Krízek M, Senft V, Motán J
1st Department of Internal Medicine, Faculty of Medicine of Charles University, Plzen, Czech Republic.
Sb Lek. 2000;101(3):241-8.
Selenium (Se) is considered an essential and very important trace element for humans. Blood Se levels in chronic hemodialysis (HD) patients are frequently reported to be lower than in controls. The aim of this study was to evaluate these lower Se blood levels with respect to the basic renal disease, duration of dialysis treatment, type of the membrane and dialysis solution used. We tried also to use the polynomial curve as a graphical method for rapid evaluation of a large number of Se blood levels. Se blood levels were measured before and after HD in 95 patients on chronic hemodialysis and in a control group of 20 healthy volunteers. Se blood levels were measured by atomic absorption spectrophotometry. Statistically significant increases of Se blood levels were found after HD (p < 0.001). During HD, the relatively high Se blood levels decreased and low levels increased but remained below the range of physiological values. These levels were lower than those of the control group (p < 0.001). Of the different dialysis membranes used, the greatest changes in Se blood levels were measured after HD with cuprophan membranes (p < 0.001). No significant difference in Se blood level in respect to the underlying kidney disease (chronic glomerulonephritis, tubulointerstitial nephritis, polycystic kidney disease, diabetic nephropathy) was revealed. No association of predialytic Se blood levels and the length of dialysis treatment was found. Concluding our results suggests low selenium content in dialysis solution and show that, in respect to the importance of Se for humans, its substitution is desirable.
硒（Se）被认为是人类必需且非常重要的微量元素。慢性血液透析（HD）患者的血硒水平经常被报道低于对照组。本研究的目的是根据基础肾脏疾病、透析治疗时长、所用透析膜类型和透析液来评估这些较低的血硒水平。我们还尝试使用多项式曲线作为一种图形方法来快速评估大量的血硒水平。对95例慢性血液透析患者及20名健康志愿者组成的对照组在血液透析前后测定血硒水平。血硒水平采用原子吸收分光光度法测定。血液透析后血硒水平有统计学意义的升高（p < 0.001）。在血液透析过程中，相对较高的血硒水平下降，较低的血硒水平上升，但仍低于生理值范围。这些水平低于对照组（p < 0.001）。在所使用的不同透析膜中，铜仿膜血液透析后血硒水平变化最大（p < 0.001）。未发现基础肾脏疾病（慢性肾小球肾炎、肾小管间质性肾炎、多囊肾病、糖尿病肾病）对血硒水平有显著差异。未发现透析前血硒水平与透析治疗时长之间存在关联。总结我们的结果表明透析液中硒含量低，并表明，鉴于硒对人类的重要性，补充硒是可取的。
