微量元素与心血管疾病

应用等离子发射光谱仪测定冠心病、急性心肌梗塞、扩张型心肌病、高血压病、风心病与对照组正常人46例的血清硒、锌、铜、铁、锰、镁浓度对照观察。结果表明,①冠心病组血清锰高和铁低于对照组;②急性心肌梗塞组,血清镁、锰与铁均高于对照组,血清硒、锌均低于对照组;③高血压病组血清镁、锰均高于对照组;④心肌病组血清铁、镁、锰均高,硒、锌均低于对照组;⑤风心病组,血清铁、锰均高于对照组。     

高血压患者血清锌、铜、钙、钴、镉、镁、镍、铬、钛的测定

本文应用直流等离子体原子发射光电直读光谱仪测定了60例正常人,45例高血压患者血清锌、铜、钙、钴、镉、镁、镍、铬、钛含量。结果表明,正常人血清锌19.70±3.75μmol/L(1.2876±0.2457μg/ml),铜17.23±3.48μmol/L(1.0945±0.2213μg/ml),钙2211.09±430.72μmol/L(104.6523±17.2634μg/ml),钴2.87±1.05μmol/L(0.3694±0.0616μg/ml),锅0.44±0.27μmol/L(0.0491±0.0300μg/ml),镁783.71±294.29μmol/L(19.0520±7.1543μg/ml),镍0.42±0.27μmol/L(0.0252±0.0156μg/ml),铬0.28±0.24μmol/L(0.0148±0.0123μg/ml),钛0.82±0.50μmol/L(0.0391±0.0243μg/ml),与文献报道值类似。高血压患者血清锌16.45±2.85μmol/L(1.0754±0.1863μg/ml),钙2308.32±276.29μmol/L(92.5175±11.0738μg/ml),钴2.23±0.62μmol/L(0.1316±0.0368μg/ml)和钛0.61±0.31μmol/L(0.0292±0.0147μg/ml),均低于正常对照组(分别为p<0.001,p<0.05)。镉0.85±0.40μmol/L(0.0951±0.0452μg/ml),镁1022.20±399.91μmol/L (24.8497±9.721 8μg/ml)和镉/锌比值高于正常对照组(P<0.001)。而铜17.58±3.11μmol/L(1.1169±0.1973μg/ml),镍0.39±0.01μmol/L(0.0231±0.0045μg/ml),铬0.31±0.12μmol/L(0.0163±0.0     

生长期缺锌对大鼠血清元素的影响

目的:研究膳食锌缺乏对生长期大鼠血清各种元素的影响。方法:刚断奶的SD大鼠,按体重相近配伍,随机分为3组,每组8只:缺锌组(ZD),配饲组(PF),对照组(ZA)。缺锌饲料、正常饲料含锌量分别为0.4mg/kg3、0 mg/kg,实验期15 d。用等离子电感耦合质谱仪(ICP—MS)测定大鼠血清元素锌、铁、铜、硒、锰、钴、铬、钙、镁、镉的含量。结果:缺锌组大鼠:血清铁(573.86±201.71μg/L)明显低于配饲组(1372.37±118.69μg/L)和正常组(1463.55±331.66μg/L)(P<0.05);血清锰(12.28±5.33μg/L)明显高于配饲组(4.24±0.73μg/L)和正常组(3.10±1.10μg/L)(P<0.05);血清铜(534.71±113.77μg/L)、硒(262.55±38.57μg/L)、镁(25.26±9.29μg/dl)低于正常组(铜725.91±158.27μg/L,硒465.90±132.18μg/L,镁39.84±14.10μg/dl)(P<0.05),与配饲组无明显差异(铜566.86±134.96μg/L,硒336.71±112.30μg/L,镁29.59±6.99μg/dl)(P>0.05);相比于配饲组与正常组,血清钙有下降趋势,但差异无显著性(P>0.05),血清钴、铬、镉有升高趋势,但差异无显著性(P>0.05)。结论:膳食锌缺乏影响生长期大鼠体内的微量元素水平。     

