血浆中微量元素水平与HCV感染及肝功能情况关系的研究

Study on association of plasma trace elements concentration with HCV infection and liver function

目的 分析丙型肝炎患者血浆中微量元素（铜、铁和锌）含量及其与丙型肝炎病毒（hepatitis Cvirus,HCV）感染及相关肝功能指标的关系。方法 运用电感耦合等离子体质谱法（inductively coupled plasmamassspec-trometry,ICP-MS）检测HCV持续感染者（90例）、自限清除者（92例）和对照（99例）血浆中的铜、铁和锌含量,偏相关和多因素Logistic回归分析HCV持续感染者血浆中微量元素水平与HCV病毒载量的关系。结果 HCV持续感染组血浆中锌含量低于对照组,铁含量高于对照组,差异均有统计学意义（均有P〈0.05）;以年龄、性别、体质指数（body mass index,BMI）为协变量的偏相关分析结果发现,铁与HCVRNA水平呈负相关（r=-0.263,P=0.016）。以年龄、性别、BMI、各微量元素含量为自变量进行多因素Logistic回归分析,结果显示铁含量升高是HCV持续感染者血浆丙氨酸氨基转移酶（alanine aminotransferase,ALT）水平升高的危险因素（OR=1.001,95%CI：1.000~1.002,P=0.030）。结论 微量元素铜、铁、锌可能和HCV感染转归相关,其中铁水平升高是HCV感染慢性化的独立危险因素。

Objective To explore the association of plasma microelements （Cu, Fe and Zn） concentration with hepatitis C virus （HCV） infection and liver function in hepatitis C patients. Methods In a case-control study, 281 par- ticipants, including 90 patients with chronic hepatitis C, 92 HCV natural clearance subjects and 99 healthy controls, were investigated. The subjects＇ plasma trace elements concentration was detected by inductively coupled plasma mass spectrom- etry （ICP-MS）. And partial correlation analysis and muhivariable logistic regression analysis were used to explore the rela- tionship of microelements concentration and HCV viral load in patients with chronic HCV infection. Results Compared with healthy controls, the level of zinc was decreased, however, the level of iron ~vas increased in patients with chronic HCV infection （ all P 〈 0.05 ）. After controlling for age, sex and BMI, the HCV viral load was negatively correlated with plasma iron concentration （r = -0. 263, P = 0. 016）. The Logistic regression showed that iron was independently associat- ed with ALT values in patients with persistent HCV infection （ OR = 1. 001,95% CI： 1. 000-1. 002,P = 0. 030）. Conclu- sions Trace elements （Cu, Fe and Zn） may be associated with HCV infection outcomes. Especially, iron level is an in- dependent risk factors of chronic HCV infection.