可溶性铁蛋白受体的检测在儿童铁缺乏诊断中的应用

目的探讨血清可溶性铁蛋白受体的检测对儿童贫血的早期诊断和营养保健的临床应用价值。方法随机采样用日本Hitachi7060全自动生化分析仪检测血清可溶性铁蛋白受体,同时测定其他血清铁代谢指标,包括血清铁(FE)、血清铁蛋白(SF)、血清转铁蛋白(TFR),同时检测RBC、Hb、MCV、MCH、MCHC、RDW。结果 RDW健康组与轻度贫血组比较,无统计学差异(P>0.05);健康组与中度贫血组比较,差异有显著性意义(P<0.05)。健康组与两贫血组儿童STfR、SF的结果比较,有显著性差异(P<0.05);STfR测定缺铁性贫血的灵敏度为71.2%,特异性87.5%。结论血清转铁蛋白受体指标的检测,可准确地反映早期铁缺乏和缺铁性贫血,有利于儿童贫血的早期诊断和营养保健,对儿童的健康大有益处,方法简便、快速可广泛用于儿童铁缺乏的筛查。     

血清铁、铁蛋白和铁染色对缺铁性贫血诊断价值的研究

目的探究血清铁、铁蛋白和铁染色对缺铁性贫血的诊断价值。方法选取笔者所在医院2010年12月～2011年10月确诊为缺铁性贫血患者60例为缺铁性贫血组、非缺铁性贫血患者150例为非缺铁性贫血组,健康患者40例为对照组进行研究。对所选标本采用全自动生化分析法、电化学发光法和普鲁士蓝反应法进行血清铁、铁蛋白和细胞内外铁检测。结果与非缺铁性贫血组以及健康对照组比较,缺铁性贫血组的血清铁、铁蛋白和骨髓细胞内、外铁含量均减少,差异有统计学意义(P<0.01);与缺铁性贫血组以及健康对照组比较,非缺铁性贫血组的血清铁、铁蛋白和骨髓细胞内、外铁含量均增高,差异有统计学意义(P<0.01)。结论血清铁、铁蛋白和骨髓细胞内、外铁对于缺铁性贫血的诊断灵敏性高,可以有效反映体内铁贮存和利用情况,对缺铁性贫血的诊断和鉴别诊断具有重要意义。     

血清铁蛋白测定对缺铁性贫血的诊断价值

目的探讨血清铁蛋白测定在缺铁性贫血中的诊断价值。方法选择2010年12月至2012年10月我院收治的缺铁性贫血患者69例,另外选择我院体检的健康者69例为健康对照组,分别采用放射免疫法对两组进行血清铁蛋白的测定,比较两组浓度差异。结果缺铁性贫血组患者的血清铁蛋白水平明显低于健康对照组,且经统计学处理差异具有显著性(P<0.05)。结论血清铁蛋白测定在缺铁性贫血的诊断中具有重要作用,其特异性也比较强,因此值得在临床上继续推广和应用。     

缺铁性贫血合并幽门螺杆菌感染治疗的临床观察

目的:探讨抗幽门螺杆菌(Hp)感染在治疗缺铁性贫血(IDA)中的作用。方法:2000年1月～2004年12月在我院确诊IDA患者,均行胃镜检查检测Hp为阳性60例。分为A、B两组,A组40例补铁加抗Hp治疗,B组20例单用补铁治疗。观察4周、12周后血红蛋白(Hb)、血清铁(SI)、铁蛋白(SF)变化。结果:A组Hb、SI、SF4周、12周后明显升高,治疗前后比较差异有显著性(P<0.01);B组三项指标升高不明显,治疗前后比较差异无显著性(P>0.05)。结论:Hp感染与IDA有密切关系,抗Hp治疗可加快Hb上升,增加铁贮存量。     

骨髓细胞内外铁及血清铁蛋白在缺铁性贫血中的对比分析

缺铁性贫血(ＩＤＡ)是由于体内贮存铁缺乏而影响血红蛋白合成所致的一种小细胞低色素性贫血,是贫血中最常见的类型,可发生于各年龄组,尤以青壮年女性多见。在缺铁性贫血的诊断中除了临床表现外,综合性铁指标的应用特别是血清铁蛋白及骨髓细胞内外铁的检测尤为重要,本文就我院50例缺铁性贫血患者的血清铁蛋白及骨髓细胞内外铁检测结果进行分析。资料与方法　来我院就诊的门诊及住院患者,均除外继发性贫血及其它类型的贫血,根据临床及实验室检查诊断为缺铁性贫血(ＩＤＡ)共50例,其中男性19例,女性31例。诊断标准:1小细胞低色素贫血:男性Ｈｂ<1…     

