Sando K, Hoki M, Nezu R, Takagi Y, Okada A
Department of Pediatric Surgery, Osaka University Medical School, Japan.
JPEN J Parenter Enteral Nutr. 1992 Jan-Feb;16(1):54-8. doi: 10.1177/014860719201600154.
Selenium (Se) is not routinely included in total parenteral nutrition (TPN) solution; thus, patients receiving long-term TPN may be at risk of Se deficiency, which may cause fatal cardiomyopathy. Platelet glutathione peroxidase (GSH-Px) activity, as well as Se levels and GSH-Px activity in plasma and erythrocytes during prolonged TPN, was measured in six patients with chronic gastrointestinal disease. During the time course of TPN, Se administration was discontinued for 12 weeks, and then resupplemented for another 12 weeks. Before the study period, all Se indices had been maintained within the normal range. After discontinuation of Se supplementation, a significant decrease in platelet GSH-Px activity was observed after 1 week (from 64 +/- 7 [mean +/- SD] to 39 +/- 5 U/g of protein). After resupplementation, it increased after 1 week (from 44 +/- 9 to 65 +/- 10 U/g of protein). Plasma Se indices significantly changed within 3 weeks after withdrawal and reintroduction of Se (Se: from 136 +/- 28 to 75 +/- 14 and from 61 +/- 22 to 125 +/- 33 micrograms/L; GSH-Px: from 236 +/- 50 to 140 +/- 36 and from 128 +/- 32 to 220 +/- 64 U/L). Erythrocyte Se indices showed no significant changes during the study period. The results demonstrate that platelet GSH-Px activity is the most sensitive index of Se status in TPN patients.
硒（Se）通常不包含在全胃肠外营养（TPN）溶液中；因此，接受长期TPN的患者可能有硒缺乏的风险，这可能导致致命的心肌病。对6例慢性胃肠道疾病患者在长期TPN期间的血小板谷胱甘肽过氧化物酶（GSH-Px）活性以及血浆和红细胞中的硒水平及GSH-Px活性进行了测定。在TPN过程中，硒的补充中断12周，然后再补充12周。在研究期之前，所有硒指标均维持在正常范围内。停止补充硒后，1周后观察到血小板GSH-Px活性显著下降（从64±7[平均值±标准差]降至39±5 U/g蛋白质）。重新补充后，1周后升高（从44±9升至65±10 U/g蛋白质）。在停止和重新引入硒后的3周内，血浆硒指标显著变化（硒：从136±28降至75±14，再从61±22升至125±33微克/升；GSH-Px：从236±50降至140±36，再从128±32升至220±64 U/L）。在研究期间，红细胞硒指标无显著变化。结果表明，血小板GSH-Px活性是TPN患者硒状态最敏感的指标。
