输血和去铁治疗对儿童重型地中海贫血心功能的影响

Effects of blood transfusion and iron removal therapy on cardiac function in children with thalassemia

目的:探讨对于重型地中海贫血儿童使用输血治疗和去铁治疗的临床效果。方法:选取160例重型地中海贫血患儿的治疗效果进行研究,根据病案资料进行回顾性分析,分成输血依从组(40例)、输血非依从组(40例)、去铁治疗依从组(40例)、去铁治疗非依从组(40例)四组,治疗一年后对患儿超声心动图、血清脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)等心功能指标进行测量。结果:输血依从组和非输血依从组相比患儿的血清BNP、cTnI水平下降(P<0.05),输血依从组左室舒张内径、左室收缩内径均低于输血非依从组(P<0.05),输血依从组心输出量、心指数高于输血非依从组(P<0.05);去铁治疗依从组和去铁治疗非依从组相比患儿的血清BNP、cTnI水平下降(P<0.05),去铁治疗依从组左室舒张内径、左室收缩内径均低于去铁治疗非依从组(P<0.05),去铁治疗依从组心输出量、心指数高于去铁治疗非依从组(P<0.05)。结论:去铁治疗和输血,对于儿童重型地中海贫血的治疗都可以在预防患儿心衰方面发挥一定的作用。

Objective：To investigate the clinical effects of blood transfusion and iron removal therapy in children with severe thalassemia.Methods：160 cases of severe thalassemia children were selected,and their data were analyzed retrospectively.They were divided into four groups：blood transfusion compliance group（n=40）,blood transfusion non compliance group（n=40）,iron removal treatment compliance group（n=40）,and iron removal treatment non compliance group（n=40）.One year after treatment,echocardiography,serum BNP,cTnI and other cardiac function indexes were measured.Results：Compared with the blood transfusion non compliance group,the serum BNP and cTnI levels decreased significantly in the blood transfusion compliance group（P〈0.05）.The left ventricular diastolic diameter and the left ventricular systolic diameter in the blood transfusion compliance group were lower than those in the blood transfusion non compliance group（P〈0.05）.The cardiac output and heart index in the blood transfusion compliance group were higher than those in the blood transfusion non compliance group（P〈0.05）.The serum levels of BNP and cTnI in the iron removal treatment compliance group were significantly decreased than those in the iron removal treatment non compliance group（P0.05）.The left ventricular diastolic diameter and left ventricular internal diameter in the iron removal treatment compliance group were lower than those in the iron removal treatment non compliance group（P〈0.05）.The cardiac output and heart index in the iron removal treatment compliance group were higher than those in the iron removal treatment non compliance group（P〈0.05）.Conclusion：The treatment with iron removal and blood transfusions for children with severe thalassemia can play a role in the prevention of heart failure.