电焊作业对工人血液中必需元素的影响

目的:探讨电焊作业对工人血液中必需元素的影响。方法:以某金属结构厂82名电焊作业工人为接触组,另以不接触毒物的61名非电焊工人为对照组,血锰含量测定采用石墨炉原子吸收法,血中铜、铁、锌、镁、钙含量则采用火焰原子吸收法测定。同时对电焊作业环境空气中的锰浓度、对照组作业场所空气中锰浓度进行采样测定。结果:血锰,接触组为42173±21163μg/L,明显高于对照组(29197±17162μg/L,P<0101);血锌,接触组和对照组分别为9102±3147mg/L和12172±3189mg/L,两者差异有显著性(P<0105);血镁,接触组和对照组分别为47199±9186mg/L和35182±15108mg/L,两者差异有显著性(P<0105);两组间血铜、血铁和血钙含量差异均无显著性(P>0105)。结论:电焊作业可能导致工人血锰含量增加,同时还可引起血锌含量下降,血镁含量升高。     

冠心病患者血清铜锌比值测定的临床意义探讨

目的:探讨冠心病(CHD)患者与微量元素铜(Cu)、锌(Zn)及其铜/锌(Cu/Zn)比值的关系,评价Cu/Zn比值是否可以作为CHD预防监测指标。方法:用OLYMPUS2700生化分析仪对95例冠心病患者及90例健康对照组测定血清铜、锌及计算其比值。结果:冠心病组血清Cu值12.5±3.2μmol/L;Zn值17.26±1.567μmol/L;Cu/Zn0.601±0.213,健康对照组Cu值15.2±2.3μmol/L,Zn值15.45±0.443μmol/L;Cu/Zn0.969±0.219,两组间Cu值差异有统计学意义(P<0.05),Zn值有统计学意义(P<0.05),Cu/Zn比值有统计学意义(P<0.01),CHD组明显低于健康组。结论:Cu/Zn比值可以作为CHD预防监测指标。     

冠心病人血液微量元素锰、铬、铜、锌的分析

本实验用电感耦合等离子体发射光谱仪测定了33名正常人和63名冠心病人,(急性心肌梗塞25人,陈旧性心肌梗塞29人,慢性冠心病患者9人)血液中微量元素Mn、Cr、Cu、Zn的含量。发现1.对照组血清Mn为0.02145±0.0107ppm;Cr为0.0230±0.0167ppm;Cu为0.905±0.278ppm;Zn为0.0230±0.404ppm;Cu/Zn比值为0.973±0.395。与冠心病组血清Mn、Cr无明显差异。2.不同发作天数的急性心肌梗塞患者血清Cu、Zn和Cu/Zn比值的动态比较,结果表明,在急性心肌梗塞发作时可出现一过性的血清Cu升高,Zn降低,Cu/Zn比值高于对照组,随时间推移铜锌比值逐渐下降。3.陈旧性心肌梗塞和慢性冠心病者血清Cu、Zn和Cu/Zn比值远较对照组低,Cu/Zn比值<0.6的百分比远较对照组多(P<0.01),说明Cu/Zn比值降低可能是冠心病易患因素。4.用Feisher判别法将血清铜锌比值和其它主要易患因素作了横向比较,证明铜锌比值下降是冠心病主要易患因素,并结合国内外资料作了初步探讨。     

早产时母血及脐血硫化去氢表雄酮含量测定及其意义

目的:探讨母血及脐血硫化去氢表雄酮(DHEA-s)含量与早产的相关性。方法:研究对象选取2002年1月～2003年6月在该院分娩的初产妇33例,其中自发性早产组12例,医源性早产组9例,正常产组12例;母血及脐血DHEA-s含量采用ELISA方法检测。结果:①自发性早产组母血DHEA-s含量(1.025±0.068μg/ml)显著高于医源性早产组(0.065±0.027μg/ml)及正常产组(0.780±0.015μg/ml)(P<0.05),且医源性早产组DHEA-s含量又显著低于正常产组(P<0.05);②自发性早产组、医源性早产组及正常产组母血及脐血DHEA-s含量均相当,无显著性差异(P>0.05),自发性早产组母血及脐血间DHEA-s含量并非呈正相关(r=0.20);③医源性早产组脐血DHEA-s含量(0.040±0.017μg/ml)显著低于正常产组(0.800±0.015μg/ml)及自发性早产组(0.907±0.066μg/ml)(P<0.05)。结论:DHEA-s含量变化与早产的发动相关。     

