Kouw P M, Konings C H, de Vries P M, van der Meulen J, Oe P L
Department of Haemodialysis, Free University Hospital, Amsterdam, The Netherlands.
J Trace Elem Electrolytes Health Dis. 1991 Jun;5(2):115-9.
The depression of immunity to various antigens in chronic uremia is a frequently encountered phenomenon. Zinc deficiency might well be an important factor in its genesis. The aim of this study was to investigate the role of zinc deficiency in this reduced immune response. Two groups of 7 patients on haemodialysis who had failed to respond with seroconversion to an earlier vaccination against hepatitis B were revaccinated. One group received zinc by the addition of zinc chloride to the dialysate. Before initiation of the study zinc in plasma and leucocytes was measured. No difference in plasma and leucocyte zinc was observed between the two groups. Zinc in leucocytes was lower in patients than in a group of healthy volunteers (61.5 pmol/10E6 cells +/- 4.6 versus 73.8 +/- 5.6, p less than 0.005). Plasma zinc showed no difference between patients and healthy volunteers. During zinc supplementation zinc in plasma rose in the patient group receiving zinc (10.4 mmol/L +/- 1.5 to 14.2 +/- 1.9, p less than 0.005). However, no rise in leucocyte zinc was seen. At the end of the trial seroconversion had occurred in 2 patients in each group. It is concluded that zinc supplementation in haemodialysis patients does not lead to the restoration of leucocyte zinc to normal levels. Neither did it lead to an enhanced antibody response in our population after revaccination of haemodialysis patients against hepatitis B.
慢性尿毒症患者对各种抗原的免疫抑制是一种常见现象。锌缺乏很可能是其发病的一个重要因素。本研究的目的是探讨锌缺乏在这种免疫反应降低中的作用。两组各7名接受血液透析且对先前乙肝疫苗接种未产生血清转化反应的患者再次接种疫苗。一组通过在透析液中添加氯化锌来补充锌。在研究开始前，测量了血浆和白细胞中的锌含量。两组之间血浆和白细胞锌含量未观察到差异。患者白细胞中的锌含量低于一组健康志愿者（61.5 pmol/10E6细胞±4.6，而健康志愿者为73.8±5.6，p<0.005）。患者与健康志愿者之间血浆锌含量无差异。在补充锌期间，接受锌补充的患者组血浆锌含量升高（从10.4 mmol/L±1.5升至14.2±1.9，p<0.005）。然而，白细胞锌含量未见升高。试验结束时，每组各有2名患者发生了血清转化。得出的结论是，血液透析患者补充锌并不能使白细胞锌恢复到正常水平。在对血液透析患者再次接种乙肝疫苗后，补充锌也未导致我们研究人群中抗体反应增强。
