Fleming C R, Hodges R E, Hurley L S
Am J Clin Nutr. 1976 Jan;29(1):70-7. doi: 10.1093/ajcn/29.1.70.
Weekly determinations of serum copper (Cu) and zinc (Zn) were made in eight adult patients receiving total parenteral nutrition (TPN) for 3 to 13 weeks. Serum Cu decreased in all eight patients. Five of eight patients had hypocupremia lasting at least 2 consecutive weeks and three of the five had Cu levels of 30 mug/dl or lower. Low levels of serum ceruloplasmin provided supportive evidence of Cu deficiency in the three patients with the lowest Cu levels. Two patients who had Cu less than or equal to 20 mug/dl demonstrated declines in hemoglobin which were probably due to Cu deficiency. The mean rate of decline in serum Cu was 10.8 mug/dl/week. After resumption of oral feedings in five patients, the mean rate of increase in Cu was 14 mug/dl/week. The sharpest rise in Cu was seen during the 2nd week after oral feedings were resumed in four of the five patients. Three of eight patients had serum Zn levels less than 70 mug/dl for at least 2 consecutive weeks. Serum Zn decreased at a mean rate of 6.6 mug/dl/week. There was a further decline in serum Zn in three of five patients in whom measurements were made after resumption of oral intake. Concentrations of Zn in TPN solutions varied between 0.63 and 1.0 mg/liter. Cu was undetectable in TPN solutions.
对8名接受全胃肠外营养（TPN）3至13周的成年患者每周测定血清铜（Cu）和锌（Zn）。所有8名患者的血清铜均下降。8名患者中有5名出现低铜血症，持续至少连续2周，其中3名患者的铜水平为30μg/dl或更低。血清铜蓝蛋白水平低为3名铜水平最低的患者铜缺乏提供了支持性证据。2名铜水平小于或等于20μg/dl的患者血红蛋白下降，这可能是由于铜缺乏所致。血清铜的平均下降速率为10.8μg/dl/周。5名患者恢复经口进食后，铜的平均上升速率为14μg/dl/周。5名患者中有4名在恢复经口进食后的第2周铜上升最为明显。8名患者中有3名血清锌水平连续至少2周低于70μg/dl。血清锌平均以6.6μg/dl/周的速率下降。5名恢复经口摄入后进行测量的患者中有3名血清锌进一步下降。TPN溶液中锌的浓度在0.63至1.0mg/升之间变化。TPN溶液中未检测到铜。
