地中海贫血患者心肌、肝脏铁沉积与血清铁蛋白相关性研究  

Correlation between myocardial iron deposit, liver iron concentration and serum ferritin in patients with thalassemia

作　　者：邓小强 黄海波[2] 尹晓林[3] 周亚丽[3] 管俊[2] 覃明[2] 

机构地区：[1]武警广西总队医院放射科,南宁530003 [2]解放军第303医院医学影像科,南宁530021 [3]解放军第303医院血液科,南宁530021

出　　处：《磁共振成像》2016年第9期669-674,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：广西壮族自治区自然科学基金(编号:2014GXNSFBA118187;2015GXNSFAA139164)~~

摘　　要：目的：定量评价地中海贫血患者心脏和肝脏铁过载，探讨心脏、肝脏铁沉积与血清铁蛋白（SF）相关性。材料与方法应用3.0 T磁共振扫描基因确诊地中海贫血患者134例（包括中间型73例和重型61例），扫描包括：肝脏冠状面T2WI及横断面T1WI、T2WI、12回波梯度回波（T2＊）序列；心脏标准横断面T2WI及两腔位、四腔位及短轴面电影和8回波梯度回波（T2＊）成像。测量心肌、肝脏T2＊值，所有受试者MRI扫描前1周完成SF检测。采用Spearman秩相关分析心肌、肝脏铁沉积和SF三者间相关性。结果134例地中海贫血患者心肌T2＊、肝脏T2＊、SF中位数分别为23.35（1.88～36.17） ms、1.33（0.36～16.39） ms、1235.3（105.1～14673.0）μg/L，心肌-肝脏T2＊（rs=0.324，P=0.000）、心肌T2＊-SF （rs=－0.491，P=0.000）、肝脏T2＊-SF （rs=－0.697，P=0.000）具有一定相关性。73例中间型地中海贫血患者心肌T2＊、肝脏T2＊、SF中位数分别为26.18（7.09～36.17） ms、1.81（0.37～16.39） ms、622.8（105.1～10807.0）μg/L，心肌-肝脏T2＊（rs=0.059，P=0.619）、心肌T2＊-SF （rs=－0.166，P=0.161）无明显相关，但肝脏T2＊-SF间中度负相关（rs=－0.583，P=0.000）。61例重型地中海贫血患者心肌T2＊、肝脏T2＊、SF中位数分别为18.80（1.88～33.11） ms、0.72（0.36～10.36） ms、3310.0（313.0～14673.0）μg/L，心肌-肝脏T2＊（rs=0.365，P=0.004）、心肌T2＊-SF （rs=－0.359，P=0.004）、肝脏T2＊-SF （rs=－0.707，P=0.000）具有轻中度相关性。结论在一定范围内，地中海贫血患者心铁沉积与肝铁含量、SF具有较低或无相关性，其间相关性可能随病情加重而增加，而肝铁过载则与SF中度负相关。AbstractObjective：To quantify the myocardial iron overload and liver iron concentration （LIC） in thalassemia （TM） patients and discuss the relationships amongst myocardial iron overload, LIC and serun ferritin （SF）.Materials and Methods：Study protocol was approved by local ethics committee, informed consent was obtained. A total of 134 patients with TM （Intermediate, 73. Major, 61） diagnosed by gene were enrolled. A multiple fast-ifeld echo （mFFE） within a single breath-hold was performed using a 3.0 tesla MR unit to acquire 8 or 12 T2＊ weighted images in the heart or liver. T2＊values of myocardium and liver were quantified based on mFFE-T2＊ protocol by a well-trained physician repectively, SF was obtained within 7 days before MRI.Spearman rank correlation was applied to analyse the relationships.Results：The median （range） of myocardial T2＊, liver T2＊ and SF in 134 patients were 23.35 （1.88—36.17） ms, 1.33 （0.36—16.39） ms, 1235.3 （105.1—14673.0） μg/L, respectively. There was weakly correlation between myocardial T2＊ and liver T2＊ （rs=0.324,P=0.000）, as well as myocardial T2＊ and SF （rs=-0.491,P=0.000）, moreover, liver T2＊ and SF were moderately linear related （rs=-0.697,P=0.000）. Furthermore, the median （range） of myocardial T2＊, liver T2＊ and SF in 73 TM inter mediate were 26.18 （7.09—36.17） ms, 1.81 （0.37—16.39） ms, 622.8 （105.1—10807.0） μg/L, respecttively. There was no linear correlation between myocardial T2＊ and liver T2＊ （rs=0.059,P=0.619）, likewise myocardial T2＊ and SF （rs=-0.166,P=0.161）, however, liver T2＊and SF was moderately related （rs=-0.583,P=0.000）. The median （range） of myocardial T2＊, liver T2＊ and SF in 61 TM major were 18.80 （1.88—33.11） ms, 0.72 （0.36—10.36） ms, 3310.0 （313.0—14673.0） μg/L, respectively. There was weak correlation between myocardial T2＊ and liver T2＊ （rs=0.365, P=0.004）, and myocardial T2＊ and SF as well （rs=-0.3

关 键 词：地中海贫血 铁 铁蛋白类 血清学 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.264[医药卫生—诊断学]