铁代谢改变对丙型肝炎治疗的影响  

INFLUENCE OF IRON METABOLISM FOR THE TREATMENT IN PATIENTS WITH HEPATITIS C

作　　者：曹治宸[1] 孔丽[1] 甄真[1] 宋艳改[1] 刘金星[1] 李兵顺[1] 

机构地区：[1]河北医科大学附属第三医院,石家庄050051

出　　处：《中华肝脏病杂志》1998年第1期8-9,共2页Chinese Journal of Hepatology

摘　　要：目的探讨铁代谢的改变对丙型肝炎治疗的影响。方法采用常规方法观察55例丙型肝炎患者临床疗效与血红蛋白及血清铁蛋白水平的关系。结果血红蛋白与疗效呈较弱的负相关(r=-0.2867,t=2.179,P<0.05)。在应用干扰素治疗的32例患者中,血红蛋白不足140g/L 者疗效明显优于140g/L 以上者(P=0.0023),提示高血红蛋白的丙型-肝炎患者干扰素疗效较差。在28例应用干扰素治疗的丙型肝炎患者中,血清铁蛋白与疗效呈明显的负相关(r=0.7152,t=5.2178,P<0.01)。在有治疗反应的患者中,疗效稳固者与复发者铁蛋白均值差异有显著意义(t′=4.5943,t′_(0.05)=2.2313,P<0.05)。结论血清铁蛋白较高可能是干扰素临床疗效不稳固的原因之一。Objective To inverstigate whether iron metabolism influences the response to treatment. Methods The hemoglubin and ferritin were determined in 55 patients with chronic hepatitis C by ELISA,RT-PCR and radioimmunoassay etc.Result After one year's treatment,eight cases were sustained response (15%),thirty-seven cases were transient response (66%),eight cases were nonresponse (15%) and two cases deterioration (4%).There is a light minus correlation between the hemoglubin and effection of treatment (r=-0.2867,t=2.179,P<0.05) in 55 cases with hepatitis C.Among 32 cases treated by IFNα-2b the effection in the group (22 cases) of hemoglubin below 140g/L is better than in the group (10 cases) of hemoglubin 140g/L and over(P=0.0023).In 28 cases the sero ferritin was measured and the mean is 273.67±149.03ng/ml.There is singnificant minus correlation between the ferritin and the effection of treatment by IFNα-2b (r=-0.7152,t=5.2178,P<0.01).In 26 cases which is response to treatment by IFNα-2b,eight are sustaines response (mean is 134.28±58.22mg/L),and eighteen are transient response (mean is 308.7±137.69mg/L).It is statistically singnificant between substained and transient response group (t′=4.5943,t′_(0.05)=2.2313,P<0.05).Perhaps higher sero ferritin is one of the causes of relapse in clinical.Conclusion It is suggested that iron metablism is an important factor of influence to in the treatment of hepatitis C by IFN.The hemoglubin and ferritin are practical and available marks.

关 键 词：丙型肝炎 血红蛋白 血清 铁蛋白 治疗 

分 类 号：R512.630.5[医药卫生—内科学]