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目的 研究血清铁、血清铁蛋白与酒精性、非酒精性脂肪肝的关系。方法 采用 1秒钟快速肝穿刺 ,对 97例脂肪肝患者取肝组织标本 ,行HE和铁染色 ,分别用原子吸收光谱法和放射免疫法检测患者的血清铁和血清铁蛋白。结果 中重度酒精性脂肪肝 (AFL)血清铁、血清铁蛋白测定值 [(2 0 .9± 9.3) μmol/L ,(2 17.6± 71.8)ng/ml;(2 9.1± 6 .5 ) μmol/L ,(2 84 .7± 77.9)ng/ml]与对照组 [(10 .5± 5 .7) μmol/L ,(14 3.3± 71.9)ng/ml]比较明显升高 (P <0 .0 1)。重度非酒精性脂肪肝 (NAFL)的血清铁和血清铁蛋白 [(2 1.5± 11.1) μmol/L ,(199.3±72 .1)ng/ml]和对照组 [(10 .5± 5 .7) μmol/L ,(14 3.3± 71.9)ng/ml]比较亦显著升高 (P <0 .0 1) ,而且AFL多出现肝细胞灶性坏死 (6 7% )和肝铁过载(87% )。结论 重度NAFL及中重度AFL多出现血清铁和铁蛋白增高 ,AFL多合并肝铁过载 ,血清铁、铁蛋白可以作为肝铁过载的重要指标。
Objective To study the relationship between serum iron, serum ferritin and alcoholic and non-alcoholic fatty liver. Methods One-second fast liver biopsy was performed in 97 patients with fatty liver. Hematoxylin-eosin and iron staining were performed. Serum iron and serum ferritin were detected by atomic absorption spectrometry and radioimmunoassay. Results Serum levels of iron and serum ferritin in patients with moderate to severe alcoholic fatty liver (AFL) were significantly higher than those in patients with AFL [(20.9 ± 9.3) μmol / L, (21.17 ± 71.8) ng / ml, (21.9 ± 6.5) μmol / (2 84.7 ± 77.9) ng / ml] was significantly higher than that in the control group [(10.5 ± 5 .7) μmol / L, (14.33 ± 71.9) ng / ml] .0 1). The levels of serum iron and serum ferritin in severe non-alcoholic fatty liver (NAFL) [(2 1.5 ± 11.1) μmol / L, (199.3 ± 72.1) ng / ml] and control group [(10.5 ± 5 .7 (14.3 ± 71.9) ng / ml] (P <0.01), and more AFL had hepatocellular focal necrosis (67%) and liver iron overload (87% ). Conclusions Serum iron and ferritin were increased in severe NAFL and moderate-severe AFL. AFL combined with hepatic iron overload. Serum iron and ferritin could be used as an important indicator of hepatic iron overload.