Rivera Maria Teresa, de Souza Andréa P, Hasslocher-Moreno Alejandro Marcel, Xavier Sergio S, Gomes Juliana A S, Rocha Manoel Otavio C, Correa-Oliveira Rodrigo, Nève Jean, Vanderpas Jean, Araújo-Jorge Tania C
Departamento de Ultra-estrutura e Biologia Celular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
Am J Trop Med Hyg. 2002 Jun;66(6):706-12. doi: 10.4269/ajtmh.2002.66.706.
Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 patients with chronic Chagas' disease from 2 Brazilian regions (Rio de Janeiro and Belo Horizonte), clinically stratified into groups as follows: indeterminate or asymptomatic (IND); cardiac asymptomatic (CARDa); cardiac symptomatic with moderate to severe heart dysfunction (CARDb); and healthy adults (HA), used for comparison. In most HA, Se levels were normal, excluding an overall Se deficiency. Se was significantly lower in CARDb than in HA, IND, or CARDa patients. This was not associated with a concomitant decrease in activity of glutathione peroxidase. Thyrotropin was normal, excluding iodine deficiency. Se correlated positive and significantly with ventricular ejection fraction (assessed via echocardiography). Asymptomatic children with acute Chagas' disease had normal Se as well as 5 noninfectious cases of cardiomyopathy. Low Se was found in 6 of 10 chagasic patients with digestive megasyndromes. Thus, the decrease in Se in chagasic patients seems to be a biological marker for Trypanosoma cruzi infection and related to the progression of pathology.
硒(Se)缺乏与某些心肌病有关。对来自巴西两个地区(里约热内卢和贝洛奥里藏特)的170例慢性恰加斯病患者的硒状态进行了测定,这些患者根据临床情况分为以下几组:不确定或无症状(IND);心脏无症状(CARDa);有中度至重度心脏功能障碍的心脏有症状(CARDb);以及健康成年人(HA,用作对照)。在大多数健康成年人中,硒水平正常,排除了总体硒缺乏的情况。CARDb组患者的硒水平显著低于健康成年人、IND组或CARDa组患者。这与谷胱甘肽过氧化物酶活性的同时降低无关。促甲状腺激素正常,排除了碘缺乏。硒与心室射血分数(通过超声心动图评估)呈显著正相关。急性恰加斯病的无症状儿童以及5例非感染性心肌病患者的硒水平正常。在10例患有消化巨症候群的恰加斯病患者中,有6例硒水平较低。因此,恰加斯病患者体内硒的降低似乎是克氏锥虫感染的一个生物学标志物,并且与病理进展有关。