铁代谢参数判断骨髓增生异常综合征和再生障碍性贫血患者铁负荷过载的临床价值  

The clinical value of iron metabolism parameters in determining iron overload in patients with myelodysplastic syndrome and aplastic anemia

作　　者：汤如[1] 李承君[1] 吴燕明[1] TANG Ru;LI Cheng-jun;WU Yan-ming(Department of Hematology,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu Anhui 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院血液内科,安徽巢湖238000

出　　处：《临床和实验医学杂志》2021年第11期1181-1185,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省高校自然科学研究重点项目(编号:KJ2019A1109)。

摘　　要：目的探讨骨髓增生异常综合征(MDS)和再生障碍性贫血(AA)患者铁负荷过载判断中铁代谢参数的临床价值。方法回顾性选取2017年7月至2020年6月安徽医科大学附属巢湖医院收治的骨髓增生异常综合征患者30例,作为MDS组;另选取同期再生障碍性贫血患者30例,作为AA组;另选取同期健康体检人员30例,作为健康组。统计分析3组人员的肝脏肿大、脾脏肿大、红细胞输注情况、基线数据、铁代谢参数,并统计分析两组患者的铁代谢受到红细胞输注的影响、骨髓细胞化学铁染色结果,分析MDS组患者的染色体核型及预后。结果MDS组患者的肝脏肿大、脾脏肿大发生率均显著高于AA组、健康组,差异均有统计学意义(P<0.05);MDS组、AA组患者的红细胞输注率均显著高于健康组,差异均有统计学意义(P<0.05)。MDS组、健康组人员的血清铁(SI)水平均显著低于AA组,差异均有统计学意义(P<0.05);MDS组、AA组患者的血清铁蛋白(SF)水平均显著高于健康组,MDS组患者的SF水平显著低于AA组,差异均有统计学意义(P<0.05)。MDS组患者的总铁结合力(TIBC)、转铁蛋白(TF)水平均显著高于AA组和健康组,差异均有统计学意义(P<0.05);AA组、MDS组患者的血清铁饱和度(TS)水平均显著高于健康组人员,MDS组患者的TS水平显著低于AA组,差异均有统计学意义(P<0.05)。MDS组、AA组有红细胞输注史有铁过载患者的TS水平明显高于无红细胞输注史有铁过载患者,差异有统计学意义(P<0.05)。MDS组患者的环形铁粒幼红细胞及其比例均显著高于AA组,细胞外铁异常率显著低于AA组,差异均有统计学意义(P<0.05)。结论铁代谢参数对于鉴别判断MDS和AA患者的铁负荷过载有较高的临床价值。Objective To investigate the clinical value of iron metabolism parameters in the determination of iron overload in patients with myelodysplastic syndrome(MDS)and aplastic anemia(AA).Methods From July 2017 to June 2020,30 patients with MDS admitted to Chaohu Hospital Affiliated to Anhui Medical University were retrospectively selected as the MDS group,and the other 30 patients with aplastic anemia were selected in the same period retrospectively as aplastic anemia(AA),the other were selected as healthy group of 30 cases of healthy physical examination personnel in the same period,the statistical analysis of three groups of researchers hepatomegaly,spleen enlargement,red blood cell transfusion,baseline data parameters,iron metabolism,and statistical analysis of two groups of patients with iron metabolism was affected by the red blood cell transfusion,bone marrow cell chemical dyeing results,Karyotype and prognosis of patients in MDS group were analyzed.Resluts The incidence of hepatomegaly and splenomegaly in the MDS group was significantly higher than that of the AA group and the healthy group,and the difference was statistically significant(P<0.05);the red blood cell infusion rate of the MDS group and the AA group was significantly higher than that of the healthy group,the differences were statistically significant(P<0.05).The serum iron(SI)levels of MDS group and healthy group were significantly lower than that of AA group,the differences were statistically significant(P<0.05);The levels of serum ferritin(SF)in MDS group and AA group were significantly higher than that in healthy group,the level of SF in MDS group was significantly lower than that in AA group,the differences were statistically significant(P<0.05);Total iron binding capacity(TIBC)and transferrin(TF)levels in MDS group were significantly higher than those in AA group and healthy group,the differences were statistically significant(P<0.05);The levels of transferrin saturation(TS)in AA group and MDS group were significantly higher than that of healt

关 键 词：骨髓增生异常综合征 再生障碍性贫血 铁负荷过载 铁代谢参数 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R556.5[医药卫生—内科学]