肝豆状核变性患者青霉胺治疗期间晨尿金属元素谱分析

目的了解肝豆状核变性（WD）患者应用青霉胺治疗期间晨尿中多种金属元素的变化。方法收集WD患者23例,青霉胺治疗时间3个月～180个月以上并低铜饮食;正常对照者18名,分别收集晨起尿液。使用电感耦合等离子体质谱仪（ICP-MS）分析尿液中铬、铁、钴、硒、锰、铜、锌、钙、镁、锂、铝、钒、镍、镓、砷、锶、镉、铯和钡19种元素。结果晨尿中7种必需微量元素（铬、铁、钴、硒、锰、铜和锌）检测结果显示WD组的尿铬、铜和锌浓度明显高于对照组（P〈0.01）。晨尿中10种非必需微量元素（锂、铝、钒、镍、镓、砷、锶、镉、铯和钡）检测结果显示WD组的尿砷、镉、镓、锶、铯和钡明显高于对照组（P〈0.05）。WD组晨尿中宏量元素尿钙明显高于对照组（P〈0.01）。结论在肝豆状核变性患者使用青霉胺驱铜治疗期间,除了晨尿中的尿铜增高外,晨尿中尿铬、锌、砷、镉、镓、锶、铯、钡和钙也明显高于对照组。晨尿铜可以作为一个监测WD患者驱铜疗效的指标。

Analysis on the multi-metal element levels in morning urine of Wilson's disease patients during penicillamine therapy

Objective To analyze the multi-metal element levels in morning urine of Wilson＇ s disease （ WD） patients during penicillamine therapy. Methods The morning urine of 23 WD patients and 18 healthy controls were collected. The 23 WD patients received penicillamine therapy for 3-180 months,and accompanied hypo-copper diets. The concentrations of chromium （ Cr） ,ferrum （ Fe） ,cobalt （ Co） ,selenium （ Se） ,manganese （ Mn） ,copper （ Cu） ,zinc （ Zn） ,calcium （ Ca） ,magnesium （ Mg） ,lithium （ Li） ,aluminium （ Al） ,vanadium （ V） ,nickel （ Ni） ,gallium （ Ga） ,arsenium （ As） ,strontium （ Sr） ,cadmium （ Cd） ,cesium （ Cs） and barium （ Ba） in morning urine were determined by inductively coupled plasma-mass spectrometry（ ICP-MS）. Results The results of 7 essential trace elements （ Cr,Fe,Co,Se,Mn,Cu and Zn） in morning urine showed that the concentrations of urine Cr,Cu and Zn in WD patients were markedly higher than those in the controls （ P〈0. 01）. The results of 10 unessential trace elements （ Li,Al,V,Ni,Ga,As,Sr,Cd,Cs and Ba） in morning urine revealed that the concentrations of urine As,Cd,Ga,Sr,Cs and Ba in WD patients were higher than those in the controls （ P〈0. 05）. The results of 2 macroelements （ Ca and Mg） in morning urine implied the concentration of urine Ca in WD patients was higher than that in the controls （ P〈0. 01）. Conclusions During the course of WD patients taking penicillamine,except the urine Cu increased,the concentrations of urine Cr,Zn,As,Cd,Ga,Sr,Cs,Ba and Ca were significantly higher than those in the controls. The effects may be monitored by the urine Cu.