早产儿与ROP患儿外周血微量元素代谢变化及意义

目的:观察微量元素在早产儿和早产儿视网膜病变(ROP)患儿外周血中的代谢变化。方法:选择30例有ROP高危因素的早产儿作为观察组,18例正常足月新生儿(未接受氧治疗)为对照组。采用原子吸收分光光度计分别检测观察组和对照组血清中微量元素的含量,用火焰法检测血清镁、铜、锌的含量;用石墨法检测血清锰、硒的含量。结果:30例观察组的早产儿血清锌、铜、硒的含量与正常18例新生儿相比有显著差异。观察组血清锌的平均含量为(0.75±0.22)mg/L,其中ROP患儿为(0.84±0.21)mg/L,而对照组血清锌的平均含量为(0.55±0.12)mg/L,观察组的含量显著增高(P<0.01);观察组铜、硒的含量分别为(0.41±0.20)mg/L和(134.07±71.57)×10-3mg/L,其中ROP患儿分别为(0.32±0.17)mg/L和(121.74±97.54)×10-3mg/L,而对照组铜和硒的含量分别为(0.65±0.194)mg/L和(202.92±4.71)×10-3mg/L,观察组血清铜、硒含量显著下降(P<0.01)。以上微量元素含量在观察组ROP患儿中降低幅度更大,但与无ROP患儿的差异无统计学意义。两组血清中镁、锰的含量差异无统计学意义(P>0.05)。结论:有ROP高危因素的早产儿血清中微量元素铜和硒的含量比正常新生儿显著下降,且患有ROP的早产儿其下降幅度更大。提示早产儿体内微量元素铜、硒含量的不足有可能在ROP的发生中起着一定作用。早产儿在其新生儿期应注意血清微量元素的检查,预防铜硒的缺乏,从而降低ROP的危险因素,预防其发生。     

深圳地区健康婴儿发微量元素含量分析

目的:研究深圳市婴儿微量元素营养状况,给婴儿合理补充微量元素提供依据。方法:采用原子吸收光谱法对486名足月出生42d的体检健康婴儿胎发进行微量元素测定,并对数据进行统计学处理。结果:42d婴儿胎发中铜、铅、锌、铁、锰、钙、镁含量(μg/g)分别为:10.45±3.91、14.40±28.01、155.2±60.1、18.35±6.87、1.356±1.310、715.0±191.4、52.99±20.55,铜/锌比值为0.080±0.053;男婴组与女婴组比较无显著差异(P>0.05);胎发中锰、锌、铜、铁、镁、钙含量偏低的婴儿比例分别是39.5%、31.7%、29.6%、24.9%、3.5%、0.4%;有21.6%的受检婴儿发铅含量高。铅高组婴儿发铜、铁、锰含量高,发锌含量低,与非铅高组比较有显著性差异(P<0.01);铅高组婴儿缺乏铜、锌、锰、铁、钙的比例及铜/锌比值升高比例与非铅高组比较差异显著(P<0.05)。结论:深圳地区婴儿钙、镁营养水平较好,发铅含量偏高,而缺乏锰、锌、铜、铁的婴儿比例较高。提示深圳地区孕、产妇应避免生活中的铅暴露,并应加强婴儿铜、锌、铁、锰元素的补充,减低铅对婴儿智力及生长发育的不良影响。     

糖尿病患者血清微量元素的含量分析

应用原子吸收分光光度法测定了51例糖尿病患者及43例正常人群血清中微量元素铬、硒、锌、铜、锰的含量。发现糖尿病患者血清铬、硒、锌、锰的含量明显低于对照组(P<0.01);铜含量明显高于对照组(P<0.01)。结果表明体内微量元素铬、硒、锌、铜、锰的含量与糖尿病具有密切的关系。     

实验性动脉粥样硬化对血清铜、锌、铬、锰、硒的影响

本研究观察高胆固醇血症和实验性动脉粥样硬化形成对必需微量元素Cu、Zn、Cr、Mn、Se代谢的影响。将22只家兔随机分为动脉粥样硬化造型组和对照组。造型组每只家兔每天喂胆固醇0.5g,该组在形成高胆固醇血症和动脉粥样硬化的4个月过程中,血清Cu均值逐渐升高,Zn逐渐降低,Ca/Zn比值逐渐增大,前后对比差异显著。对照组血清Cu、Zn无显著变化。两组的血清Cu、Zn同次测定值对比有显著或高度显著差异。血清Cr、Mn、Se均无显著变化。相关性检验证实,造型组血清胆固醇均值与血清Ca均值无显著相关(P>0.5),而与血清Zn均值呈高度负相关(P<0.01)。结果表明,在形成实验性动脉粥样硬化的过程中,高胆固醇食物及高胆固醇血症可引起血清Zn降低,又通过锌铜拮抗,使血清Cu升高。     

