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测定血液透析患者的血清锌和镁水平可能对临床医生有帮助。

Determining Serum Zinc and Magnesium Levels in Hemodialysis Patients Could be Helpful for Clinicians.

作者信息

Ahmadipour Fereshteh, Mahjoub Soleiman, Pouramir Mahdi, Siahposht Abbas, Afshar Naderi Azam, Absalan Abdorrahim

机构信息

Department of Biology, Hariri Science Foundation, Babol, Iran.

Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

出版信息

Indian J Clin Biochem. 2017 Oct;32(4):464-467. doi: 10.1007/s12291-016-0604-7. Epub 2016 Aug 27.

Abstract

Trace element determination is requested rarely for critically ill patients in Iran, due to the underestimation of the trace element determination by Iranian physicians. The aim was to compare the levels of Zn and Mg in a group of hemodialysis patients and normal individuals. This study shows that trace element determination is helpful for management of hemodialysis patients. Fifty-three hemodialysis patients and 51 control individuals were randomly analyzed for Zn and Mg serum levels. Comparison of before or after dialysis and with normal individuals was done and receiver operating characteristics (ROC) curves were plotted to evaluate the analytical sensitivity and specificity of Zn and Mg determination. Confidence interval for all statistical methods was 95 %. Zinc serum levels were decreased after hemodialysis insignificantly ( = 0.201) but Mg levels were decreased significantly ( = 0.000). Both Zn and Mg levels, before and after hemodialysis were meaningfully lower than normal controls ( < 0.05). ROC analysis showed that the area under the curve was high for Zn levels both before and after hemodialysis but it was high for Mg only before hemodialysis. Current study shows that serum Zn and Mg measurements can have clinical importance. Both before and after hemodialysis, serum Zn = 297.5 µg/L and Mg = 2.295 µg/L are proposed as cut-off values with about 90 % specificity, for monitoring of these two element in hemodialysis patients. It is suggested that clinicians consider the measurement of these trace elements for hemodialysis patients routinely or periodically as clinical chemistry tests.

摘要

由于伊朗医生对微量元素测定的重视不足,伊朗对重症患者很少进行微量元素测定。本研究旨在比较一组血液透析患者和正常个体的锌(Zn)和镁(Mg)水平。研究表明,微量元素测定有助于血液透析患者的管理。对53例血液透析患者和51例对照个体的血清锌和镁水平进行了随机分析。比较了透析前后以及与正常个体的情况,并绘制了受试者工作特征(ROC)曲线以评估锌和镁测定的分析敏感性和特异性。所有统计方法的置信区间为95%。血液透析后血清锌水平无显著下降(P = 0.201),但镁水平显著下降(P = 0.000)。血液透析前后的锌和镁水平均显著低于正常对照组(P < 0.05)。ROC分析表明,血液透析前后锌水平的曲线下面积较高,但仅在血液透析前镁水平的曲线下面积较高。当前研究表明,血清锌和镁的测量具有临床意义。建议将血液透析前后血清锌 = 297.5 μg/L和镁 = 2.295 μg/L作为临界值,用于监测血液透析患者的这两种元素,其特异性约为90%。建议临床医生将这些微量元素的测量作为临床化学检测项目,常规或定期用于血液透析患者。

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