继发性铁粒幼细胞性贫血铁代谢诊断指标研究应用

Study of metabolism of ferric in secondary sideroblastic anemia (SA)

关键词:  继发  铁粒幼细胞贫血  铁代谢

Key words:  sideroblastic  anemia  indicators of ferric metabolism

摘要:

探讨研究继发性铁粒幼细胞性贫血铁代谢状况及发病机理，开发铁粒幼贫血早期诊断及预防方法。［方法］ 利用骨髓五铁（即细胞内铁、细胞外铁、病理环铁粒幼细胞、铁粒幼细胞比率（SR）、铁粒红细胞）；血清四铁（血清铁、总铁结合力、未饱和铁、饱和度）上述各项指标，对14 282例各种不同血液病患者进行检测。［结果］ 原发性铁粒幼细胞贫血30例；继发性铁粒幼细胞贫血93例，可继发于20多种疾病，化疗后白血病28例（30.1%）；除缺铁贫外各种贫血43例（46.2 %）；其它感染、粒细胞减少、骨髓纤维化、真性红细胞增多症22例（23.7 %）；原发铁粒幼细胞贫血病理环铁粒幼细胞体积小，铁颗粒数目多 ，常如黄豆粒似的撒在核周围，病理环铁粒幼细胞数目增多>30 %，此点与骨髓增生异常综合症（MDS-RAS）不同，该病病理环铁粒幼细胞颗粒数目少，并出现病态造血巨幼细胞浆带中，铁粒幼细胞≥15%。 ［结论］ 骨髓五铁、血清四铁各项指标，对原发性、继发性铁粒幼细胞贫血以及MDS、RA-S的诊断、鉴别诊断、预防有重要意义，对输血补铁有重要价值

Abstract:

To study the condition of metabolism of ferric in secondary sideroblastic anemia (SA) and the pathomechanism . ［Measures］ The author assay 14 282 cases of various anemia patients'nine indexes including ferric of inside and outside cells, morbidly circle of ferric granule, SR, erythrocyte of ferric granule ,ferric of serum, total ferric combination power，unsaturated iron, saturation degree. ［Results］ Primary SA 30; secondary SA 93. Leukemia 28(30.1 %); other kinds of anemia 43(46.2%), other diseases such as infection, hypogranulocytosis, myelofibrosis , erythrocythemia 22(23.7 %). In primary S A, ferric granule are small in size and large in number sorounding the nucleus .The positivity rate of circled ferric gradual cells >30 %,which is different from RA-S whose granule are few existing in the megaloblastic cells. ［Conclusion］ These nine indicators play an important part in the prevention, diagnosis anddifferentiation diagnosis