高水平血清铁蛋白对初诊AML患者远期预后的影响研究  

Study on the effect of high serum ferritin on the long-term prognosis of newly diagnosed AML patients

作　　者：陈连连 罗鹏[2] 王海峰[1] 薛茹[3] CHEN lianlian;LUO Peng;WANG Haifeng;XUE Ru(Department of Clinical Laboratory,Xi′an No.3 Hospital/the Affiliated Hospital of Northwest University,Xi′an,Shaanxi 710018,China;Department of Laboratory Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Neonatology,Xi′an Fourth Hospital,Xi′an,Shaanxi 710004,China)

机构地区：[1]西北大学附属医院/陕西省西安市第三医院检验科,710018 [2]重庆医科大学附属第一医院检验科,400016 [3]陕西省西安市第四医院新生儿科,710004

出　　处：《重庆医学》2021年第3期393-397,共5页Chongqing medicine

基　　金：国家自然科学基金青年基金项目(81501834)。

摘　　要：目的探讨血清铁蛋白(SF)水平在初诊急性髓系白血病(AML)患者化疗前后的变化及初诊时高SF水平对AML远期预后的影响。方法回顾性分析2015年6月至2018年6月新诊断的80例AML患者临床资料,以同期住院的100例非恶性肿瘤性疾病患者作为对照组。收集所有AML患者初诊和治疗后SF水平、骨髓活检组织内铁染色和随访资料。基于C反应蛋白(CRP)排除亚临床炎症后将AML患者分为高SF组和低SF组,进行患者生存分析。结果AML患者初诊时SF较对照组明显增高,且治疗后SF水平较初诊时升高(P<0.05)。同时,化疗后AML患者骨髓组织铁颗粒增多,但其初诊时骨髓组织铁颗粒与对照组比较,差异无统计学意义(P>0.05)。生存分析发现,高SF组无病生存(DFS)期和总生存(OS)期较低SF组缩短(P<0.05)。结论AML患者初诊时存在较高的SF水平,与AML患者的不良预后有一定的相关性。Objective To explore the influence of the different levels and clinical significance of serum ferritin(SF)at diagnosis on acute myeloid leukemia(AML)patients.Methods SF was measured by Automatic fluorescence analyzer in 80 newly diagnosed patients with AML and 100 patients with non-malignant tumor disease(excluding liver disease,fever and iron therapy)who were hospitalized at the same time were selected as the control group from June 2015 to June 2018.After C-reactive protein(CRP)-based adjustment for inflammation,patients were grouped as the high SF group and the low SF group according to their subclinical inflammations based on a collection of the levels and SF of patients after treatment and their iron storage in bone marrow tissue and some follow-up data.After conventional chemotherapy,Survival analysis were performed accordingly.Results SF level was significantly higher in AML patients before and after treatment than that of the control group,and SF level after treatment was higher than that of the initial diagnosis(P<0.05).The iron storage in bone marrow tissue of the patients after chemotherapy was significantly increased,but there was no statistical difference at the initial diagnosis on iron storage in bone marrow tissue of the patients compared with the control group(P>0.05).A significant decline is found in disease-free survival(DFS)and overall survival(OS)in patients with high SF compared with low SF(P<0.05).Conclusion AML patients have elevated baseline SF at diagnosis which are related directly to their poor prognosis.

关 键 词：白血病 髓样 加速期 铁蛋白质类 骨髓组织铁染色 无病生存 预后 

分 类 号：R551.3[医药卫生—血液循环系统疾病]