深圳地区儿童微量元素的水平及其影响因素的研究

目的了解深圳市新生儿、1～6岁健康体检儿童、门诊咨询儿童血铅等微量元素的水平及其影响因素.方法收集0～6岁儿童静脉血或脐血,测定血铅、锌、钙、铁、镁等微量元素的水平,对儿童进行社会环境及家庭生活因素调查.结果 （1）新生儿组与1～6岁健康体检组儿童血铅平均水平、门诊咨询组与1～6岁健康体检组儿童血铅平均水平差异均有显著意义（P＜0.01）, 门诊咨询儿童同时有较低平均水平血锌、钙、铁.（2）血铅水平与锌水平呈负相关,与血钙、铁、镁水平不相关. （3）高血铅与生活习惯及生活环境有关,血锌、钙、铁、镁缺乏或过剩与饮食、生活习惯等因素有关. 结论铅中毒或体内微量元素不均衡,应给予高度重视,对不同类型儿童给予相应预防及干预措施.     

124例腹泻患儿血锌含量分析

目的观察腹泻患儿血中锌含量的变化。方法使用原子吸收分光光度法测定124例腹泻患儿和145例健康儿童血锌（Zn）含量。结果腹泻患儿血锌含量为（51.75±14.54）μmol/L,健康儿童血锌含量为（69.67±18.47）μmol/L,腹泻患儿童血锌（Zn）含量明显低于健康儿童,差异有统计学意义（P〈0.01）。结论腹泻患儿血锌含量明显低于健康儿童,应对腹泻患儿进行血锌含量的测定,为临床治疗提供参考。     

日照地区23例苯丙酮尿症患儿微量元素检测结果分析

目的全面了解日照市苯丙酮尿症（PKU）患儿给以低苯丙氨酸（Phe）饮食后,其末梢血铁、锌、钙、镁及铜的含量,探讨其缺乏的综合防治措施。方法对我市2003年6月-2010年6月筛查出的23例PKU患儿,取末梢血对铁、锌、钙、镁及铜进行检测。结果患病儿的末梢血中钙、锌的含量低于正常儿童（〈0.05）,而铁、镁、铜的含量无统计学意义（﹥0.05）结论患儿应全面搭配营养膳食,努力达到膳食结构的多样化,以保证患儿正常的生长发育。     

1100例儿童微量元素检测结果分析

目的了解费县0～6岁儿童体内微量元素含量及不同时期的变化规律。方法采用微量元素检测仪器检测1100例儿童微量元素铜、锌、钙、铁、铅含量。结果在不同年龄组间锌、钙、铁、铅含量差异显著（P值均〈0.05）,锌、铁、铅含量随年龄的增长而逐渐增加,钙含量随年龄的增长而逐渐降低。铜含量差异无显著性（P值〉0.05）。结论费县儿童存在锌、钙、铁微量元素缺乏,应注意均衡饮食,加强铁、钙、锌的补充及促进其吸收。远离铅污染,预防铅中毒。     

高血钙和厌食症

对280例厌食的6～12岁学龄儿童作血锌、铜、钙、镁测定发现:63.2%(177例)血钙总值为4.18土0.38(正常2.2～3.9 mmol/l),健康对照组100例为3.55±0.10(P＜0.01)血钙显著高于正常值和对照组.血镁0.86±0.08(正常0.7～1.18 mmol/l),对照组0.78±0.06(P＞0.05),两组差异不明显.血锌6.4%(18例)为10.79±0.44(正常11.47～19.10 mmol/l),对照组15.51±3.19(P＜0.01),血锌降低较对照组显著.铜/锌比例10.35%(29例)为1.71±0.34(正常0.82～1.2),对照组0.9±0.11(P＜0.05),铜/锌比例升高较对照组显著.低锌与铜/锌比升高之总和16.8%(6.4%±10.4%).     

