去铁胺治疗血液病输血相关性铁过载42例疗效观察

Effects of deferoxamine on 42 patients with blood diseases and blood transfusion related iron overload

目的：探讨去铁胺治疗输血依赖性铁过载的疗效。方法：回顾2009年1月至2012年12月收治合并铁过载的血液病患者42例。观察去铁前后血清铁蛋白、血象、脏器功能、输血频次的变化。结果：去铁胺1～3疗程的反应率分别为11．9％、15．2％和16％。3个疗程治疗中，每增加1个疗程。总体疗效等级分别提高21．2％和20％。铁负荷2—4级的患者。3个疗程反应率分别为50％．27．5％，0％。3个疗程后。骨髓衰竭性疾病患者血红蛋白提高（P〈0．05），每月输血量减少，输血间隔延长。去铁治疗能改善患者脏器功能，不良反应较少。结论：去铁胺治疗输血依赖铁过载安全、有效，能一定程度上改善造血，但需坚持治疗。

Objective To explore the effects of deferoxamine on patients with blood transfusion related iron overload. Methods Forty-two patients with blood diseases combined with iron overload from Jan 2009 and Dec 2012 was retrospectively reviewed. The levels of serum ferritin, hemogram, organ function, frequency of blood transfusion were observed. Results The response rates of 1-3 course of deferoxamine treatment were 11.9%, 15.2% and 16%, respectively. The total curative effect level was improved by 21.2% and 20% when patients received the second and third course of treatment, respectively. From degree 2 to 4, the response rates after 3 courses of treatment were 50%, 27.5%, and 0%, respectively. After 3 courses of treatment, the hemoglobin level of patients with bone marrow failure disease was significantly improved, the amount of blood transfusion was decreased, and the transfusion interval was prolonged. The deferoxamine could improve organ function with little side effects. Conclusion Deferoxamine could safely and effectively treating blood transfusion related iron overload, and can improve the hemogram and remit the transfusion dependence when proper course of treatment was administered.