Olivares M, Walter T, Llaguno S, Osorio M, Chadud P, Velozo L
Unidad de Hematología, Universidad de Chile, Santiago.
Sangre (Barc). 1993 Jun;38(3):211-6.
To assess the duration and intensity of the changes appearing in laboratory values related to iron utilisation during viral infection.
With previous parental consent, 120 eutrophic infants received vaccination with attenuated measles virus or a combination of measles, mumps and rubella viruses as a model of mild viral infection. A number of laboratory tests were performed on day 0 and in two later occasions (4-21, 9-14 or 9-30); these included blood cell counts, ESR, serum iron, total iron binding capacity, transferrin saturation index, free erythrocytic protoporphyrin, serum ferritin, intra-erythrocytic ferritin, direct anti-human globulin test and C-reactive protein. The statistical analyses were done in accordance with ANOVA, Student's t test, Wilcoxon, Kruskall - Wallis, Mann-Whitney and Fisher methods.
A significant haemoglobin drop was seen on days 9 and 14 post-vaccination. This descent was > 10 g/L in 8.2% of the cases, and > or = 6 g/L in 19.6%. Serum iron and transferrin saturation decreased significantly, whereas mean corpuscular volume, free erythrocyte protoporphyrin and serum ferritin were significantly increased. All these but protoporphyrin recovered by day 30. Subjects with normal iron metabolism figures on day 0 and those whose thermal variations were above 38 degrees C had greater changes in the figures related to iron metabolism.
The evaluation of iron metabolism is not reliable if the patient has suffered from infection, although a mild viral one, in the three weeks prior to the study.
评估病毒感染期间与铁利用相关的实验室检查值变化的持续时间和强度。
经家长事先同意,120名营养良好的婴儿接种了减毒麻疹病毒疫苗或麻疹、腮腺炎和风疹病毒联合疫苗,作为轻度病毒感染的模型。在第0天以及随后的两个时间点(4 - 21天、9 - 14天或9 - 30天)进行了多项实验室检查;这些检查包括血细胞计数、红细胞沉降率、血清铁、总铁结合力、转铁蛋白饱和度指数、游离红细胞原卟啉、血清铁蛋白、红细胞内铁蛋白、直接抗人球蛋白试验和C反应蛋白。统计分析采用方差分析、学生t检验、威尔科克森检验、克鲁斯卡尔 - 沃利斯检验、曼 - 惠特尼检验和费舍尔检验方法。
接种疫苗后第9天和第14天出现了显著的血红蛋白下降。在8.2%的病例中,这种下降幅度>10 g/L,在19.6%的病例中>或 = 6 g/L。血清铁和转铁蛋白饱和度显著降低,而平均红细胞体积、游离红细胞原卟啉和血清铁蛋白显著升高。除原卟啉外,所有这些指标在第30天恢复。第0天铁代谢指标正常的受试者以及体温变化高于38摄氏度的受试者,其铁代谢相关指标的变化更大。
如果患者在研究前三周内曾感染过病毒,即使是轻度病毒感染,铁代谢的评估也不可靠。