HCV 慢性感染及自发清除对血清微量元素含量的影响及其与血清白蛋白和HCV 病毒载量的关联研究

Effects of chronic HCV infection and spontaneously resolved HCV infection on serum trace elements and their relationships with serum albumin and circulating HCV RNA load

目的：分析HCV慢性感染和HCV自发清除者体内血清微量元素锌、铁、镁、钙、铜和磷的含量特征及其与血清白蛋白和HCV病毒载量之间的关系。方法采用原子吸收分光光度法检测并比较HCV慢性感染患者（59人）、HCV自发清除者（65人）和健康对照者（48人）血清中上述6种微量元素的含量变化。分析HCV慢性感染者中微量元素水平与血清白蛋白和HCV病毒载量的关联性。结果 HCV慢性感染者血清中锌的含量明显低于健康对照者，铁、铜和磷的含量高于健康对照者；在HCV慢性感染患者中锌和血清白蛋白呈正相关关系（r＝0．4022， P＝0．0016），铁（r＝-0．3001， P＝0．0209）、铜（ r＝-0．3856， P＝0．0036）及磷（ r＝-0．3600， P＝0．0075）与血清白蛋白呈负相关；在HCV慢性感染者中血清锌（r＝-0．4367， P＝0．0005）与HCV病毒载量呈负相关，铜（r＝0．3328， P＝0．0139）和病毒载量呈正相关关系。 HCV自发清除者体内微量元素含量与健康对照者之间无明显差异，血清钙、镁水平在3组人群之间没有显著差异。结论 HCV慢性感染可引起血清中微量元素锌、铁、铜及磷的含量异常，随着HCV的自发清除体内微量元素含量恢复正常，在慢性HCV感染中微量元素的异常与肝功能和病毒载量的水平密切相关。

Objective To comparatively analyze serum levels of zinc , iron, magnesium, calcium, copper and phosphorus and their relationships with serum albumin and circulating HCV viral load in patients with chronic HCV infection , subjects with spontaneously resolved HCV infection and healthy subjects . Methods Serum levels of the six trace elements in patients with chronic HCV infection （n=59）, subjects with spontaneously resolved HCV infection （n=65） and healthy subjects （n=48） were measured by a flame atomic absorption spectrophotometer and then a comparative analysis was performed to analyze the differences among the three groups .The relationships of the six trace elements with serum albumin and HCV viral load were analyzed among patients with chronic HCV infection .Results Compared with healthy subjects , the levels of serum zinc were significantly decreased , but serum levels of iron , copper , phosphorus were signifi-cantly increased in patients with chronic HCV infection .There was a significant positive correlation between the levels of zinc（r=0.4022, P=0.0016）and albumin in patients with chronic HCV infection with ALT no less than 40 IU/L, whereas negative correlations were presented between trace elements of iron （ r=-0.3001, P=0.0209）, copper （r=-0.3856, P=0.0036）, phosphorus （r=-0.3600, P=0.0075） and serum albumin.The circulating HCV viral load was negatively correlated with serum zinc （r=-0.4367, P=0.0005）, but positively correlated with serum copper （r=0.3328, P=0.0139）.The serum levels of six trace elements showed no significant differences between healthy subjects and spontaneous resolvers of HCV infection.Moreover, no significant differences of serum calcium and magnesium were found among the three groups.Conclusion Chronic HCV infection can induce abnormal serum levels of zinc , iron, copper and phosphorus and the abnormal serum levels of trace elements were closely related with liver function and HCV viral load.With the spontaneous clearance of HCV infection , the serum levels of trace elements could restore to normal .