去铁胺对重型β地中海贫血患儿心脏、肝脏铁沉积状态以及糖代谢的影响

摘要

Objective] To explore the effects of deferoxamine (DFO) on cardiohepatic iron deposition sta‐tus and glucose metabolism in children with severe β‐thalassemia .[Methods] From September 2012 to October 2013 at our hospital ,60 children of severe β‐thalassemia were recruited for evaluations of serum ferritin (SF) , sugar metabolism and cardiohepatic iron deposition (MRIT2 * value) .And re‐examinations were performed after a 12‐month treatment of DFO .[Results] Normal index rate of hepatic iron deposition increased to 10 .0%from 36 .7% and cardiac iron deposition rose to 20 .0% from 48 .3% .And the differences were statistically significant before and after treatment ( P < 0 .05) .And post‐treatment SF also significantly decreased com‐pared with pre‐treatment .And the difference was statistically significant ( P < 0 .05) .After DFO treatment , fasting plasma glucose (FPG) or fasting insulin (FINS) showed no obvious changes ( P > 0 .05) .However , blood glucose 2h after oral glucose (PG2h) and insulin (FINS2h) decreased markedly .And the differences were statistically significant ( P < 0 .05) .[Conclusion] Deferoxamine can effectively reduce cardiohepatic iron deposition and improve glucose metabolism in children with severe β‐thalassemia .%【目的】观察分析去铁胺（DFO）对重型β地中海贫血患儿心脏及肝脏铁沉积状态以及糖代谢的影响。【方法】选择2012年9月至2013年10月来本院治疗的60例β地中海贫血患儿，对患儿的血清铁蛋白（SF）、糖代谢水平、心脏及肝脏的铁沉积状况（MRI T2倡值）进行分析，评估 DFO 治疗12个月后患儿的健康情况。【结果】DFO 治疗12个月后β地中海贫血患儿的心脏、肝脏铁沉积状况均得到相应改善：肝铁沉积程度正常指标率从10．0％增加到了36．7％，心铁沉积程度正常指标率从20．0％增加到了48．3％，治疗前后差异具有明显统计学意义（ P ＜ 0．05）；治疗后 SF 也显著下降，与治疗前相比较，差异具有统计学意义（ P ＜0．05）；患儿治疗后空腹血糖（FPG）、空腹胰岛素（FINS）与治疗前比较，差异无显著性（ P ＞ 0．05）但餐后2 h血糖（2hPG）、胰岛素（2hFINS）明显降低，差异有统计学意义（ P ＜ 0．05）。【结论】DFO 可以有效降低重型β地中海贫血患儿心脏及肝脏铁沉积状态以及改善糖代谢，值得在临床上推广应用。