CAJ | 학술논문

目的：探讨血清铁蛋白（SF）在初诊未输血骨髓增生异常综合征（MDS）患者不同亚型中的水平及临床意义。方法对103例初诊MDS患者和100例健康对照组采用电化学发光免疫法测量SF，观察MDS患者SF的水平及与国际预后积分系统（IPSS）的关系。随访58例患者，根据SF水平将患者分为两组（SF＜500 ng/ml组与SF≥500 ng/ml组），比较两组向白血病转化和生存时间。结果 MDS患者SF水平明显高于健康对照组（P＜0.05），MDS各亚型间SF水平差异无统计学意义（P＞0.05），每例MDS患者SF与细胞外铁呈显著正相关（P＜0.05），按IPSS分组相对低危组与相对高危组间SF水平差异有统计学意义（P＜0.05），58例随访患者中14例转化为急性白血病，两组向白血病转化率分别为22.58%和25.93%，向白血病转化的中位时间分别为10（7，14）个月和5（2，7）个月，两组间向白血病转化时间的差异有统计学意义（P＜0.05），两组间生存时间差异无统计学意义（P＞0.05）。结论初诊未输血 MDS患者存在铁过载，SF可作为监测MDS患者铁负荷的指标之一，其对预后判断具有一定的意义。
목적：탐토혈청철단백（SF）재초진미수혈골수증생이상종합정（MDS）환자불동아형중적수평급림상의의。방법대103례초진MDS환자화100례건강대조조채용전화학발광면역법측량SF，관찰MDS환자SF적수평급여국제예후적분계통（IPSS）적관계。수방58례환자，근거SF수평장환자분위량조（SF＜500 ng/ml조여SF≥500 ng/ml조），비교량조향백혈병전화화생존시간。결과 MDS환자SF수평명현고우건강대조조（P＜0.05），MDS각아형간SF수평차이무통계학의의（P＞0.05），매례MDS환자SF여세포외철정현저정상관（P＜0.05），안IPSS분조상대저위조여상대고위조간SF수평차이유통계학의의（P＜0.05），58례수방환자중14례전화위급성백혈병，량조향백혈병전화솔분별위22.58%화25.93%，향백혈병전화적중위시간분별위10（7，14）개월화5（2，7）개월，량조간향백혈병전화시간적차이유통계학의의（P＜0.05），량조간생존시간차이무통계학의의（P＞0.05）。결론초진미수혈 MDS환자존재철과재，SF가작위감측MDS환자철부하적지표지일，기대예후판단구유일정적의의。
Objective To explore the level and clinical significance of serum ferritin(SF) in myelodysplastic syndromes(MDS) patients with different subtypes. Methods SF was measured by electrochemiluminescence immunoassay in 103 cases MDS patients and 100 cases healthy control groups, and the level of SF and the relationship with International Prognostic Scoring System (IPSS) was observed. 58 patients were followed up and divided into two groups(SF<500 ng/ml and SF≥500 ng/ml) according to the level of SF, and the time of transformed into leukemia and survival was compared. Results The SF level was significantly higher in MDS patients than in healthy control groups(P<0.05), but the SF level between each subtypes of MDS showed no statistical significance(P>0.05). SF and extracellular iron was significantly positively correlation in every MDS patients (P<0.05). SF showed statistical significance between the relatively low-risk group and the relatively high risk group(P<0.05). 14 cases of the followed up 58 patients were developed into acute leukemia. The leukemic transformation rates were 22.58%and 25.93%of the two groups, and the median time of leukemic transformation were 10 (7, 14) and 5 (2, 7) months. The time of leukemic transformation between the two groups was significantly (P<0.05), but the time of survival was no significant (P>0.05). Conclusion Non-transfused MDS patients have iron overload. SF can be used as one of the indicators in monitoring the MDS patients with iron overload, so it has a certain significance on prognosis.