Iron overload in patients with chronic hepatitis C virus infection: Clinical and histological study
Iron overload in patients with chronic hepatitis C virus infection: Clinical and histological study
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DOI：
10.1111/j.1400-1746.2004.03549.x
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发表时间：
2005-02-01
影响因子：
4.1
通讯作者：
Ferraz, MLG
中科院分区：
文献类型：
--
作者：
Silva, VSS;Perez, RM;Ferraz, MLG
背景：最近发现铁是丙型肝炎自然史中的重要元素。慢性丙型肝炎病毒（HCV）感染者的血清铁储存标志物经常增加，但肝脏铁超载的真实的影响却知之甚少。为了解慢性丙型肝炎病毒（HCV）感染者铁超载的发生情况，探讨其肝铁浓度（HIC）与临床、生化及组织学特征的关系。采用原子吸收分光光度法测定肝组织铁含量。分析了HIC与年龄、性别、传播危险因素、感染持续时间、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平、铁和血清铁蛋白、转铁蛋白饱和度、HCV-RNA水平、炎症活动度分级、纤维化分期、肝脂肪变性和血清铁蛋白的关系。统计分析包括Mann-Whitney检验和多元线性回归模型。结果：96例患者（58%男性），平均年龄为44 - 10岁进行了研究。分别有28%、27%和12.5%的患者血清铁、铁蛋白和转铁蛋白饱和度升高。少数患者（15.6%）检出血清铁。仅在7%中观察到较高等级的硅铁（2和3）。5名患者（5%）的HIC（>30 mmol/g干重）升高。分级和分期均与HIC无关。男性患者HIC明显高于男性（P
Background: Recently it has been found that iron is an important element in the natural history of hepatitis C. Serum markers of iron stores are frequently increased in chronic hepatitis C virus (HCV)infected carriers but the real impact of the hepatic iron overload is poorly understood. The purpose of the present paper was to determine the prevalence of iron overload and to study the relationship between hepatic iron concentration (HIC) and clinical, biochemical and histological characteristics in chronic HCV-infected carriers.Methods: Patients presenting with anti-HCV and HCV-RNA were included. Hepatic iron concentration was determined in liver tissue by atomic absorption spectrophotometry. The association between HIC and age, gender, risk factor of transmission, duration of infection, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, iron and serum ferritin, transferrin saturation, HCV-RNA level, grading of inflammatory activity, staging of fibrosis, hepatic steatosis, and stainable iron was analyzed. Statistical analysis included the Mann-Whitney test and a multiple linear regression model.Results: Ninety-six patients (58% male) with a mean age of 44 10 years were studied. Serum iron, ferritin and transferrin saturation were elevated in 28%, 27% and 12.5% of patients, respectively. Stainable iron was detected in few patients (15.6%). Higher grades of stainable iron (2 and 3) were observed in only 7%. The HIC (>30 mmol/g dry weight) was elevated in five patients (5%). Neither grading nor staging were related to HIC. Higher HIC were observed in male patients (P