血清铁蛋白与培干扰素α-2a治疗慢性丙型肝炎疗效的关系

Relationship between the level of serum ferritin and the effects of peginterferon alfa-2a in treating chronic hepatitis C patients

目的：探讨血清铁蛋白(SF)的变化与培干扰素α-2a(Peg-IFNα-2a)治疗慢性丙型肝炎疗效的关系。方法：试验组31例慢性丙型肝炎病人,年龄(34±s 8)a,18～65 a；15例健康志愿者为对照组。试验组给予培干扰素α-2a,180μg,皮下注射,每周1次,疗程24 wk,治疗结束后随访24 wk。分别在0,12,24及48 wk检测血清ALT及HCV RNA以判断疗效。在0 wk时检测31例病人和15例健康对照者的血清铁蛋白水平。根据疗效的不同,将病人分为持续应答、复发和无应答组。以SF值等于300μg·L^(-1)为界,将病人分为高SF组(≥300μg·L^(-1))与低SF组(＜300μg·L^(-1))。结果：慢性丙型肝炎病人的SF水平显著高于健康对照者。治疗前慢性丙型肝炎病人SF与ALT水平呈正相关。治疗前持续应答组SF含量明显低于复发组及无应答组(P＜0．01)。治疗前低SF组的病人对Peg-IFNα-2a的持续应答率显著高于高SF组的病人(P＜0．05)。结论：慢性丙型肝炎病人的SF水平与肝脏损伤程度有关,治疗前高SF水平与Peg-IFNα-2a疗效差及不稳固有关。

AIM： To investigate the relationship between the level of serum ferritin of peginterferon alfa-2a （Peg-IFN α-2a） in treating chronic hepatitis C （CHC） patients. （SF） and the effects METHODS ： Thirtyone CHC patients were treated with Peg-IFN α-2a for 24 wk （subcutaneous injection of 180 μg, once a week）, and followed up for 24 wk. The serum ferritin was determined prior to treatment, and then ALT and HCV RNA levels in serum were determined at 0, 12, 24, 48 wk during the antiviral treatment. The serum ferritin level vided into low SF （〈 300 μg·L^-1） group and high SF （ ≥ 300 μg·L^-1） group according to SF value. RESULTS： The levels of SF in CHC patients were significantly higher than those in controls, and there was a positive correlation between the levels of SF and ALT. The pretreatment levels of SF in sustained responders were significantly lower than those in relapse responders and nonresponders （P 〈 0.01 ）. The sustained ratio of the low SF group was significantly higher than that of high SF group （P 〈 0.05）. CONCLUSION： The level of SF is closely related with the degree of liver damage in CHC patients. The pretreatment high serum ferritin level is related with non-response or relapse to Peg-IFN α-2a treatment in CHC patients.