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铁对慢性丙型肝炎患者肝纤维化严重程度的影响。

Influence of iron on the severity of hepatic fibrosis in patients with chronic hepatitis C.

作者信息

Lin Tsung-Jung, Liao Li-Ying, Lin Shyr-Yi, Lin Chih-Lin, Chang Ting-An

机构信息

Department of Gastroenterology, Ren-Ai Branch, Taipei City Hospital, Da-an District Taipei City 106, Taiwan, China.

出版信息

World J Gastroenterol. 2006 Aug 14;12(30):4897-901. doi: 10.3748/wjg.v12.i30.4897.

DOI:10.3748/wjg.v12.i30.4897
PMID:16937477
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4087629/
Abstract

AIM

To evaluate the association among hepatic fibrosis, serum iron indices, and hepatic iron stores in patients with Chronic Hepatitis C (CHC).

METHODS

Thirty-two CHC patients were included in our study. The histological degree of fibrosis and inflammation activity was assessed according to the Metavir system. The serum iron indices including ferritin, iron and transferrin saturation were measured. Hepatic iron deposition was graded by Perls' stain.

RESULTS

The CHC patients with severe hepatic fibrosis (n = 16) were significantly older than CHC patients with mild fibrosis (n = 16) (P = 0.024). The serum iron indices, increased serum iron store and positive hepatic iron stain were not significantly different between the two groups. In multivariate logistic regression analysis, the age at biopsy was an independent predictor of severe hepatic fibrosis (Odds ratio = 1.312; P = 0.035). The positive hepatic iron stain was significantly associated with the values of alanine aminotransferase (ALT) (P = 0.017), ferritin (P = 0.008), serum iron (P = 0.019) and transferrin saturation (P = 0.003). The ferritin level showed significant correlation with the value of ALT (r = 0.531; P = 0.003), iron (r = 0.467; P = 0.011) and transferrin saturation (r = 0.556; P = 0.002).

CONCLUSION

Our findings suggest that the severity of hepatitis C virus (HCV)-related liver injury is associated with patient age at biopsy. Both serum iron indices and hepatic iron deposition show correlation with serum indices of chronic liver disease but are not related to grade and stage of liver histology.

摘要

目的

评估慢性丙型肝炎(CHC)患者肝纤维化、血清铁指标和肝脏铁储存之间的关联。

方法

本研究纳入32例CHC患者。根据梅塔维(Metavir)系统评估纤维化和炎症活动的组织学程度。测量血清铁指标,包括铁蛋白、铁和转铁蛋白饱和度。采用普鲁士蓝染色对肝脏铁沉积进行分级。

结果

重度肝纤维化的CHC患者(n = 16)明显比轻度纤维化的CHC患者(n = 16)年龄大(P = 0.024)。两组之间血清铁指标、血清铁储存增加和肝脏铁染色阳性无显著差异。在多因素逻辑回归分析中,活检时的年龄是重度肝纤维化的独立预测因素(比值比 = 1.312;P = 0.035)。肝脏铁染色阳性与丙氨酸氨基转移酶(ALT)值(P = 0.017)、铁蛋白(P = 0.008)、血清铁(P = 0.019)和转铁蛋白饱和度(P = 0.003)显著相关。铁蛋白水平与ALT值(r = 0.531;P = 0.003)、铁(r = 0.467;P = 0.011)和转铁蛋白饱和度(r = 0.556;P = 0.002)显示出显著相关性。

结论

我们的研究结果表明,丙型肝炎病毒(HCV)相关肝损伤的严重程度与活检时的患者年龄有关。血清铁指标和肝脏铁沉积均与慢性肝病的血清指标相关,但与肝脏组织学分级和分期无关。

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