中文摘要：

目的：了解地中海贫血患者体内的氧化应激及铁代谢水平,并探讨两者之间的相关性。方法：选取30例重型地中海贫血患者（A组）及60例血红蛋白H病患者（B组）作为观察组,并选取同期到我院体检的30例健康人群（C组）作为对照组。采用丙二醛（MDA）、超氧化物歧化酶（SOD）、维生素C（VC）及总抗氧化能力（TAC）评价氧化应激水平;采用血清铁蛋白（SF）和肝脏铁浓度（LIC）评估体内铁状态;采用促红细胞生成素（EPO）和转化生长因子-15（GDF15）评估铁代谢水平。测定所有研究对象血清的MDA、SOD、VC、TAC、SF、EPO、GDF15含量,并对其中5例A组患者及24例B组患者采用磁共振测定LIC,且探讨氧化应激与铁代谢的相关性。结果：与C组相比,A组血清MDA、SOD升高,VC下降,差异均有统计学意义（P〈0.01）;与C组相比,B组血清MDA升高,VC下降,差异均有统计学意义（P〈0.01）;A组及B组血清TAC均降低,但与C组相比,差异均无统计学意义。观察组血清MDA、SOD与SF、LIC呈正相关（P〈0.05）,血清VC、TAC与SF、LIC呈负相关（P〈0.05）;观察组血清MDA与SOD、EPO、GDF15呈正相关（P〈0.05）,与VC呈负相关（P〈0.05）。结论：地中海贫血患者存在铁过载和氧化应激,而且氧化应激与铁代谢有关。

英文摘要：

Objective：To investigate the level of iron metabolism,oxidative stress in thalassemia patients,and to explore the correlation between oxidative stress and iron metabolism.Method：We chose 30 outpatients with thalassemia major（group A）and 60 outpatients with hemoglobin H disease（group B）as observed subjects,and 30 healthy people（group C）as control group.We evaluated oxidative stress by using the serum malondialdehyde（MDA）,superoxide dismutase（SOD）,vitamin C（VC）and total antioxidant capacity（TAC）.And we determined serum ferritin and liver iron concentration（LIC）to evaluate the iron condition.We chose erythropoietin（EPO）and grow differentiation factor-15（GDF15）as marks to evaluate iron metabolism.We detected the serum MDA,SOD,VC,TAC,hepcidin,EPO and GDF15 in all of controls and observations.We also detected the LIC by MRI in5 patiens with thalassemia major and 24 patients with Hb H disease.And we explored the relationship between iron metabolism and oxidative in thalassemia patients.Result：There were significantly increased levels of MDA,SOD and decreased level of VC in serum in group A,when compared with those in group C（P〈0.01）.There were also significantly increased levels of MDA and decreased level of VC in serum in group B,when compared with those in group C（P〈0.01）.The levels of serum TAC were decreased in the group A and group B,but there were no significant differences when compared with group C.Meanwhile,the levels of serum MDA,SOD were positively correlated with SF,LIC（P〈0.05）,the levels of serum VC,TAC were negatively correlated with SF,LIC（P〈0.05）in the observed subjects.The level of serum MDA was positively correlated with SOD,EPO and GDF15（P〈0.05）,and negatively correlated with VC in the observed subjects（P〈0.05）.Conclusion：It demonstrates the presence of oxidative stress and iron overload in thalassemia patients.Moreover,the related metabolic pathway of oxidative stress is active with iron metabolism.