George E, Wong H B, George R, Ariffin W A
Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
Singapore Med J. 1994 Feb;35(1):62-4.
Patients on a moderate red cell transfusion programme have iron overload where the concentrations of the serum ferritin were inappropriate to increases in the transfusion load as a result of limitations of apoferritin synthesis and conversion of ferritin into haemosiderin. This study confirms the limitations for the use of estimations of the serum ferritin to evaluate the iron status in patients with expected high overload as would be seen in patients on many years of maintenance red cell transfusions in the absence of iron chelation therapy. Poor compliance, inadequate dosage of Desferal (deferoxamine), and the late initiation of iron chelation therapy were factors that were considered in the patients with failure of response to iron chelation.
接受适度红细胞输血方案的患者会出现铁过载，由于脱铁铁蛋白合成受限以及铁蛋白向含铁血黄素的转化，血清铁蛋白浓度与输血负荷的增加不相适应。本研究证实了在未进行铁螯合治疗的情况下，对于多年维持性红细胞输血患者中预期会出现的高铁过载患者，使用血清铁蛋白估计值来评估铁状态存在局限性。依从性差、去铁胺（Desferal）剂量不足以及铁螯合治疗开始较晚是导致铁螯合治疗反应失败的患者中所考虑的因素。
