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迟发性皮肤卟啉症血清铁蛋白的测定。肝铁沉积症的可靠标志

[Determination of serum ferritin in porphyria cutanea tarda. A reliable sign of hepatic siderosis].

作者信息

Gibertini P, Rocchi E, Cassanelli M, Pietrangelo A, Coppini M, Ventura E

出版信息

Minerva Med. 1984 Mar 10;75(9-10):469-74.

PMID:6709223
Abstract

Some parameters of iron metabolism in 26 patients with porphyria cutanea tarda (PCT) which is often associated with mild iron overload and hepatic siderosis, are studied. Serum iron, percent transferrin saturation and ferritin were pathologically increased. Statistical comparisons were performed between PCT patients and healthy controls, liver disease patients (cirrhosis, chronic active hepatitis) and patients with associated liver siderosis (alcoholic cirrhosis, cirrhosis and chronic active hepatitis in thalassemia). Ferritin levels are higher in patients with porphyria than in healthy controls (p less than 0,001) and in patients without liver siderosis (p less than 0,001). No statistical difference is observed between patients with porphyria and patients with siderosis. A significant decrease in ferritin levels is registered after venesection therapy. The conclusion is drawn that serum ferritin increase in PCT is related to hepatic iron store amounts rather than hepatic necrosis. It is assumed that ferritin follow-up during phlebotomy therapy and also during remission is useful to indicate the exhaustion or an early replenishment of hepatic iron stores.

摘要

对26例迟发性皮肤卟啉病(PCT)患者的一些铁代谢参数进行了研究,该病常伴有轻度铁过载和肝铁质沉着症。血清铁、转铁蛋白饱和度百分比和铁蛋白均呈病理性升高。对PCT患者与健康对照、肝病患者(肝硬化、慢性活动性肝炎)以及伴有肝铁质沉着症的患者(酒精性肝硬化、地中海贫血中的肝硬化和慢性活动性肝炎)进行了统计学比较。卟啉病患者的铁蛋白水平高于健康对照(p<0.001)和无肝铁质沉着症的患者(p<0.001)。卟啉病患者与铁质沉着症患者之间未观察到统计学差异。放血疗法后铁蛋白水平显著下降。得出的结论是,PCT中血清铁蛋白升高与肝脏铁储存量有关,而非肝坏死。据推测,在放血治疗期间以及缓解期对铁蛋白进行随访,有助于指示肝脏铁储存的耗尽或早期补充情况。

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