流动注射分析法测定红桃K生血剂中铁的含量

目的：建立红桃Ｋ生血剂中铁的含量测定方法。方法：采用流动注射法测定红桃Ｋ生血剂中铁的含量。以水为流动相,流速为４．５ｍｌ／ｍｉｎ,０．１％硫氰酸铵溶液为显色剂,流速为３．６ｍｌ／ｍｉｎ,采样体积为５０μｌ,频率为１２０次／ｈ,反应通道为８０ｃｍ,测定波长为４７５ｎｍ（每样进３次）,记录峰高。结果：铁浓度的检测线性范围为１３．４～４０．２μｇ／ｍｌ,相关系数０．９９９９。样品的平均加样回收率为９９．     

竹笋提取液复合制剂在失血性贫血中的疗效观察

目的观察竹笋提取液复合制剂治疗失血性贫血的疗效。方法分别采用医用生化分析仪、HP1100色谱仪以及ICTMS检测竹笋提取液中葡萄糖、总蛋白、宏量元素,氨基酸和微量元素的含量。以小鼠内眦静脉丛取血法,建立失血性贫血小鼠动物模型;采用灌胃给药的方式,2个实验组(药物组)分别给予竹笋提取液复合铁制剂1(0.15%铁卟啉、10%蜂蜜)、制剂2(70%竹笋提取液、0.15%铁卟啉、10%蜂蜜),1个对照组给予同等剂量去离子水,于给药的不同时间点0、18、42、67和90 h从小鼠尾静脉取血,测定血红蛋白(Hb)、红细胞(RBC)、红细胞压积(Hct)。急性毒性试验采用小鼠最大灌胃量给药,观察有无毒性反应。结果制剂2中的竹笋提取液中含有葡萄糖,蛋白质,Na、Cl、Mg、K、Ca、P等多种宏量元素,刺激或参与造血功能的Mn、Fe、Zn、Cu等微量元素,以及促进非血红素铁吸收的多种氨基酸成分;小鼠失血后立刻给药,制剂1与制剂2对失血性贫血的疗效均好于对照组,且制剂2优于制剂1(P<0.05);急性经口毒性动物实验未见异常。结论竹笋提取液含有丰富的葡萄糖、蛋白质以及多种元素,能够刺激造血,扩充血容量,其复合铁制剂对失血性贫血的恢复有促进作用。     

新型网织红细胞参数在缺铁性贫血疗效观察中的应用

目的　观察网织红细胞绝对数 (RET #)、网织红细胞内血红蛋白量 (CHr)、平均网织红细胞体积 (MCVr)及网织红细胞内血红蛋白浓度 (CHCMr)等网红参数在缺铁性贫血 (IDA)患者铁剂治疗中的动态变化 ,确定骨髓对铁剂治疗反应的早期指标。方法　用Advia 12 0血细胞分析仪对 13例缺铁性贫血患者在治疗过程中网红参数的变化进行了动态观察。结果　缺铁性贫血患者在铁剂治疗后 ,网红参数RET #、CHr、MCVr于第 4天明显升高 (P <0 0 1) ,第七天恢复正常 ;血红蛋白于第 14天明显升高 (P <0 0 1) ,第 2 8天恢复正常 ;CH、MCV、CHCM于第 2 8天明显升高 (P <0 0 1) ,第 4 9天后恢复正常 ;RDW于第 7天明显升高 (P <0 0 1) ,14天后又逐渐降低 ,第 12 0天恢复正常。结论　网红参数RET #、CHr、MCVr可作为评价缺铁性贫血患者铁剂治疗后骨髓对治疗反应最敏感的指标     

Iron Deficiency without Anemia: A Common Yet Under-Recognized Diagnosis in Young Women with Heavy Menstrual Bleeding

Study ObjectiveTo assess the proportion of iron deficiency that is not detected with a screening hemoglobin or complete blood count (CBC) alone in young women with heavy menstrual bleeding.DesignRetrospective review of electronic medical records.SettingNationwide Children's Hospital in Columbus, Ohio.Participants, Interventions, and Main Outcome MeasuresOne hundred fourteen young women aged 9-19 years consecutively referred to a young women's hematology clinic with a complaint of heavy menstrual bleeding.ResultsFifty-eight (50.9%) of all patients had ferritin <20 ng/mL indicating iron deficiency. Of the 58 patients with iron deficiency, only 24 (41.4%) were anemic and 25 (46.3%) were microcytic. The sensitivity of hemoglobin alone and CBC alone for identifying women with ferritin <20 ng/mL was 41.4% (95% confidence interval [CI], 28.7-54.1) and 46.3% (95% CI, 33.0-59.6), respectively. Both tests had reasonable specificity at 91.1% (95% CI, 83.6-98.5) for hemoglobin and 83.9% for CBC (95% CI, 74.3-93.6). Patients had significantly higher odds of having iron deficiency if they were overweight or obese (odds ratio, 2.81; 95% CI, 1.25-6.29) compared with patients with normal body mass index. Age at presentation for heavy menstrual bleeding, presence of an underlying bleeding disorder, and median household income were not significantly associated with iron deficiency.ConclusionIn adolescents with heavy menstrual bleeding, fewer than half of iron deficiency cases are detected when screening is performed with hemoglobin or blood count alone. Measuring ferritin levels in at-risk patients might allow for earlier implementation of iron therapy and improvement in symptoms.     

