HBV感染患者血清铁代谢指标与肝损伤关系的探讨

The relationship between the indicators of iron metabolism and hepatic injury in patients with HBV infection

目的探讨HBV感染患者血清铁代谢指标的变化及与肝损伤的关系。方法检测90例HBV感染患者的血清铁(SI)、铁蛋白(Ferr)、总铁结合力(TIBC)、转铁蛋白(TRF)、可溶性转铁蛋白受体(sTfR)水平,依据病变程度将患者分为慢性乙型肝炎组、乙肝后肝硬化组、肝癌组;肝炎组依据慢性肝炎分级标准分为轻、中、重型;肝硬化组依据Child-Pugh分级标准进一步分为A、B、C级,分析不同分组情况下各组患者铁代谢指标的变化。结果三组患者的Ferr高于健康对照组,肝癌组患者SI低于对照组,sTfR表达在肝癌组高于肝炎组和肝硬化组(P<0.05);在慢性肝炎不同分级中,SI含量重度组高于轻度组;SI、Ferr、TIBC、TRF、sTfR在肝硬化不同Child-Pugh分级中均存在差异性,Ferr水平C级患者高于A级和B级。结论铁超载可加重HBV感染患者肝损伤,铁代谢指标对肝脏疾病病情判断具有重要意义。

Objective To investigate the relationship between the indicators of iron metabolism and hepatic injury in patients with HBV infection. Methods Serum iron,serum ferritin, total iron binding capacity,transferrin,soluble transferrin receptor were detected. The patientes were divided into chronic hepatitis group,liver cirrhosis group, hepatocellular carcinoma group. Hepatitis patients were futher divided into mild,moderate and severe hepatitis groups. Cirrhotic patients were divided into A,B and C grade according to Child-Pugh classification standards. Results Serum ferritin levels of three groups were higher than control group. Serum iron level of hepatocellular carcinoma group was lower. Soluble transferrin receptor level in patients with hepatocellular carcinoma was higher than chronic hepatitis group and liver cirrhosis group（P^0.05）. Serum iron level of severe was higher than mild in chronic hepatitis group. The levels of Serum iron, serum ferritin,total iron binding capacity, transferrin, soluble transferrin receptor were all different among grades of liver cirrhosis group,serum ferritin level of C grade was higher than A and B grde. Conclusion The overload of iron may enhance the hepatic injury with HBV infection. Detection of indicators of iron metabolism is useful in determining pathogenetic condition in liver diseases.