摘要
目的探讨MRI-R2＊定量评价肝铁超负荷患者去铁治疗疗效的价值。方法采用完全随机均衡设计法将24例铁超负荷患者分成2组，地拉罗司组和去铁胺组各12例。地拉罗司组和去铁胺组的剂量分别为40和50mg·kg-1·d-1，所有患者分别在治疗前及治疗后6和12个月行3次肝脏MR检查并测量R，’值。采用配对设计秩和检验分别比较2种药物治疗6及12个月后肝脏R2＊值与治疗前的差异，并采用完全随机设计两样本秩和检验分别比较2组患者治疗6、12个月的肝脏R：。变化率（△R2＊）及SF变化率（ASF）。结果地拉罗司组治疗前及治疗后6、12个月肝脏R2＊值中位数分别为1081、889和712Hz，去铁胺组分别为1042、838和488Hz，治疗前2组患者肝脏R2＊值间差异无统计学意义（Z=-0．029，P〉0．05）。地拉罗司治疗12个月的△R2＊为-32％，去铁胺组为-58％，差异有统计学意义（Z=-3．060，P〈0．01）。ASF地拉罗司治疗12个月为-15％，去铁胺组为-55％，差异有统计学意义（Z=-2．945，P〈0．01）。结论MIRI-R2＊技术能检测去铁疗效，去铁胺和地拉罗司都能有效去除肝铁，且去铁胺的去铁效能优于地拉罗司。
Objective To explore the value of MRI-R2 ＊ and to compare clinical effect of two iron chelators （ deferasirox and deferoxamine） in iron-overloaded patients. Methods By completely randomized balanced design, 24 iron-overloaded patients were randomly divided into 2 groups, which consisted of 12 patients treated with deferasirox and 12 patients treated with deferoxamine. The planned deferasirox dose was 40 mg. kg-1 . d-1 , and the deferoxamine dose was no less than 50 mg. kg-1 . d-1. All patients underwent quantitative MRI at the time points of the primary screening, 6 months and 12 months. Pair Wilcoxon rank sum test was used to compare the differences of liver R2 ＊ values of the 2 groups at various time points respectively. Wilcoxon rank sum test was used to compare the differences of change rate of liver R2＊ values between the two groups at the time point of 6 months, 12 months, respectively. Results Deferasirox group＇s liver R： ＊ values of primary screening, 6 months and 12 months were 1081, 889 and 712 Hz, while deferoxamine group＇s liver R2 ＊ values were 1042, 838 and 488 Hz. There was no statistically significant difference between liver R2 ＊ values of two groups at primary screening （ Z = - 0. 029 ,P 〉 0. 05 ）. The change rate of liver R2 ＊ of deferasirox group at 12 month was - 32% , while it was - 58% for the deferoxamine group, and there was statistically significant difference between the two groups （ Z = - 3. 060, P 〈0. 01 ）. The change rate of serum ferritin of deferasirox group at 12 month was - 15% , while it was -55% for the deferoxamine group, and there was statistically significant difference between the two groups （Z = -2. 945, P 〈 0.01 ）. Conclusion By using MRI-R2＊, it suggest that both deferasirox anddeferoxamine can effectively remove liver iron and deferoxamine is superior to deferasirox.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2013年第1期55-59,共5页
Chinese Journal of Radiology
基金
国家自然科学基金资助项目（30960361,81160175）
广西自然科学基金资助项目（2011GXNSFA018226）
关键词
磁共振成像
治疗效果
对比研究
Magnetic resonance imaging
Treatment outcome
Comparative study
