Moreb J, Popovtzer M M, Friedlaender M M, Konijn A M, Hershko C
Nephron. 1983;35(3):196-200. doi: 10.1159/000183074.
The diagnostic usefulness of bone marrow hemosiderin, serum ferritin, transferrin saturation, mean corpuscular volume (MCV) and red cell protoporphyrin (EPP) in the evaluation of iron status in patients on chronic hemodialysis was studied in 39 subjects. The correlation between serum ferritin and the number of transfusions received per month was slightly higher (r = 0.717; p less than 0.001) than the correlation between bone marrow hemosiderin and transfusions (r = 0.685; p less than 0.01). Serum ferritin was useful in identifying subjects with both increased or reduced iron stores. In contrast, transferrin saturation could only be used for indicating iron overload. MCV for indicating iron deficiency, and EPP was not useful in either case. The abnormal increase of EPP in chronic uremia has not been previously described. It is unrelated to iron deficiency and is most probably explained by the known reduction in red cell ferrochelatase activity associated with chronic uremia. Serum ferritin is clearly the most useful diagnostic aid for assessing iron stores in patients on chronic hemodialysis. Whether ferritin is also the best predictor of response to iron therapy, cannot be determined on the basis of the present data.
对39名受试者研究了骨髓含铁血黄素、血清铁蛋白、转铁蛋白饱和度、平均红细胞体积（MCV）和红细胞原卟啉（EPP）在评估慢性血液透析患者铁状态方面的诊断价值。血清铁蛋白与每月输血次数之间的相关性（r = 0.717；p < 0.001）略高于骨髓含铁血黄素与输血之间的相关性（r = 0.685；p < 0.01）。血清铁蛋白有助于识别铁储存增加或减少的受试者。相比之下，转铁蛋白饱和度仅可用于指示铁过载。MCV用于指示缺铁，而EPP在两种情况下均无用处。慢性尿毒症中EPP的异常升高此前未见报道。它与缺铁无关，很可能是由已知的与慢性尿毒症相关的红细胞亚铁螯合酶活性降低所解释。血清铁蛋白显然是评估慢性血液透析患者铁储存最有用的诊断辅助指标。基于目前的数据无法确定铁蛋白是否也是铁治疗反应的最佳预测指标。
