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地中海贫血患者血浆生化参数与心肝铁沉积的相关性。

Correlation between plasma biochemical parameters and cardio-hepatic iron deposition in thalassemia major patients.

机构信息

Department of Echocardiography, Dezful University of Medical Sciences, Dezful, Iran.

Student Research Committee, Dezful University of Medical Sciences, Dezful, Iran.

出版信息

Scand J Clin Lab Invest. 2024 Jul;84(4):245-251. doi: 10.1080/00365513.2024.2369991. Epub 2024 Jul 2.

Abstract

INTRODUCTION

Major Thalassemia patients suffer from iron overload and organ damage, especially heart and liver damage. Early diagnosis and treatment with a chelator can reduce the complications and mortality of iron overload. Therefore, we aimed to investigate the biochemical and hematological predictors as an alternative and indirect indicator of iron deposition in heart and liver cells in comparison with the MRI T2* method as the gold standard.

MATERIAL AND METHOD

MRI T2* was evaluated in the heart and liver tissues of 62 major beta-thalassemia patients undergoing regular transfusion and chelator therapy. Biochemical and hematological factors were also measured, including serum ferritin, serum electrolytes, liver enzymes, hemoglobin, blood glucose, and serum magnesium. The correlation between these factors was assessed using statistical evaluations.

RESULT

Serum ferritin had a positive and significant correlation with liver siderosis based on MRI T2* (-value = .015), and no significant association was observed with cardiac siderosis (-value = .79). However, there was a significant positive correlation between cardiac iron deposition and fasting blood sugar level (-value = -.049), and plasma level of liver enzymes (alanine aminotransferase (ALT) (-value = .001), aspartate aminotransferase (AST ((-value = .01)). Moreover, there was a significant negative correlation between cardiac iron overload and plasma magnesium level (-value = .014). According to MRI T2*, there was no significant correlation between cardiac and hepatic iron overload ( value = .36).

CONCLUSION

An increase in blood sugar or liver enzymes and a decrease in serum magnesium was associated with an increase in cardiac iron overload based on MRI T2*. Liver iron overload based on MRI T2* had a significant correlation with serum ferritin.

摘要

简介

重型地中海贫血患者会遭受铁过载和器官损伤,尤其是心脏和肝脏损伤。早期诊断和螯合剂治疗可以减少铁过载的并发症和死亡率。因此,我们旨在研究生化和血液学指标作为心脏和肝细胞铁沉积的替代和间接指标,与 MRI T2*法作为金标准进行比较。

材料和方法

对 62 名接受常规输血和螯合剂治疗的重型β地中海贫血患者的心脏和肝脏组织进行 MRI T2*评估。还测量了生化和血液学因素,包括血清铁蛋白、血清电解质、肝酶、血红蛋白、血糖和血清镁。使用统计评估评估这些因素之间的相关性。

结果

血清铁蛋白与基于 MRI T2的肝脏铁沉积呈正相关且具有统计学意义(-值 = .015),与心脏铁沉积无显著相关性(-值 =.79)。然而,心脏铁沉积与空腹血糖水平呈显著正相关(-值 = -.049),与血浆肝酶水平(丙氨酸氨基转移酶(ALT)(-值 = .001),天门冬氨酸氨基转移酶(AST)(-值 = .01))呈显著正相关。此外,心脏铁过载与血浆镁水平呈显著负相关(-值 = .014)。根据 MRI T2,心脏和肝脏铁过载之间无显著相关性( value = .36)。

结论

基于 MRI T2*,血糖或肝酶升高和血清镁降低与心脏铁过载增加相关。基于 MRI T2*的肝脏铁过载与血清铁蛋白呈显著相关。

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