原子吸收法检测高血压患者血清中金属元素的含量

目的 探讨高血压病人血清中金属元素含量与高血压的关系,以提供科学的控制和补充金属元素的依据.方法 采用原子吸收法对高血压患者血清中Ca、Mg、K、Na、Zn、Cu、Fe和Mn进行检测,并与正常健康人的血清进行比较.结果 高血压组血清中Mg、Na、Zn、Fe、Mn的水平含量均高于对照组,Ca、K、Cu的水平含量均低于对照组;高血压组血清Na/K比值均高于对照组,Ca/Mg、Cu/Zn比值均低于对照组.结论 适当增补Ca、K、Cu、Mg的含量,减少Na的过多摄入,科学控制Zn、Fe、Mn的增加,降低Na/K比,提高Cu/Zn比,补Ca的同时一定要注意适当补Mg,有利于高血压的预防和治疗.     

老年冠心病患者血清Zn、Cu、Fe、Cr的测定及临床意义

目的 :探讨老年冠心病与血清锌 (Zn)、铜 (Cu)、铁 (Fe)及铬 (Cr)的关系及其临床意义。方法 :用日本岛津 AA176型原子吸收分光光度计 ,对 81例老年冠心病患者及 6 5例老年对照组测定了血清 Zn、Cu、Fe及 Cr的含量。结果 :老年冠心病患者血清 Zn、 Fe水平明显高于老年对照组。而老年冠心病组血清 Cu水平显著低于老年对照组。老年冠心病组血清 Cr和 Cu/Zn水平明显低于对照组。结论 :高 Zn、Fe,低 Cu、Cr与冠心病的发生发展有密切关系。从饮食结构上调整微量元素的摄入量可能对防治老年冠心病有一定的临床意义     

不孕症患者外周血中Zn、Cu、Fe、Ca、Mg水平测定及意义

目的探讨Zn、Cu、Fe、Ca及Mg等微量元素对女性生育功能的影响。方法用原子吸收分光光度法测定75例不孕症患者（观察组,排除子宫、输卵管因素）及51例健康妇女（对照组）外周血中Zn、Cu、Fe、Ca及Mg水平。结果观察组中Zn及Zn／Cu值明显低于对照组（P〈0．05）;而Cu、Fe、Ca和Mg含量两组无显著性差异。结论Zn水平降低及Zn／Cu值降低是影响女性生育功能的重要原因之一;外周血Zn及Zn／Cu值对女性不孕的诊断及治疗有指导意义。     

IL-22在乙型肝炎肝硬化失代偿期患者中表达的临床分析

目的 通过检测失代偿期乙型肝炎肝硬化患者血清和肝组织白介素22（IL-22）表达水平,探讨检测IL-22的临床意义。方法 在168例乙型肝炎肝硬化患者和56例健康人,采用ELISA法检测血清IL-22水平,在38例乙型肝炎肝硬化患者行肝活检,采用免疫组化法检测IL-22表达。计算患者MELD评分。结果 失代偿期乙型肝炎肝硬化患者血清IL-22水平为（36.2±16.4）pg/ml,显著高于健康人【（16.4±1.4）pg/ml,t=15.48,P<0.05】;在38例患者中,33例（86.9%）肝组织IL-22表达阳性;IL-22水平与MELD评分呈显著正相关（r=0.982, P=0.000）。结论 失代偿期乙型肝炎肝硬化患者肝组织IL-22高表达,与病变严重程度有明显的相关性,对于判断该病的转归及预后有一定的价值。     

失代偿期乙型肝炎肝硬化患者营养状况分析

目的 了解和评估失代偿期乙型肝炎肝硬化患者的营养状况。方法 选取本院2015年9月～2016年8月住院的失代偿期乙型肝炎肝硬化患者32例和慢性乙型肝炎患者40例,入院后测量患者身高、体质量,并计算体质指数（BMI）。住院24小时内空腹采静脉血检测血清白蛋白（Alb）和视黄醇结合蛋白（RBP）等指标,并以BMI、Alb评估患者营养不良状况。采用营养风险筛查2002（NRS2002）评估患者营养风险。结果 失代偿期乙型肝炎肝硬化组BMI为（22.21±2.79） kg/m2,与慢性乙型肝炎组（21.70±2.74） kg/m2比,无统计学差异（P>0.05）;失代偿期乙型肝炎肝硬化组血清Alb和RBP分别为（28.05±4.71）g/L和（10.88±9.36）mg/L,均显著低于慢性乙型肝炎组【分别为（41.57±3.47） g/L和（23.67±10.48） mg/L,P<0.000］;以BMI或Alb评估失偿期乙型肝炎肝硬化患者营养不良发生率分别为81.3%和93.8%,显著高于慢性乙型肝炎组（分别为0.0%和2.5%,P<0.000）;以NRS2002评估失代偿期乙型肝炎肝硬化患者存在营养风险百分比为59.4%,显著高于慢性乙型肝炎组的2.5%（P<0.000）。结论 失代偿期乙型肝炎肝硬化患者存在高比例的营养不良及营养风险,应注意干预。     