妊娠糖尿病患者血清中硒、锌、铜、钙含量分析

目的:检测妊娠糖尿病(GDM)患者血清中微量元素硒、锌、铜、钙的含量,探讨其与GDM的关系。方法:采用原子分光光度计分别检测78例GDM孕妇和72例正常孕妇血清中硒、锌、铜和钙的含量。结果:GDM组孕妇血清中微量元素硒、锌及钙的含量明显低于正常对照组(P<0.000 1);而铜的含量,GDM组却显著高于正常对照组(P<0.000 1)。结论:微量元素硒、锌、铜、钙在GDM的发生和发展过程中具有重要的作用。GDM组孕妇体内存在微量元素的代谢紊乱,应加强孕妇的饮食指导,适时补充硒、锌、钙等。     

Dosing and monitoring of trace elements in long-term home parenteral nutrition patients

Background: Trace elements (TEs) dosing and monitoring in home parenteral nutrition (PN) patients vary with their underlying conditions. Methods: This retrospective observational study evaluated parenteral TE dosing, serum TE concentrations and monitoring, and dose‐concentration relationships between TE doses and serum TE concentrations in 26 adult and adolescent home PN patients. Results: There was a total of 40,493 PN days. Average parenteral zinc doses of 9.1 mg/d and 7.6 mg/d resulted in the majority of serum zinc concentrations (90%) within normal range in patients with and without short bowel syndrome (SBS), respectively. Selenium at about 70 mcg/d resulted in about 60% of serum selenium concentrations within normal range, with 38% of values below normal in patients with and without SBS alike. Copper at 1 mg/d resulted in 22.5% of serum copper concentrations above the normal range. The majority of serum manganese (94.6%) and chromium (96%) concentrations were elevated. Serum TE concentrations were infrequently monitored. Significant relationships existed between doses and serum concentrations for zinc (P < .0001), manganese (P = .012), and chromium (P < .0001) but not for selenium or copper. Conclusions: TE doses in home PN should be individualized and adjusted based on regular monitoring of TE status. In long‐term home PN patients, higher zinc and selenium doses may be necessary to maintain their normal serum concentrations. Lower copper doses and restrictions of manganese and chromium supplementation may be needed to avoid their accumulation. Relationships between TE doses and serum TE concentrations vary for each TE and underlying clinical conditions.     

妊娠期高血压疾病与血清微量元素锌 铜 铁 锰的关系

目的:探讨妊娠期高血压疾病患者血清微量元素锌、铜、铁、锰的变化,指导妊娠期高血压疾病的预防及临床治疗。方法:用火焰原子吸收法及石墨炉法测定妊娠期高血压疾病患者血清47例、新生儿脐血清44例及正常晚期妊娠孕妇血清及脐血清各30例的锌、铜、铁、锰血清含量并进行对照研究。结果:①重度子痫前期患者血清锌含量显著低于正常对照组(P<0.05)、血清铁含量显著高于正常对照组(P<0.05)。②轻、重度妊娠期高血压患者新生儿脐血清锌、铜、铁、锰含量与正常对照组比较均无明显差异(P>0.05)。③从妊娠期高血压疾病患者血清与脐血血清锌、铜、铁、锰含量的比较中可以看出,孕妇血清锌、铁含量均显著低于脐血清锌、铁含量(P<0.01,P<0.05),孕妇血清铜含量显著高于脐血清铜含量(P<0.01),孕妇血清与脐血清锰含量无显著差异(P>0.05)。④本病孕妇血清铜/锌、铁/铜、铁/锌及铁/锰比值与对照组比较,除铜/锌比值未发现两组有明显差异外(P>0.05),其他各比值均有较明显变化(P<0.01,P<0.05)。结论:①血清微量元素锌的减少、铁的升高及锌、铜、铁、锰间的比例失衡可能与妊娠期高血压疾病的发生、发展有一定的关系。②无论孕妇机体在正常状态下还是在病理状态下,都首先保证胎儿对锌、铜、铁、锰的需要。     

