血清铁蛋白测定在肝损伤中的临床意义

Clinical significance of serum ferritin assay in hepatic injury

目的 :探讨血清铁蛋白 (SF)在肝损伤时的变化 ,将SF用于肝损伤评估的可能性。方法 :对 71例乙型病毒性肝炎(HB)、78例甲型病毒性肝炎 (HA) ,3例药物性肝炎 (DIH)患者用ELISA法定量测定其血清铁蛋白 ,用化学法测定其谷丙转氨酶 (ALT)、血清总胆红素 (TB)。结果 :HA ,HB及DIH的急性期SF和ALT均明显增高 (P <0 .0 1)。HA恢复初期多数患者ALT恢复正常 ,SF虽然有下降但仍未正常 ,与对照组比较仍有显著性 (P <0 .0 1)。ALT、TB正常的HB患者有SF增高 (P <0 .0 5 ) ,ALT、TB异常的HB患者SF明显增高 (P <0 .0 1) ,并与ALT和 /或TB呈正相关。DIH急性期SF极度增高。重症肝炎ALT下降时 ,有SF持续升高。结论 :血清铁蛋白检测是评价肝功能的又一实验室指标 ,其比ALT更能反映肝损害的实际情况。

Objective:To study concentration change in serum ferritin(SF) in hepatic injury,and the possibility of using SF index to evaluate hepatic injury.Methods:The concentration of SF, and serum glutamic-pyruvic transaminase(ALT),total bilirubin (TB) in 71 cases of viral hepatitis B(HB),78 cases of viral hepatitis A(HA) and 3 cases of drug-induced hepatitis(DIH) were detected by ELISA and chemistry measurement method.Results:The levels of SF and ALT in HA, HB and DIH increased significantly compared with the control group (P<0.01).In the HA patients at early stage of recovery,ALT level decreased to normal,while SF level also decreased but not to normal,and there was still significant increase compared with the control group(P<0.01).The SF concentration increased (P<0.05) in the HB patients with normal ALT and TB levels and it significantly increased (P<0.01) in those HB patients with abnormal ALT and TB levels,the change in SF concentration was positively correlated with ALT and/or TB.The SF concentration increased greatly in the DIH patients at acute stage.When ALT level decreased the SF concentration continued to rise in the grave hepatitis A or B.Conclusion:SF assay was a new laboratory marker in liver function evaluation,and could better reflect the actual pathological changes than ALT.