A Study Of Cardic And Hepatic Iron Overload In Patients With Beta Thalassaemia Major In Guangxi

Objective To evaluate the serum ferritin levels and cardiac and hepatic iron overload in patients with beta thalassaemia major in Guangxi.Methods 50 patients with beta thalassaemia major in Guangxi who age was older than 10 years was evaluated by the serum ferritin detection and heart T2~* value and liver R2 value .Serum ferritin was detected by radio immune method(RIA) and linked immune osorbent assay(ELISA). Heart T2~* value and liver R2 value were tested by Magnetic resonance imagine (MRI) technology .The patients were divided to the regular chelated group and non-regular chelated group . The correlation between serum ferritin and heart T2 * value and liver iron concentration(LIC) were evaluated .Results(1)The median of SF in 50 patients with beta thalassaemia major is 5511(4204.75)μg/L., SF>2500μg/L was in 44(88%) patients(2)25 (50%) patients were heart T2~* value >20ms (non- heart iron overload) and 25 (50%) patients were heart T2~* value≤20ms( heart iron overload), among them, 13(26%) patients were heart T2~* value between 10~20ms (Mild-to-moderate heart iron overload); 12 cases (24%) patients were heart T2~*value <10ms (Severe heart iron overload).(3)Liver iron concentration(LIC) of 50 patients are all greater than 3mg Fe/g dry weight, the median was 42.3 mg Fe/g dry weight.(4)Compare the regular chelated group and non-regular chelated group , the Serum ferritin median values were 3974μg/L and 6490μg/L(P=0.026) respectively ; the heart T2~* median values were 36.7ms and 10.6ms(P=0.000) respectively; LIC median values were 37.2 mg Fe/g dry weight and 43 mg Fe/g dry weight (P=0.0003) respectively .(5)For different degree heart iron overload , Serum ferritin and LIC were different (P=0.033 ; P=0.005). the serum ferritin levels and the liver R2 values of Mild-to-moderate and Severe heart iron overload groups were all greater than non-heart iron overload group(both P less than 005) ; the LIC of Mild-to-moderate and Severe heart iron overload groups were both greater than non- heart iron overload group(both P less than 005).(6)The Serum ferritin had no correlation with the Heart T2~* value(P>0.05) , the Serum ferritin have moderately positive correlation with the LIC (correlation coefficient was 0.546, P < 0.05).Conclusion(1)Iron overload in patients with beta thalassaemia major in Guangxi who age was older than 10 years was serious .88 percent of patients had Severe iron overload (SF>2500μg/L) .(2)Cardiac and hepatic iron overload in patients with beta thalassaemia major who age was older than 10 years in Guangxi were serious . 50 percent of patients had Cardiac iron overload ; 100 percent of the patients had hepatic iron overload .(3)The non-rugular chelated treatment was the leading reason to cause Systemic iron overload and cardiac and hepatic iron overload .(4)The Serum ferritin had no correlation with the Heart T2 * value , and had moderately positive correlation with the LIC. So the Serum Ferritin could not reflect the heart iron deposition of patients. But, to some extent ,could reflect the hepatic iron deposition of patients.(5)MRI measurement as a new method to assess iron overload can more accurate,non-invasive and effectively estimate the Cardiac and hepatic iron overload and guide the chelated therapy regime.