肝硬化患者血清锌水平及其与肝性脑病分期的相关性研究

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Suraj Hiwarkar, M. Holay, Bhiwagade Rahul, Patil Prashant
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引用次数: 0

摘要

背景:锌可以增强活性氧自由基的天然防御能力;锌还可以作为抗氧化剂、抗凋亡剂、DNA合成的辅助因子和抗炎剂。因此,缺乏锌水平似乎对肝性脑病(HE)的发病机制有影响。目的:本前瞻性观察性研究旨在评估肝硬化伴失代偿性肝病(DCLD)患者的血清锌水平,并观察血清锌水平与HE分期和患者预后的相关性。材料和方法:本前瞻性观察研究在印度中部的一家三级保健机构进行。本文分析肝硬化合并DCLD 66例。50名健康对照者被纳入研究。所有病例均评估血清锌水平,并根据肝硬化类型和HE分期进一步划分。研究了血清锌水平与HE分期及预后的关系。采用SPSS软件22对数据进行分析。结果:患者平均年龄45.67±8.73岁。男女比例为10:1。对照组血清锌均值为104.16±22.60 μg/dl,病例血清锌均值为47.68±16.72 μg/dl。与对照组相比,这些病例的死亡率明显较低,P < 0.0001。血清锌与HE的West Haven分级呈负相关。血清锌水平与血清白蛋白水平有直接的相关性。血清白蛋白越少,血清锌水平越低。P <0.0001极显著。幸存者40例(60.61%)平均血清锌水平为57.67 μg/dl,非幸存者26例(39.30%)平均血清锌水平为32.30 μg/dl。低血清锌水平与高死亡率相关。P <0.0001具有高度统计学意义。结论:低血清锌与肝硬化、DCLD及HE高发有关。因此,所有肝硬化合并低白蛋白血症和HE的患者都应进行低血清锌评估。HE患者血清锌含量低与高死亡率相关。目前的研究不能确定低血清锌与DCLD合并HE的肝硬化之间的因果关系。这些病例的补锌是否能预防病情恶化,有待进一步评价。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study of serum zinc level in liver cirrhosis and its correlation with stages of hepatic encephalopathy
Background: Zinc increases the natural defense of reactive oxygen radicals; Zinc also acts as an antioxidant, an anti-apoptotic agent, a cofactor for DNA synthesis, and an anti-inflammatory agent. Hence, deficient zinc levels seem to have an effect in the pathogenesis of hepatic encephalopathy (HE). Aims: This prospective observational study was done to assess serum zinc levels in cases of liver cirrhosis with decompensated liver disease (DCLD) and to see the correlation of serum zinc levels with stages of HE and patients' outcome. Materials and Methods: This prospective observational study was conducted at a tertiary care institution in Central India. Total 66 cases of liver cirrhosis with DCLD were studied. Fifty healthy controls were enrolled. All cases were evaluated for serum zinc levels, and all were divided further according to the class of liver cirrhosis and stages of HE. The association between serum zinc level and stages of HE and outcome was studied. The data were analyzed with SPSS software version 22. Results: The mean age of the cases at presentation was 45.67 ± 8.73 years. The M: F ratio was 10:1. The mean serum zinc level in controls was 104.16 ± 22.60 μg/dl, while in cases, it was 47.68 ± 16.72 μg/dl. It was significantly low in cases as compared to the controls, P < 0.0001. An inverse correlation was observed between serum zinc and West Haven classification grading of HE. There was found a direct correlation between serum zinc level and serum albumin. The lesser the serum albumin, the lesser the serum zinc level. P <0.0001 was highly significant. The mean serum zinc level was 57.67 μg/dl in survivors 40 cases (60.61%) as compared to 32.30 μg/dl in nonsurvivors 26 (39.30%). Low serum zinc level was associated with high mortality. P <0.0001 was statistically highly significant. Conclusion: Low serum zinc is associated with cirrhosis of the liver, DCLD, and high incidence of HE. Hence, all patients of cirrhosis liver with hypoalbuminemia and HE should be evaluated for low serum zinc. Low serum zinc in HE was associated with high mortality. The present study could not establish a causal relationship between low serum zinc and liver cirrhosis with DCLD having HE. Whether correction of zinc in these cases can prevent worsening, HE needs further evaluation.
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来源期刊
Indian Journal of Medical Specialities
Indian Journal of Medical Specialities MEDICINE, GENERAL & INTERNAL-
自引率
16.70%
发文量
51
期刊介绍: The Indian Journal of Medical Specialities is an all-encompassing peer-reviewed quarterly journal. The journal publishes scholarly articles, reviews, case reports and original research papers from medical specialities specially pertaining to clinical patterns and epidemiological profile of diseases. An important highlight is the emphasis on undergraduate and postgraduate medical education including various aspects of scientific paper-writing. The journal gives priority to research originating from the developing world, including from the tropical regions of the world. The journal also publishes special issues on health topics of current interest. The Indian Journal of Medical Specialities is one of the very few quality multispeciality scientific medical journals.
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