Arber N, Konikoff F M, Moshkowitz M, Baratz M, Hallak A, Santo M, Halpern Z, Weiss H, Gilat T
Department of Gastroenterology, Tel-Aviv Medical Center, Ichilov Hospital, Israel.
Dig Dis Sci. 1994 Dec;39(12):2656-9. doi: 10.1007/BF02087705.
One hundred twenty-three patients with chronic liver diseases of various etiologies were evaluated for their iron status. The patients were divided into four distinct groups: chronic hepatitis C (63), chronic hepatitis B (14), B + C (3) and nonviral chronic liver diseases (43). In 107 patients (87%) the chronic liver disease was confirmed by biopsy. Mean serum iron (+/- SD) levels in the above four groups were: 166 +/- 62, 103 +/- 52, 142 +/- 48, and 115 micrograms/dl; iron-binding capacity was 346 +/- 80, 325 +/- 72, 297 +/- 27, and 374 +/- 75 micrograms/dl, and iron saturation 50 +/- 18, 32 +/- 16, 48 +/- 16, and 28 +/- 10%, respectively. Serum ferritin, increased in all four groups, was highest in HCV; however, no evidence of hepatic iron accumulation could be found in any of the patients. There were no significant differences in liver function parameters measured in the four groups. We conclude that serum iron, iron saturation, and ferritin are increased in patients with hepatitis C in comparison to hepatitis B or other nonviral, nonhemochromatotic liver diseases. The increased iron status in hepatitis C patients is not manifested by increased liver iron. Awareness of these distinct features of chronic hepatitis C is essential in the diagnosis and treatment of chronic liver diseases.
对123例不同病因的慢性肝病患者的铁状态进行了评估。这些患者被分为四个不同的组：慢性丙型肝炎（63例）、慢性乙型肝炎（14例）、乙+丙型肝炎（3例）和非病毒性慢性肝病（43例）。107例患者（87%）的慢性肝病经活检确诊。上述四组患者的平均血清铁（±标准差）水平分别为：166±62、103±52、142±48和115微克/分升；铁结合能力分别为346±80、325±72、297±27和374±75微克/分升，铁饱和度分别为50±18%、32±16%、48±16%和28±10%。四组患者的血清铁蛋白均升高，在丙型肝炎组中最高；然而，在任何患者中均未发现肝铁蓄积的证据。四组患者的肝功能参数无显著差异。我们得出结论，与乙型肝炎或其他非病毒性、非血色素沉着性肝病患者相比，丙型肝炎患者的血清铁、铁饱和度和铁蛋白升高。丙型肝炎患者铁状态的升高并未表现为肝铁增加。了解慢性丙型肝炎的这些独特特征对慢性肝病的诊断和治疗至关重要。
