Kato S, Arao M, Kuriki J, Tagaya T, Takiya S, Kato K, Takikawa T, Hayashi H
Department of Medicine, Inazawa City Hospital, Japan.
Nagoya J Med Sci. 1994 Dec;57(3-4):153-7.
Although chronic hepatitis C is frequently complicated by iron overload, it remains unclear whether iron cytotoxicity is involved in the disease process. Five patients with chronic hepatitis C showed rapid reduction of serum aminotransferase activity after gastrointestinal bleeding. Posthemorrhagic reduction of liver enzyme levels lasted for more than one week. Anemia was associated with a reduction of serum ferritin concentration. Considering the short half-lives of circulating liver enzymes, reduced release of enzymes, that is inactivation of cell lysis, is the likely cause of the improved biochemical indices. Reactive iron, which is cytotoxic for patients infected by HCV, may be rapidly incorporated into hemoglobin when erythropoiesis is stimulated. Our observation also suggests that intensive iron removal by phlebotomy is a safe, economic treatment for patients with chronic hepatitis C.
尽管慢性丙型肝炎常并发铁过载，但铁的细胞毒性是否参与疾病进程仍不清楚。5例慢性丙型肝炎患者在胃肠道出血后血清转氨酶活性迅速降低。出血后肝酶水平降低持续超过一周。贫血与血清铁蛋白浓度降低有关。考虑到循环肝酶的半衰期较短，酶释放减少，即细胞裂解失活，可能是生化指标改善的原因。对丙型肝炎病毒感染患者具有细胞毒性的反应性铁，在红细胞生成受到刺激时可能会迅速整合到血红蛋白中。我们的观察还表明，通过放血进行强化铁清除对慢性丙型肝炎患者是一种安全、经济的治疗方法。
