Taher Ali T, Musallam Khaled M, Inati Adlette
Department of Internal Medicine, Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon.
Hemoglobin. 2009;33 Suppl 1:S46-57. doi: 10.3109/03630260903346676.
In patients suffering from transfusion-dependent anemia, excess iron secondary to regular transfusions cannot be physiologically excreted. This leads to a state of chronic iron overload with iron accumulating in the liver, heart, and endocrine organs, and ultimately results in significant morbidity and mortality. Historically, iron overload was assessed through measurement of serum ferritin or direct determination of liver iron concentration (LIC) by means of biopsy. Although both correlate well with iron overload severity, several limitations pertinent to both are of concern. This has led to the identification of novel noninvasive iron assessment measures, namely magnetic resonance imaging (MRI) R2 and T2*. Moreover, investigations of other potential indices like nontransferrin-bound iron (NTBI) and labile plasma iron (LPI) are yielding promising results. Optimal iron overload assessment and monitoring is a key element in the development of improved strategies of iron chelation therapy that can be tailored to meet the patient's specific needs.
在患有依赖输血的贫血症的患者中，定期输血导致的铁过量无法通过生理方式排出。这会导致慢性铁过载状态，铁在肝脏、心脏和内分泌器官中蓄积，最终导致显著的发病率和死亡率。从历史上看，铁过载是通过测量血清铁蛋白或通过活检直接测定肝脏铁浓度（LIC）来评估的。尽管两者都与铁过载严重程度密切相关，但两者都存在一些相关局限性，令人担忧。这促使人们确定了新的非侵入性铁评估方法，即磁共振成像（MRI）的R2和T2*。此外，对其他潜在指标如非转铁蛋白结合铁（NTBI）和不稳定血浆铁（LPI）的研究也取得了有希望的结果。最佳的铁过载评估和监测是制定可根据患者具体需求进行调整的改进铁螯合治疗策略的关键要素。
