Shroff K, Gaiha M, Singh T, Sharma S K
Department of Medicine, Medical College and associated LNJPN Hospital, New Delhi.
J Assoc Physicians India. 1991 Sep;39(9):675-7.
Thirty patients of rheumatoid arthritis comprising 16 classical and 14 definite cases based on the ARA criteria were evaluated in a prospective and controlled study for iron status with special reference to serum ferritin levels. Serum ferritin levels were estimated by RIA technique and marrow iron status was ascertained by semi-quantitative estimation after Pearl's staining of marrow aspirate (G 0-6). Marrow iron stores were found absent to decreased in 17 patients (56.7%), normal in 2 (6.7%) and increased in 11 patients (36.6%). The serum ferritin levels in the iron depleted rheumatoid arthritis patients were significantly lower in comparison to patients with normal to increased marrow iron stores (23.91 +/- 11.45 ug/L vs 69.94 +/- 24.7 ug/L, p less than 0.001). There was a strong positive correlation between serum ferritin levels and marrow iron stores (r = +0.08, p less than 0.001). A serum ferritin value of less than or equal to 32 ug/L was a good predictor of decreased iron stores in the bone marrow, with a sensitivity of 88.2% and specificity of 84.5%. The test had a predictive value of 83.33%. There was no correlation between marrow iron stores and conventional indicators or iron status i.e. serum iron, TIBC, transferrin saturation and MCHC. It is concluded that serum ferritin correlates well with marrow iron stores and can be used as a simple non-invasive test for predicting iron-deficiency in patients of rheumatoid arthritis.
在一项前瞻性对照研究中，依据美国风湿病学会（ARA）标准，对30例类风湿关节炎患者进行了评估，其中包括16例典型病例和14例确诊病例，特别关注血清铁蛋白水平以评估铁状态。采用放射免疫分析（RIA）技术测定血清铁蛋白水平，并通过对骨髓穿刺液进行Pearl染色（G 0 - 6）后的半定量评估来确定骨髓铁状态。发现17例患者（56.7%）骨髓铁储存缺乏或减少，2例患者（6.7%）正常，11例患者（36.6%）增加。与骨髓铁储存正常至增加的患者相比，缺铁性类风湿关节炎患者的血清铁蛋白水平显著降低（23.91±11.45μg/L对69.94±24.7μg/L，p＜0.001）。血清铁蛋白水平与骨髓铁储存之间存在强正相关（r = +0.8，p＜0.001）。血清铁蛋白值小于或等于32μg/L是骨髓铁储存减少的良好预测指标，敏感性为88.2%，特异性为84.5%。该检测的预测价值为83.33%。骨髓铁储存与传统铁状态指标即血清铁、总铁结合力（TIBC）、转铁蛋白饱和度和平均红细胞血红蛋白浓度（MCHC）之间无相关性。结论是血清铁蛋白与骨髓铁储存密切相关，可作为预测类风湿关节炎患者缺铁的简单非侵入性检测方法。