小剂量递增补铁法治疗小儿中度缺铁性贫血的临床效果

目的探讨小剂量递增补铁法治疗小儿中度缺铁性贫血的临床效果。方法选取我院收治的小儿中度缺铁性贫血患儿89例进行研究,按照患儿入院时间单双数进行分组,44例为对照组,采用常规治疗,另45例为观察组,采用小剂量递增补铁方式治疗,比较两组患者的临床疗效。结果观察组患儿经递增补铁方式治疗后其总有效率略高于对照组,但差异无统计学意义(P 0.05);治疗前,组间在血红蛋白、血清铁蛋白、血清运铁蛋白饱和度、平均红细胞体积及平均红细胞血红蛋白含量等指标比较差异无统计学意义(P 0.05),治疗后两组患儿各指标均明显优于治疗前,治疗后组间比较各指标比较,差异无统计学意义(P0.05);治疗期间,观察组患者不良反应发生率明显低于对照组,差异有统计学意义(P 0.05)。结论采用小剂量递增补铁方法对小儿中度缺血性贫血患儿实施治疗可取得与常规剂量较为相似的效果,但其安全性较高,副作用,更易于被患儿家属接受,可推广应用。     

间隔补铁治疗农村小儿缺铁性贫血临床分析

目的探讨间隔补铁治疗小儿缺铁性贫血的临床意义。方法将98例缺铁性贫血的小儿随机分为观察组和对照相。经12周补铁治疗,以血红蛋白(Hb)、血清铁蛋白(SF)作为评价治疗效果的血液学指标,并观察不同补铁方式的不良反应发生情况。结果两组病例在治疗后Hb、SF值交有不同程度的上升,与治疗前相比,有显著性差异(P<0.01)。治疗后Hb值无差异(P>0.05);SF值明显低于对照组(P<0.01)。副作用明显减少。结论间隔补铁在纠正贫血上与每日补铁同样有效且副作用少,在增加铁贮备上不如每日补铁明显。     

右旋糖酐铁与蔗糖铁治疗胃大部切除术后缺铁性贫血的疗效及安全性比较

目的:比较右旋糖酐铁与蔗糖铁治疗胃大部切除术后缺铁性贫血的临床疗效及安全性。方法:将90例胃大部切除术后缺铁性贫血患者随机均分为右旋糖酐铁组和蔗糖铁组。所有患者均于胃大部切除术后给予抗溃疡、胃肠减压、抗感染等常规治疗。在此基础上,右旋糖酐铁组患者给予右旋糖酐铁注射液100 mg,深部肌肉注射,每周3次;蔗糖铁注射液组患者给予蔗糖铁注射液100 mg加入0.9%氯化钠注射液10 ml中,静脉滴注,每周3次。两组患者疗程均为2周。观察两组患者的临床疗效,治疗前后血常规指标[血红蛋白(HGB)、血细胞比容(HCT)、平均红细胞血红蛋白浓度(MCH)、血清铁蛋白(SF)、转铁蛋白饱和度(TS)]、术后恢复情况(感染例数、平均住院天数)及不良反应发生情况。结果:两组患者的总有效率、术后恢复情况比较,差异均无统计学意义(P>0.05)。治疗前两组血常规指标比较,差异均无统计学意义(P>0.05);治疗后两组患者血常规指标均显著高于同组治疗前,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。蔗糖铁组患者不良反应发生率显著低于右旋糖酐铁组,两组比较差异有统计学意义(P<0.05)。结论:右旋糖酐铁、蔗糖铁治疗胃大部切除术后缺铁性贫血的疗效相当,但蔗糖铁的安全性优于右旋糖酐铁。     

