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维持性血液透析患者的锌代谢

Zinc metabolism in patients on maintenance hemodialysis.

作者信息

Muirhead N, Kertesz A, Flanagan P R, Hodsman A B, Hollomby D J, Valberg L S

出版信息

Am J Nephrol. 1986;6(6):422-6. doi: 10.1159/000167247.

Abstract

Recent studies have focused attention on the possible role of zinc depletion in the pathogenesis of uremic symptoms such as dysgeusia and impotence. The present studies were undertaken to evaluate the prevalence of zinc deficiency and abnormalities of zinc metabolism in patients with end-stage renal disease. A total of 43 stable chronic hemodialysis patients were screened for evidence of zinc deficiency by measurement of fasting predialysis leukocyte and plasma zinc. The results were compared with those from 30 healthy volunteers. Seventeen of these 43 patients had 65Zn absorption measured, and in 9 the rate of disappearance of 65Zn from the body was also measured. The results were compared with those obtained in 20 healthy controls. The nutritional status of these 17 patients was estimated by global nutritional assessment and calculation of the Quetelet index while 9 of 17 had dietary zinc intake calculated from a diet history. The mean plasma zinc level was lower in the hemodialysis patients (11.7 +/- 2.3 mumol/l vs. 13.3 +/- 2.9 mumol/l in controls; p less than 0.05). The mean leukocyte zinc level was 0.81 +/- 0.27 mumol/g dry weight in dialysis patients and 0.81 +/- 0.22 mumol/g in controls (p greater than 0.2). The mean 65Zn absorption in the patients was 49 +/- 14% and in controls 53 +/- 12% (p greater than 0.2). Mean turnover of body 65Zn was 0.47 +/- 0.11%/day in patients and 0.43 +/- 0.18%/day in controls (p greater than 0.1). The mean 65Zn half-life was 154 +/- 29 days in patients and 187 +/- 75 days in controls (p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

近期研究已将注意力集中于锌缺乏在味觉障碍和阳痿等尿毒症症状发病机制中可能发挥的作用。开展本研究以评估终末期肾病患者锌缺乏的患病率及锌代谢异常情况。通过测定透析前空腹白细胞和血浆锌,对43例稳定的慢性血液透析患者进行锌缺乏证据筛查。将结果与30名健康志愿者的结果进行比较。对这43例患者中的17例测定了⁶⁵Zn吸收情况,其中9例还测定了⁶⁵Zn从体内的消失率。将结果与20名健康对照者的结果进行比较。通过整体营养评估和计算奎特莱指数对这17例患者的营养状况进行评估,同时根据饮食史计算了17例患者中9例的膳食锌摄入量。血液透析患者的平均血浆锌水平较低(11.7±2.3μmol/L,对照组为13.3±2.9μmol/L;p<0.05)。透析患者的平均白细胞锌水平为0.81±0.27μmol/g干重,对照组为0.81±0.22μmol/g(p>0.2)。患者的平均⁶⁵Zn吸收率为49±14%,对照组为53±12%(p>0.2)。患者体内⁶⁵Zn的平均周转率为0.47±0.11%/天,对照组为0.43±0.18%/天(p>0.1)。患者的平均⁶⁵Zn半衰期为154±29天,对照组为187±75天(p>0.05)。(摘要截选至250词)

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