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目的:探讨青海地区不同基因型慢性丙型肝炎患者肝功能与血清铁代谢指标的差异。方法:入组丙型肝炎基因分型成功的慢性丙型肝炎患者138例,收集患者血清铁(SI)、血清铁蛋白(SF)、天门冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、球蛋白(GLB)指标,比较1b、2a、3a/3b三种不同丙型肝炎患者肝功能、铁代谢指标的差异性。结果:本组患者lb型61例、2a型50例、3a/3b型27例;1b、2a及3a/3b三种基因型慢性丙型肝炎患者的ALT、AST、SF存在统计学差异(P<0.05),其他指标无统计学差异;SI、SF与ALT、AST、GLB正相关,1b组ALT与SF(r=0.326,P<0.01)。结论:青海地区人群中丙型肝炎感染以1b和2a型为主;不同基因型的患者肝脏炎症指标和铁蛋白存在差异;血清铁代谢指标与肝脏炎症指标有明显的相关性,而1b型患者相较2a型患者可能更容易出现铁沉积。
Objective: To investigate the differences of liver function and serum iron metabolism indexes in patients with different genotypes of chronic hepatitis C in Qinghai. Methods: A total of 138 patients with chronic hepatitis C were enrolled in this study. Serum iron (SI), serum ferritin (SF), aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB) and globulin (GLB), and to compare the difference of hepatic function and iron metabolism between three different hepatitis C patients with 1b, 2a and 3a / 3b. Results: There were 61 cases of type 1b, 50 cases of type 2a and 27 cases of type 3a / 3b. The levels of ALT, AST and SF in patients with genotype 1b, 2a and 3a / 3b were significantly different (P <0.05). There was no significant difference in other indexes between the two groups. SI and SF were positively correlated with ALT, AST and GLB, while ALT and SF in group 1b were significantly higher than those in group 1b (r = 0.326, P <0.01). Conclusion: Hepatitis C infection is predominant in 1b and 2a in the population of Qinghai. Liver inflammation and ferritin are different in different genotypes. There is a significant correlation between serum iron metabolism and hepatic inflammation, while patients with type 1b Iron deposition may be more likely to occur than in patients with type 2a.