摘要
目的探讨重型β地中海贫血(β-TM)患者胰腺铁过载状况及其与临床各监测指标之间的关系。方法 51例β-TM患者,进行胰腺MRI T2*检测。按是否有铁过载分为两组,组间比较性别、年龄、空腹血糖、血红蛋白(Hb);与血清铁蛋白(SF)、心脏T2*、肝脏T2*及输血时间进行相关性分析;比较铁螯合剂去铁胺联合去铁酮及单用地拉罗司(DFO+DFP组与DFX组)对胰腺T2*和心脏T2*的影响。结果 51例患者中有42例胰腺铁过载,占83%。胰腺铁过载与胰腺无铁过载组间比较,性别、年龄、空腹血糖、Hb差异无显著性(P>0.05);肝脏T2*、SF、输血时间与胰腺T2*之间呈低度相关(r值分别为-0.36、0.35及0.48);心脏T2*与胰腺T2*之间呈中度相关(r=0.50);心脏铁过载患者中91%有胰腺铁过载,89%胰腺无铁过载患者中心脏也无铁过载发生;DFX治疗组胰腺T2*显著高于DFO+DFP组(U=-2.23,P=0.03),但心脏T2*两组间差异无显著性(U=-0.67,P=0.51)。结论胰腺铁过载发生普遍;年龄、空腹血糖、是否足量输血对胰腺铁过载影响不明显;SF、肝脏T2*不能准确反映胰腺铁过载的情况,输血时间对胰腺铁过载影响不明显;胰腺与心脏有相同的铁动力学,可以通过胰腺铁过载来预测心脏铁过载;DFX可有效降低胰腺铁过载,但对心脏铁过载疗效有待进一步观察。
Objective To study the status of pancreatic T2 ＊ in β- thlassemia major （13-TM） patients with iron overload and the relationship with clinical data. Methods Pancreatic MRI T2 ＊ was performed in 51 patients with β-TM. The patients were divided into two groups according to the iron overload or not overload. Their gender, age, fasting blood glucose, hemoglobin （Hb） were analyzed. was investigated. The effect of pancreatic T2 ＊ and myocardial T2 ＊ by different iron chelators （ DFO ＋ DFP group and DFX group） was compared. Results Forty-two patients （83%） had pancreatic iron overload. There were no statistical differences among gender, age, fasting blood glucose and Hb （P 〉 0. 05 ）. The liver T2 ＊ , SF, transfusion time were lowly correlated with pancreatic T2 ＊ （ r = - 0. 36, r = 0. 35 ,r = 0.48 ）, while myocardial T2 ＊ was moderately correlated with pancreatic （r = 0.50）. 91% of patients with myocardial iron overload had pancreatic iron overload; 89% patients with no pancreatic iron overload had no myocardial iron overload. Pancreatic T2 ＊ in DFX group was higher than that in DFO ＋ DFP group （ U = - 2. 23, P = 0.03 ） , but there was no difference of myocardial T2 ＊ between two groups （ U = - 0. 67,P = 0.51 ）. Conclusion Pancreatic iron overload was commonly seen in TM ; age, fasting blood glucose, sufficient transfusion and transfusion time have little effect on pancreatic iron overload; SF, liver T2 ＊ could not predict pancreatic iron overload; pancreas and heart have the same ferrokinetics ; pancreatic iron loading could predict myocardial iron loading; DFX could reduce pancreatic iron rather than heart iron.
出处
《中国小儿血液与肿瘤杂志》
CAS
2012年第4期165-168,共4页
Journal of China Pediatric Blood and Cancer
