肾移植术后早期铁参数的监测  

A study of iron parameters early after renal transplantation

作　　者：黄俊[1] 王立明[2] 朱有华[2] 朱起之[1] 

机构地区：[1]广州军区广州总医院肾脏科,广州510010 [2]第二军医大学长征医院泌尿外科,上海200003

出　　处：《广东医学》2001年第11期1005-1007,共3页Guangdong Medical Journal

摘　　要：目的　探讨铁对肾移植后贫血纠正的影响 ,评价各项铁参数反映肾移植患者储铁情况的准确性。方法　47例肾移植患者术后连续监测血清铁蛋白、血清铁、总铁结合力和转铁蛋白饱和度等铁参数和血红蛋白的变化 3个月 ,其中 12例铁缺乏患者口服补铁治疗。结果　不补铁患者术后血清铁蛋白随着血红蛋白的上升而迅速下降 ,而血清铁和转铁蛋白饱和度并无显著改变。低铁组患者血红蛋白上升比高铁组和正常铁组缓慢 ,贫血纠正时间比前两组显著延长 (P <0 0 1) ,且有 3例患者发展为小细胞低色素性贫血。而补铁组患者血红蛋白比低铁组显著升高 (P <0 0 1) ,贫血纠正时间与正常铁组无差异。结论　铁是影响肾移植术后贫血改善的重要因素 ,血清铁蛋白是评价肾移植患者铁储存情况较准确的指标 。Objective To investigate the effect of iron on corre ction of anemi a and assess the accuracy of iron parameters in indicating iron stores of renal transplant patients. Methods Forty-seven renal transplan t patients were follow ed for three months after operation and iron parameters, including serum ferriti n(SF), serum iron(SI), total iron-binding capacity(TIBC) and transferrin saturat ion(TS), were monitored every two weeks. Hemoglobin was monitored weekly. Twelve iron-deficient patients(FeS group, SF<100 μ g/L ) received iron supplement atio n.Results In 35 patients who did not receive iron sup plementation, serum ferritin level decreased quickly following the increment of hemoglobin aft er renal transplantation. During the early postoperative period,serum iron and t ransferrin saturation did not change significantly. The hemoglobin levels in Fe L patients(SF<100 μ g/L ) increased slowly and their duration of anemia cor rection i n FeL patients was significantly longer(P<0.01) than those in FeN(100 μ g/L ≤SF≤300 μ g/L ) and FeH(SF>300 μ g/L ) patients. In addition,t hree patients in FeL group had hypochromic microcythemia at the end of the study . With iron supplementatio n,the hemoglobin levels in FeS patients were significantly higher than those in FeL patients(P<0.01) and there was no difference in the time of anemi a correctio n between FeS patients and FeN patients. Conclusions Iro n is an important factor of affecting correction of anemia after renal transplan tation. Serum ferritin is a useful diagnostic tool for the assessment of iron stores in renal transplan t patients. Iron deficiency could prolong the duration of anemia correction in some renal transplant patients.

关 键 词：肾移植 贫血 铁 手术后 

分 类 号：R699.2[医药卫生—泌尿科学] R556[医药卫生—外科学]