去铁胺对输血相关性铁过载患者骨密度的影响

目的观察输血相关铁过载患者在使用去铁胺(DFO)降铁治疗后骨密度的变化,探讨去铁胺对铁过载骨质疏松患者辅助治疗的应用前景。方法回顾性研究22例输血相关铁过载患者临床资料,检测患者DFO降铁治疗前后的骨密度和血清生化指标。采用配对样本t检验、Wilcoxon非参数检验分析研究患者DFO降铁治疗前后骨密度以及血清生化指标的变化。结果进行DFO有效的铁螯合治疗后,患者血清铁蛋白(Fer)明显下降,由基线水平的2019.95±630.77 ng/m L降至843.61±91.01 ng/m L(P0.05);股骨颈和腰椎的骨密度明显增加,分别由基线水平的0.73±0.12 g/cm2、0.92±0.14 g/cm2增加至0.77±0.09 g/cm2、0.94±0.14 g/cm2(P0.05);骨量正常、骨量减少和骨质疏松患者分别由治疗前的4、12、6例变为治疗后的10、11、1例(P0.05)。结论 DFO降铁治疗可改善输血相关铁过载患者的低骨量状态。本研究为DFO可能用于伴有铁过载的骨质疏松症的辅助治疗提供了有意义的支撑。

The effect of deferoxamine on bone mineral density in patients with transfusion-associated iron overload

Objective To explore the curative effect of deferoxamine (DFO) on bone mineral density (BMD) in patients with osteoporosis induced by transfusion-associated iron overload. Methods BMD and serum biochemical indexes were measured at baseline and end of DFO treatment in all of 22 patients. The differences between baseline and end of the treatment were studied with paired t-test and Wilcoxon nonparametric test. Results A significant decrease in serum ferritin was observed (2019.95 ± 630.77 at baseline to 843.61 ± 91.01 ng/mL, P<0.05) and a significant increase in femoral and lumbar BMD was observed (0.73 ± 0.12, 0.92 ± 0.14 g/cm2 at baseline to 0.77 ± 0.09, 0.94 ± 0.14 g/cm2, respectively, P<0.05). The number of patients with normal bone mass, osteopenia, and osteoporosis was significant difference (4, 12, 6 patients at baseline to 10, 11, 1 patients, respectively, P<0.05). Conclusion Decreasing iron overload improves the low bone mass in patients with transfusion-associated iron overload. The results provide new clinical evidence for the use of DFO in the patients with osteoporosis induced by transfusion-associated iron overload.