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非HFE铁过载作为肝硬化患者疾病严重程度的替代标志物。

Non-HFE iron overload as a surrogate marker of disease severity in patients of liver cirrhosis.

作者信息

Noor Mohd Talha, Tiwari Manish, Kumar Ravindra

机构信息

Department of Gastroenterology, Sri Aurobindo Medical College and Post Graduate Institute, Saims Campus, Indore-Ujjain State Highway, Near MR-10 Crossing, Indore, 453 111, India.

Central Research Laboratory, Sri Aurobindo Medical College and Post Graduate Institute, Saims Campus, Indore-Ujjain State Highway, Near MR-10 Crossing, Indore, 453 111, India.

出版信息

Indian J Gastroenterol. 2016 Jan;35(1):33-9. doi: 10.1007/s12664-016-0623-6. Epub 2016 Feb 13.

Abstract

BACKGROUND

Decompensated liver cirrhosis is an important cause of mortality worldwide. Various modifiable and non-modifiable factors are involved in the pathogenesis of cirrhosis and its complications. This study was aimed to evaluate the association of iron overload and disease severity in patients of liver cirrhosis and its association with HFE gene mutation.

METHODS

Forty-nine patients with decompensated liver cirrhosis were recruited. Clinical and laboratory parameters were compared in patients with and without iron overload. C282Y and H63D gene mutation analysis was performed in all patients with iron overload.

RESULTS

Iron overload was found in 20 (40.82%) patients. A significant positive correlation of transferrin saturation with Child-Turcotte-Pugh (CTP) score (r = 0.705, p < 0.001) and model for end-stage liver disease (MELD) score (r = 0.668, p < 0.001) was found. Transferrin saturation was also independently associated with high CTP and MELD score on multivariate analysis. Mortality over 3 months was significantly more common in iron-overloaded patients (p = 0.028). C282Y homozygosity or C282Y/H63D compound heterozygosity was not found in any of the patients with iron overload.

CONCLUSION

Iron overload was significantly associated with disease severity and reduced survival in patients of decompensated liver cirrhosis.

摘要

背景

失代偿期肝硬化是全球范围内重要的死亡原因。肝硬化及其并发症的发病机制涉及多种可改变和不可改变的因素。本研究旨在评估肝硬化患者铁过载与疾病严重程度的关联及其与HFE基因突变的关系。

方法

招募了49例失代偿期肝硬化患者。比较了有铁过载和无铁过载患者的临床和实验室参数。对所有铁过载患者进行C282Y和H63D基因突变分析。

结果

20例(40.82%)患者存在铁过载。发现转铁蛋白饱和度与Child-Turcotte-Pugh(CTP)评分(r = 0.705,p < 0.001)和终末期肝病模型(MELD)评分(r = 0.668,p < 0.001)呈显著正相关。多因素分析显示,转铁蛋白饱和度也与高CTP和MELD评分独立相关。铁过载患者3个月内的死亡率明显更高(p = 0.028)。在任何铁过载患者中均未发现C282Y纯合子或C282Y/H63D复合杂合子。

结论

铁过载与失代偿期肝硬化患者的疾病严重程度显著相关,并降低了生存率。

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