贫血患者血清和红细胞铁蛋白测定意义的初步探讨

本文应用放免测定法,观察了再障、骨髓增生异常综合征(MDS)和消化道肿瘤合并贫血患者血清和红细胞铁蛋白含量变化。结果表明:血清铁蛋白(SF)和红细胞铁蛋白(RBC·F)虽然均为铁贮指标,但在不同类型贫血中显示出不同的变化规律。早期、轻型再障病人铁代谢异常首先反映出RBC·F改变,晚期、重症病人则可伴有SF升高。MDS患者,除铁代谢异常波及SF和RBC·F改变外,体内的恶性克隆细胞合成铁蛋白增加也可导致SF、RBC·F升高。消化系统肿瘤并贫血患者存在多种可使SF升高的因素,但RBC·F改变仅只受铁代谢影响,可以较可靠地提供体内贮铁情况。

PRELIMINARY STUDY OF SERUM FERRITIN AND ERYTHROCYTES FERRITIN DETERMINATIONS IN ANEMIA PATIENTS

By means of radioimmunoassay serum ferritin (SF) and erythrocyte ferritin (RBC-F) of 49 anemia patients were estimated, including aplastic anemia 9, MDS 25, and secondary anemia 15; 22 males and 23 females, aged from 23 to 54.Results showed elevation of SF and RBC- F in most cases of aplastic anemia. The data demonstrated elevation of RBC. F prior to SF elevation in early aplastic anemia. But SF and R3C. F usually increased simultaneously in severe cases or long lasting chronic cases of aplasttc anemia.SF and RBC.F determination increased in half of the cases of MDS. Especially, in RAEB and RAEB-T, since 4 patients with RAEB and RAEB-T who had high level SF and RBC.F developed acute leukemia within 6 months. So, SF and RBC.F determinations could not only reflect the iron status in the body, but probably also predict the prognosis of MDS.In secondary anemia, of patients with esophagus cancer. SF elevated in half of the patients. But RBC.F were normal in most cases. This discrepancy might help to explain that SF alone could not fully reflect the iron status in the body. Because more ferritin is synthesized in tumor as well as cancerous necrosis, and / or tissue damage could cause high SF level. Therefore, RBC. F level might be more reliable.