乙型肝炎肝硬化失代偿期患者首发食管静脉曲张出血或腹水的临床特征

目的比较乙型肝炎肝硬化失代偿期患者首发食管静脉曲张破裂出血或首发腹水的检验学和超声影像学方面的差异。方法回顾性研究2005年-2007年50例乙型肝炎肝硬化失代偿期患者首发以食管静脉曲张破裂出血或腹水住院者的血液分析、肝肾功能、电解质及门脾静脉宽度等资料。性别分层分析这些资料的改变与出血和腹水之间的关系。结果乙型肝炎肝硬化失代偿期首发食管静脉曲张破裂出血患者的血红蛋白显著低于以腹水为首发症状的乙型肝炎肝硬化失代偿期患者（P〈0.05）,而血糖则显著高于后者（P〈0.01）。出血组女性患者红细胞总数显著低于腹水组男性患者（P〈0.05）,出血组男女患者的血钠都显著高于腹水组男性患者（P〈0.05,0.0001）,腹水组男性血钠显著低于女性（P〈0.05）。腹水组平均发病年龄大于出血组,但差异无显著性（P〉0.05）。两组之间在白蛋白水平、凝血酶原时间、白细胞总数、血小板总数、血钾、血肌酐、血尿素氮和门脾静脉宽度等方面均无显著性差异。结论乙型肝炎肝硬化失代偿期患者首发食管静脉曲张破裂出血者多见高血糖和低血红蛋白,首发腹水者男性更多见低血钠,表明乙型肝炎肝硬化失代偿期出血性损害更倾向侵袭男性患者。     

肝硬化患者血清GLP-1和PYY变化及其与消化不良症状的关系

目的探讨肝硬化患者血清GLP-1和PYY水平变化及其与消化不良症状的关系。方法用ELISA法检测乙型肝炎肝硬化患者(肝硬化代偿组和肝硬化失代偿组)和健康对照者血清中GLP-1和PYY的水平,并根据功能性消化不良罗马Ⅲ标准,制定消化道症状评分标准,记录消化道症状评分,观察血清GLP-1和PYY水平与消化不良症状之间的关系。结果与健康对照组相比,乙型肝炎肝硬化患者血清GLP-1和PYY水平均升高,失代偿组显著高于代偿组,并且血清GLP-1和PYY水平与肝硬化患者的消化不良症状呈正相关。结论乙型肝炎肝硬化患者存在高GLP-1血症和高PYY血症,其与早饱、上腹胀痛等消化不良症状有关。     

冠心病患者血清微量元素锌、铜、铁水平变化及其临床意义

目的观察冠心病患者血清微量元素锌(Zn)、铜(Cu)、铁(Fe)水平变化,探讨其临床意义。方法选取2012年1月—2014年1月在成都市第五人民医院就诊的冠心病患者146例,其中急性心肌梗死(AMI)患者68例作为A组,非AMI患者78例作为B组;同时选取在本院进行健康体检的非冠心病志愿者70例作为对照组(C组)。比较3组受检者血清Zn、Cu、Fe水平;采用Gensini评分系统对冠状动脉病变严重程度进行评分,分析冠心病患者血清Zn、Cu、Fe水平与Gensini评分的相关性。结果 A组、B组患者血清Zn、Cu水平均低于C组,血清Fe水平高于C组(P0.05);A组患者血清Zn、Cu水平低于B组,血清Fe水平高于B组(P0.05)。血清Zn、Cu水平与Gensini评分呈负相关(r值分别为-0.781、-0.517,P值分别为0.024、0.042),血清Fe水平与Gensini评分呈正相关(r=0.425,P=0.048)。结论血清微量元素Zn、Cu、Fe水平与冠心病密切相关,可作为冠心病及冠心病病情严重程度的辅助诊断指标。     