大连地区母血及脐血中21种微量元素浓度测定分析

目的调查铁、锌、铜等11种必需微量元素及铅、砷、镉等10种有毒微量元素在正常产妇静脉血及新生儿脐血间的分布规律及其相关性,为孕期合理保健提供科学依据。方法随机对150名健康住院分娩的产妇分别抽取外周静脉血和新生儿脐静脉血,微波消解法制备供试品,电感耦合等离子体-质谱（ICP-MS）法进行全血21种微量元素水平的测定。结果大连地区孕妇全血中微量元素铁、钴、硒、铬、钼、砷、镉、铊和钒的浓度在正常成人参考值范围,锌、钙、铜、铅、银和钡的浓度明显低于参考值,而镁、锰和镍的浓度则高于该范围。与母血中各种微量元素浓度相比,脐血中的锌、钴、铜、锰、镍、铅、砷和镉的浓度均显著性降低（P〈0.01）,而铁的浓度则显著高于母血（P〈0.01）。直线相关分析结果表明,母血与脐血之间钙、镁、钴、铅、砷、铍、银、钡和钍的浓度呈显著正相关（P〈0.05）。结论微量元素在孕妇体内的浓度有别于正常成人的水平,新生儿体内微量元素的浓度与母亲体内微量元素的水平高低密切相关,孕期对上述多种重要的必需微量元素和有毒微量元素的水平进行监测和及时采取科学、有效的应对措施是优生的重要内容。     

钙、锌、镁、铜、铁元素与维吾尔族孕妇子痫前期发生的关系

目的探讨维吾尔族子痫前期患者血清微量元素锌、铜、铁、锰的变化,指导子痫前期的预防及临床治疗。方法用日立7600型自动生化分析仪及罗氏自动生化分析仪测定子痫前期轻度孕妇血清维吾尔族、汉族各30例,新生儿脐血清维吾尔族、汉族各30例。子痫前期重度患者血维吾尔族、汉族各36例,新生儿脐血清维吾尔族、汉族各36例的钙、镁、锌、铁、铜含量并进行对照研究。结果子痫前期轻度汉族母血清铁、钙、镁含量高于维吾尔族,差别有统计学意义（P〈0.05）,汉族铜低于维吾尔族,锌高于维吾尔族,但差异无统计学意义（P〉0.05）;子痫前期重度组汉族母血清钙、镁、锌含量高于维吾尔族,差别有统计学意义（P〈0.05）,汉族铁高于维吾尔族,铜低于维吾尔族,但差异无统计学意义（P〉0.05）。结论维吾尔族与汉族患者微量元素锌、铜、钙、镁的含量有差异且与子痫前期的发生及病情发展有一定的相关性。可能由于生活习惯以及信仰习俗不同,饮食习惯存在差异,而导致血清微量元素锌、铁、铜、钙、镁含量的差异,这与维吾尔族子痫前期的患病率高于汉族有一定的关系。     

腺样体肥大儿童血清微量元素含量的分析

目的 检测腺样体肥大儿童血清中钙(ca)、铁(Fe)、锌(Zn)、铜(Cu)、镁(Mg)五种微量元素的含量,为腺样体肥大以及相应并发症的治疗提供理论依据.方法 用火焰原子吸收分光光度法检测50例腺样体肥大儿童和32例健康儿童血清中Ca、Fe、Zn、Cu、Mg的含量.结果 腺样体肥大组儿童血清中Zn的含量低于对照组(P＜0.01),Cu和Ca的含量高于对照组(P＜0.05),而Fe和Mg的水平在两组间无统计学差异(P＞0.05).结论 儿童腺样体肥大可能与血清中铜、钙元素水平升高及锌元素的缺乏有关,避免血钙、血铜过高及适量补锌可作为对腺样体肥大儿童早期干预的一种方法.     

