Docci D, Cenciotti L, Turci F, Salvi G, Mosconi G, Baldrati L
Quad Sclavo Diagn. 1982 Dec;18(4):454-62.
Serum ferritin, measured by radioimmunoassay in 65 dialysis patients (mean time of dialysis 38.9 months), was significantly higher (247.9 +/- 224.5 ng/ml) than in controls (p less than 0.001), inversely correlated with dialytic age (p less than 0.05), and had no difference as far as sex or underlying nephropathy were concerned. With regard to the other hematological parameters, serum ferritin correlated inversely with total transferrin and directly with percentage of total transferrin only. In 28 patients, an intravenous iron load (0.6 g in one month) induced a further increase in serum ferritin (p less than 0.001), rather disomogenous and not clearly correlated with initial levels. The change in hemoglobin concentration after iron administration was in close relationship with initial serum ferritin levels (r = -0,72, p less than 0.001). A significant increase in hemoglobin could be detected in all the patients with serum ferritin less than 65 ng/ml and in most patients with serum ferritin less than 160 ng/ml, while hemoglobin change was negligible when serum ferritin levels in dialysis exceeded this value. Thus, although serum ferritin levels in dialysis patients may reflect not only iron overload but also an abnormal metabolism, serum ferritin measurement remains a reliable guide to iron requirement. We suggest maintaining serum ferritin levels between 65 and 160 ng/ml, to avoid iron stores depletion and on the contrary, iron overload.
采用放射免疫分析法对65例透析患者（平均透析时间38.9个月）的血清铁蛋白进行检测，结果显示其水平（247.9±224.5 ng/ml）显著高于对照组（p<0.001），与透析龄呈负相关（p<0.05），且在性别或潜在肾病方面无差异。关于其他血液学参数，血清铁蛋白仅与总转铁蛋白呈负相关，与总转铁蛋白百分比呈正相关。28例患者静脉注射铁剂（1个月内0.6 g）后血清铁蛋白进一步升高（p<0.001），升高情况较为不均一，且与初始水平无明显相关性。补铁后血红蛋白浓度的变化与初始血清铁蛋白水平密切相关（r = -0.72，p<0.001）。血清铁蛋白低于65 ng/ml的所有患者以及血清铁蛋白低于160 ng/ml的大多数患者血红蛋白均显著升高，而透析患者血清铁蛋白水平超过此值时血红蛋白变化可忽略不计。因此，尽管透析患者的血清铁蛋白水平可能不仅反映铁过载，还反映异常代谢，但血清铁蛋白检测仍是铁需求的可靠指标。我们建议将血清铁蛋白水平维持在65至160 ng/ml之间，以避免铁储备耗竭，反之亦然，避免铁过载。
