Noori Noor Mohammad, Teimouri Alireza
Children and Adolescents Health research center, Research Institute of cellular and Molecular Science in Infectious Diseases , Zahedan University of Medical Sciences, Zahedan, Iran.
Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Caspian J Intern Med. 2023 Summer;14(3):460-469.
Iron overload is connected with an expanded prevalence of thalassemia due to heart impairment. This considers pointing to survey changes in thalassemia's aortic elasticity due to iron deposition in the heart and liver of children.
This case-control study was performed on 80 healthy and 160 thalassemia patients. The subjects gathered from educational pediatric hospital of Ali Asghar in Zahedan, Iran, from 2019 to 2021. Echocardiography parameters were measured. Ferritin, lipids profile, cardiac and liver MRI T2 * measured in patients only. Aortic elasticity parameters were aortic strain, aortic stiffness β index, aortic distensibility and pressure strain elastic modulus. Data analyzed by SPSS,p< 0.05 was considered as significant.
Diastolic blood pressure (p<0.001), aortic diameter in diastole (p<0.001), aortic diameter in systole (p<0.001), ferritin (p<0.001), aortic strain (p<0.001), aortic distensibility(p<0.001), pressure strain elastic modulus (p<0.001) and aortic stiffness β index (p<0.001) were changed significantly in thalassemia patients compared to controls. From these variables, AoD, AoS, ferritin, AS and AD increased in thalassemia. Ferritin was higher in thalassemia patients with abnormal heart iron deposition (2131.89±1992.74 v.s 4887.66±3122.59 ng/ml). Considering the level of liver iron deposition, ferritin did not change in patients. Our highlighted variables did not change in patients based on the groups of ferritin.
Concluded that AoD, AoS, ferritin, AS and AD increased in thalassemia patients. Ferritin increased in thalassemia with abnormal iron overload in the heart but did not change in the liver. Recommended MRI T2* to evaluate dynamic functions of liver and heart in thalassemia patients.
由于心脏损害,铁过载与地中海贫血患病率的增加有关。这考虑指向调查儿童心脏和肝脏中铁沉积导致的地中海贫血主动脉弹性变化。
本病例对照研究对80名健康人和160名地中海贫血患者进行。研究对象于2019年至2021年从伊朗扎黑丹的阿里·阿斯加尔教育儿童医院招募。测量了超声心动图参数。仅在患者中测量了铁蛋白、血脂谱、心脏和肝脏MRI T2*。主动脉弹性参数包括主动脉应变、主动脉僵硬度β指数、主动脉扩张性和压力应变弹性模量。数据采用SPSS进行分析,p<0.05被认为具有统计学意义。
与对照组相比,地中海贫血患者的舒张压(p<0.001)、舒张期主动脉直径(p<0.001)、收缩期主动脉直径(p<0.001)、铁蛋白(p<0.001)、主动脉应变(p<0.001)、主动脉扩张性(p<0.001)、压力应变弹性模量(p<0.001)和主动脉僵硬度β指数(p<0.001)有显著变化。在这些变量中,地中海贫血患者的主动脉舒张期直径、主动脉收缩期直径、铁蛋白、主动脉应变和主动脉扩张性增加。心脏铁沉积异常的地中海贫血患者铁蛋白水平更高(2131.89±1992.74对4887.66±3122.59 ng/ml)。考虑到肝脏铁沉积水平,患者的铁蛋白没有变化。根据铁蛋白分组,我们突出显示的变量在患者中没有变化。
得出结论,地中海贫血患者的主动脉舒张期直径、主动脉收缩期直径、铁蛋白、主动脉应变和主动脉扩张性增加。心脏铁过载异常的地中海贫血患者铁蛋白增加,但在肝脏中没有变化。建议采用MRI T2*评估地中海贫血患者肝脏和心脏的动态功能。