Holtkamp W, Brodersen H P, Thiery J, Falkner C, Bolzius R, Larbig D, Reis H E
Medizinische Klinik, Krankenhaus Maria Hilf Mönchengladbach, Akademisches Lehrkrankenhaus, RWTH Aachen.
Klin Wochenschr. 1991 Jun 18;69(9):392-6. doi: 10.1007/BF01647412.
Infection is a major cause of morbidity and mortality in patients undergoing hemodialysis for end stage renal disease. Low plasma zinc levels have been associated with immunodepression in these patients. In a randomized, placebo controlled double-blind cross over study, plasma zinc levels, delayed hypersensivity to 7 Antigens (Merieux-Multitest), absolute lymphocyte counts, T- and B-lymphocytes, suppressor-T and helper T-cells and natural killer cells were studied in 25 hemodialysis patients before, during and after intravenous zinc supplementation for 8 weeks. The hemodialysis patients had significantly lower predialysis plasma zinc concentrations compared to 76 healthy controls (74 +/- 12 vs. 126 +/- 28 mcg/dl, p less than 0.001). The plasma zinc concentrations increased to the normal range during the treatment period. Lymphocyte subtype analysis showed a significant decrease of suppressor-T cells and an increase of the helper-T/suppressor-T ratio (2.09 +/- 0.26 vs. 3.18 +/- 0.48, p less than 0.05) after zinc supplementation. Delayed hypersensivity to intradermal antigens increased significantly only after zinc treatment (2.0 +/- 0.7 vs. 5.8 +/- 1.7, p less than 0.05), not after placebo. The changes were reversible after finishing the zinc treatment. It is concluded, that plasma zinc levels are reduced in hemodialysis patients and that the substitution of zinc restores some of the depressed immune functions in these patients.
感染是终末期肾病患者接受血液透析时发病和死亡的主要原因。血浆锌水平低与这些患者的免疫抑制有关。在一项随机、安慰剂对照双盲交叉研究中，对25例血液透析患者在静脉补充锌8周前、期间和之后的血浆锌水平、对7种抗原的迟发型超敏反应（梅里埃多种试验）、绝对淋巴细胞计数、T淋巴细胞和B淋巴细胞、抑制性T细胞和辅助性T细胞以及自然杀伤细胞进行了研究。与76名健康对照者相比，血液透析患者透析前血浆锌浓度显著降低（74±12 vs. 126±28 mcg/dl，p<0.001）。治疗期间血浆锌浓度升至正常范围。淋巴细胞亚群分析显示，补充锌后抑制性T细胞显著减少，辅助性T细胞与抑制性T细胞的比例增加（2.09±0.26 vs. 3.18±0.48，p<0.05）。仅在锌治疗后，对皮内抗原的迟发型超敏反应显著增加（2.0±0.7 vs. 5.8±1.7，p<0.05），而安慰剂治疗后未增加。锌治疗结束后，这些变化是可逆的。结论是，血液透析患者的血浆锌水平降低，补充锌可恢复这些患者一些受到抑制的免疫功能。
