对不同基因型地中海贫血儿童全血中9种金属元素的研究

目的：了解不同基因型地中海贫血儿童全血铜、锌、钙、镁、铁、钾、钠、铅、铬9种金属元素含量,为临床对不同类型地贫患儿营养状况的评价并进行针对性地监测、干预治疗提供依据。方法：对选取的240例地贫患儿21例静止型,108例标准型α地贫,18例H病,81例β地贫杂合子（β＋）,12例β地贫双重杂合子（或纯合子）（β0）]以及70例健康儿童全血的9种元素进行检测和统计学分析。结果：①β0地贫全血铜、钙、钠水平明显高于其他组（P〈0.05）,镁、锌、钾水平明显低于其他组（P〈0.05）。H病全血铜水平与β0地贫相近（P〉0.05）,且明显高于其他组（P〈0.05）;②各地贫组全血铁、镁水平均低于健康对照组（P〈0.05）（血镁静止型α地贫与健康对照组差异无统计学意义）;③铅与铬水平：各组间均差异无统计学意义（P〉0.05）。结论：①地贫患儿体内金属元素的失衡（全血铁除外）主要集中在β地贫纯合子（或双重杂合子）和H病,前者要加强全血镁、钾、锌、钙、铜、钠的监测,后者则着重监测全血铜;②全血铁元素不宜用于评价地贫患儿的铁代谢状况。

Study on nine blood metal elements of children with thalassemia of different genotypes

Objective：To observe the levels of nine blood elements including cuprum（Cu）,zincum（Zn）,calcium（Ca）,magnesium（Mg）,ferrum（Fe）,kalium（K）,natrium（Na）,plumb（Pb） and chromium（Cr）of the children with thalassemia（thal） of different genotypes and to provide evidence for the evaluation,monitoring and intervention of nutritional status of children with thalassemia.Method：310 samples,which were divided into 7 groups including 21 silent α thal,108 standard α thal,18 HbH disease,81 βthal heterozygote（β＋thal）,12βthal homozygote or double heterozygotes（β0 thal） and 70 healthy children as control,were detected for blood Cu,Zn,Ca,Mg,Fe,K,Na,Pb and Cr,and the results were statistic analyzed.Result：①（1） In β0 thal group,levels of blood Cu,Ca,Na were higher while blood Mg,Zn,K were lower than those of other groups（P 0.05）.Level of blood Cu in HbH disease group had no statistical difference with that of β0 thal group（P 0.05） but higher than that of other groups（P 0.05）.② Levels of blood Fe and Mg in all kinds of thal groups were lower than those of the control group except that level of blood Mg in silent α thal had no statistical difference with the control group（P 0.05）.③ No statistical difference was found among all the groups for levels of blood Pb and Cr.Conclusion：①Disequilibrium of Blood metal elements in children with thal is mainly found inβ0 thal and HbH disease,which means that more attention should be paid to monitor blood Mg,Zn,K,Cu,Ca and Na for the former while blood Cu for the latter.②Blood Fe would be not suitable for the evaluation of iron metabolism conditions in children with thal.