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血液透析患者血清锌和铜水平的纵向研究及其与生化标志物的关系。

Longitudinal study of serum zinc and copper levels in hemodialysis patients and their relation to biochemical markers.

作者信息

Navarro-Alarcon M, Reyes-Pérez A, Lopez-Garcia H, Palomares-Bayo M, Olalla-Herrera M, Lopez-Martinez M C

机构信息

Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain.

出版信息

Biol Trace Elem Res. 2006 Dec;113(3):209-22. doi: 10.1385/BTER:113:3:209.

Abstract

A 6-mo longitudinal study of 48 hemodialysis patients (HPs) with chronic renal failure was performed. Three blood samplings were done. Samples of whole blood from each patient were collected during hemodialysis sessions after passing through the artificial kidney. Zinc and copper levels were measured by atomic absorption spectrometry. Additionally, 36 biochemical indexes were evaluated during the study. Fifty-two healthy matched controls were also considered. Mean serum zinc and copper concentrations in HPs were significantly decreased (Zn) and increased (Cu), when compared with healthy controls (p < 0.01). Zinc concentrations found in the first and second blood samplings from patients were significantly lower than those measured for the third sampling (p < 0.01). The etiology of chronic renal failure influenced the statistically serum Zn levels of patients (p < 0.05). Serum copper levels of HPs were significantly diminished by the existence of secondary associated diseases (p < 0.01). Uric acid and parathyroid hormone, and total-cholesterol and glutamic-pyruvic-transaminase levels were significantly (p < 0.05) and linearly related with serum zinc and copper concentrations, respectively. From all of indexes, creatinine, direct bilirubin, magnesium, calcium, parathyroid hormone, transferrin, and albumin were statistically modified along the longitudinal study (p < 0.05). Transferrin serum levels were significantly diminished in the third blood sampling, indicating the tendency toward anemia in the patients. This result is reinforced by low levels of biochemical and hematological indexes related with iron body staus.

摘要

对48例慢性肾衰竭血液透析患者进行了为期6个月的纵向研究。进行了三次血液采样。在血液透析过程中,当血液通过人工肾后,采集每位患者的全血样本。通过原子吸收光谱法测量锌和铜的水平。此外,在研究期间评估了36项生化指标。还纳入了52名健康匹配对照。与健康对照相比,血液透析患者的血清锌平均浓度显著降低(锌),血清铜平均浓度显著升高(铜)(p < 0.01)。患者第一次和第二次血液采样中的锌浓度显著低于第三次采样测量的浓度(p < 0.01)。慢性肾衰竭的病因影响患者的血清锌水平(p < 0.05)。继发性相关疾病的存在使血液透析患者的血清铜水平显著降低(p < 0.01)。尿酸和甲状旁腺激素水平,以及总胆固醇和谷丙转氨酶水平分别与血清锌和铜浓度显著(p < 0.05)且呈线性相关。在所有指标中,肌酐、直接胆红素、镁、钙、甲状旁腺激素、转铁蛋白和白蛋白在纵向研究中均有统计学改变(p < 0.05)。第三次血液采样中转铁蛋白血清水平显著降低,表明患者有贫血倾向。与铁状态相关的生化和血液学指标水平较低强化了这一结果。

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