铁过载的危害.ppt 36页

1.人体内的铁是通过转铁蛋白来转运的，当转铁蛋白几乎完全饱和时 ，血浆内会出现非转铁蛋白结合铁(NTBI) 2.非转铁蛋白结合铁(NTBI)可以沉积在组织及器官上，形成非结合不稳定铁(LPI) , 促进有害的活性氧自由基(ROS)形成，是造成铁过载并发症的主要原因 * In patients who are iron-overloaded the capacity of serum transferrin to bind iron may be exceeded, which means that NTBI may circulate in the plasma. This unbound iron, which is carried in the iron storage protein ferritin, can promote the generation of free hydroxyl radicals, which propagate oxygen-related tissue damage. Additionally, insoluble iron complexes called hemosiderins may become deposited in body tissues causing toxicity and death. Cardiac failure is a major, life-threatening complication of iron overload.1 Iron deposition can cause myocarditis and cardiac fibrosis.2 Myocardial fibrosis typically develops after a cumulative dose of approximately 100 units of blood.3 Symptoms of heart failure imply advanced disease and patients with iron-associated congestive heart failure or severe arrhythmias typically survive less than a year.3 There are a number of other possible complications of iron overload: Excess iron deposition in the liver can lead to fibrosis/cirrhosis or cancer, and diabetes mellitus may occur as a result of β-cell destruction secondary to iron overload in the pancreas Excess iron overload in the pituitary may cause growth failure due to hypogonadism and infertility due to reduced gonadotropin levels. References Borgna-Pignatti C et al. Ann NY Acad Sci 1998;850:227–231. Ishizaka N et al. Circulation 2002;106:1840–1846. Hershko C & Weatherall DJ. Crit Rev Clin Lab Sci 1988;26:303–345. * EXJ-PM001/01-4/2009 * 含铁血黄素浸润：当铁蛋白在铁过载的情况下饱和时，铁会逐渐转换为含铁血黄素，这是储存铁的一个病理形式。当含铁血黄素增多时，它会占据受影响的细胞内空间。这会危害到细胞的功能，甚至会导致细胞和组织的死亡，并被纤维瘢痕组织所取代。瘢痕组织的圆形聚集区被称为微小结节。 EXJ-PM001/01-4/2009 * Speaker Notes Iron overload may affect several different endocrine organs including the pancreas, pituitary gland, thyroid and parathyroid glands, the testes in males and ovaries in females. Dysfunction of the pancreas is common. Some people even develo