肝癌、肝硬化患者血清TNF-α,IL-2,sIL-2R检测的临床意义

目的：了解原发性肝癌、代偿期肝硬化、失代偿期肝硬化患者血清肿瘤坏死因子－α（TNF-α）、白细胞介素-2(IL-2)、可溶性白细胞介素-2受体（sIL-2R）水平的变化，探讨其临床意义。方法：原发性肝癌33例，肝炎后肝硬化60例。分为肝癌组33例，肝硬化代偿期组30例，肝硬化失代偿期组30例。采用双抗体夹心酶联免疫法检测血清TNF-α、IL-2、sIL-2R水平。肝癌组织患者追踪2月至2年，观察其变化情况。结果：1.原发性肝癌组血清TNF-α、sIL-2R水平明显高于各期肝炎后肝硬化组，而血清IL-2水平较各期肝炎后肝硬化组显著降低。2.肝硬化失代偿期组血清TNF-α、sIL-2R水平明显高于肝硬化代偿期组，而肝硬化失代偿期组IL-2水平低于肝硬化代偿期组。3.原发性肝癌组经有效手术治疗及导管化疗者血清TNF-α及sIL-2R水平较治疗前明显降低，,IL-2则较前升高，而未经有效治疗或治疗时已是晚期者TNF-α及sIL-2R水平逐渐升高，IL-2则逐渐降低。结论：本文提示原发性肝癌及肝炎后肝硬化与TNF-α、IL-2及sIL-2R有密切相关性。TNF-α、IL-2及sIL-2R水平的变化有助于了解肝硬化的进展情况，早期发现恶性肿瘤并决定治疗的预后。     

不同时期肝硬化患者中医证候与肝脏纤维增生程度的相关性研究

目的:研究不同时期肝硬化中医证候与肝脏纤维增生程度的相关性。方法:将肝硬化患者按肝脏代偿情况分为临床前代偿期、临床代偿期、失代偿期3组,利用腹腔镜或开腹手术直视观察肝脏大体形态学改变,获取肝组织并制成玻片,运用体视学软件测定肝纤维组织占比,采用描述性统计分析方法对其与肝硬化各中医证型之间相关性进行研究。结果:(1)各组患者肝纤维组织占比依次从临床失代偿期组(26.23±18.14)、临床代偿期组(17.96±11.38)、临床前代偿期组(17.64±10.26)逐渐减少,临床失代偿期组与其他两组比较;差异有显著性意义P0.05。(2)不同证型的肝硬化患者肝纤维占比依次减少:脾肾阳虚证(42.23±00.00)肝肾阴虚证(36.71±0.18)湿热蕴结证(26.17±10.82)瘀血内阻证(19.20±10.63)肝气郁结证(15.23±8.18)水湿内阻证(6.81±4.47),组问比较差异有显著性意义,P0.05。结论:(1)肝纤维占比可作为肝纤维化程度的量化指标;(2)肝硬化的中医证候与肝脏纤维增生程度有一定内在联系。     

慢性肝病141例与微量元素关系的研究

本文对141例慢性肝病(慢活肝30例,肝硬化111例)患者血、肝组织中微量元素锌、铜、铁的含量测定,并测定肝硬化患者血清铜兰蛋白含量及尿锌的排出量。结果血清中锌值均明显低于对照组(P<0.05),肝硬化较慢活肝更低,而铜与铜兰蛋白含量均明显高于对照组(P<0.01)。其中19例肝硬化患者作肝组织锌、铜测定,锌含量特别低,其均值比对照组低3倍(P<0.05),而铜含量则高于对照组1倍以上(P<0.05)。肝硬化患者24h尿锌排出量明显高于对照组(P<0.001)。通过对这些微量元素代谢变化的探讨,为慢性肝病治疗中纠正其代谢障碍提供了科学依据。     

肝硬化患者透明质酸与辨证施治关系的探讨

本文检测了８０例乙型肝炎后肝硬化患者和６０例健康人血清透明质酸（ＨＡ），用自拟抗纤方为基本方，观察治疗后血清ＨＡ的变化，探讨血清ＨＡ与辨证施治之间的关系。结果显示，肝硬化患者血清ＨＡ显著高于健康人（Ｐ＜０．０１）；ＨＡ水平与中医证型密切相关，其变化规律为热血淤型＞气滞血淤型＞肝郁脾虚型＞正常对照组，证型之间差异显著（Ｐ＜０．０５～０．０１）。提示血清ＨＡ可作为乙型肝炎后肝硬化中医辨证分型、判断病情及预后，指导治疗的客观指标之一。经抗纤方加减治疗，ＨＡ水平显著下降（Ｐ＜０．０１），肝功能得到显著改善（Ｐ＜０．０１），证明该方不但能有效地改善肝脏功能，而且具有显著的抗纤维化的作用。     

