Bonomini M, Manfrini V, Marini A, De Risio F, Niri L, Klinkmann H, Albertazzi A
Institute of Nephrology, University of Chieti, Italy.
Artif Organs. 1995 Jan;19(1):81-5. doi: 10.1111/j.1525-1594.1995.tb02249.x.
Selenium (Se) is considered an essential and very important trace element for humans. Se blood levels are frequently low in end-stage renal disease (ESRD) patients, but very little has been established concerning the mechanisms that could modify Se status in uremia, including a supposed dialysis-mediated Se depletion. In order to verify whether hemodialysis (HD) can induce a loss of Se, thereby leading or contributing to a low plasma Se concentration, we investigated the effect of HD procedure with the most commonly used regenerated cellulosic membrane (Cuprophan) on plasma Se levels in 20 uremic patients on HD for 62.5 +/- 49.4 months. Plasma Se levels were also determined in 15 chronic renal failure (CRF) nondialyzed patients and in 28 age-matched healthy controls. Se concentration was determined by atomic absorption spectrophotometry. Plasma Se levels of both HD patients (61.3 +/- 8.5 micrograms/L) and CRF nondialyzed patients (56.4 +/- 10.1 micrograms/L) were significantly lower than in normal subjects (78.3 +/- 9.7 micrograms/L, p < 0.001). In CRF nondialyzed patients, a significant (p < 0.05) negative correlation was found between the plasma Se concentration versus serum creatinine values. Within the HD group, plasma Se levels significantly increased after the HD procedure (72.8 +/- 17.2 micrograms/L, p < 0.02) together with hematocrit and total plasma protein values (p < 0.05 and p < 0.001, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
硒(Se)被认为是人体必需且非常重要的微量元素。终末期肾病(ESRD)患者的血硒水平通常较低,但关于尿毒症中可能改变硒状态的机制,包括推测的透析介导的硒消耗,目前所知甚少。为了验证血液透析(HD)是否会导致硒流失,进而导致或促成血浆硒浓度降低,我们研究了使用最常用的再生纤维素膜(铜仿膜)进行HD治疗对20例接受HD治疗62.5±49.4个月的尿毒症患者血浆硒水平的影响。还测定了15例未透析的慢性肾衰竭(CRF)患者和28例年龄匹配的健康对照者的血浆硒水平。通过原子吸收分光光度法测定硒浓度。HD患者(61.3±8.5微克/升)和未透析的CRF患者(56.4±10.1微克/升)的血浆硒水平均显著低于正常受试者(78.3±9.7微克/升,p<0.001)。在未透析的CRF患者中,血浆硒浓度与血清肌酐值之间存在显著的负相关(p<0.05)。在HD组中,HD治疗后血浆硒水平显著升高(72.8±17.2微克/升,p<0.02),同时血细胞比容和血浆总蛋白值也升高(分别为p<0.05和p<0.001)。(摘要截断于250字)