缺铁性贫血患者血清红细胞生成素 铁蛋白等相关指标及T淋巴细胞水平的检测及分析

目的分析缺铁性贫血(IDA)患者血清红细胞生成素、铁蛋白、叶酸、维生素B12及T淋巴细胞水平的变化,为该病的诊断、治疗提供临床依据。方法收集2015年7月至2017年7月我院收治的缺铁性贫血患者80例为IDA组;同期慢性疾病性贫血患者80例为ACD组;同期于我院体检的健康志愿者80名为健康对照组。检测各组患者血清中红细胞生成素、铁蛋白、叶酸、维生素B12及T淋巴细胞水平。结果 IDA组及慢性疾病性贫血(ACD)组患者血清中红细胞生成素水平显著高于健康对照组,且IDA组患者血清中红细胞生成素水平显著高于ACD组,差异均有统计学意义(P<0.05)。IDA组患者血清铁蛋白水平明显低于健康对照组,ACD组患者血清铁蛋白水平明显高于健康对照组,差异有统计学意义(P<0.05)。IDA组及ACD组患者血清叶酸、维生素B12、CD3+、CD4+、CD4+/CD8+水平显著低于对照组,CD8+水平明显高于健康对照组,差异均有统计学意义(P<0.05)。IDA组患者血清叶酸、维生素B12水平显著低于ACD组,差异有统计学意义(P<0.05)。结论缺铁性贫血会导致患者红细胞生成及铁代谢障碍,维生素水平显著降低、细胞免疫紊乱。血清铁蛋白含量可作为区分缺铁性贫血及慢性疾病性贫血的指标。     

多糖铁复合物胶囊和硫酸亚铁片治疗缺铁性贫血的疗效比较

目的:观察多糖铁复合物胶囊和硫酸亚铁片治疗缺铁性贫血的临床疗效。方法:选择2012年10月—2013年10月确诊的缺铁性贫血患者190例,随机分为两组,各95例。对照组口服硫酸亚铁片,每次2片,每日3次,治疗组口服多糖铁复合物胶囊,每次2粒,每日1次。治疗16周,观察两组患者治疗前后血常规各项指标变化情况以及临床疗效。结果:两组患者治疗后血常规红细胞指标均有所改善,治疗组与对照组比较差异有统计学意义(P<0.05),白细胞和血小板指标变化比较差异无统计学意义(P>0.05)。治疗组治疗后和对照组治疗后总有效率比较,差异有统计学意义(P<0.05)。结论:口服多糖铁复合物胶囊改善缺铁性贫血的效果优于硫酸亚铁片,是一种安全有效的补铁制剂。     

Anthracyclines induce accumulation of iron in ferritin in myocardial and neoplastic cells: inhibition of the ferritin iron mobilization pathway

Anthracyclines are potent antitumor agents that cause cardiotoxicity at high cumulative doses. Because anthracycline cardiotoxicity is attributed to their ability to avidly bind iron (Fe), we examined the effect of anthracyclines on intracellular Fe trafficking in neoplastic cells and differentiated cardiomyocytes. In both cell types, incubation with doxorubicin (DOX) resulted in a significant (p < 0.004) accumulation of Fe in the storage protein, ferritin. Pulse-chase experiments using control cells demonstrated that within 6 h, the majority of (59)Fe donated from transferrin was incorporated into ferritin. Over longer incubation periods up to 18 to 24 h, (59)Fe was subsequently mobilized from ferritin into other compartments in control cells. However, anthracyclines inhibited ferritin-(59)Fe redistribution during the 18- to 24-h period, resulting in a significant (p < 0.0003) 3- to 5-fold accumulation of ferritin-(59)Fe compared with control cells. The increase in ferritin-(59)Fe after a 24-h incubation with DOX could not be correlated with increased ferritin expression, suggesting that (59)Fe accumulation occurred in pre-existing ferritin. In addition to DOX, other redox-cycling agents (i.e., menadione and paraquat) also increased ferritin-(59)Fe levels. Moreover, the intracellular superoxide scavenger, Mn(III) tetrakis(4-benzoic acid)-porphyrin complex, partially prevented the ability of DOX and menadione at inducing this effect. Hence, superoxide generation by these compounds could play a role in causing ferritin-(59)Fe accumulation. This study is the first to demonstrate the effect of anthracyclines at inhibiting Fe mobilization from ferritin, resulting in marked Fe accumulation within the molecule. This response may have consequences in terms of the cytotoxic effects of anthracyclines.     

Serum ferritin levels in iron deficient children

A group of 42 iron deficient children had serum ferritin levels in the range of 0-19 micrograms/l, with a mean figure of 7.2 micrograms/l. A control group had levels of 11 micrograms/l to 130 micrograms/l with a mean of 39.8 micrograms/l. The use of this assay has particular relevance whilst iron deficiency anaemia continues to be a common disorder in New Zealand children.     

