骨髓增生异常综合征输血依赖患者铁代谢状况分析  

Iron Metabolism Status in Transfusion-Dependent Patients with Myelodysplastic Syndrome

作　　者：陈梅[1] 顾俊[1] 陆弘逾[1] 徐玲[1] 

机构地区：[1]同济大学附属杨浦医院血液内科,上海200090

出　　处：《实用临床医学（江西）》2016年第1期1-4,共4页Practical Clinical Medicine

基　　金：上海市卫生局面上项目(20134443)

摘　　要：目的探讨骨髓增生异常综合征(MDS)输血依赖患者铁代谢情况。方法选择38例MDS患者,按就诊前是否接受红细胞输注分为研究组(接受红细胞输注者20例)和对照组(未接受红细胞输注者18例),按血清SF值高低将MDS患者分为<500ng·mL-1和≥500ng·mL-12个亚组。比较各组SF、血清铁(SI)、总铁结合力(TIBC)、血清未饱和铁(UIBC)、铁饱和度(TS)及部分肝功能指标改变。结果 SF、SI、TS在研究组显著高于对照组,而UIBC在研究组显著低于对照组(均P<0.001)。不论在研究组还是对照组,SF≥500ng·mL-1的患者在SI、UIBC、TS、细胞外铁染色增高比例均与SF<500ng·mL-1患者的差异有统计学意义(均P<0.001),且SF≥500ng·mL-1的患者出现ALT、AST增高(P<0.01)。结论 MDS输血依赖可致铁过载,SF值>500ng·mL-1时可导致肝功能损害,因此应联合各项指标合理评估MDS患者铁代谢的状况进行治疗。Objective To investigate the iron metabolism status in transfusion-dependent patients with myelodysplastic syndrome（MDS）.Methods A total of 38 patients with MDS were selected in this study,including 20 patients who received red blood cell transfusion before visiting doctors（study group）and 18 patients who did not receive red blood cell transfusion before visiting doctors（control group）.According to the levels of serum ferritin（SF）level,these patients were divided into two subgroups：〈500ng·mL-1 and ≥ 500ng·mL-1.Levels of SF,serum iron（SI）,total iron binding capacity（TIBC）,serum unsaturated iron（UIBC）and iron saturation（TS）and changes in liver function markers were determined in all patients.Results Compared with control group,SF,SI and TS increased but UIBC decreased in study group（P〈0.001）.There were significant differences in SI,UIBC,TS and increased proportion of extracellular iron staining between patients with SF ≥ 500ng·mL-1 and patients with SF〈500ng·mL-1（P〈0.001）.Moreover,levels of ALT and AST increased in patients with SF≥500ng·mL-1（P〈0.01）.Conclusion Transfusion dependence leads to iron overload and SF values〉500ng·mL-1results in liver damage in patients with MDS.Therefore,the treatment should be performed according to the iron metabolism status assessed by the combination of various indicators in patientswith MDS patients.

关 键 词：骨髓增生异常综合征 输血 铁代谢 

分 类 号：R551.3[医药卫生—血液循环系统疾病]