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目的探讨重型β地中海贫血(thalassemia major,TM)患者肝脾肿大的影响因素。方法 2008-07/2010-03月,171例TM患者接受腹部超声检查,观察其肝脾肿大情况及胆囊结石的发生,并记录一般情况、输血和去铁状况,测量血清铁蛋白浓度。结果 171例患者中113例肝脏增大,89例脾脏增大,15例曾行切脾术,4例有胆囊结石。地贫基因类型、是否高量输血是影响脾脏增大的因素。结论 TM患者中肝脾增大较为普遍,需加强规范化输血治疗,以维持输血前血红蛋白大于90g/L,尤其是β0/β0纯合子TM患者。
Objective To investigate the influencing factors of hepatosplenomegaly in patients with thalassemia major (TM). Methods From July 2008 to March 2010, 171 patients with TM underwent abdominal ultrasonography to observe the hepatosplenomegaly and the occurrence of gallstones. The general conditions, blood transfusion and iron removal were recorded, and serum ferritin concentration was measured. Results Among the 171 patients, 113 cases of liver enlargement, 89 cases of spleen enlargement, 15 cases of splenectomy and 4 cases of gallstone. Thalassemia gene type, whether the high amount of blood transfusion affect the spleen increased. Conclusion The increase of liver and spleen in patients with TM is more common. It is necessary to strengthen the standardization of blood transfusion in order to maintain the hemoglobin greater than 90g / L before transfusion, especially in patients with β0 / β0 homozygote.