骨髓增生异常综合征患者铁过载与中医血瘀证的临床研究

Clinical study between iron overload and blood stasis syndrome in patients with myelodysplastic syndrome

目的:观察骨髓增生异常综合征(MDS)患者铁过载的中医血瘀证证候,探讨MDS患者铁过载临床特征与血瘀证的相关性。方法:纳入MDS患者64例,根据铁过载诊断标准,将其分为MDS铁过载组(34例)和MDS非铁过载组(30例)。对纳入患者按中医血瘀证候评分表进行评分,整理分析患者临床资料包括输血量、预后危度分层、铁代谢指标(血清铁蛋白、血清铁、转铁蛋白、转铁蛋白饱和度、不饱和铁、总铁结合力),并与血瘀证进行相关性分析。结果:铁过载组血瘀证积分显著高于非铁过载组(P<0.05);预后危度与血瘀证评分呈显著正相关(r=0.266,P<0.05);输血量与血瘀证评分呈显著正相关(r=0.704,P<0.05);血清铁蛋白与血瘀证评分呈显著正相关(r=0.731,P<0.05);转铁蛋白饱和度与血瘀证评分呈显著正相关(r=0.335,P<0.05);转铁蛋白与血瘀证评分呈显著负相关(r=-0.435,P<0.05);不饱和铁与血瘀证评分呈显著负相关(r=-0.466,P<0.05);总铁结合力与血瘀证评分呈显著负相关(r=-0.371,P<0.05)。结论:MDS铁过载的输血量、预后危度分层及铁代谢指标与血瘀证存在显著相关性,为进一步活血化瘀法论治MDS铁过载临床治疗研究提供参考。

Objective:To observe the blood stasis syndrome(BSS)of the iron overload in patients with myelodysplastic syndrome(MDS),and to discuss the correlation between the clinical characteristics of the iron overload and the blood stasis.Methods:A total of 64 patients with MDS were included.According to the diagnostic criteria of iron overload,they were divided into the MDS iron overload group(34 cases)and MDS non-iron overload group(30 cases).The patients were scored according to the TCM BSS score table,and the correlation between the clinical data and the BSS of the patients was analyzed,which included blood transfusion volume,prognosis risk stratification,and iron metabolism indicators(serum ferritin,serum iron,transferrin,transferrin saturation,unsaturated iron,total iron binding capacity).Results:The score of iron overload BSS was significantly higher than that of the non-iron overload group(P<0.05).The prognostic risk was positively correlated with the score of BSS(r=0.266,P<0.05).The blood transfusion level was positively correlated with the score of BSS(r=0.704,P<0.05).The serum ferritin level was positively correlated with the score of BSS(r=0.731,P<0.05).The transferrin saturation level was positively correlated with the score of BSS(r=0.335,P<0.05).The transferrin level was negatively correlated with the score of BSS(r=-0.435,P<0.05).The unsaturated iron level was negatively correlated with the score of BSS(r=-0.466,P<0.05).The total iron-binding ability level was negatively correlated with the score of BSS(r=-0.371,P<0.05).Conclusion:There is a significant correlation between blood transfusion volume,prognosis risk stratification,iron metabolism index of MDS iron overload,and blood stasis syndrome,which provides a reference for further clinical treatment of iron overload in MDS by activating blood circulation and removing blood stasis.