慢性肾功能不全病人红细胞内游离原卟啉测定

FEP in Patients with Chronic Renal Dysfunction

目的：了解肾性贫血病人骨髓细胞内可染铁明显增加的原因。方法：采用免疫荧光分光光度法测定４０ 例慢性肾功能不全病人红细胞内游离原卟啉（ＦＥＰ），并以３１ 例正常人作为对照。结果：显示慢性肾功能不全组ＦＥＰ／Ｈｂ 及ＦＥＰ／ＲＢＣ水平（２．８５±１．２９ μｇ／Ｈｂ．ｇ；８２．４５±３４．６５ μｇ／ＲＢＣ．ｄｌ），显著高于正常对照组（１．７６±０．７１ μｇ／Ｈｂ．ｇ；５１．１６±２０．２５ μｇ／ＲＢＣ．ｄｌ）Ｐ＜ ０．００１。而全血ＦＥＰ值两组之间差异无显著性（慢性肾功能不全组：２１．０４±１０．８０ μｇ／ｄｌ全血；正常组：２４．７８±９．８３ μｇ／ｄｌ全血， Ｐ＞ ０．０５）。同时，慢性肾功能不全组血清铁蛋白水平（２３８．５６±１６９．５９ μｇ／Ｌ）显著高于正常对照组（１１２．５１±７１．５４μｇ／Ｌ，Ｐ＝ ０．０００２）。而且反复接受输血组与未曾输血组之间差异无显著性。结论：肾性贫血具有ＦＥＰ增高及铁负荷增加等特点。

Objectiue:To study on the anaemia due to chronic renal dysfunction,free erythrocyte protoporphyrin(FEP).Method:Fluorospectophyotometry was used in 40 patents with chronic renal dysfunction (group 1) and in 31 normal persons (group 2).Result:The levels of FEP/Hb and FEP/RBC in group 1( 2.85 ± 1.29 μg/Hb.g; 82.45 ± 34.65 μg/RBC.dl) were significantly higher (P< 0.001 ) than that in group 2( 1.76 ± 0.71 μg/Hb.g; 51.16 ± 20.25 μg/RBC.dl),and were also higher than the previously published normal value derived from a large population ( 2.3 μg/Hb.g;75 μg/RBC.dl).However,no intergroup difference of FEP in whole blood could be found (group 1: 21.04 ± 10.80 μg/dl whole blood;group 2: 24.78 ± 9.83 μg/dl whole blood;P> 0.05 ).Meanwhile,the level of serum ferritin in group 1 ( 238.56 ± 169.59 μg/L) was also significantly higher (P= 0.0002 )than that in group 2( 112.51 ± 71.54 μg/L),and there was no significantly difference (P> 0.05 ) between repeatedly received blood transfusion ( 297.68 ± 196.11 μg/L) and never received blood transfusion ( 194.86 ± 135.33 μg/L).Conclusion:The anaemia due to chronic renal dysfunction is characterized of high level of FEP and overload iron.