Delves H T
Clin Endocrinol Metab. 1985 Aug;14(3):725-60. doi: 10.1016/s0300-595x(85)80014-1.
Biochemical and clinical investigations involving trace elements are made for the diagnosis of inherited or acquired deficiencies of essential trace elements and their treatment, to monitor the efficacy of the therapeutic administration of non-essential trace elements in order to achieve maximum clinical response with minimum toxicity, and for the early detection of excessive ingestion of non-essential toxic trace elements. The wide range of tests used to assess trace element status in these three areas of clinical importance is discussed with examples of essential and of toxic trace elements since therapeutic use of trace elements is discussed elsewhere in this issue. Particular attention is given to zinc, copper, selenium, lead and cadmium because the various tests used to assess the status of these elements encompass the principles of all currently available tests. Although trace element analysis of body fluids and tissues is the most useful and most commonly used method of assessment of trace element status, this is of limited value and no single test may be considered as ideal for any element. The provision of more detailed information from elemental analysis of cellular and subcellular fractions and of protein fractions from plasma leads inexorably to measurements of element-dependent enzymes, metalloproteins and of low molecular weight element-binding ligands. Even at this level of discrimination the choice of body tissue or tissue fluid for investigation is determined by the trace element and its principal metabolic targets.
涉及微量元素的生化和临床研究用于诊断必需微量元素的遗传性或获得性缺乏及其治疗，监测非必需微量元素治疗给药的疗效以实现最小毒性下的最大临床反应，以及早期检测非必需有毒微量元素的过量摄入。鉴于本期其他地方讨论了微量元素的治疗用途，本文通过必需和有毒微量元素的例子讨论了用于评估这三个临床重要领域中微量元素状态的广泛测试。特别关注锌、铜、硒、铅和镉，因为用于评估这些元素状态的各种测试涵盖了所有现有测试的原理。虽然体液和组织的微量元素分析是评估微量元素状态最有用和最常用的方法，但这一方法价值有限，没有任何一种测试可被视为对任何元素都是理想的。从细胞和亚细胞部分以及血浆蛋白质部分的元素分析中提供更详细的信息不可避免地导致对元素依赖性酶、金属蛋白和低分子量元素结合配体的测量。即使在这种区分水平上，用于研究的身体组织或组织液的选择也取决于微量元素及其主要代谢靶点。
