血清微量元素含量在肾移植前后的变化及与血清白蛋白的关系

Level change of serum trace elements in patients around renal transplantation

目的:检测肾功能衰竭患者肾移植前后血清Ca2+,Mg2+,Fe2+,Cu2+,Zn2+5种微量元素含量的变化及与血清白蛋白的关系并探讨其意义。方法:用络合物比色法检测24例肾功能衰竭患者肾移植前后血清Ca2+,Mg2+,Fe2+,Cu2+,Zn2+及30例正常人血清中Ca2+,Mg2+,Fe2+,Cu2+,Zn2+的含量。血清白蛋白测定用溴钾酚绿(BCG)法。结果:患者血清Ca2+的下降在术后己有所改善,达到了正常人的血清Ca2+水平。术后血清Fe2+水平较术前有所提高,但仍显著低于正常人水平(P<0.01)。术后血Mg2+水平较术前明显下降(P<0.01)。手术前后血Zn2+水平均显著低于正常对照组(P<0.01),而血Cu2+水平手术前后则与正常人的血清差异无统计学意义(P>0.05)。血清白蛋白含量较术前亦有上升,但仍低于正常水平,其浓度与血清Zn2+浓度呈显著正相关。结论:应重视肾移植患者手术后出现的低Mg2+、低Zn2+和低Fe血症,并深入探讨微量元素与血清蛋白的关系,针对情况作适当补充。

Objective To study the serum level of Ca^2＋,Mg^2＋,Fe^2＋,Cu^2＋ and Zn^2＋ in the patients before and after renal transplantation,their correlation with the levels of serum albumin and its significance.Methods The serum levels of Ca^2＋,Mg^2＋,Fe^2＋,Cu^2＋ and Zn^2＋ were detected by complex colorimetric determination in 24 patients before and after renal transplantation and in 30 normal volunteers.Results The decreased level of serum Ca^2＋ caused by dialysis pre-transplantation was improved after operation,and the result raised to the normal range.The level of serum Fe2＋ in patients post-transplantation was higher than pre-transplantation,but significantly lower than those in controls（P〈0.01）.The level of serum Mg^2＋ in patients post-transplantation was remarkably lower than pre-transplantation（P〈0.01）.The level of serum Zn^2＋ in patients around renal transplantation was lower than in control（P〈0.01）.The serum Cu^2＋ was not obvious different from the controls（P〉0.05）.The level of Zn^2＋ was correlated positively with the level of serum albumin respectively.Conclusion Hypomagnesemia,hypozinc anemia and iron deficiency should be paid attention in the transplanted patients.Proper dose of Mg^2＋,Zn^2＋,Fe^2＋ and serum albumin should be added to these patients.