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[血液透析患者血清铁的评估及其因采血时间差异而产生的变化]

[Evaluation of serum iron in hemodialysis patients and its variation due to the difference of blood sampling time].

作者信息

Matsumoto Yasutoshi, Ozawa Yasuaki, Imafuku Yuji, Yoshida Hiroshi

机构信息

Department of Clinical Laboratory, Nishi Hospital, Futaba-gun, Fukushima-pref. 979-1521, Japan.

出版信息

Rinsho Byori. 2011 Nov;59(11):1021-5.

Abstract

Diurnal variations in serum iron concentration were examined to investigate the influence of sampling time in hemodialysis (HD) patients and healthy subjects. The serum iron concentration and TIBC of HD patients decreased significantly (p<0.01, p<0.01 respectively) compared to those of healthy subjects. Inversely, the serum ferritin concentration of HD patients increased significantly (p<0.01) compared to that of healthy subjects. These findings show the disturbance of iron transport system: under such condition intracellural iron transition out into peripheral blood stream is low in HD patients. Serum iron concentration in samples collected in the evening decreased significantly both in HD patients (p<0.05) and in healthy subjects (p<0.01). Diurnal variations in serum iron concentration reveal almost similar decrement in both groups. In HD patients, serum iron concentration of the blood samples collected on the third day morning after HD and second day morning after HD was examined to see the influence from changes of circulating plasma volume. The serum iron concentration and Hct value in the second day sampling increased significantly compared to the third day sampling (p<0.01, p<0.01 respectively). In addition, the serum iron concentration corrected by Hct in the second day sampling increased significantly (p<0.01) compared to the third day sampling. We conclude from our results that diurnal variations of serum iron concentration vary in sampling time in HD patients as well as in healthy subjects. We also deduct that there may be other factors concerning changes in circulating plasma volume.

摘要

研究了血清铁浓度的昼夜变化,以探讨采样时间对血液透析(HD)患者和健康受试者的影响。与健康受试者相比,HD患者的血清铁浓度和总铁结合力(TIBC)显著降低(分别为p<0.01,p<0.01)。相反,HD患者的血清铁蛋白浓度与健康受试者相比显著升高(p<0.01)。这些发现表明铁转运系统受到干扰:在这种情况下,HD患者细胞内铁向外周血流的转运较低。HD患者和健康受试者在晚上采集的样本中血清铁浓度均显著降低(HD患者中p<0.05,健康受试者中p<0.01)。两组血清铁浓度的昼夜变化显示出几乎相似的下降。在HD患者中,检测HD后第三天早晨和HD后第二天早晨采集的血样中的血清铁浓度,以观察循环血浆量变化的影响。与第三天采样相比,第二天采样时的血清铁浓度和血细胞比容值显著升高(分别为p<0.01,p<0.01)。此外,与第三天采样相比,第二天采样时经血细胞比容校正的血清铁浓度显著升高(p<0.01)。我们从结果中得出结论,HD患者和健康受试者血清铁浓度的昼夜变化在采样时间上有所不同。我们还推断,可能存在其他与循环血浆量变化有关的因素。

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