文章摘要
范凤珍,陈倩,朱银梅,等.输血依赖型 β地中海贫血小儿铁代谢与心肾功能的关系分析[J].安徽医药,2021,25(7):1379-1382.
输血依赖型 β地中海贫血小儿铁代谢与心肾功能的关系分析
Relationship between iron metabolism and cardiac and renal function in children with trans?fusion-dependent β-mediterranean anemia
  
DOI:10.3969/j.issn.1009-6469.2021.07.027
中文关键词: β地中海贫血  输血依赖型  铁代谢  心功能  肾功能  儿童
英文关键词: Beta-thalassemia  Transfusion-dependent  Iron metabolism  Cardiac function  Renal function  Child
基金项目:
作者单位
范凤珍 海南省血液中心体采科海南海口 570311 
陈倩 海南省血液中心 临床输血研究室海南海口 570311 
朱银梅 海南省血液中心体采科海南海口 570311 
符艺影 海口市第三人民医院儿科海南海口 571100 
邢东文 海口市第三人民医院儿科海南海口 571100 
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中文摘要:
      目的分析输血依赖型 β地中海贫血小儿铁代谢与心肾功能的关系。方法选取 2014年 2月至 2019年 2月海口市第三人民医院收治的 108例输血依赖型 β地中海贫血病儿,并于同时间段向社会招募 96例健康小儿,分别记为研究组和正常组。检测并对比两组铁代谢指标、心功能指标及肾功能指标,采用 Pearson相关性分析法分析研究组小儿铁代谢分别与心功能及肾功能的关系。结果两组血清铁(SI)、血清铁蛋白(SF)、总铁结合力(TIBC)指标均差异有统计学意义(P<0.05)且研究组各指标均明显高于正常组[(18.36±3.59)μmol/L比( 12.44±2.17)μmol/L、(271.41±57.35)μg/L比( 112.24±18.36)μg/L、(94.,62±15.63)μmol/L比(62.18±9.74)μmol/L];研究组左心室射血分数(LVEF)指标显著低于正常组(P<0.05)[(47.32±5.56)%比(54.28±6.89)%]、研究组左室舒张末期内径( LVEDD)、左室收缩末期内径( LVESD)指标均显著高于正常组( P<0.05)[(52.64±5.91)mm比( 47.42±4.36) mm、(38.28±4.69)mm比(33.45±4.13)mm];两组尿微量白蛋白(mAlb)、β2-微球蛋白(β2-MG)、N-乙酰 -β-D-氨基葡萄糖苷酶(UNAG)均差异有统计学意义(P<0.05),且研究组均明显高于正常组[(21.31±3.93)mg/d比(16.47±3.27)mg/d(181.31±27.62)μg/L比(173.44±25.13)μg/L、(11.58±2.42)U/L比(8.84±1.23)U/L];研究组中铁代谢指标 SI、SF、TIBC与 LVEF指标呈负相关,与 LVEDD、 LVESD、mAlb、β2-MG、UNAG均呈正相关。结论输血依赖型 β地中海贫血小儿铁代谢指标 SI、SF、TIBC、心功能指标 LVEF、 LVEDD、LVESD及肾功能指标 mAlb、β2-MG、UNAG均存在异常。铁代谢与心功能、肾功能均存在相关性。
英文摘要:
      Objective To analyze the correlation between iron metabolism and cardiac and renal function in children with transfusion-dependent β-mediterranean anemia.Methods A total of 108 transfusion-dependent β-mediterranean anemia children admitted to Haikou Third People's Hospital from February 2014 to February 2019 were selected as the study group, while 96 healthy children recruited in the same time were selected as the normal group. The iron metabolism index, cardiac function index and renal function indexof the two groups were detected and compared. Pearson correlation analysis was used to explore the correlation between iron metabolism and cardiac and renal function of children in the study group.Results There were significant differences in serum iron (SI), serum ferritin (SF), total iron binding capacity (TIBC) between the two groups (P<0.05), and the indexes in the study group were significantly higher than those in the normal group [(18.36±3.59) μmol/L vs. (12.44±2.17) μmol/L, (271.41±57.35) μg/L vs. (112.24±18.36) μg/L, (94.62±15.63) μmol/L vs. (62.18±9.74) μmol/L]. The indexes of left ventricular ejection fraction (LVEF) in the study group weresignificantly lower than that in the normal group (P<0.05) [(47.32±5.56) % vs. (54.28±6.89) %], and the indexes of left ventricular enddiastolic diameter (LVEDd), left ventricular end systolic diameter (LVESD) in the study group were significantly higher than those inthe normal group (P<0.05) [(52.64±5.91) mm vs. (47.42±4.36) mm, (38.28±4.69) mm vs. (33.45±4.13) mm]. There were significant differences in urinary microalbumin (mAlb) β 2-microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (UNAG) between the two groups (P<0.05), which in the study group were significantly higher than those in the normal group [(21.31±3.93) mg/d vs. (16.47±3.27) mg/d, (181.31±27.62) μg/L vs. (173.44±25.13) μg/L, (11.58±2.42) U/L vs. (8.84±1.23) U/L]. The iron metabolic indexes SI, SF and TIBC inthe study group were negatively correlated with the LVEF index, and positively correlated with LVEDD, LVESD, mAlb, β2-MG and UNAG.Conclusion In children with transfusion-dependent β-mediterranean anemia, iron metabolic indicators: SI, SF and TIBC, cardiac function indices: LVEF, LVEDD, LVESD and renal function indices: mAlb, β2-MG, UNAG were abnormal. There is a correlation between iron metabolism and cardiac function and renal function.
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