长期小剂量铁螯合剂治疗对高量输血重型β地贫患儿铁负荷的影响研究  

Impact of Long Time Small Doses of Iron Chelating Agent Treatment on Iron Overload of Patients with Serious β Thalassemia Major

作　　者：周敏芳[1] 刘坚鹏 罗应超 

机构地区：[1]武警广东总队医院,广东广州511000 [2]广东省汕头潮南民生医院 [3]广东省龙门县人民医院

出　　处：《中国医学创新》2016年第11期55-58,共4页Medical Innovation of China

基　　金：广东省中医药局科研课题(粤中医[2012]23号)

摘　　要：目的：探讨长期小剂量铁螯合剂治疗对高量输血重型β地贫患儿铁负荷的影响研究。方法：回顾性分析本院2014年2月-2015年2月因高量输血治疗后铁负荷过量的重型β地贫患儿80例,按照其用小剂量铁螯合剂治疗的时间长短分为A组、B组和C组,A组30例患儿治疗时间为〉20 d,B组30例患儿治疗时间为10~20 d,C组20例患儿治疗时间为〈10 d,比较三组患儿治疗前后血清铁（SI）、铁蛋白（SF）及尿SF水平的变化及发生不良反应的情况。结果：高量输血后三组患儿的铁负荷均处于较高水平,三组患儿比较差异无统计学意义（P〉0.05）;用小剂量铁螯合剂治疗后,三组患儿的SI、SF均有所下降,尿SF均有所升高,且A组患儿铁负荷的变化程度大于B组和C组患儿,差异均有统计学意义（P〈0.05）;A组患儿不良反应的发生率（6.67%）低于B组患儿（36.67%）与C组患儿（40.00%）,差异均有统计学意义（P〈0.05）。结论：使用小剂量铁螯合剂治疗高量输血重型β地贫患儿铁负荷过重,应坚持长期治疗,才能明显改善铁负荷过重的问题,且长期治疗能够减少不良反应的发生,有利于患儿的治疗。Objective：To explore the impact of long time small doses of iron chelating agent treatment on iron overload of Patients with serious β thalassemia major.Method：A total of 80 patients with serious β thalassemia major who received high amount of blood transfusion in our hospital from February 2014 to February 2015 were selected,according to the length of time of small dose of iron chelating agent treatment,they were divided into group A（time of therapy20 d） and group B（time of therapy 10-20 d） and group C（time of therapy10 d）.The group A had 30 patients,the group B had 30 patients and the group C had 20 patients.Compared the serum iron（SI）,ferritin（SF） and urine SF levels of the three groups of patients before and after treatment,and observed the incidence of adverse response.Result：The iron load of three groups of patients were at a high level after receiving high amount of blood transfusion,the serum iron（SI）,ferritin（SF） and urine SF levels of the three groups had no statistical significant differences（P〉0.05）.After treatment,the serum iron（SI）,ferritin（SF） had decreased,and urine SF had increased,the change scope in the group A was bigger than the group B and the group C,the differences were statistical significant（P〈0.05）.The incidence of adverse response in the group A（6.67%）was lower than the group B（36.67%） and the group C（40.00%）,the differences were also statistical significant（P〈0.05）.Conclusion：Using small doses of iron chelating agent treatment to treat iron overload of patients with serious β thalassemia major,should adhere to long-term treatment,so than it can significantly improve iron overload problem and reduce the occurrence of adverse reactions,and then it can be useful for the treatment of patients.

关 键 词：铁螯合剂 高量输血 重型β地贫 铁负荷 

分 类 号：R725.5[医药卫生—儿科]