HOMA-IR showed no significant difference between two groups（P 0.05）.Serum calcium and parathyroid hormone of patients in the case group were lower than those in the control group（P 0.05）;Serum phosphorus,osteocalcin and ferritin of patients in the case group were higher than those in the control group（P 0.05）.The incidences of bone age lag,osteoporosis,short stature,and low weight in the case group were higher than those in the control group（all P 0.05）.Conclusion Performance of β-thalassemia major companied by iron overload is associated with endocrine dysfunction in many aspects,which mainly presents short stature,delayed puberty and low sex hormone level,and then thyroid and parathyroid hypofunction.

关 键 词：地中海贫血 铁负载 内分泌 

分 类 号：R556[医药卫生—血液循环系统疾病]