Hastka J, Lasserre J J, Schwarzbeck A, Strauch M, Hehlmann R
III. Med. Klinik, University of Heidelberg, Germany.
Blood. 1993 Mar 1;81(5):1200-4.
Hematofluorometric determination of zinc protoporphyrin (ZPP) is a screening method for the assessment of iron deficiency (ID). Chronic disorders are frequently accompanied by anemias of unclear origin, most probably caused by an impairment of iron metabolism. We investigated the relevance of ZPP for the detection of derangements of iron metabolism in anemias of chronic disorders (ACD). In 19 patients with ACD caused by chronic inflammatory non-neoplastic diseases, ZPP was determined and correlated with ferritin, transferrin saturation, and hemoglobin (Hb). Marrow sideroblast counts and semiquantitative grading of the marrow hemosiderin were performed in all patients to exclude ID and to show the decreased iron bioavailability. In all ACD patients who exhibited the typical laboratory findings of disturbed iron metabolism, such as hypoferremia, decreased transferrin saturation, decreased bone marrow sideroblasts, and increased marrow hemosiderin, strongly elevated ZPP levels were found (131 +/- 23 mumol/mol heme). ZPP returned to normal after successful treatment of the underlying disease. This is shown in three patients with polymyalgia rheumatica. We conclude that the fluorometric determination of ZPP allows detection and quantification of derangements of iron metabolism associated with chronic inflammatory disorders. By recording the derangements quantitatively, ZPP allows monitoring of therapy of chronic inflammatory diseases.
锌原卟啉（ZPP）的血液荧光测定法是一种用于评估缺铁（ID）的筛查方法。慢性疾病常伴有病因不明的贫血，很可能是由铁代谢受损所致。我们研究了ZPP在检测慢性疾病性贫血（ACD）中铁代谢紊乱方面的相关性。对19例由慢性炎症性非肿瘤性疾病引起的ACD患者测定了ZPP，并将其与铁蛋白、转铁蛋白饱和度和血红蛋白（Hb）进行关联分析。对所有患者进行骨髓铁粒幼细胞计数和骨髓含铁血黄素的半定量分级，以排除ID并显示铁生物利用度降低。在所有表现出铁代谢紊乱典型实验室检查结果（如低铁血症、转铁蛋白饱和度降低、骨髓铁粒幼细胞减少和骨髓含铁血黄素增加）的ACD患者中，均发现ZPP水平显著升高（131±23μmol/mol血红素）。在基础疾病成功治疗后，ZPP恢复正常。这在3例风湿性多肌痛患者中得到了体现。我们得出结论，ZPP的荧光测定法能够检测和量化与慢性炎症性疾病相关的铁代谢紊乱。通过定量记录这些紊乱情况，ZPP可用于监测慢性炎症性疾病的治疗。