血微、常量元素水平与儿童支气管哮喘的相关性研究

【目的】 观察支气管哮喘患儿全血锌、铁、钙、镁、铜、铅、锰、硒等微、常量元素含量的变化,并探讨其在支气管哮喘发病机制中的意义。 【方法】 采用原子吸收光谱法检测1 986例支气管哮喘患儿和856例正常对照组儿童全血锌、铁、钙、镁、铜、铅、锰、硒8种元素含量,并对检测结果作比较分析。 【结果】 支气管哮喘患儿组锌、铁和钙含量较正常对照组低,血铅含量较正常对照组高,两组间差异有统计学意义(P＜0.05);而铜、镁、硒、锰两组间差异无统计学意义(P＞0.05)。在哮喘的急性发作期,血锌、钙含量低于缓解期(P＜0.05)。 【结论】 锌、铁、钙缺乏,铅暴露增加,是造成哮喘患儿免疫功能减低、免疫调节紊乱的重要原因,在治疗中需适当补充锌、铁、钙,减少铅暴露。     

Poor zinc and selenium status in phenylketonuric children and adolescents in Brazil

Because of the restricted intake of high-biologic-value protein, children with phenylketonuria (PKU) may have lower than normal plasma concentrations of copper, zinc, and selenium. The purpose of the present study was to investigate erythrocyte zinc levels and serum copper and selenium levels in children and adolescents with PKU by analyzing the relation between their diet and the laboratory profiles of these elements. The study was conducted in 32 children and adolescents with PKU, who were on a special diet. Dietary records and blood samples were collected from each subject. Erythrocyte zinc and serum selenium levels were below normal in 37.5% and 90.6% of the subjects, respectively. Plasma copper levels were normal. Metabolic formulas were the only source of 86.9% of the zinc, 65.6% of the copper, and 32.4% of the selenium. Despite this, there was no significant correlation between the zinc formula supply and erythrocyte zinc levels (ρ = −0.143, P = .435) or the supply and serum levels for copper (ρ = −0.117, P = .523) and selenium (ρ = 0.113, P = .538). These results suggest that Brazilian patients with PKU present with low ingestion levels, low serum selenium levels, and low erythrocyte zinc levels.     

Alterations in serum levels of trace elements in tuberculosis and HIV infections

OBJECTIVE: To evaluate serum concentrations of trace elements in tuberculosis (TB) patients with or with out human immunodeficiency virus (HIV) coinfection before and after anti-TB chemotherapy. SUBJECTS: A total of 155 TB patients, 74 of which were coinfected with HIV, and 31 healthy controls from Gondar, Ethiopia. METHODS: Serum levels of copper, zinc, selenium and iron were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 44 TB patients (22 with HIV coinfection) at the end of an intensive phase of anti-TB chemotherapy. RESULTS: Compared with the control group, the concentrations of iron, zinc and selenium were significantly lower (P<0.05) while that of copper and copper/zinc ratio was significantly higher (P<0.05) in the serum of TB patients. TB patients with HIV coinfection had significantly lower serum zinc and selenium concentrations and significantly higher copper/zinc ratio compared to that in TB patients without HIV coinfection (P<0.05). The serum concentration of zinc had significantly increased at the end of intensive phase of anti-TB chemotherapy in patients without HIV coinfection (P<0.05). An increase in serum selenium level was observed in TB patients with or without HIV coinfection after therapy. On the contrary, serum copper concentration and copper/zinc ratio declined significantly after anti-TB chemotherapy irrespective of HIV serostatus (P<0.05). CONCLUSIONS: The results indicate that TB patients have altered profile of trace elements in their sera. This warrants the need for further investigations so that strategies for trace elements supplementation can be planned in addition to their potential as diagnostic parameters in monitoring responses to anti-TB chemotherapy.     

扩张型心肌病合并慢性重度心力衰竭血B型脑钠肽浓度正常的临床意义

目的评价扩张型心肌病合并慢性重度心力衰竭(心衰)血B型脑钠肽(B-type natriuretic peptide,BNP)浓度正常的临床意义。方法选取92例扩张型心肌病合并慢性重度心衰(心功能III～IV级)患者,血BNP浓度正常的24例为研究组,血BNP浓度升高的68例为对照组。对比两组患者的左室舒张末期内径(LVEDd)、左室射血分数(LVEF)及死亡率。结果研究组LVEDd值明显高于对照组,LVEF值明显低于对照组,两组比较差异均有统计学意义(均P0.05)。研究组随访(17.36±10.38)个月,死亡率为54.2%;对照组随访(30.55±16.63)个月,死亡率为13.2%。两组死亡率比较差异有统计学意义(P0.05)。Logistic多因素回归分析:血BNP降低为预测心源性死亡的独立预测因素,回归系数3.622,OR值42.466,95%可信区间5.115～355.796(P0.05)。结论扩张型心肌病合并重度心衰血BNP浓度正常预示BNP分泌机制耗竭及心脏功能进一步恶化。