肝脏铁过载的评估及治疗新进展

丁蕊; 贾继东

doi:10.3969/j.issn.1001-5256.2014.09.031

肝脏铁过载的评估及治疗新进展

DOI: 10.3969/j.issn.1001-5256.2014.09.031

丁蕊,
贾继东

首都医科大学附属北京友谊医院肝病中心

详细信息

中图分类号: R575.5
计量
- 文章访问数: 3821
- HTML全文浏览量: 40
- PDF下载量: 651
- 被引次数: 0
出版历程
- 收稿日期: 2013-12-04
- 出版日期: 2014-09-20

Progress in evaluation and treatment of hepatic iron overload

Liver Research Center, Beijing Friendship Hospital, Capital Medical University

摘要

摘要: 铁过载为铁在体内过度沉积并导致肝脏、胰腺、心脏、内分泌器官等结构损害和功能障碍的一种病理状态。肝脏为机体储存铁的主要部位,过度铁沉积可诱发肝内炎症及纤维组织增生,后期可发展为肝硬化,甚至肝癌,影响预后。正确的评估及有效的治疗可在一定程度上改善铁过载引起的肝组织损伤,提高患者生存率。
- 铁超负荷 /
- 铁蛋白质类 /
- 静脉切开术 /
- 铁螯合剂 /
- 综述
Abstract: Iron overload is a metabolic disorder characterized by excessive iron deposition in the liver, pancreas, heart, endocrine organs, etc., resulting in structural damage and dysfunction. The liver is the primary organ for iron storage, and excessive iron deposition induces liver inflammation and fibrosis, which may progress to cirrhosis and even liver cancer, with a poor prognosis. Accurate evaluation and effective treatment can reduce liver injury caused by iron overload and improve patients' survival.
- iron overload /
- ferritins /
- phlebotomy /
- iron chelating agents /
- review

HTML全文

参考文献(34)

[1] FRANCHINI M, MONTAGNANA M, LIPPI G.Hepcidin and iron metabolism:from laboratory to clinical implications[J].Clinica Chimica Acta, 2010, 411 (21) :1565-1569.

[2]BHATTACHARYYA S, GHOSH J, SIL PC.Iron induces hepatocytes death via MAPK activation and mitochondria-dependent apoptotic pathway:Beneficial role of glycine[J].Free Radic Res, 2012, 46 (10) :1296-1307.

[3]PHILIPPE MA, RUDDELL RG, RAMM GA.Role of iron in hepatic fibrosis:one piece in the puzzle[J].World J Gastroenterol, 2007, 13 (35) :4746-4754.

[4]NELSON JE, WILSON L, BRUNT EM, et al.Relationship between the pattern of hepatic iron deposition and histological severity in nonalcoholic fatty liver disease[J].Hepatology, 2011, 53 (2) :448-457.

[5]FUJITA N, SUGIMOTO R, URAWA N, et al.Hepatic iron accumulation is associated with disease progression and resistance to interferon/ribavirin combination therapy in chronic hepatitis C[J].J Gastroenterol Hepatol, 2007, 22 (11) :1886-1893.

[6]COSTA-MATOS L, BATISTA P, MONTEIRO N, et al.HFE mutations and iron overload in patients with alcoholic liver disease[J].Arq Gastroenterol, 2013, 50 (1) :35-41.

[7] KO C, SIDDAIAH N, BERGER J, et al.Prevalence of hepatic iron overload and association with hepatocellular cancer in end-stage liver disease:results from the National Hemochromatosis Transplant Registry[J].Liver Int, 2007, 27 (10) :1394-1401.

[8]HAMED MA, ALI SA.Non-viral factors contributing to hepatocellular carcinoma[J].World J Hepatol, 2013, 5 (6) :311-322.

[9]ZHAO R, ZHANG LY.Recent progress in relationship between iron overload and hepatocellular carcinoma[J].J Clin Hepatol, 2011, 27 (6) :670-673. (in Chinese) 赵睿, 张岭漪.铁超载与肝细胞癌关系的研究进展[J].临床肝胆病杂志, 2011, 27 (6) :670-673.

[10] MOYER TP, HIGHSMITH WE, SMYRK TC, et al.Hereditary hemochromatosis:laboratory evaluation[J].Clin Chim Acta, 2011, 412 (17) :1485-1492.

[11] BARTON JC, BARTON JC, ACTON RT, et al.Increased risk of death from iron overload among 422 treated probands with HFE/hemochromatosis and serum levels of ferritin greater than 1000μg/L at diagnosis[J].Clin Gastroenterol Hepatol, 2012, 10 (4) :412-416.

[12] TSITSIKAS DA, NZOUAKOU R, AMEEN V, et al.Comparison of serial serum ferritin measurements and liver iron concentration assessed by MRI in adult transfused patients with sickle cell disease[J].Eur J Haematol, 2014, 92 (2) :164-167.

[13]BACON BR, ADAMS PC, KOWDLEY KV, et al.Diagnosis and management of hemochromatosis:2011 practice guideline by the American Association for the study of liver diseases[J].Hepatology, 2011, 54 (1) :328-343.

[14]FISCHER R, HARMATZ PR.Non-invasive assessment of tissue iron overload[J].ASH Education Program Book, 2009, 2009 (1) :215-221.