厌食、腹痛儿童血铅水平的检测及预防探讨

目的探讨铅污染对小儿消化系统的影响以及预防措施。方法采用BH2100原子吸收光谱仪对118例腹痛患儿和123例厌食症患儿及148例健康儿童（年龄：1～6岁）进行血铅检测。结果腹痛组患儿和厌食组患儿血铅水平均值均高于对照组,两者对比差异有显著性意义。腹痛组（u=26.4,P〈0.01）,厌食组（u=25.1,P〈0.01）。结论血铅水平增高对小儿消化系统有影响,可导致小儿不明原因的腹痛,厌食,食欲低下等消化道症状。提示临床对小儿不明原因的腹痛、厌食应考虑其血铅水平,以查明病因,及时治疗,从而提高儿童的生长发育水平。     

全血微量元素含量与妊娠期高血压相关性研究

目的探讨妊娠高血压的发生发展与全血微量元素含量的关系,为妊娠期高血压的预防及治疗提供理论依据。方法按妊娠期高血压疾病诊断标准将入选的78例晚孕孕妇分为妊娠期高血压、子痫前期轻度、子痫前期重度3个组,40例正常健康晚孕孕妇为对照组;采用火焰原子吸收光谱法分别测定患病组和对照组孕妇全血微量元素（铜、锌、钙、镁、铁）浓度水平,对数据统计处理并进行对照研究。结果患病各组与对照组比较微量元素铜、钙、镁含量无显著性差异（P〉0．05）;微量元素锌含量在正常对照组、妊娠高血压组、子痫前期轻度组、子痫前期重度组之间依次递减,妊娠高血压组与对照组比较无显著性差异（P〉0．05）,子痫前期轻、重度组锌元素含量显著低于对照组,差异有统计学意义（P〈0．05）,子痫前期轻、重度组锌元素含量显著低于妊娠高血压组,差异有统计学意义（P〈0．05）,子痫前期重度组锌元素含量显著低于子痫前期轻度组,差异有统计学意义（P〈0．05）;微量元素铁含量在正常对照组、妊娠高血压组、子痫前期轻度组、子痫前期重度组之间依次递增,妊娠高血压组与对照组比较无显著性差异（P〉0．05）,子痫前期轻、重度组铁元素含量显著高于对照组,差异有统计学意义（P〈0．05）,子痫前期轻、重度组铁元素含量显著高于妊娠高血压组,差异有统计学意义（P〈0．05）,子痫前期重度组铁元素含量显著高于子痫前期轻度组,差异有统计学意义（P〈0．05）。结论妊娠高血压是孕期常见合并症,要加强妊高征孕妇微量元素的均衡摄入,确保母婴健康。     

Growth hormone inhibition causes increased selenium levels in Duchenne muscular dystrophy: a possible new approach to therapy.

Nine children with Duchenne muscular dystrophy were given Sanorex (mazindol), a growth hormone inhibitor, daily for 6 months. There was no significant change in their muscle function, but there was a significant reduction in weight gain and in levels of growth hormone, somatomedin C, hair zinc, serum zinc, and serum LDH. Selenium and glutathione peroxidase in the serum increased significantly. Thirteen other children with growth hormone deficiency had a significant reduction in hair selenium following growth hormone administration. These results show a significant relationship between growth hormone and selenium nutritional status and confirm our previous reports indicating an effect of growth hormone on zinc nutritional status. It is possible that prolonged therapy with a growth hormone inhibitor would attenuate the course and improve the longevity of patients with muscular dystrophy.     

