酒精性肝病患者血清铁蛋白和血清铁的变化观察

目的:观察酒精性肝病(ALD)患者血清中铁和铁蛋白的变化。方法:对酒精性肝病、嗜酒者、正常健康人群的血清铁(SI)、血清铁蛋白(Ferr)、血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)和红细胞平均体积(MCV)进行检测和分析。结果:在238例嗜酒者中符合诊断ALD者65例,占27.3%;GGT异常者(>90 U/L)107例,占45%;MCV>99 fL者60例,占25%;AST异常者96例,占40%。ALD组的血清Fe(10.9±2.6)μmol/L,较嗜酒组(19.4±5.3)μmol/L低,差异有统计学意义(P<0.01)。Ferr增高者在ALD组中的阳性率为61%,在嗜酒组中的阳性率也达20%;血清铁蛋白在ALD组(207.7±50.3)μg/L,与嗜酒者组(196.6±55.4)μg/L均较对照组(161.3±30.1)μg/L明显增高。结论:Ferr在诊断慢性酒精中毒患者的敏感性较高,甚至高于GGT;多指标联合检测对酒精性肝病的早期预防和诊断有重要价值。

Analysis of changes of serum iron and ferrion in patients with alcoholic liver disease

Objective To observe the changes of serum iron（SI） and ferrion（Ferr） in patients with alcoholic liver disease （ALD）. Method To detect and analysis SI, Ferr, alanine aminotransferase （ ALT）, aspartate aminotransferase （AST） , T - glutamyl transpeptidase （GGT） and mean corpuscular volume（MCV） in patients of ALD, aleoholists and healthy controls. Results Among 238 eases of alcoholics, 65 cases accorded with the diagnosis of ALD, accounting for 27.3% ;107 had abnormal GGT （ 〉 90 U/L）, accounting for 45% ;60 had abnormal MCV 〉99 t, accounting for 25% ;96 had abnormal AST, accounting for 40% ; ALD group＇s SI（ 10. 9 ±2. 6） μmol/L was lower than the alcohol group（ 19.4 ± 5.3 ） μmol/L. The positive rate of cases with increased Ferr levels in ALD group and alcoholic group were 61% and 20%, respectively, significantly higher than those in control group. Conclusion Ferr remains high sensitivity in diagnosis of patients with chronic alcoholism, which is even higher than GGT. The combined detection of multicriteria has great significance in early prophylaxis and diagnosis of ALD