[15]TURLIN B, DEUGNIER Y.Evaluation and interpretation of iron in the liver[C].Semin Diagn Pathol, 1998, 15 (4) :237-245.

[16]DEUGNIER Y, TURLIN B.Pathology of hepatic iron overload[J].World J Gastroenterol, 2007, 13 (35) :4755-4760.

[17]BASSETT ML, HALLIDAY JW, POWELL LW.Value of hepatic iron measurements in early hemochromatosis and determination of the critical iron level associated with fibrosis[J].Hepatology, 1986, 6 (1) :24-29.

[18]TROTTIER BJ, BURNS LJ, DEFOR TE, et al.Association of iron-overload with allogeneic hematopoietic cell transplantation outcomes:a prospective cohort study using R2 MRI measured liver iron content[J].Blood, 2013, 122 (9) :1678-1684.

[19]SAVANI BN.Ferritin and FerriScan in HCT recipients[J].Blood, 2013, 122 (9) :1539-1541.

[20] WOOD JC.Magnetic resonance imaging measurement of iron overload[J].Curr Opin Hematol, 2007, 14 (3) :183.

[21] FRAQUELLI M, CASSINERIO E, ROGHI A, et al.Transient elastography in the assessment of liver fibrosis in adult thalassemia patients[J].Am J Hematol, 2010, 85 (8) :564-568.

[22]PAPARO F, CEVASCO L, ZEFIRO D, et al.Diagnostic value of real-time elastography in the assessment of hepatic fibrosis in patients with liver iron overload[J].Eur J Radiol, 2013, 82 (12) :e755-e761.

[23] EVERS D, KERKHOFFS JL, van EGMOND L, et al.The efficiency of therapeutic erythrocytapheresis compared to phlebotomy in relation to blood volume and delta-hematocrit:An evaluation in hereditary hemochromatosis polycythemia vera and secondary erythrocytosis[J].Transfus Apher Sci, 2013, 48 (2) :187.

[24] EVERS D, KERKHOFFS JL, van EGMOND L, et al.The efficiency of therapeutic erythrocytapheresis compared to phlebotomy:a mathematical tool for predicting response in hereditary hemochromatosis, polycythemia vera, and secondary erythrocytosis[J].J Clin Apher, 2014, 29 (3) :133-138.

[25] STEFASHYNA O, STERN M, INFANTI L, et al.Pattern of care of blood donors with early-uncomplicated hereditary haemochromatosis in a Swiss blood donation centre[J].Vox Sang, 2013, 106 (2) :111-117.

[26] FLATEN TP, AASETH J, ANDERSEN O, et al.Iron mobilization using chelation and phlebotomy[J].J Trace Elem Med Biol, 2012, 26 (2) :127-130.

[27]AYDINOK Y, ULGER Z, NART D, et al.A randomized controlled1-year study of daily deferiprone plus twice weekly desferrioxamine compared with daily deferiprone monotherapy in patients with thalassemia major[J].Haematologica, 2007, 92 (12) :1599-1606.

[28]PEPE A, MELONI A, ROSSI G, et al.Cardiac and hepatic iron and ejection fraction in thalassemia major:multicentre prospective comparison of combined deferiprone and deferoxamine therapy against deferiprone or deferoxamine monotherapy[J].J Cardiovasc Magn Reson, 2013, 15 (1) :1.

[29] PREZA GC, RUCHALA P, PINON R, et al.Minihepcidins are rationally designed small peptides that mimic hepcidin activity in mice and may be useful for the treatment of iron overload[J].J Clin Invest, 2011, 121 (12) :4880-4888.

[30]SCHMIDT PJ, TOUDJARSKA I, SENDAMARAI AK, et al.An RNAi therapeutic targeting Tmprss6 decreases iron overload in Hfe-/-mice and ameliorates anemia and iron overload in murineβ-thalassemia intermedia[J].Blood, 2013, 121 (7) :1200-1208.

[31] CORRADINI E, SCHMIDT PJ, MEYNARD D, et al.BMP6 treatment compensates for the molecular defect and ameliorates hemochromatosis in HFE knockout mice[J].Gastroenterology, 2010, 139 (5) :1721-1729.

[32]ZHEN AW, NGUYEN NH, GIBERT Y, et al.The small molecule genistein increases hepcidin expression in human hepatocytes[J].Hepatology, 2013, 58 (4) :1315-1325.

[33] O’GLASSER AY, SCOTT DL, CORLESS CL, et al.Hepatic and cardiac iron overload among patients with end-stage liver disease referred for liver transplantation[J].Clin Transplant, 2010, 24 (5) :643-651.

[34]BARDOU-JACQUET E, PHILIP J, LORHO R, et al.Liver transplantation normalizes serum hepcidin level and cures iron metabolism alterations in HFE hemochromatosis[J].Hepatology, 2013, 59 (3) :839-847.引证本文:DING R, JIA JD.Progress in evaluation and treatment of hepatic iron overload[J].J Clin Hepatol, 2014, 30 (9) :961-964. (in Chinese) 丁蕊, 贾继东.肝脏铁过载的评估及治疗新进展[J].临床肝胆病杂志, 2014, 30 (9) :961-964.

施引文献

资源附件(0)

访问统计