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[血液透析对终末期肾衰竭患者血液中微量元素浓度变化的影响]

[Influence of hemodialysis on changes of trace metals concentrations in blood of patients with end-stage renal failure].

作者信息

Skarupskiene Inga, Kuzminskis Vytautas, Abdrachmanovas Olegas, Ryselis Stanislovas, Smalinskiene Alina, Naginiene Rima, Laukevicius Arvydas

机构信息

Clinic of Nephrology, Kaunas University of Medicine Hospital, Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2003;39 Suppl 1:131-8.

Abstract

This study on blood levels of trace metals in hemodialysis patients was carried out with an aim to clarify the impact of hemodialysis therapy on the trace metals status in such patients. Two hundred sixty six hemodialysis patients were enrolled. All patients underwent standard hemodialysis. Blood was collected before and after hemodialysis sessions. Atomic absorption spectrophotometry was applied to measure blood levels of aluminum, lead, cadmium, mercury as well as plasma levels of copper, and zinc. Aluminum, lead, mercury, and cadmium level in blood significant by increased after hemodialysis. The patients treated with acetate hemodialysis had significantly higher blood aluminum levels than the patients treated with bicarbonate hemodialysis (38.4+/-44.6 versus 25.9+/-43.5 microg/l, p=0.03). We observed negative correlation between copper concentration (n=60) in plasma and ultrafiltration (r=-0.4, p=0.003). The zinc and cadmium level increased with dialysis duration (r=0.2, p<0.001; r=0.2, p<0.02). Low plasma zinc levels, that is, <800 microg/l, was more often found in patients with <12 hour/week and <12 months hemodialysis duration. After 3 years of dialysis treatment blood lead, cadmium level (n=30) increased and plasma copper level decreased.

摘要

本研究旨在阐明血液透析治疗对血液透析患者体内微量金属元素状态的影响,对血液透析患者的血液中微量金属元素水平进行了研究。共纳入266例血液透析患者。所有患者均接受标准血液透析治疗。在血液透析前后采集血液样本。采用原子吸收分光光度法测定血液中铝、铅、镉、汞的水平以及血浆中铜和锌的水平。血液透析后,血液中的铝、铅、汞和镉水平显著升高。接受醋酸盐血液透析的患者血液铝水平显著高于接受碳酸氢盐血液透析的患者(38.4±44.6对25.9±43.5微克/升,p=0.03)。我们观察到血浆中铜浓度(n=60)与超滤之间呈负相关(r=-0.4,p=0.003)。锌和镉水平随透析时间延长而升高(r=0.2,p<0.001;r=0.2,p<0.02)。每周透析时间<12小时且透析时间<12个月的患者中,血浆锌水平较低(即<800微克/升)的情况更为常见。透析治疗3年后,血液中的铅、镉水平(n=30)升高,血浆铜水平降低。

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