骨髓增生异常综合征血清铁蛋白检测的临床意义

The Clinical Significance of Serum Ferritin in Myelodysplastic Syndrome

目的 探讨骨髓增生异常综合征 (myelodysplasticsyndromes ,MDS)血清铁蛋白检测与预后的关系。 方法 采用液相平衡竞争放射免疫分析法 (radio immunityanalysis,RIA)对 6 1例MDS患者进行血清铁蛋白检测 ,并进行追踪随访观察。结果 环形铁粒幼红细胞增多性难治性贫血 (refractoryanemiawithringsideroblasts,RAS)、原始细胞增多性难治性贫血 (refractoryanemiawithexcessofblasts,RAEB)、转化型原始细胞增多性难治性贫血 (refractoryanemiawithexcessofblastsintransformation ,RAEB T)、慢性粒 单核细胞白血病 (chronicmyelomonocyticleukemia ,CMML)中血清铁蛋白 (serumferritin ,SF)均明显增高 ,与对照组比较差异有显著性。难治性贫血 (refractoryanemia ,RA)中有 7例的血清铁蛋白升高 ,最高值为 2 30 μg/L ,但无一例转化为急性白血病。但是RAEB、RAEB T的SF均大于 4 0 0 μg/L ,差异有显著性 ,尤其是RAEB T的SF最高值达 92 0 μg/L ,且都转化为急性白血病 ,死亡率高达 83.3%。死亡组和转化为AL组的SF均明显升高 ,差异有显著性。结论 血清铁蛋白水平与MDS转化为急性白血病呈正相关 ,且与死亡率有关。

Objective To discuss the relation of the level of serum ferritin in MDS and it's prognosis.Methods Sixty one patients were inspected by RIA,they were observed long termly according to the course of disease.Results The level of serum ferritin in refractory anemia with ring sideroblasts(RAS)?refractory anemia with excess of blasts( RAEB)?refractory anemia with excess of blasts in transformation( RAEB T)?chronic myelomonocytic leukemia (CMML) was higher than in the normal control( P <0.001).Patients with a leukemic growth pattern had higher serum ferritin levels than those with a non leukemic pattern.Conclusion The level of serum ferritin in MDS has close relationship with it's prognosis and motality.