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目的探讨使用磁共振成像T2*(MRI T2*)方法检测重型β地中海贫血(重型β地贫)患者肝脏、胰腺和心脏铁过载状况,并评估其有效性。方法总结2010年5月至2010年12月中国广东及广西省共7所医院的153例重型β地贫患者的临床资料,对其肝脏、胰腺、心脏MRI T2*与年龄、血清铁蛋白作相关性分析,并按肝脏不同铁沉积等级比较患者心脏和(或)胰腺铁沉积的情况。结果心脏铁沉积重度37例,轻度21例,正常95例。肝脏、胰腺和心脏MRI T2*值与血清铁蛋白水平有相关性,但与年龄无相关性,血清铁蛋白水平也与年龄无关。肝脏与胰腺T2*值(r=0.529,P=0.000)、肝脏与心脏的T2*值(r=0.369,P=0.000)以及胰腺与心脏T2*值(r=0.715,P=0.000)有相关性。随着肝脏铁沉积等级的增加,患者同时合并心和胰腺的比例也随之增大(χ2=20.78,P=0.000)。结论肝脏、胰腺、心脏三器官间的MRI T2*值有相关性。随着肝脏铁沉积等级增加,患者合并心脏、胰腺铁沉积的比例逐渐增高。
Objective To investigate the iron overload status of liver, pancreas and heart in patients with severe β-thalassemia major (β-thalassemia major) using magnetic resonance imaging T2 * (MRI T2 *) method and assess its effectiveness. Methods The clinical data of 153 patients with severe β-thalassemia from 7 hospitals in Guangdong and Guangxi of China from May 2010 to December 2010 were summarized. MRI T2 *, age, and serum ferritin in liver, pancreas and heart were correlated Sex analysis, and according to the different levels of liver deposition of iron in patients with heart and / or pancreatic iron deposition situation. Results Severe myocardial iron deposition in 37 cases, mild in 21 cases and normal in 95 cases. Liver, pancreas and heart MRI T2 * values and serum ferritin levels are related, but no correlation with age, serum ferritin level also has nothing to do with age. Liver and pancreas T2 * (r = 0.529, P = 0.000), liver and heart T2 * (r = 0.369, P = 0.000) and pancreas and heart T2 * (r = 0.715, P = 0.000) Sex. As the grade of hepatic iron deposition increased, the proportion of patients with concurrent heart and pancreas also increased (χ2 = 20.78, P = 0.000). Conclusion There is a correlation between MRI T2 * values of liver, pancreas and heart in three organs. As the level of hepatic iron deposition increased, the proportion of patients with combined heart and pancreatic iron deposition increased gradually.