[中国遗传性血色病诊断和治疗指南]。

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引用次数: 0

摘要

遗传性血色病是一种铁超载疾病,由铁调节基因突变引起,导致肝脏、心脏、皮肤、胰腺和性腺等器官中铁过度沉积,引起相应的多系统损害。这种疾病在欧美人群中比较常见,主要是由 HFE 基因突变引起的;但在中国和其他亚洲国家却很少见,几乎完全是由非 HFE 基因突变引起的。临床特征包括原因不明的慢性肝炎或肝硬化,伴有血清铁蛋白升高和/或转铁蛋白饱和度升高。核磁共振成像显示肝脏内有铁沉积,肝脏活检显示肝细胞内有铁积聚,基因检测有助于该病的诊断。反复抽血是治疗这种疾病的一线疗法。对于不能耐受抽血疗法的患者,可采用铁螯合疗法,进展到终末期肝病的患者则需要进行肝移植。为了帮助临床医生对遗传性血色病的诊断和治疗做出明智的决定,中华医学会肝病学分会邀请了来自临床医学、分子遗传学、病理学、影像学和方法学等领域的专家,系统总结了该领域的进展,并共同制定了目前的指南。
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[Chinese guidelines for the diagnosis and treatment of hereditary hemochromatosis].

Hereditary hemochromatosis is an iron overload disease caused by mutations in iron-regulating genes, resulting in excessive iron deposition in organs such as the liver, heart, skin, pancreas, and gonads, leading to corresponding multi-system damage. This condition is relatively common in European and American populations, primarily caused by mutations in the HFE gene; however, it is rare in China and other Asian countries, almost exclusively due to mutations in non-HFE genes. Clinical features include unexplained chronic hepatitis or cirrhosis, accompanied by elevated serum ferritin and/or increased transferrin saturation. MRI shows iron deposition in the liver, liver biopsy reveals iron accumulation in hepatocytes, and genetic testing facilitate the diagnosis of this disease. Repeated phlebotomy is the first-line therapy for this condition. For those who cannot tolerate phlebotomy, iron chelation therapy may be used, and patients who progress to end-stage liver disease will require liver transplantation. To assist clinicians in making informed decisions on the diagnosis and treatment of hereditary hemochromatosis, the Chinese Society of Hepatology, Chinese Medical Association has invited experts from clinical medicine, molecular genetics, pathology, imaging, and methodology to systematically summarize the advancement in this field and collaboratively develop the current guidelines.

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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
7574
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