骨髓增生异常综合征贫血患者铁代谢、炎症指标与铁调素的关系及对病情转归的影响  

Relationship between Iron Metabolism,Inflammatory Markers and Hepcidin in Anemia Patients with Myelodysplastic Syndromes and Their Effects on Disease Outcome

作　　者：谢杨 汪丹 刘建会[1] XIE Yang;WANG Dan;LIU Jian-hui(Department of Hematology,the Second Central Hospital of Baoding City,Zhuozhou,Hebei 072750,China)

机构地区：[1]保定市第二中心医院血液科,河北涿州072750

出　　处：《临床误诊误治》2022年第10期58-62,共5页Clinical Misdiagnosis & Mistherapy

基　　金：保定市科技计划项目课题(2041ZF028)。

摘　　要：目的探讨骨髓增生异常综合征(MDS)贫血患者铁代谢、炎症指标与铁调素的关系及对病情转归的影响。方法选取2016年5月-2020年12月MDS 48例,根据是否贫血分为贫血组28例、无贫血组20例,另选取同期45例健康体检者作为对照组。比较3组红细胞系指标[红细胞计数(RBC)、血红蛋白(Hb)、红细胞平均体积(MCV)、红细胞平均血红蛋白浓度(MCHC)]、铁代谢指标[血清铁(SI)、铁蛋白(FERR)、总铁结合力(TIBC)、铁调素]、炎症指标[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,应用Spearman或Pearson相关性分析对相关性进行探讨。结果贫血组、无贫血组RBC、Hb、MCHC低于对照组,MCV高于对照组(P<0.05);贫血组RBC、Hb、MCHC低于无贫血组,MCV高于无贫血组(P<0.05);贫血组、无贫血组SI、FERR、TIBC、铁调素、IL-1、IL-6、TNF-α高于对照组,且贫血组高于无贫血组(P<0.05)。贫血组RBC、Hb与铁调素呈负相关(r=-0.773、-0.762,P<0.05),MCV、SI、FERR、TIBC、IL-1、IL-6、TNF-α与铁调素呈正相关(r=0.819、0.673、0.797、0.736、0.800、0.732、0.785,P<0.05)。MDS贫血患者RBC、Hb与病情转归呈正相关(r=0.859、0.871,P<0.05);MCV、SI、FERR、TIBC、IL-1、IL-6、TNF-α、铁调素与病情转归呈负相关(r=-0.813、-0.765、-0.744、-0.796、-0.826、-0.709、-0.737、-0.926,P<0.05)。结论MDS贫血患者红细胞系、铁代谢、炎症指标与铁调素存在显著相关性,临床可通过上述指标对其早期病情转归进行评估,以针对性制订个体化治疗方案,改善预后。Objective To investigate the relationship between iron metabolism,inflammatory markers and hepcidin in anemia patients with myelodysplastic syndrome(MDS)and their impact on the disease outcome.Methods A total of 48 MDS patients treated from May 2016 to December 2020 were selected and divided into anemia group(n=28)and non-anemia group(n=20)according to presence of anemia,and 45 healthy physical examinees during the same period were selected as control group.The erythrocyte indexes[red blood cell count(RBC),hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin concentration(MCHC)],iron metabolism indexes[serum iron(SI),serum ferritin(FERR),serum total iron binding capacity(TIBC),hepcidin],inflammatory markers[interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]levels were compared among the three groups.Correlation analysis was performed using Spearman's correlation or Pearson's correlation.Results The RBC,Hb and MCHC in anemia group and non-anemia group were lower than those in control group,while the MCV was higher than that in control group(P<0.05).The RBC,Hb and MCHC of anemia group were lower than those of non-anemia group,while the MCV was higher than that of non-anemia group(P<0.05).The levels of SI,FERR,TIBC,hepcidin,IL-1,IL-6 and TNF-αin anemia group and non-anemia group were higher than those in control group,and higher in anemia group than in non-anemia group(P<0.05).RBC and Hb in anemia group were negatively correlated with hepcidin(r=-0.773,-0.762,P<0.05).MCV,SI,FERR,TIBC,IL-1,IL-6,and TNF-αwere positively correlated with hepcidin(r=0.819,0.673,0.797,0.736,0.800,0.732,0.785,P<0.05).RBC and Hb in patients with anemia and MDS were positively correlated with the disease outcome(r=0.859,0.871,P<0.05).MCV,SI,FERR,TIBC,IL-1,IL-6,TNF-αand hepcidin were negatively correlated with the outcome of the disease(r=-0.813,-0.765,-0.744,-0.796,-0.826,-0.709,-0.737,-0.926,P<0.05).Conclusion There is a significant correlation of erythrocyte lineage,iron metabolism,and inflam

关 键 词：骨髓增生异常综合征 贫血 铁蛋白 总铁结合力 铁调素 白细胞介素-6 肿瘤坏死因子-α 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R556.9[医药卫生—内科学]