乙肝病毒携带者铁代谢与血清铁调素相关性研究

Relationship between serum hepcidin and iron metabolism in hepatitis B virus carriers

目的:研究乙型肝炎病毒携带者血清铁调素与机体铁代谢的关系。方法:选取465例乙型肝炎病毒携带者为研究对象(重度肝炎组76例,中度肝炎组136例,轻度肝炎组253例),169例正常健康人员为对照组,比较各组血清铁调素、铁蛋白(SF)、血清铁(SI)、C反应蛋白(CRP)的检测情况。结果:SI:重度肝炎组出现升高,与其他3组比较均有统计学差异(P<0.05),对照组、轻度肝炎组及中度肝炎组3组比较无统计学差异(P>0.05)。SF:任意两组比较均有统计学差异(P<0.05),随肝炎病情加重依次升高。铁调素:对照组、轻度肝炎组比较无统计学差异(P>0.05),重度肝炎组、中度肝炎组依次降低,与其他各组比较有统计学差异(P<0.05)。CRP:4组均存在统计学差异(P<0.05),随肝炎病情加重依次升高。相关性分析:铁调素与铁蛋白、CRP均呈负相关(P<0.05),相关系数以CRP较高,铁调素与血清铁无相关性(P>0.05)。结论:铁调素与慢性乙型肝炎的铁过载关系密切,铁调素降低的程度可反映疾病的严重性,重型乙型肝炎中普遍存在铁调素过低及铁过载现象,消除铁过载对延缓肝硬化进程有重要的临床意义。

Objective：To study the relationship between hepatitis B virus serum hepcidin and iron metabolism.Methods：A total of 465 cases of hepatitis B virus were selected as the object of study,including 76 cases as severe hepatitis group,136 cases as moderate hepatitis group,253 cases as mild hepatitis group,and 169 cases of normal healthy persons as control group.Serum hepcidin,iron protein（SF）,serum iron（SI）,C reactive protein（CRP）were detected.Results：SI of severe hepatitis group was significantly increased compared with the other three groups（P〈0.05）,and there was no significant difference among control group,mild and moderate hepatitis hepatitis group（P〉0.05）.There was significant difference in SF among groups（P〈0.05）,and it was increased as status of disease aggravating.There was no significant difference in hepcidin between control group and moderate group（P〉0.05）,and it was lower in severe group compared with mild group,with significant difference among groups（P〈0.05）.There was significant difference in CRP among group（P〈0.05）,and it was increased as status of disease aggravating.Hepcidin was negatively correlated with ferrtin and CRP（P〈0.05）,and coefficient of CRP was the highest.Hepcidin had no correlation with the levels of serum iron（P〉0.05）.Conclusion：Hepcidin is closely related with overload of iron in chronic hepatitis B patients.The level of hepcidin can reflect the severity of diseases.Over-low hepcidin and overload of iron is common in severe hepatitis B patients.Reducing iron overload is significant to delay the process of liver cirrhosis.