Ito Toshikazu, Uenoyama Kazuya, Kobayashi Kazuhiro, Kakumoto Mikio, Mizumoto Hiroshi, Katsura Toshiya, Onoue Masahide
Department of Pharmacy, Kitano Hospital, Tazuke Kofukai Medical Research Institute. 2-4-20, Ogimachi, Kita-ku, Osaka, 530-8480, Japan.
Laboratory of Clinical Pharmaceutics and Therapeutics, College of Pharmaceutical Sciences, Ritsumeikan University, 1-1-1, Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.
J Pharm Health Care Sci. 2021 Dec 2;7(1):46. doi: 10.1186/s40780-021-00229-4.
Zinc is an essential trace element involved in various physiological functions. In Japan, zinc acetate dihydrate is administered to neonates and infants with hypozincemia. Since serum copper concentrations are reduced by the administration of zinc, we retrospectively investigated changes in serum zinc and copper concentrations in preterm infants with hypozincemia receiving zinc acetate dihydrate.
Sixty-three preterm infants were included in the present study. Serum zinc and copper concentrations, doses, and other clinical characteristics were retrieved from electronic medical records.
The medians and interquartile ranges of the dosage and duration of zinc acetate dihydrate were 2.1 (1.8-2.5) mg/kg/day and 12.0 (10.0-13.0) days, respectively. Its administration increased serum zinc concentrations in 39 patients (61.9%) and to more than 70 μg/dL in 16 patients (25.4%). The group with a serum zinc concentration of 70 μg/dL or higher after administration had a significantly higher zinc dose of 2.5 mg/kg/day than the group with a serum zinc concentration of less than 70 μg/dL. Serum copper concentrations did not decrease in 44 patients (69.8%). In the group with a decreased serum copper concentration, postmenstrual age and body weight were significantly lower, while serum zinc concentrations were significantly higher at the start of administration.
The present results showed that when zinc acetate dihydrate was administered to preterm infants with hypozincemia, it was possible to increase serum zinc concentrations without decreasing serum copper concentrations in many cases. However, caution may be required when administering zinc to preterm infants with a lower postmenstrual age or milder hypozincemia because serum copper concentrations may decrease.
锌是一种参与多种生理功能的必需微量元素。在日本，二水醋酸锌被用于治疗低锌血症的新生儿和婴儿。由于锌的使用会降低血清铜浓度，我们回顾性研究了接受二水醋酸锌治疗的低锌血症早产儿血清锌和铜浓度的变化。
本研究纳入了63名早产儿。从电子病历中获取血清锌和铜浓度、剂量及其他临床特征。
二水醋酸锌的剂量中位数和四分位间距分别为2.1（1.8 - 2.5）mg/kg/天和12.0（10.0 - 13.0）天。其使用使39名患者（61.9%）的血清锌浓度升高，16名患者（25.4%）的血清锌浓度升至70μg/dL以上。给药后血清锌浓度≥70μg/dL的组锌剂量显著高于血清锌浓度<70μg/dL的组，为2.5mg/kg/天。44名患者（69.8%）的血清铜浓度未降低。血清铜浓度降低的组，月经后年龄和体重显著更低，而给药开始时血清锌浓度显著更高。
目前的结果表明，给低锌血症的早产儿使用二水醋酸锌时，在许多情况下有可能提高血清锌浓度而不降低血清铜浓度。然而，对于月经后年龄较小或低锌血症较轻的早产儿使用锌时可能需要谨慎，因为血清铜浓度可能会降低。
