Hayashi H, Takikawa T, Nishimura N, Yano M, Isomura T, Sakamoto N
Laboratory for Development of Medicine, School of Pharmacy, Hokuriku University, Kanazawa, Japan.
Am J Gastroenterol. 1994 Jul;89(7):986-8.
Iron metabolism may be altered in patients with chronic active hepatitis C. In an attempt to evaluate whether excess iron contributes to liver injury, we used phlebotomy for removal of iron from patients with chronic hepatitis C.
All 10 patients had histochemically detectable iron in the liver and underwent an initial period of weekly or monthly phlebotomy of 200 or 400 ml. A serum ferritin level of 10 ng/ml or less was chosen as the endpoint, and maintenance phlebotomy was performed if the level rebounded.
The treatment reduced mean serum alanine aminotransferase activity from 152 +/- 49 to 55 +/- 32 IU/L; this level became normal in five of the 10 patients. Anti-HCV antibodies could be detected in all patients throughout the study. Histologic abnormalities of the liver were unchanged except for disappearance of iron deposits from seven of the patients studied.
Our findings suggest that iron removal may be beneficial for patients with chronic active hepatitis C and histochemical iron in the liver.
慢性丙型肝炎患者的铁代谢可能会发生改变。为了评估过量铁是否会导致肝损伤，我们采用放血疗法从慢性丙型肝炎患者体内去除铁。
所有10例患者肝脏组织化学检查可检测到铁，最初每周或每月进行一次200或400毫升的放血。将血清铁蛋白水平降至10纳克/毫升或更低作为终点指标，如果该水平反弹则进行维持性放血。
治疗使平均血清丙氨酸氨基转移酶活性从152±49降至55±32国际单位/升；10例患者中有5例该水平恢复正常。在整个研究过程中，所有患者均可检测到抗丙型肝炎病毒抗体。除了所研究的7例患者肝脏铁沉积消失外，肝脏组织学异常未发生变化。
我们的研究结果表明，去除铁可能对患有慢性活动性丙型肝炎且肝脏有组织化学铁沉积的患者有益。
