Bai Yuanyuan, Li Yang, Liu Juan, Ju Peng
Department of Clinical Laboratory, Tianjin First Central Hospital, Tianjin 300192, China (Bai YY, Liu J); Department of Transplant Surgery, Tianjin First Central Hospital, Tianjin 300192, China (Li Y); Department of Clinical Laboratory, Tianjin Haibin People's Hospital, Tianjin 300280, China (Ju P). Corresponding author: Liu Juan, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Aug;30(8):804-806. doi: 10.3760/cma.j.issn.2095-4352.2018.08.018.
To evaluate the effect of iron metabolism of preoperation on the length of intensive care unit (ICU) stay in liver transplant recipients.
A retrospective study was conducted. 120 adult liver transplant recipients admitted to Tianjin First Central Hospital from September 2015 to September 2017 were enrolled. The basic data, model of end-stage liver disease (MELD) evaluation system score at admission; iron metabolism index, routine blood test, blood biochemistry, coagulation time and C-reactive protein (CRP) level within 24 hours after admission; intraoperative clinical indicators such as operation time, operation bleeding volume, red blood cells and fresh frozen plasma input volume, hot ischemia time, cold ischemia time, urine volume; and the length of ICU stay were collected. All patients were divided into iron deficiency group (ID group; serum ferritin < 100 μg/L, or serum ferritin 100-300 μg/L and transferrin saturation < 0.20) and non-iron deficiency group (non-ID group; serum ferritin > 300 μg/L, or serum ferritin 100-300 μg/L and transferrin saturation > 0.20) according iron deficiency standard. The indexes of iron metabolism, basic data and clinical indicators of two groups were compared. The correlation between serum ferritin level and the length of ICU stay was analyzed by Pearson correlation.
Compared with non-ID group, the levels of serum iron concentration and serum ferritin were significantly decreased in ID group [serum iron concentration (μmol/L): 3.50±1.62 vs. 14.50±2.31, serum ferritin (μg/L): 67.00±31.54 vs. 315.00±36.73, both P < 0.01], infusion volume of intraoperative red blood cells and fresh frozen plasma were significantly increased, and the length of ICU stay was significantly prolonged (days: 6.5±2.4 vs. 3.3±0.5, P < 0.01). There was no significant difference in transferrin saturation, CRP and other clinical indicators between the two groups. Correlation analysis showed that serum ferritin level was negative correlated with the length of ICU stay (r = -0.768, P < 0.001).
Preoperative iron deficiency in liver transplant recipients will lead to increased blood transfusion and prolonged length of ICU stays.
评估肝移植受者术前铁代谢情况对其重症监护病房（ICU）住院时间的影响。
进行一项回顾性研究。纳入2015年9月至2017年9月在天津市第一中心医院收治的120例成年肝移植受者。收集其基本资料、入院时终末期肝病模型（MELD）评估系统评分；入院后24小时内的铁代谢指标、血常规、血生化、凝血时间及C反应蛋白（CRP）水平；术中临床指标如手术时间、手术出血量、红细胞及新鲜冰冻血浆输入量、热缺血时间、冷缺血时间、尿量；以及ICU住院时间。根据缺铁标准将所有患者分为缺铁组（ID组；血清铁蛋白<100μg/L，或血清铁蛋白100 - 300μg/L且转铁蛋白饱和度<0.20）和非缺铁组（非ID组；血清铁蛋白>300μg/L，或血清铁蛋白100 - 300μg/L且转铁蛋白饱和度>0.20）。比较两组的铁代谢指标、基本资料及临床指标。采用Pearson相关性分析血清铁蛋白水平与ICU住院时间的相关性。
与非ID组相比，ID组血清铁浓度和血清铁蛋白水平显著降低[血清铁浓度（μmol/L）：3.50±1.62 vs. 14.50±2.31，血清铁蛋白（μg/L）：67.00±31.54 vs. 315.00±36.73，均P<0.01]，术中红细胞及新鲜冰冻血浆输入量显著增加，ICU住院时间显著延长（天：6.5±2.4 vs. 3.3±0.5，P<0.01）。两组转铁蛋白饱和度、CRP及其他临床指标差异无统计学意义。相关性分析显示血清铁蛋白水平与ICU住院时间呈负相关（r = -0.768，P<0.001）。
肝移植受者术前缺铁会导致输血增加及ICU住院时间延长。