Zinc and selenium status in cows with dermatophytosis

Dermatophytosis (ringworm), an infection of the superficial keratinized structures of the skin and hair, is the most common contagious skin disease in cattle. The infectious diseases caused by dermatophytes are mainly related to the enzymes product by these fungi. Conversely, elements such as zinc and selenium are involved in the regulation of immune responses to infection. There are rare reports about the possible role of zinc and selenium concentration in the pathogenesis of cattle dermatophytosis. Thus, this study was conducted in a humid area of Iran on 35 healthy and 35 infected cows. After diagnosis confirmation by direct microscopic examination and fungi isolation via inoculation on Sabouraud dextrose agar using skin scrap and broken hair samples of infected cows, the zinc and selenium concentration of serum and hair in both groups were determined by potentiometric stripping analyzer and atomic absorption spectrometry, respectively. Results showed that serum concentration of selenium and zinc in cattle with dermatophytosis were significantly lower (P < 0.05) than the healthy ones. Although hair concentration of selenium and zinc in infected cattle were lower than the healthy ones, the differences were not significant (P > 0.05). In conclusion, it seems that zinc and selenium have a determinant role in immune status and the response of animal’s immunity system to dermatophytosis.     

血清降钙素原、超敏C反应蛋白及白细胞介素-6在小儿急性上呼吸道感染中的诊断价值

目的:分析降钙素原(PCT)、超敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)在小儿急性上呼吸道感染(AURI)时血清水平变化及其临床诊断价值。方法:分别收集100例AURI患儿,分为细菌感染组和病毒感染组(各50例),采用ELISA和免疫比浊法测定其血清PCT、hs-CRP、IL-6等指标,分析两病例组间及与健康体检儿童组间差异,并绘制细菌感染组上述检测指标的ROC曲线,比较其临床诊断价值。结果:细菌感染组血清PCT、hs-CRP与IL-6水平明显高于病毒感染组及健康对照组,差异有统计学意义(P0.05);病毒感染组PCT、hs-CRP和IL-6水平与健康对照组之间差异无统计学意义(P0.05)。对诊断细菌性AURI,血清PCT的ROC曲线下面积最大;灵敏度、特异度、阳性似然比明显高于hs-CRP和IL-6,阴性似然比显著低于IL-6,差异均有统计学意义(P0.05)。结论:血清PCT与hs-CRP、IL-6比较,其对小儿细菌性AURI具有更高的诊断价值及早期诊断意义。     

妊娠期高血压患者血浆、红细胞内五种微量元素代谢水平比较

目的探求妊娠期高血压（简称妊高征）患者元素代谢方面的变化情况及为药物治疗提供理论参考依据。方法使用电感耦合等离子体发射光谱仪（ICP）分别测定妊高征患者与正常孕妇血浆,红细胞内五种人体微量元素（锰、镍、锌、铬、硒）的浓度。结果①妊高征患者与正常孕妇血浆元素水平比较：镍、铬、硒元素水平明显低;铜、锰元素水平高。②妊高征患者与正常孕妇红细胞内元素水平比较：锰的元素水平明显高,硒元素水平明显低,而铜、镍、铬元素无明显差别。结论妊高征患者存在着明显的元素代谢异常,尤其是血浆元素水平与正常孕妇有显著差异。     

初诊苯丙酮尿症患者微量元素测定

目的探讨初诊PKU患者血清内微量元素铁、铜、锌的变化及与高苯丙氨酸的关系。方法采用分光光度法测定27例PKU患儿及42例正常儿童血清内的铁、铜、锌含量，用HPLC法测定血清内的苯丙氨酸浓度并对两者进行分析比较。结果PKU患儿血清铁、锌明显低于正常时照，血清铜无显著性差异。血清锌的水平与患者体内苯丙氨酸浓度有关。结论PKU患儿体内存在微量元素的缺乏，有必要在治疗时适当的补充微量元素以达到更好的治疗效果。     

C-反应蛋白在小儿支原体肺炎中的检测价值

研究C反应蛋白(CRP)在小儿支原体肺炎中的应用价值.采用胶乳强化浊度法测定128例支原体肺炎和79例细菌性肺炎患儿血清CRP,与51名健康儿童作对比.结果表明,128例支原体肺炎组(A组)CRP阳性者45例,阳性率为35.2%,其中3例重症支原体肺炎患儿CRP大于80mg/L.79例细菌性肺炎组(B组)CRP阳性者为73例,阳性率为92.4%,对照组51名(C组)CRP阳性者为2例,阳性率为3.9%.A组、B组与C组相比较有显著性差异(P<0.01),A组与B组相比也有显著性差异(P<0.01).对于一般非重症肺炎,支原体肺炎患儿CRP稍高,但没有细菌性肺炎增高明显,CRP可作为鉴别支原体肺炎或细菌性肺炎的重要辅助指标.     

