Fernández-Bañares F, Mingorance M D, Esteve M, Cabré E, Lachica M, Abad-Lacruz A, Gil A, Humbert P, Boix J, Gassull M A
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Am J Gastroenterol. 1990 Dec;85(12):1584-9.
Serum levels of zinc, copper, and selenium, and alkaline phosphatase activity were prospectively studied in 29 patients with inflammatory bowel disease. Fifteen patients had extensive active colitis (active colitis group). Seven patients had active, and seven cases inactive small bowel or ileocecal Crohn's disease (small bowel disease group). Ninety-three healthy subjects acted as controls. Serum trace element levels were considered in relation to vitamin A and E levels, nutritional parameters, the activity of the disease, and the recent intake of steroids. The effect of total enteral nutrition on serum trace elements was studied in seven cases. Serum zinc levels were lower and serum copper levels higher in the active colitis group than in controls (p = 0.0007, and p = 0.02, respectively). More than 50% of patients with active colonic or small bowel disease showed zinc levels below the 15th percentile of the control group. Serum zinc levels correlated with plasma vitamin A in acute colitis (r = 0.67; p = 0.006), and with both serum albumin concentration (r = 0.76; p = 0.002) and disease activity score (r = -0.67, p = 0.009) in patients with small bowel disease. The copper:zinc ratio was higher in the active colitis group than in controls (p = 0.002). In spite of the increase in serum albumin levels and the decrease in disease activity, serum zinc levels remained low after total enteral nutrition. The implications of the abnormal trace element status in patients with inflammatory bowel disease are discussed.
对29例炎症性肠病患者的血清锌、铜、硒水平及碱性磷酸酶活性进行了前瞻性研究。15例患者患有广泛性活动性结肠炎（活动性结肠炎组）。7例患有活动性小肠或回盲部克罗恩病，7例为非活动性（小肠疾病组）。93名健康受试者作为对照。研究了血清微量元素水平与维生素A和E水平、营养参数、疾病活动度及近期类固醇摄入量之间的关系。对7例患者研究了全肠内营养对血清微量元素的影响。活动性结肠炎组的血清锌水平低于对照组，血清铜水平高于对照组（分别为p = 0.0007和p = 0.02）。超过50%的活动性结肠或小肠疾病患者的锌水平低于对照组的第15百分位数。急性结肠炎患者的血清锌水平与血浆维生素A相关（r = 0.67；p = 0.006），小肠疾病患者的血清锌水平与血清白蛋白浓度（r = 0.76；p = 0.002）及疾病活动评分（r = -0.67，p = 0.009）均相关。活动性结肠炎组的铜锌比值高于对照组（p = 0.002）。尽管血清白蛋白水平升高且疾病活动度降低，但全肠内营养后血清锌水平仍较低。本文讨论了炎症性肠病患者微量元素状态异常的意义。
