初发骨髓增生异常综合征患者血清铁蛋白水平变化及意义

发布时间：2018-04-16 13:29

  本文选题：骨髓增生异常综合征 + 铁蛋白　； 参考：《山东医药》2017年48期

【摘要】：目的探讨初发骨髓增生异常综合征(MDS)患者血清铁蛋白(SF)水平变化及临床意义。方法选取初发MDS患者50例,其中RA型6例、RARS型4例、RCMD型20例、RAEB-1型13例、RAEB-2型7例,极低危3例、低危8例、中危20例、高危15例、极高危4例。患者分别于输血前及累计输注红细胞达10、20、30 U时取血,采用放射免疫法检测血清SF水平,计算SF变化量(SFΔ);分析血清SFΔ与患者输血量、临床分型、危险分层的关系。输注红细胞达30 U时,将患者分为SFΔ≥2 000 ng/m L组和2 000 ng/m L组,比较两组预后。结果输血前RARS、RAEB-1、RAEB-2型患者血清SF水平均高于RA、RCMD型患者(P均0.05),高危、极高危患者均高于极低危、低危及中危患者(P均0.05)。RAEB-1、RAEB-2型患者在输注红细胞量为20、30 U时血清SFΔ均低于其他各型(P均0.05)。高危、极高危患者输注红细胞达30 U时血清SFΔ均低于其他危险度患者(P均0.05)。两组均随访至2016年6月,输注红细胞达30 U时SFΔ≥2 000 ng/m L组的MDS/急性髓系白血病(AML)转化率低于SFΔ2 000 ng/m L组(P0.01),中位总体生存时间长于SFΔ2 000 ng/m L组(P0.01)。结论初发RARS、REAB-1、RAEB-2型及高危、极高危MDS患者血清SF水平均高于其他分型及危险度者;随着输血量的增加,RAEB-1、RAEB-2型及高危、极高危患者铁过载程度均高于其他分型及危险度者;血清SF水平变化对MDS患者预后有一定的预测作用。
[Abstract]:Objective to investigate the changes and clinical significance of serum ferritin (SF) levels in patients with primary myelodysplastic syndromes (MDS).Methods A total of 50 patients with primary MDS were selected, including 6 patients with RA type, 4 patients with RCMD type, 20 patients with RCMD type and 13 patients with RAEB-1 type, 7 patients with very low risk, 8 patients with low risk, 20 patients with moderate risk, 15 patients with high risk and 4 patients with very high risk.The serum SF level was measured by radioimmunoassay and the changes of SF 螖 were calculated, and the relationship between serum SF 螖 and blood transfusion volume, clinical type and risk stratification were analyzed.The patients were divided into two groups: SF 螖 鈮，

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