Brissot P, Bourel M, Herry D, Verger J P, Messner M, Beaumont C, Regnouard F, Ferrand B, Simon M
Gastroenterology. 1981 Mar;80(3):557-65.
Two direct methods for hepatic iron assessment (liver iron concentration and stainable liver iron--judged by a new histologic grading) and three indirect methods (serum iron and transferrin saturation, deferoxamine-chelation test, and ferritinemia) were reevaluated in 271 patients. These patients consisted of: 103 with idiopathic hemochromatosis, 39 with alcoholic cirrhosis, 54 with noncirrhotic alcoholic liver diseases, 13 with nonalcoholic liver diseases, and 62 with miscellaneous disorders. The results indicate that: (a) liver iron concentration, well correlated with mobilized excess iron (r = 0.88; p < 0.01), is the method of reference and validates the proposed histologic grading; (b) serum ferritin, which is in good correlation with liver iron concentration (r = 0.80; p < 0.01), is a valuable indirect method for hepatic iron evaluation; (c) regarding the other indirect methods a "boundary zone" may be delimited, thus corresponding to liver iron concentration values of 10.7 mumol/100 mg dry liver weight, beyond which values of serum iron less than 28.6 micrometer or transferrin saturation less than 45% or chelatable iron less than 45 mumol/24 h are rare; and (d) using the various indirect methods, there is a marked risk in idiopathic hemochromatosis to underestimate and in alcoholic liver diseases to overestimate hepatic iron content.
在271例患者中重新评估了两种直接评估肝脏铁含量的方法（肝脏铁浓度和可染色肝脏铁——通过一种新的组织学分级判断）以及三种间接方法（血清铁和转铁蛋白饱和度、去铁胺螯合试验和铁蛋白血症）。这些患者包括：103例特发性血色素沉着症患者、39例酒精性肝硬化患者、54例非肝硬化酒精性肝病患者、13例非酒精性肝病患者以及62例患有其他杂症的患者。结果表明：(a)肝脏铁浓度与动员的过量铁密切相关（r = 0.88；p < 0.01），是参考方法并验证了所提出的组织学分级；(b)血清铁蛋白与肝脏铁浓度高度相关（r = 0.80；p < 0.01），是评估肝脏铁含量的一种有价值的间接方法；(c)对于其他间接方法，可以划定一个“边界区域”，其对应于肝脏铁浓度值为10.7 μmol/100 mg干肝重，超过此值时血清铁低于28.6 μmol或转铁蛋白饱和度低于45%或可螯合铁低于45 μmol/24小时的情况很少见；以及(d)使用各种间接方法时，特发性血色素沉着症存在明显低估肝脏铁含量的风险，而酒精性肝病则存在高估肝脏铁含量的风险。
