慢性肾脏病患者血清硒元素水平及其与临床指标的相关性
Change in plasma selenium level of patients with chronic kidney disease at different stages and its correlation with clinical indicators

摘要：目的 探究血浆硒含量在我国慢性肾脏病(CKD)患者各个阶段的严重程度及与临床指标相关性。方法 检测107名研究对象(包括23名健康对照、10名CKD3期、11名CKD4期、45名CKD5期、6名腹膜透析及12名血液透析患者)的基本临床指标和硒、铁、铜、钙、钾、磷6项元素的血浆含量。结果 随着患者肾功能不全的进展，患者血浆中的硒元素不断下降，尤其在终末期接受血液净化治疗的患者中，以腹膜透析患者血浆中硒含量最低；CKD患者血浆硒含量与血白蛋白、血总胆固醇、血三酰甘油呈正相关，与甲状旁腺素、血尿素氮及血肌酐水平呈负相关；CKD不同分期患者的血浆硒含量与钙元素呈正相关。结论 CKD患者普遍存在低血硒，且与病情严重程度及临床指标相关，应深入研究，以期为低硒地区人群精确补硒及CKD发病率的防治提供坚实的理论依据。
ABSTRACT: Objective To explore the severity of selenium (Se) deficiency in different stages of chronic kidney disease (CKD) and its relationship between Se content and clinical indicators and other elements. Methods We detected the clinical indicators and element contents including Se, iron, copper, calcium, potassium and phosphorus of 107 subjects who were 23 healthy controls, 10 of CKD3 stage, 11 of CKD4 stage, 45 of CKD5 stage, 6 on peritoneal dialysis, 12 on hemodialysis. Results With the progression of CKD, plasma Se level in the patents got lower, especially in ESRD and PD groups. Plasma Se level had significantly positive correlation with albumin, total cholesterol and triglyceride, but negative correlation with parathyroid hormone, blood urea nitrogen and serum creatinine. Plasma Se level had significantly positive correlation with calcium level. Conclusion Se deficiency does exist in CKD patients, and it correlates with CKD severity and other clinical indicators. Further studies are needed to clarify the real extent of Se deficiency and carry out Se supplementation in patients with kidney disease