慢性再生障碍性贫血患者铁过载与中医血瘀证的相关性研究  

Correlation Study between Iron Overload and Blood Stasis Syndrome in Chronic Aplastic Anemia Patients

作　　者：刘文宾[1] 吴迪炯[1] 叶宝东[1] 高雁婷[1] 胡慧瑾[1] 俞庆宏[1] 沈一平[1] 周郁鸿[1] 

机构地区：[1]浙江中医药大学附属第一医院血液科,杭州310006

出　　处：《中国中西医结合杂志》2018年第1期38-41,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：浙江省中医药优秀青年人才基金资助项目(No.2015ZQ013);国家中医临床基地科研专项课题(No.JDZX2015118)

摘　　要：目的观察慢性再生障碍性贫血患者的中医血瘀证候,探讨血瘀证与铁过载和由铁过载介导的氧化应激反应的相关性。方法选择慢性再生障碍性贫血患者63例,根据是否符合铁过载诊断标准分为铁过载组(37例)和非铁过载组(26例)。入组患者进行中医血瘀证候评分,采用酶联免疫吸附(ELISA)法检测血清铁调素(Hepcidin)、活性氧(ROS)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平,并与血瘀证进行相关性分析。结果铁过载组中血瘀证30例(81.08%),且血瘀证评分显著高于非铁过载组(P<0.05);血清铁蛋白(SF)与血瘀证评分呈正相关(r=0.702,P<0.01),Hepcidin与血瘀证评分呈负相关(r=-0.905,P<0.01);铁过载组中ROS、MDA表达明显较非铁过载组高(P<0.05);SOD、GSH-Px表达则较非铁过载组明显下降(P<0.05),其中ROS和MDA与血瘀证评分呈正相关(r=0.403、0.471,P<0.01);SOD、GSHPx与血瘀证评分呈负相关(r=-0.645、-0.562,P<0.01)。结论铁过载与血瘀证呈显著正相关性;其诱导产生氧化应激反应,与血瘀证相关。Objective To observe blood stasis syndrome （BSS） of chronic aplastic anemia （CAA） patients, and to explore the correlation between BSS and iron overload as well as oxidative stress response mediated by iron overload. Methods According to whether they met the diagnostic criteria of iron overload, 63 CAA patients were assigned to the iron overload group （37 cases） and the non-iron overload group （26 cases）. TCM BSS score was graded. The levels of serum Hepcidin, reactive oxygen species （ROS）, malondialdehyde （MDA）, superoxide dismutase （SOD）, glutathione peroxidase （GSH- Px） were detected by ELISA. The correlation between these indices and BSS was analysed. Results In the iron overload group, 30 patients （81.08%） met the diagnostic criteria of BSS, and TCM BSS score was significantly higher than that of the non-iron overload group （P 〈0.05）. The serum ferritin （FS） level was positively correlated with BSS score （r =0.702, P 〈0.01 ）. Hepcidin level was negatively correlated with BSS score （r = -0.905, P 〈0.01 ）. Compared with the non-iron overload group, the levels of ROS and MDA were significantly higher （P 〈0.05）, and the levels of SOD and GSH-Px obviously decreased in the iron overload group （P 〈0.05）. Levels of ROS and MDA were positively correlated with BSS score （r =0.403, P 〈0.01 ; r =0.471, P 〈0.01 ）. Level of GSH-Px and SOD were negatively correlated with BSS score （r = -0.645, P 〈 0.01 ; r = - 0. 562, P 〈 0.01 ）. Conclusions Iron overload was positively correlated with BSS. Oxidative stress response might be induced by iron overload, which was correlated with BSS.

关 键 词：铁过载 慢性再生障碍性贫血 血瘀证 氧化应激反应 

分 类 号：R259[医药卫生—中西医结合]