Piperno A, Sampietro M, D'Alba R, Roffi L, Fargion S, Parma S, Nicoli C, Corbetta N, Pozzi M, Arosio V, Boari G, Fiorelli G
Istituto di Scienze Biomediche, Cattedra di Medicina Interna, Ospedale S. Gerardo dei Tintori, Monza e Università degli Studi di Milano, Italy.
Liver. 1996 Aug;16(4):248-54. doi: 10.1111/j.1600-0676.1996.tb00737.x.
We studied 81 patients with chronic hepatitis C to investigate the relationship between iron and alpha-interferon response. Sixty-one patients (group A) were given alpha-interferon irrespective of iron status, whereas 20 (group B) with iron overload, were iron depleted before alpha-interferon therapy. In group A, 21 patients responded to alpha-interferon and 40 were non-responders. Increased iron indices were significantly more frequent in non-responders than responders. Multivariate analysis showed that among the independent variables evaluated, only gamma-GT and liver iron concentration predicted therapy outcome. After phlebotomy treatment, serum alanine aminotransferase fell significantly both in patients of group B (196 +/- 122 IU/l vs 82 +/- 37 IU/l, p < 10(-6)) and in 12 non-responders of group A (198 +/- 89 IU/l vs 107 +/- 81 IU/l, p < 10(-6)). In 16 iron depleted patients, eight from each group, subsequent treatment with alpha-interferon produced a response in only one patient. These results suggest that increased liver iron is a negative prognostic factor for alpha-interferon response in chronic hepatitis C. Iron depletion had a beneficial effect on serum alanine aminotransferase in all the patients treated, but did not improve the response to alpha-interferon.
我们研究了81例慢性丙型肝炎患者，以调查铁与α干扰素反应之间的关系。61例患者（A组）无论铁状态如何均给予α干扰素，而20例（B组）铁过载患者在α干扰素治疗前进行了铁清除。在A组中，21例患者对α干扰素有反应，40例无反应。无反应者中铁指标升高的情况明显比有反应者更频繁。多变量分析显示，在评估的独立变量中，只有γ-谷氨酰转移酶和肝脏铁浓度可预测治疗结果。放血治疗后，B组患者（196±122 IU/L对82±37 IU/L，p<10⁻⁶）和A组12例无反应者（198±89 IU/L对107±81 IU/L，p<10⁻⁶）的血清丙氨酸氨基转移酶均显著下降。在16例铁清除患者中，每组8例，随后用α干扰素治疗仅1例有反应。这些结果表明，肝脏铁增加是慢性丙型肝炎患者对α干扰素反应的不良预后因素。铁清除对所有接受治疗的患者的血清丙氨酸氨基转移酶有有益影响，但并未改善对α干扰素的反应。
