肝豆状核变性患者青霉胺治疗期间尿中多种元素分析

Analysis of multiple elements in urine of patients with Wilson's disease during penicillamine therapy

目的分析肝豆状核变性(WD)患者应用青霉胺治疗期间尿液中21种元素的变化。方法WD患者40例(WD组),青霉胺治疗并低铜饮食;另设健康对照组(n=12)。使用电感耦合等离子体质谱仪检测24 h尿液中21种元素(铬、铁、钴、硒、锰、铜、锌、砷、铍、铝、钒、镍、镉、锑、钡、铅、铊、钍、铀、钙和镁)。结果24 h尿液中7种必需微量元素(铬、铁、钴、硒、锰、铜和锌)检测结果显示,WD组的锰、铜和锌较对照组明显增加(P<0.05,P<0.01和P<0.01)。24 h尿液中12种非必需微量元素(砷、铍、铝、钒、镍、镉、锑、钡、铅、铊、钍和铀)检测结果显示,WD组的砷明显高于对照组(P<0.05)。24 h尿液中宏量元素钙和镁检测结果显示,WD组的钙明显高于对照组(P<0.001)。结论在WD患者使用青霉胺驱铜治疗期间,24 h尿液中除铜的排出量增加外,锰、锌、砷和钙的排出量也发生了变化。

Objective To analyse the concentrations of 21 elements in 24 h urine of patients with Wilson＇s disease （WD） during penicillamine therapy. Methods Forty patients with WD undergoing penicillamine therapy and hypo-copper diets were collected （WD group）, and another 12 healthy people were served as control group. The concentrations of 21 elements ofCr, Fe, Co, Se, Mn, Cu, Zn, As, Be, Al, V, Ni, Cd, Sb, Ba, Pb, Ti, Th, U, Ca and Mg in 24 h urine were determined by inductively coupled plasma mass spectrometry. Results For 7 essential trace elements （Cr, Fe, Co, Se, Mn, Cu and Zn）, the concentrations of Mn, Cu and Zn in 24 h urine of WD group were significantly higher than those in control group （P〈0.05, P〈0.01 and P〈0.01）. For 12 unessential trace elements （As, Be, Al, V, Ni, Cd, Sb, Ba, Pb, Ti, Th and U）, the concentration of As in 24 h urine of WD group was significantly higher than that in control group （P 〈 0.05）. For 2 macroelements （Ca and Mg）, the concentration of Ca in 24 h urine of WD group was significantly higher than that in control group （P 〈 0. 001）. Conclusion For patients with WD undergoing penicillamine therapy and hypocopper diets, the concentration of Cu in 24 h urine increases, and those of Mn, Zn, As and Ca also change.