地拉罗司治疗重型β-地中海贫血铁过载患儿临床疗效及安全性研究

目的：探讨铁螯合剂地拉罗司（deferasirox,DFX）治疗重型β-地中海贫血（β-thalassemia major,β-TM）铁过载患儿的疗效及安全性。方法随机选择24例规律输血的β-TM铁过载患儿,参加DFX不同服药剂量的临床研究,调查血清铁蛋白（SF）的变化及不良反应。并将持续服用DFX 5年患儿与同期使用去铁胺联合去铁酮治疗患儿（对照组）的心脏MRI T2*、肝脏MRI T2*值进行比较。结果DFX每日20～30 mg/kg的起始剂量对于铁过载患儿无明显效果,加量至每日30～40 mg/kg 后SF水平下降显著(U=58,P＜0.01);不良反应以血清肝脏转氨酶升高最为常见,其次为血清肌酐非进行性升高。持续DFX 治疗5年组SF水平明显低于对照组（1748±481 ng/mL vs 3462±1744 ng/mL,P<0.05）;肝脏MRI T2* 值明显高于对照组（8.5±2.9 ms vs 2.7±1.9 ms,P<0.01）。两组心脏MRI T2*均值比较差异无统计学意义。结论DFX能显著降低β-TM 患儿SF水平,并显示出剂量依赖性变化;其对心脏铁负荷的减少未显示出明显优势,而对肝脏铁负荷的减低疗效显著。DFX治疗的不良反应以肝酶升高、血清肌酐非进行性升高为主。     

Placental IGF-I, IGFBP-1, zinc, and iron, and maternal and infant anthropometry at birth

Aim: To correlate placental protein levels of insulin‐like growth factor (IGF)‐I and insulin‐like growth factor binding protein (IGFBP)‐1, with previously determined levels of IGF‐I and IGF‐II mRNA expression, and the micronutrients zinc and iron, and maternal and newborn anthropometry. Methods: Placental samples were collected from rural field sites in Pakistan. Samples were divided into small and large for gestational age groups (SGA and LGA, respectively). IGFBP‐1 levels were assessed using Western immunoblotting. IGF‐I protein levels were assessed using ELISA techniques. IGF mRNA expression, zinc, and iron, were quantified as previously described and were used for comparative purposes only. Results: Thirty‐three subjects were included (SGA, n = 12; LGA n = 21). Higher levels of IGFBP‐1 were seen in the SGA group (p < 0.01). IGFBP‐1 correlated positively with maternal and infant triceps skin‐fold thickness in the LGA and SGA groups, respectively (p < 0.05). Significantly lower IGF‐I protein levels were seen in the SGA group. IGF‐I levels correlated significantly with maternal and newborn anthropometry. IGFBP‐1 correlated significantly with IGF‐II mRNA expression (p < 0.05). Conclusion: Placental protein levels of IGF‐I and IGFBP‐1 appear to be associated with maternal anthropometry. Maternal anthropometry may thus influence IGFBP‐1 and IGF‐I levels and may possibly be used for screening of pregnancies, with the potential for timely identification of these high‐risk pregnancies.     

Infant anaemia is associated with infection,low birthweight and iron deficiency in rural Bangladesh

Aim: To estimate the prevalence of infant anaemia and its association with iron deficiency, growth, infection and other micronutrient deficiencies. Methods: Using data from MINIMat, a randomized maternal food and micronutrient supplementation trial, we assessed the associations between anaemia (haemoglobin < 105 g/L) in 580 infants at 6 months and deficiencies of iron, vitamin A, vitamin B12, zinc and folate, infection and anthropometric indices. Variables associated with anaemia in bivariate analyses were evaluated in logistic regression models, adjusting for potential confounders. Results: Anaemia was found in 46% of the infants, and among these, 28% had iron deficiency (plasma ferritin <9 μg/L). Elevated C‐reactive protein (>10mg/L) (OR = 2.7, 95% CI: 1.6, 4.7), low birthweight (OR = 2.3, 95% CI: 1.5, 3.5) and iron deficiency (OR = 2.2, 95% CI: 1.4, 3.6) were independently associated with increased risk for anaemia. We also observed a seasonal variation in anaemia not mediated through the other factors studied. Conclusion: In a cohort in rural Bangladesh, anaemia at age 6 months was common and associated with infection, low birthweight and iron deficiency.     

Assessment of Thyroid Function in Children Aged 1-13 Years with Beta-Thalassemia Major

Objective

Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major and to see if they appear in the earlier period of life.

Methods

Thyroid function and iron load status were evaluated in 90 children with a mean age of 7.17±3.78 years with beta-thalassemia major by measuring serum free thyroxin (FT4), serum free triiodothyronine (FT3), total thyroxin (T3), serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from serum of patients admitted to the Pediatric Department, Faculty of Medicine University of Dicle between March 2005 and July 2009. A control group formed from an age-sex matched healthy children with a mean age of 6.98±3.66 years was also included. A standard thyrotropin releasing hormone test was applied to 3 patients who had high TSH levels and were classified as subclinical primer hypothyroidism. The study was designed according to the Declaration of Helsinki and informed consent was obtained from the parents of all participants.

Findings

All thyroid parameters in patients were in the normal ranges compared with the controls except three of them which had high TSH levels. Serum ferritin level (2703±1649 ng/mL) in patients was significantly higher than in controls (81.5±15.5 ng/mL).

Conclusion

The work implies that hypothyroidism could be even seen in the first decade of life in patients with beta-thalassemia major in spite of improved hematological cares.