Zinc, iron, copper, selenium, lactoferrin, and ferritin in human pus

BACKGROUND: Restriction of zinc and iron available for microbial growth in tissues are well-recognized host defense mechanisms. The present studies were performed to characterize some constituents of human pus that may affect these important host defenses. METHODS: Zinc, iron, copper, calcium, and magnesium in pus were measured using an atomic absorption spectrophotometer; selenium was measured fluorometrically. Ferritin was measured with a fluorometric enzyme immunoassay, and lactoferrin was measured with a radial diffusion assay. The growth of Escherichia coli at 37 degrees C was measured in pus supernate adjusted to pH 5.5 or 7.4, in boiled supernate, or in supernate adjusted with 1.3 mM iron or 0.9 mM zinc singly or together. RESULTS: Zinc and iron concentrations in pus exceeded normal serum. Calcium and magnesium levels were 2- to 3-fold lower and higher, respectively, than normal serum values. Lactoferrin concentrations of were 880 +/- 48 microg/mL and ferritin levels were 20,726 +/- 2,667 ng/mL. Growth of an E coli strain was inhibited in pus at pH 5.5 but not at pH 7.4, and growth was enhanced by addition of iron or zinc to E coli suspended in pus at pH 6.7. CONCLUSIONS: To our knowledge, this is the first report of the zinc, iron, copper, selenium, lactoferrin, and ferritin levels of human pus. These studies provide additional insight into host defense mechanisms mediated by the restriction of the bioavailability of zinc and iron in suppurative infection.     

肺炎患儿血清中微量元素含量的临床探讨

目的研究肺炎患儿血清中铜、锌、铁、镁、钙等微量元素的含量的变化情况。方法选择50例肺炎的患儿作为观察组,随机选择同期在我院门诊健康体检的50例健康儿童作为对照组,分别测定两组患儿血清中微量元素铜、锌、铁、镁、钙的含量。结果观察组中患有肺炎的患儿血清中的铜、锌、钙的含量明显低于对照组,具有统计学意义(P<0.01);观察组中患有重症肺炎的患儿血清中钙。镁、铁、锌、铜的含量都比轻症肺炎患儿显著降低,具有显著差异性(P<0.01)。结论肺炎患儿血清中钙、铁、锌、铜、镁等微量元素的代谢紊乱,故应对肺炎患儿进行血微量元素的检测,并对缺乏者给予合理的补充治疗,以助疾病的迅速恢复。     

Trace elements (zinc, copper, manganese) in alcoholic cirrhosis: effect of chronic alcoholism

The authors studied the influence of alcohol intake and liver disease in the disturbances of trace elements detected in patients with alcoholic cirrhosis. A determination of zinc, copper and manganese was carried out in the serum, the 24 h urine and a liver sample in 15 patients with alcoholic cirrhosis, 11 chronic alcoholics and 17 control subjects. In the serum of cirrhotic patients, zinc was significantly decreased, copper and manganese significantly increased. In the liver, zinc was decreased and copper increased, but the difference did not read significantly. The elimination of zinc in urine was increased and that of manganese decreased. In the chronic alcoholic patients only the serum zinc was decreased. Chronic alcoholism seemed to be therefore one of the factors responsible for low serum zinc in patients with alcoholic liver disease.     

Serum trace metals in chronic viral hepatitis and hepatocellular carcinoma in Thailand

This study was conducted to determine and compare serum trace metal levels in viral hepatitis-associated chronic liver disease. Of 98 patients aged 43 (± 13) [mean (± SD)] years, 83 (85%) were seropositive for hepatitis B surface antigen (HBsAg) and 15 (15%) were seropositive for anti-hepatitis C virus (HCV). Twenty-five patients had chronic persistent hepatitis, 32 chronic active hepatitis, 21 post-necrotic cirrhosis, and 20 hepatocellular carcinoma. Determination of fasting serum trace metal levels (zinc, copper, calcium, magnesium, and phosphorus) was performed after the patients had been on a 2-day diet containing 10–12 mg zinc/day. Compared to healthy volunteers (n=30), serum zinc levels were significantly decreased in patients with chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (P≤0.0001), and copper levels were significantly elevated only in patients with hepatocellular carcinoma (P<0.0001). The overall serum levels of calcium, magnesium, and phosphorus were within normal ranges, and levels of calcium and magnesium correlated with serum zinc (P=0.01–0.03). Serum zinc levels correlated with bilirubin, albumin, and cholesterol (P=0.0004≤0.0001), but not with daily urinary zinc excretion. Serum copper levels correlated with alkaline phosphatase and gamma-glutamyltransferase (P=0.008–0.0001). These results suggested that changes in liver cell pathology compounded by functional impairment may alter the metabolism of trace metals, in particular, zinc and copper. The possible relationship of these changes to the pathogenesis of chronic liver disease is discussed.     

