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输血依赖型地中海贫血合并慢性肝炎的铁螯合作用

Iron chelation in transfusion-dependent thalassemia with chronic hepatitis.

作者信息

De Virgiliis S, Cossu P, Sanna G, Frau F, Loi E, Lobrano R, Nucaro A, Toccafondi C, Cornacchia G, Loi A, Cao A

出版信息

Acta Haematol. 1982;67(1):49-56. doi: 10.1159/000207024.

Abstract

In this study maximum urinary iron elimination with continuous desferrioxamine subcutaneous infusion was obtained in thalassemia major patients with chronic persistent or active hepatitis with lower doses (60 mg/kg) than those necessary in patients without hepatitis (80 mg/kg). Since dose-response curves were highly variable the treatment schedule should be tailored to the individual needs of each patient. Both groups may achieve iron balance but chronic hepatitis patients have more frequently a net urinary iron excretion. In patients with chronic hepatitis no correlation was found between serum ferritin levels or serum ferritin/aspartate aminotransferase ratios and transfusional iron overload while serum ferritin/aspartate aminotransferase ratios were seen to be correlated with liver iron stores.

摘要

在本研究中,对于患有慢性持续性或活动性肝炎的重型地中海贫血患者,通过皮下持续输注去铁胺,以低于无肝炎患者所需的剂量(60毫克/千克)即可实现最大尿铁排出量,无肝炎患者所需剂量为80毫克/千克。由于剂量反应曲线变化很大,治疗方案应根据每个患者的个体需求进行调整。两组患者都可能实现铁平衡,但慢性肝炎患者尿铁净排泄更为常见。在慢性肝炎患者中,未发现血清铁蛋白水平或血清铁蛋白/天冬氨酸转氨酶比值与输血性铁过载之间存在相关性,而血清铁蛋白/天冬氨酸转氨酶比值与肝脏铁储存相关。

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