Significance of extremely elevated ferritin level in medical inpatients

The diagnostic and prognostic utility of extremely elevated ferritin values in hospitalized medical patients is lacking. We aimed to determine the clinical significance of ferritin levels ≥ 1000 ng/mL in adults hospitalized in the general medical service. We scanned the hospital laboratory database for ferritin values ≥ 1000 ng/mL, and evaluated the medical history, diagnoses, and survival of patients hospitalized in the general medical service. We compared the characteristics and outcomes of patients with values up-to versus above 2,999 ng/mL. Ferritin samples ranging from 1,003 to 12,170 ng/mL from 422 patients in the lower and 94 in the higher ferritin groups were included. Malignancy, repeat blood transfusions and recent chemotherapy were more prevalent in the higher ferritin group (p=0.003, p=0.002, and p<0.001, respectively). Infection (58.7%), chronic kidney disease (22.0%), and solid or hematological malignancies (21.6% and 17.1%, respectively) were the leading conditions associated with elevated ferritin. One-year survival was low, and significantly lower in patients in the higher ferritin group (10.8% vs. 16.9%, p=0.004). In conclusion, extremely elevated ferritin values in patients admitted to the general medical service are associated with multiplicity of clinical conditions and poor outcome.     

急性肺损伤患者血清铁蛋白测定的临床价值

目的探讨血清铁蛋白变化与急性肺损伤的关系。方法收集2004年至2006年住院患者中具有急性肺损伤危险因素者192例，按以后是否发展为急性肺损伤分为急性肺损伤组（52例）和非急性肺损伤组（140例），另设同期50例正常人为正常组，分别测定血清铁蛋白，各组之间进行比较分析、统计学处理。结果急性肺损伤组，其血清铁蛋白水平[女性（354．7±19．8）μg／L、男性（789．7±30．8）μg／L]较非急性肺损伤组明显增高（P〈0．01）。非急性肺损伤组血清铁蛋白水平[女性（182．7±27．8）μg／L，男性（312．5±21．9）μg／L]较正常人[女性（67．5±14．5）μg／L，男性（147．8±23．6）μg／L]增高（P〈0．01）。结论血清铁蛋白水平对预测急性肺损伤有一定价值。     

淋巴瘤患者铁蛋白检测及临床意义

目的探讨血清铁蛋白（serum ferritin,SF）在淋巴瘤患者中的表达及临床意义。方法应用电化学发光免疫法检测54例初治淋巴瘤患者（治疗组）和30例非血液系统恶性疾病患者（对照组）的SF水平。结果54例淋巴瘤患者铁蛋白检测水平（888．84±88．27）ng／ml显著高于对照组的（111．35±34．94）ng／ml,差异有统计学意义（P〈0．01）;淋巴瘤晚期（Ⅲ-Ⅳ期）患者铁蛋白检测水平（1293．31±647．47）ng／ml高于淋巴瘤早期（Ⅰ～Ⅱ期）患者（343．68±168．32）ng／ml,差异有统计学意义（P〈0．01）;淋巴瘤患者常规2个疗程化疗结束后观察疗效,完全缓解（CR）组化疗前SF水平（691．18±646．79）ng/ml明显低于非完全缓解（NR）组化疗前水平（1199．44±648．26）ng／ml,差异有统计学意义（P〈0．05）。结论淋巴瘤患者SF检测水平明显升高,且淋巴瘤越晚期及治疗效果越差者SF检测水平披高．提示监测观察淋巴瘤患者SF的变化有助于对病情及预后的判断。     

Inhibition of spontaneous transmitter release by the membrane ligand cationized ferritin

Summary Exposure of the frog neuromuscular junetion to cationized ferritin (200 g ml^–1) results in a reduction in MEPP frequency of approximately 25% within 10 min. This effect is not dependent on extracellular Ca²⁺, and identical results are obtained in salines buffered with EGTA. It is suggested that cationized ferritin does not inhibit transmitter release via a reduction in the intracellular Ca²⁺ concentration, but exerts its effect by a direct action on exocytosis. A mode of action is proposed.Unlike Con A, cationized ferritin is unable to suppress the stimulation of spontaneous release caused by high osmolarity.     

Brucellosis with very high ferritin levels: report of five cases

Brucellosis is a zoonotic disease caused by a kind of Brucella bacteria, which commonly appears in humans and rarely causes mortality. In our study, five cases, who were diagnosed by evaluation of clinical findings and serological tests, they also had very high ferritin levels, were reported. Ages of the patients were 16, 12, 10, 16 and 8 years, respectively. Serum ferritin levels were 1200, 985, 886, 748 and 435 ng/ml, respectively. We observed that complaints of the patients reduced after the treatment and ferritin levels returned to its normal range. In the situations of extremely evaluated serum ferritin which is an acute-phase reactant, its levels are able to raise in brucellosis, without existing hemochromatosis and Still's disease.