Metallothionein concentration in the liver of patients with Wilson''s disease, primary biliary cirrhosis, and liver metastasis of colorectal cancer

In patients with primary biliary cirrhosis and Wilson's disease liver copper concentrations become elevated during the evolution of the disorder. The accumulated copper is thought to be detoxified by metallothionein, a protein which binds copper and zinc. In liver metastasis of colorectal cancer, copper and zinc concentrations are usually decreased compared to normal liver tissue, but little is known about the concomitant metallothionein levels. In the present study metallothionein concentrations were determined in archival liver samples from patients with primary biliary cirrhosis and Wilson's disease, and in both normal and malignancy-containing liver samples from patients with metastasis from a colorectal adenocarcinoma. Twenty-seven control liver samples contained 3.98 +/- 1.55 mg metallothionein/g protein. From the 21 liver samples of patients with primary biliary cirrhosis, which had a mean metallothionein concentration of 6.06 +/- 5.03 mg/g protein, 6 were above the highest control level. Liver metallothionein concentrations for the 8 patients with Wilson's disease were significantly elevated (10.98 +/- 6.93 mg/g protein, p < 0.005 vs. controls and p < 0.05 vs. primary biliary cirrhosis). In the 11 liver metastases from colorectal adenocarcinomas metallothionein concentrations (1.17 +/- 0.90 mg/g protein) were significantly (p < 0.005) lower than surrounding normal liver tissue (4.25 +/- 1.75 mg/g protein). We conclude that in primary biliary cirrhosis and Wilson's disease increased liver metallothionein concentrations may detoxify the accumulated copper. Furthermore, liver metastasis of colorectal cancer contains less metallothionein than the surrounding normal liver tissue.     

草原兔尾鼠主要脏器及毛发中无机元素测定分析

用原子吸收光谱法测定了25只健康草原兔尾鼠（雌雄各半）心、肝、肾、脾、肺及毛发中无机元素铜,铁、锌、铅、镉、砷的含量,发现锌、镉、铅、砷在毛发中浓度最高,铜、镁在脾脏中浓度最高,铁在肝脏中浓度最高,铝在心脏中浓度最高。     

Comparison of serum copper, magnesium, zinc and calcium levels between G6PD deficient and normal Chinese adults

Minerals are important for normal hematopoiesis and may play a role in acute hemolytic anemia induced by G6PD deficiency. To compare serum magnesium, copper, zinc and calcium levels between G6PD deficiency and normal control adults, we investigated 69 G6PD deficient (28 male, 41 female) and 61 age- matched G6PD normal adults (26 male, 35 female). Serum magnesium, copper, zinc and calcium levels were determined by atomic absorbance spectrometry. Our results revealed that male adults with G6PD deficiency had significantly higher serum copper and magnesium levels than those of the control group (P < 0.01, < 0.05, respectively). In G6PD normal adults, serum copper levels were significantly lower in males than in females (P < 0.01). In the group of G6PD deficiency adults, serum copper levels in males (103.0 +/- 10.4 ug/dL) were significantly lower than those in females (139.0 +/- 34.3 ug/dL) (P < 0.01). Serum magnesium values and zinc values in males (2.42 +/- 0.38 mEq/L and 102.2 +/- 26.5 ug/dL) were significantly higher than those in females (2.07 +/- 0.20 mEq/L and 87.0 +/- 14.9 ug/dL) (P all < 0.01). Female adults with G6PD deficiency had significantly higher serum calcium levels and lower magnesium levels than those of the control group (P all < 0.01). The significantly higher levels of serum copper and magnesium in G6PD deficient male adults may play some role concerning red blood cells in resistance to plasmodium falciparum.     

慢性肝病中医证型与血清肝纤维化指标及甘胆酸的关系

目的：探讨慢性肝病中医证型与肝纤维化标志物透明质酸（HA）、Ⅳ型胶原（Ⅳ－C）、Ⅲ型前胶原（PCⅢ）及甘胆酸（CG)之间的关系。方法：采用放射免疫法测定120例慢性肝病瘀血阻络、湿热中阻、肝肾阴虚的肝纤维化指标及CG水平,同时与40例正常对照者比较。结果：各中医证型组的肝纤维化3项指标均较对照组升高,以瘀血阻络组的HA、PCⅢ升高最为显著;各中医证型组的CG指标均较对照组升高,以湿热中阻组升高最为显著。结论：上述指标对慢性肝病患者的中医分型有一定的指导意义。