Haque S, Chandra B, Gerber M A, Lok A S
Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Hum Pathol. 1996 Dec;27(12):1277-81. doi: 10.1016/s0046-8177(96)90337-8.
Recent studies suggest that increased hepatic iron may impair the response to interferon therapy in patients with chronic hepatitis C. We reviewed the records and liver biopsies of 72 patients with chronic hepatitis C to determine the prevalence of iron overload and to evaluate whether there is a correlation between serum and hepatic iron concentrations and activity of liver disease. Patients with other causes of liver disease or iron overload were excluded. Necroinflammatory activity and fibrosis were evaluated using modified Knodell score. Hepatic iron was assessed using Brissot's grading system. Increased serum iron and ferritin levels were found in 29% and 43% patients, respectively. Hepatic iron grades 0, I, II, III, and IV were present in 37%, 35%, 25%, 3%, and 0% of patients, respectively. A significant correlation was found between hepatic iron grade and serum ferritin (P = .0001). There was no correlation between hepatic iron grade and histological activity index or fibrosis score. In summary, we found a high proportion of patients with chronic hepatitis C had mild to moderate increase in hepatic iron content even when patients with alcoholism and recurrent transfusions were excluded. However, very few patients had severely increased iron load.
近期研究表明，肝铁含量增加可能会损害慢性丙型肝炎患者对干扰素治疗的反应。我们回顾了72例慢性丙型肝炎患者的病历和肝活检结果，以确定铁过载的患病率，并评估血清铁和肝铁浓度与肝病活动之间是否存在相关性。排除了患有其他肝病或铁过载原因的患者。使用改良的Knodell评分评估坏死性炎症活动和纤维化。使用布利索分级系统评估肝铁。分别在29%和43%的患者中发现血清铁和铁蛋白水平升高。肝铁分级为0、I、II、III和IV的患者分别占37%、35%、25%、3%和0%。肝铁分级与血清铁蛋白之间存在显著相关性（P = .0001）。肝铁分级与组织学活动指数或纤维化评分之间无相关性。总之，我们发现即使排除了酗酒和反复输血的患者，仍有很大比例的慢性丙型肝炎患者肝铁含量有轻度至中度增加。然而，极少患者有严重的铁负荷增加。
