MRI定量肝脏及心脏铁过载对地中海贫血全相合造血干细胞移植的影响

发布时间：2018-03-29 13:48

本文选题：β地中海贫血　切入点：造血干细胞移植　出处：《中国组织工程研究》2017年33期

【摘要】：背景:大部分的重型β-地中海贫血患儿都存在铁过载的情况,而铁过载可对造血干细胞移植产生不利影响。目的:利用MRI T2*检测肝脏及心脏铁过载情况,从而评估肝脏、心脏铁过载对重型β-地中海贫血患儿全相合异基因造血干细胞移植的影响。方法:对81例全相合异基因造血干细胞移植、年龄3岁,能配合MRI检测的重型β-地中海贫血患儿,进行肝脏及心脏MRI T2*检测。根据检测结果计算出肝脏及心脏铁浓度,作为评价肝心铁过载的指标,并将肝脏、心脏铁浓度与患儿血清铁蛋白、造血重建时间、死亡率、植入率、移植后常见并发症的发病率,如移植物抗宿主病、感染、免疫性溶血、全血细胞减少、肝静脉阻塞病、败血症进行相关因素分析。结果与结论:肝脏铁浓度与血红蛋白植入时间呈正相关(r=0.229,P=0.043),心脏铁浓度与死亡率呈正相关(r=0.266,P=0.017),血清铁蛋白与植入率呈负相关(r=-0.289,P=0.009),血清铁蛋白与败血症发病率呈正相关(r=0.251,P=0.024),血清铁蛋白与全血细胞减少发病率呈正相关(r=0.276,P=0.013)。由此可见,铁过载可对重型β-地中海贫血患儿全相合异基因造血干细胞移植产生不利影响。因此,对行造血干细胞移植的β-地中海贫血患儿综合进行血清铁蛋白、肝脏及心脏铁过载的评估非常必要。
[Abstract]:Background: most children with severe 尾 -thalassemia have iron overload, which can have adverse effects on hematopoietic stem cell transplantation. Objective: to evaluate liver iron overload by detecting liver and heart iron overload using MRI T2 *. Effect of cardiac iron overload on allogeneic hematopoietic stem cell transplantation in children with severe 尾 -thalassemia methods: 81 patients with severe 尾 -thalassemia, aged 3 years, were treated with allogeneic hematopoietic stem cell transplantation (HSCT). Liver and heart MRI T2 * were measured. The iron concentrations in liver and heart were calculated as an index to evaluate iron overload in liver and heart, and serum ferritin, hematopoietic reconstitution time, mortality, implantation rate were measured. Incidence of common complications after transplantation, such as graft-versus-host disease, infection, immune hemolysis, whole blood cell decline, hepatic vein obstruction, Results and conclusion: there was a positive correlation between liver iron concentration and hemoglobin implantation time, a positive correlation between heart iron concentration and mortality rate, a negative correlation between serum ferritin and implantation rate, and a negative correlation between serum ferritin concentration and implantation rate. There was a positive correlation between the incidence of septicemia and the incidence of septicemia, and a positive correlation between serum ferritin and the incidence of whole blood cell reduction, and a positive correlation between serum ferritin and the incidence of whole blood cell reduction. Iron overload could adversely affect allogeneic hematopoietic stem cell transplantation in children with severe 尾 -thalassemia. Therefore, serum ferritin was given to 尾 -thalassemia children undergoing hematopoietic stem cell transplantation. Assessment of iron overload in the liver and heart is necessary.
【作者单位】：南方医科大学附属南方医院儿科;柳州市柳铁中心医院儿科;
【基金】：广东省科技计划项目(2014A020212186) 南方医院院长基金(2014B012)~~
【分类号】：R725.5

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