【摘要】 目的探讨重度β-地中海贫血患儿脾脏切除术前后铁负荷状况的变化。方法回顾性分析2003年1月至2012年12月18例重度β-地中海贫血患儿行脾切除术前、后的年输血量及血清铁蛋白水平。结果重度β-地中海贫血患儿脾切除术后第1年和第2年的平均年输血量为(101.94±30.73)ml/kg和(96.50±34.00)ml/kg,均分别低于脾切除术前2年(241.89±73.66)ml/kg和前1年(289.22±102.30)ml/kg的年输血量,差异均有统计学意义(P<0.05)。脾切除术后6、12、18和24个月患儿的血清铁蛋白(SF)水平分别为(2 410.00±731.77)μg/L、(2 742.78±813.74)μg/L、(2 870.56±740.94)μg/L和(2 886.67±795.34)μg/L,均低于脾切除术前SF水平[(4 975.00±1 245.85)μg/L],差异均有统计学意义(P<0.05)。结论行脾切除术后β-地中海贫血患儿血清铁蛋白水平较前降低,但仍远高于正常值,需持续监测及去铁治疗。更多还原

【Abstract】 Objective To explore the changes of iron overload in children with severe β-thalassemia pre-and post-splenectomy.Method The annual amount of blood transfused and serum ferritin(SF) levels of 18 children with severe β-thalassemia before and after splenectomy from January 2003 to December 2012 were retrospectively analyzed.Result The annual amount of blood transfused in children with severe β-thalassemia at one year and two years after splenectomy were(101.94± 30.73) ml/kg and(96.50 ± 34.00) ml/kg respectively,significantly lower than the amount of two years before splenectomy(241.89 ± 73.66) ml/kg and one year before splenectomy(289.22 ± 102.30) ml/kg(P<0.05).The SF levels at 6,12,18 and 24 months after splenectomy were(2 410.00 ± 731.77) μg/L,(2 742.78 ± 813.74) μg/L,(2 870.56 ± 740.94) μg/L and(2 886.67 ± 795.34) μg/L,significantly lower than that(4 975.00±1 245.85) μg/L of before splenectomy(P<0.05).Conclusions The serum ferritin level after splenectomy significantly decreases compared with that of before splenectomy,but still remarkably higher than that of normal controls.Monitoring of serum ferritin level and iron-chelating therapy are needed.更多还原