11例肝硬化患者出入肝血中铁铜锌含量变化及其意义

Plasma iron, copper and zinc determination in portal and hepatic veins of 11 patients with hepatic cirrhosis

通过观测肝硬化患者经颈静脉肝内门体支架分流（ＴＩＰＳ）术中肝前、后血中的铁铜锌含量变化，旨在探讨肝脏对铁铜锌的调节作用。结果显示肝静脉血中的铁含量明显高于外周和门静脉血中的铁含量，提示在没有肠道吸收铁的情况下（空腹），肝脏动员自身贮藏的铁来满足人体的生理需要。推测，肝脏对铁的吸收、贮藏和代谢是一个主动的过程。门静脉血中的铜含量明显低于肝静脉和外周血中的铜含量，而肝静脉与外周血之间的铜含量差异无显著性意义。提示肝脏在维持机体铜代谢平衡方面起着决定性的作用。肝静脉、门静脉以及外周血中锌的含量差异无显著性意义。提示肝脏对锌未起明显的调节作用。

The aim of this paper was to evaluate the regulation effects of liver on iron, copper and zinc. METHODS: Eleven patients (10 male, 1 female) with post hepatitis cirrhosis were admitted to this study. In the morning of operation day of Transjugular Intrahepatic Portosystemic Stent Shunt (TIPS), whole blood was sampled from cubital vein. In the process of TIPS, samples of whole blood from hepatic vein and portal vein were taken orderly. Plasma were separated from the whole blood for measurement. Iron, copper and zinc levels were measured by atomic absorption spectrophotometry. RESULTS: The concentrations of plasma iron were significantly increased in hepatic vein ( P <0.05),while the concentrations of plasma copper were significantly reduced in protal vein ( P <0.05). Insignificant different levels of copper were found between hepatic vein and cubital vein. No variation of zinc was found in cubital, hepatic, and portal veins ( P >0.05)。 CONCLUSIONS:The liver may actively mobilize iron in order to meet the physiological needs, and play a key role in maintaining the balance of copper in body. But it does not affect the regulation of blood zinc.