肝硬化脾功能亢进患者肝组织中铁过载及铁调素mRNA表达的意义

目的 探讨肝硬化合并不同程度脾功能亢进(脾亢)患者肝组织中铁过载及铁调素(hepcidin)mRNA表达的意义.方法 收集肝硬化合并轻、中及重度脾亢患者肝活检标本各10例,共30例(肝硬化组),外伤性肝破裂手术标本10例(对照组),采用原子分光光度计检测肝组织铁元素含量;采用化学发光法检测血清铁蛋白的含量;采用逆转录-聚合酶链反应(RT-PCR)检测肝组织hepcidin mRNA的表达.结果 肝硬化脾亢患者按脾功能亢进程度分为轻、中及重度3组,其肝组织中铁元素含量明显递增,分别为(0.1205±0.0021)、(0.1624±0.0028)和(0.1716±0.0032)mmol/g,均明显高于正常肝组织(0.0639±0.0025)mol/g(P<0.05),表现为铁过载;肝硬化组血清铁蛋白的含量为(436.2±51.6)μg/L,显著高于对照组的(152.5±38.7) μg/L(P<0.01);肝硬化组hepcidin mRNA的表达水平为1.73±0.26,明显高于对照组的0.68±0.22(P<0.01);而且各组的hepcidin mRNA表达水平与血清铁蛋白含量之间具有显著相关性(肝硬化组r=0.735,对照组r=0.648,P<0.01).结论 肝硬化脾亢患者的肝组织中存存铁过载,并随脾亢程度加重而明显增加;hepcidinmRNA是调节铁代谢平衡并影响肝硬化进程的重要因素.

Implication of iron overload and hepcidin mRNA expression in liver tissues of cirrhotic patients with hypersplenism

Objective To investigate the implication of iron overload and hepcidin mRNA expression in hver tissues of cirrhotic patients with varying degrees of hypersplenism. Methods Hepatic iron was evaluated retrospectively using atomic absorption spectrophotometer method in liver biopsies of 30 cirrhotic patients with varying degrees of hypersplenism (cirrhosis) and 10 liver traumatic subjects (controls). Serum ferritin level was defined by photochmemistry, and hepeidin mRNA expression by reverse transcrip-tion polymerase chain reaction (RT-PCR). Results The hepatic iron contents were (0.1205±0.0021), (0.1624±0.0028) and (0.1716±0.0032) mmol/g in cirrhotic patients with slight, moderate and serious hypersplenism respectively, which were significantly higher than in controls (0.0639±0.0025) mmol/g]. This liver iron overload became serious when hypersplenism developed (P<0.05). Furthermore, serum ferritin and hepcidin mRNA expression level were (436.2±51.6) μg/L and 1.73±0.26 respectively, both elevated in cirrhotic patients dramatically as compared with those in controls (152.5±38.7) μg/L and 0.68±0.22, respectively, P<0.01]. It was also demonstrated there was a marked correlation between serum ferritin and hepcidin mRNA in cirrhosis and controls (r=0.735 and r=0.648 ,P<0.01). Conclusion Liver iron overload in cirrhotic patients with hypersplenism seems to enhance as hypersplenism developed. Hepcidin mRNA plays a key role in the maintenance of iron homeostasis and pathogenesis of cirrhosis.