血清25-羟维生素D水平对儿童免疫功能的影响

目的探讨25-（OH）VitD水平与儿童免疫功能之间的关系。方法随机选取山西省妇幼保健院门诊进行健康体检的3～8岁儿童117名,采用酶联免疫法检测25-（OH）VitD水平,流式细胞术检测细胞免疫功能。按照血清25-（OH）VitD浓度将病例分为两组：维生素D缺乏组（〈50nmol／L）及维生素D正常组（≥50nm01／L）,比较各组免疫功能以及发生RRI的情况。结果维生素D缺乏组发生RRI的人数明显高于正常组的发生人数,有显著性差异（P〈0.05）。且维生素D缺乏组儿童的免疫功能明显低于正常组的儿童,主要表现在IgA和CD3＋以及NK的降低,有显著性差异（P〈0.05）。结论维生素D缺乏可造成儿童体液及细胞免疫能力的降低,容易导致儿童反复呼吸道感染的发生,针对反复呼吸道感染的患儿及时补充维生素D,对降低呼吸道感染的再次发生起着积极的作用。     

Micronutrient levels and HIV disease status in HIV-infected patients on highly active antiretroviral therapy in the Nutrition for Healthy Living cohort

BACKGROUND: Low serum micronutrient levels were common before widespread use of highly active antiretroviral therapy (HAART) and were associated with adverse outcomes. Few data are available on micronutrient levels in subjects taking HAART. OBJECTIVE: To determine the prevalence of low serum retinol, alpha-tocopherol, zinc, and selenium in HIV-infected subjects taking HAART and to assess the association of micronutrient levels with HIV disease status. DESIGN: Cross-sectional. SETTING: Nutrition for Healthy Living (NFHL) study. PARTICIPANTS: HIV-infected subjects on HAART. METHODS: Retinol, alpha-tocopherol, zinc, and selenium were determined in frozen serum samples from 171 men and 117 women. Low serum levels were defined as retinol <30 microg/dL, selenium <85 microg/L, alpha-tocopherol <500 microg/dL, and zinc <670 microg/L. Association of micronutrient quartiles with CD4 cell count, CD4 count <200 cells/mm, HIV viral load (VL), and undetectable VL was assessed using adjusted multivariate regression. RESULTS: Five percent of men and 14% of women had low retinol, 8% of men and 3% of women had low selenium, and 7% of men and no women had low alpha-tocopherol. Forty percent of men and 36% of women had low zinc, however. Subjects in the upper quartiles of zinc had lower log VL levels than those in the lowest quartile (significant for women). Subjects in the upper quartiles of selenium also tended to have lower VL levels compared with those in the lowest quartile. Surprisingly, women in the upper quartiles of retinol had higher log VLs than those in the lowest quartile. There was no significant association of any micronutrient with CD4 cell count or likelihood of CD4 count <200 cells/mm. The level of CD4 cell count influenced the association of retinol with log VL in men, however. In men with CD4 counts >350 cells/mm, those with higher retinol had higher log VLs compared with the lowest quartile, whereas in men with CD4 counts <350, those with higher retinol levels had lower log VLs compared with the lowest quartile. CONCLUSIONS: Low retinol, alpha-tocopherol, and selenium are uncommon in HIV-infected subjects on HAART. Zinc deficiency remains common, however. Decreased retinol levels in women and in men with CD4 counts >350 cells/mm and increased zinc and selenium levels in both genders may be associated with improved virologic control.