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在迪拜地中海贫血中心接受治疗的重型β地中海贫血患者中铁过载并发症的患病率。

Prevalence of iron overload complications among patients with b-thalassemia major treated at Dubai Thalassemia Centre.

作者信息

Belhoul Khawla Mohammed, Bakir Maisan Lateef, Kadhim Ahmed Mohamed, Dewedar Hany ElSayed, Eldin Mohamed Salah, Alkhaja Fatheya Abbas

机构信息

Dubai Health Authority Thalassemia Center, Dubai, United Arab Emirates.

出版信息

Ann Saudi Med. 2013 Jan-Feb;33(1):18-21. doi: 10.5144/0256-4947.2013.18.

Abstract

BACKGROUND AND OBJECTIVES

Authors and team members of the Dubai Thalassemia Centre obtained data on the prevalence of iron overload complications among patients with b-thalassemia major (b-TM) and compared it to international data to improve patient care and evaluate the effectiveness of earlier used treatment modalities. The information obtained is also expected to be useful in genetic counseling.

DESIGN AND SETTING

Cross-sectional study of all living transfusion-dependent b-TM patients registered at the Thalassemia Centre in Dubai, United Arab Emirates, until the end of 2007 (n=382).

PATIENTS AND METHODS

Diagnosis of TM was based on clinical history and laboratory confirmation by hemoglobin electrophoresis and DNA testing. All were uniformly treated with desferrioxamine and monitored by serial serum ferritin. results: The mean (SD) age of patients was 15.4 (7.6) years, with 50.5% males. Mean (SD) serum ferritin was 2597.2 (1976.8) micro g/L. The frequency of iron overload complications were as follows: hypogonadism (n=99, 52.7%), hypoparathyroidism (n=40, 10.5%), diabetes mellitus (n=40, 10.5%), hypothyroidism (n=24, 6.5%) and cardiomyopathies (n=7, 1.8%). Hypogonadism was the most common endocrine abnormality in our study and other reported series. However, cardiomyopathies were less prevalent among our patients with higher rates of diabetes and hypoparathyroidism compared to rates reported internationally. Females had statistically significant lower serum ferritin (2530.8 (1931.2), P < .05) with a lower cardiomyopathies rate.

CONCLUSION

Iron overload related complications among our patients with thalassemia major were different from those reported internationally. Studying the genetic status of patients from our area may uncover the underlying genetic modifiers of iron overload mediated organs injury.

摘要

背景与目的

迪拜地中海贫血中心的作者和团队成员获取了重型β地中海贫血(β-TM)患者铁过载并发症的患病率数据,并将其与国际数据进行比较,以改善患者护理并评估早期使用的治疗方式的有效性。所获得的信息预计在遗传咨询中也将有用。

设计与地点

对阿拉伯联合酋长国迪拜地中海贫血中心登记的所有存活的依赖输血的β-TM患者进行横断面研究,截至2007年底(n = 382)。

患者与方法

TM的诊断基于临床病史以及血红蛋白电泳和DNA检测的实验室确认。所有患者均接受去铁胺统一治疗,并通过系列血清铁蛋白进行监测。结果:患者的平均(标准差)年龄为15.4(7.6)岁,男性占50.5%。平均(标准差)血清铁蛋白为2597.2(1976.8)μg/L。铁过载并发症的发生率如下:性腺功能减退(n = 99,52.7%)、甲状旁腺功能减退(n = 40,10.5%)、糖尿病(n = 40,10.5%)、甲状腺功能减退(n = 24,6.5%)和心肌病(n = 7,1.8%)。性腺功能减退是我们研究以及其他报道系列中最常见的内分泌异常。然而,与国际报道的发生率相比,我们的患者中心肌病的发生率较低,而糖尿病和甲状旁腺功能减退的发生率较高。女性的血清铁蛋白在统计学上显著较低(2530.8(1931.2),P <.05),心肌病发生率也较低。

结论

我们的重型地中海贫血患者中铁过载相关并发症与国际报道的不同。研究我们地区患者的基因状态可能会揭示铁过载介导的器官损伤的潜在基因修饰因子。

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