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肝组织内储存铁可以降低α-干扰素单一疗法的应答性,并且有可能促进慢性丙型肝炎的发展。现就有关的通过检测患者血清中生物化学和病毒学标记物及脂质过氧化和肝组织纤维化标记物水平研究铁耗竭对它们的影响进行介评。研究对18例慢性丙型肝炎患者采用干扰素单一疗法均未出现病毒生物学应答,每周1次的静脉切开放血致体内铁耗竭,检测铁耗竭前后血清中丙氨酸转氨酶、丙型肝炎病毒RNA、转铁蛋白饱和度、铁蛋白、8-异前列烷、透明质酸、氨基末端前胶原Ⅲ肽和YKL-40水平。分别经过4～11周放血处理致铁耗竭后,患者血清中丙氨酸转氨酶、转铁蛋白饱和度和铁蛋白的改变具有统计学意义。4例患者血清丙氨酸转氨酶恢复正常(22%)。出现生化应答的患者中血清前胶原Ⅲ肽明显下降,而其他标记物未见明显变化。结果提示对应用干扰素单一疗法无效的患者中,有22%表现出这种生化应答与体内铁耗竭有相关性。在表现出生化应答的患者体内肝组织纤维化关键标记物也有明显降低。
Storing iron in liver tissue can reduce the responsiveness of IFN-α monotherapy and may promote the development of chronic hepatitis C. A review of the effects of iron depletion on their detection of biochemical and virological markers and lipid peroxidation and liver fibrosis markers in patients’ sera is now under review. The study of 18 patients with chronic hepatitis C using interferon monotherapy did not appear biological response to the virus once a week of venous opening caused by iron-depleted iron in vivo before and after iron depletion test serum alanine aminotransferase, hepatitis C Viral RNA, transferrin saturation, ferritin, 8-isoprostane, hyaluronic acid, amino-terminal procollagen III peptide, and YKL-40 levels. After 4 ~ 11 weeks of excretion of iron after exhaustion, serum alanine aminotransferase, transferrin saturation and ferritin changes were statistically significant. Serum alanine aminotransferase returned to normal in 4 patients (22%). Serum procollagen III peptide was significantly decreased in patients with biochemical response, while no significant changes were observed in other markers. The results suggest that 22% of patients treated with interferon monotherapy showed an association between this biochemical response and iron depletion in the body. In patients with biochemical response to liver fibrosis in key markers have also been significantly reduced.