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摘要: 目的:调查36例骨髓增生异常综合征(MDS)患者的铁过载发生率及铁过载严重程度。方法:收集MDS患者36例,采用电化学发光法测定其血清铁蛋白(SF)。结果:36例MDS患者的SF为851.42(360.75~7885.62)ng/ml,其中16例(44.4%)SF>1000 ng/ml。14例有输血史,SF为887.14(360.75~7885.62)ng/ml,其中7例(50.0%)SF>1000 ng/ml;22例无输血史,SF为851.42(459.87~5277.71)ng/ml,其中9例(40.9%)SF>1000 ng/ml。SF<1000 ng/ml者(20例)与 SF>1000 ng/ml者(16例)的输血量分别为4 U和36 U,差异有统计学意义(P=0.024)。SF水平与输血总量呈正相关(P=0.000)。不同年龄段间SF值差异有统计学意义(P=0.022)。结论:本组MDS患者中16例(44.4%)出现铁过载。铁过载的发生与输血有关,但无输血史的患者中也有9例(40.9%)出现铁过载。Abstract: Objective: To investigate the incidence and severity of iron overload in 36 patients with myelodysplastic syndrome (MDS).Method: The serum ferritin (SF) was measured by electrochemiluminescence immunoassay (ECLIA) in 36 patients with MDS.Result: In the 36 patients with MDS,the SF value was 851.42(form 360.75 to 7885.62)ng/ml,16 patients (44.4%) with SF>1000 ng/ml.Fourteen patients had a history of blood transfusion,the SF value was 887.14 (from 360.75 to 7885.62)ng/ml,7 cases (50.0%) with SF>1000 ng/ml.Twenty-two patients without history of blood transfusion,the SF value was 851.42(from 459.87 to 5277.71)ng/ml,9 cases (40.9%) with SF>1000 ng/ml.The amount of blood transfusion in patients with SF<1000 ng/ml and SF>1000 ng/ml were 4 U and 36 U (P=0.024).SF was positively correlated with the total blood transfusion (P=0.000).There were significant differences in the SF values among difference ages (P=0.022).Conclusion: In this study,16 patients (44.4%) are iron overloaded.The occurrence of iron overload is correlated with transfusion,but 9 cases (40.9%) in the patients without history of blood transfusion also occurs iron overload.
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Key words:
- myelodysplastic syndrome /
- iron overload
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[1] 中华医学会血液学分会/中国医师协会血液科医师分会.铁过载诊断与治疗的中国专家共识[J].中华血液学杂志,2011,32(8):572-574.
[2] JABBOUR E,KANTARJIAN H M,KOLLER C,et al.Red blood cell transfusions and iron overload in the treatment of patients with myelodysplastic syndromes[J].Cancer,2008,112:1089-1095.
[3] 聂玲.骨髓增生异常综合征患者铁代谢的基础和临床研究[D].北京:北京协和医学院研究生学院,2009.
[4] SUZUKI T,TOMONAGA M,MIYAZAKI Y,et al.Japanese epidemiological survey with consensus statement on Japanese guidelines for treatment of iron overload in bone marrow failure syndromes[J].Int J Hematol,2008,88:30-35.
[5] GREENBERG P L,ATTAR E,BENNETT J M,et al.NCCN Clinical Practice Guidelines in Oncology:myelodysplastic syndromes[J].J Natl Compr Canc Netw,2011,9:30-56.
[6] ROSE C,BRECHIGNAC S,VASSILIEF D,et al.Does iron chelation therapy improve survival in regularly transfused lower risk MDS patients? A multicenter study by the GFM[J].Leuk Res,2010, 34:864-870.
[7] LEITCH H A,CHAN C,LEGER C S,et al.Improved survival with iron chelation therapy for red blood cell transfusion dependent lower IPSS risk MDS may be more significant in patients with a non-RARS diagnosis[J].Leuk Res,2012,36:1380-1386.
[8] NEUKIRCHEN J,FOX F,KVNDGEN A,et al.Improved survival in MDS patients receiving iron chelation therapy-a matched pair analysis of 188 patients from the Düsseldorf MDS registry[J].Leuk Res,2012,36:1067-1070.
[9] ALESSANDRINO E P,DELLA PORTA M G,BACIGALUPO A,et al.Prognostic impact of pre-transplantation transfusion history and secondary iron overload in patients with myelodysplastic syndrome undergoing allogeneic stem cell transplantation:a GITMO study[J].Haematologica,2010,95:476-484.
[10] KATAOKA K,NANNYA Y,HANGAISHI A,et al.Influence of pretransplantation serum ferritin on nonrelapse mortality after myeloablative and nonmyeloablative allogeneic hematopoietic stem cell transplantation[J].Biol Blood Marrow Transplant,2009,15:195-204.
[11] ARMAND P,SAINVIL M M,KIM H T,et al.Does iron overload really matter in stem cell transplantation?[J].Am J Hematology,2012,87:569-572.
[12] 谢芳,赵明峰,李玉明,等.铁过载诱导活性氧物质生成对骨髓造血功能影响的体外实验研究[J].中华血液学杂志,2011,32(9):606-609.
[13] CHAN L.Iron overload and haematopoiesis in MDS:does blood transfusion promote progression to AML[J].Leuk Res,2009,33:S112-S113.
[14] MEERPOHL J J,ANTES G,RVCKER G,et al.Deferasirox for managing iron overload in people with myelodysplastic syndrome[J].Cochrane Database Syst Rev,2010,10:CD007461.
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