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血液透析和肾移植对慢性肾衰竭儿童微量元素浓度的影响。

Influence of haemodialysis and renal transplantation on trace element concentrations in children with chronic renal failure.

作者信息

Wihelm M, Hanewinckel B, Bläker F

出版信息

Eur J Pediatr. 1986 Oct;145(5):372-6. doi: 10.1007/BF00439241.

Abstract

Whole blood levels of Cd and Pb (microgram/g Hb), serum concentrations of Sr and Zn and their urinary excretion were measured in healthy, renal transplant and dialyzed children by atomic absorption spectroscopy. Furthermore, before and after dialysis the concentrations of these elements were determined in blood/serum as well as in the dialysis fluid. The predialytic concentrations of Cd, Pb and Sr in blood/serum were significantly increased compared to controls. Haemodialysis had only minor effects on whole blood Cd and Pb levels but serum Sr and Zn concentrations increased as a result of high metal levels in dialysis fluid. Children after renal transplantation showed no alterations in Pb, Sr and Zn concentrations compared to healthy children but whole blood Cd was increased. According to the renal function the Pb, Cd and Zn urinary excretion decreased in the following order: healthy, renal transplant and dialysis children. Sr urinary excretion was increased in haemodialysis and renal transplant patients. In conclusion, we found no Zn deficiency. Elevated blood levels of Cd and Pb and elevated Sr serum concentrations in paediatric patients undergoing dialysis and increased Cd whole blood levels in renal transplant children could be of clinical interest.

摘要

通过原子吸收光谱法测定了健康儿童、肾移植儿童和透析儿童的全血镉(Cd)和铅(Pb)水平(微克/克血红蛋白)、血清锶(Sr)和锌(Zn)浓度及其尿排泄量。此外,在透析前后还测定了血液/血清以及透析液中这些元素的浓度。与对照组相比,血液/血清中透析前镉、铅和锶的浓度显著升高。血液透析对全血镉和铅水平影响较小,但由于透析液中金属水平较高,血清锶和锌浓度升高。与健康儿童相比,肾移植儿童的铅、锶和锌浓度没有变化,但全血镉升高。根据肾功能,铅、镉和锌的尿排泄量按以下顺序降低:健康儿童、肾移植儿童和透析儿童。血液透析和肾移植患者的锶尿排泄量增加。总之,我们未发现锌缺乏。接受透析的儿科患者血液中镉和铅水平升高、血清锶浓度升高以及肾移植儿童全血镉水平升高可能具有临床意义。

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