CAJ | 학술논문

目的研究锌与持续非卧床腹膜透析(CAPD)患者营养和免疫状态的关系.方法以45例病情稳定的CAPD患者为研究对象,测定膳食锌摄入量和血清锌水平,并与年龄和性别相匹配的45名健康人进行对比.分析CAPD患者膳食锌摄入量和血清锌水平与主观整体营养评价(SGA)分数、血细胞计数、白蛋白(Alb)、前白蛋白(PA)、C-反应蛋白(CRP)及淋巴细胞亚群等营养和免疫指标的相关性.结果 CAPD组患者膳食锌摄入不足率(P=0.007)和低血锌率(P=0.036)均明显高于健康对照组,CD8水平明显低于健康对照组(P=0.000),CD4/CD8水平明显高于健康对照组(P=0.033).相关性分析检测结果显示,CAPD患者膳食锌摄入量与血清前白蛋白水平呈显著正相关(r=0.577,P=0.000),与SGA评分(r=-0.354,P=0.015)和CRP(r=-0.354,P=0.015)呈显著负相关,与各类淋巴细胞亚群和CD4/CD8无明显相关性;血清锌水平与血红蛋白(r=0.411,P=0.005)、红细胞比容(r=0.345,P=0.023)、白细胞(r=0.318,P=0.035)、SGA评分(r=0.417,P=0.005)及CRP(r=0.342,P=0.027)均呈显著正相关,与各淋巴细胞亚群和CD4/CD8均无明显相关性.结论 CAPD患者存在锌缺乏.充足的膳食锌有助于促进蛋白质合成,提高整体营养水平.较高的血清锌水平有利于血红蛋白的合成,改善贫血.
목적 연구자여지속비와상복막투석(CAPD)환자영양화면역상태적관계.방법 이45례병정은정적CAPD환자위연구대상,측정선식자섭입량화혈청자수평,병여년령화성별상필배적45명건강인진행대비.분석CAPD환자선식자섭입량화혈청자수평여주관정체영양평개(SGA)분수、혈세포계수、백단백(Alb)、전백단백(PA)、C-반응단백(CRP)급림파세포아군등영양화면역지표적상관성.결과 CAPD조환자선식자섭입불족솔(P=0.007)화저혈자솔(P=0.036)균명현고우건강대조조,CD8수평명현저우건강대조조(P=0.000),CD4/CD8수평명현고우건강대조조(P=0.033).상관성분석검측결과현시,CAPD환자선식자섭입량여혈청전백단백수평정현저정상관(r=0.577,P=0.000),여SGA평분(r=-0.354,P=0.015)화CRP(r=-0.354,P=0.015)정현저부상관,여각류림파세포아군화CD4/CD8무명현상관성;혈청자수평여혈홍단백(r=0.411,P=0.005)、홍세포비용(r=0.345,P=0.023)、백세포(r=0.318,P=0.035)、SGA평분(r=0.417,P=0.005)급CRP(r=0.342,P=0.027)균정현저정상관,여각림파세포아군화CD4/CD8균무명현상관성.결론 CAPD환자존재자결핍.충족적선식자유조우촉진단백질합성,제고정체영양수평.교고적혈청자수평유리우혈홍단백적합성,개선빈혈.
Objective To determine the relationship between zinc and nutritional status or immunity in patients with end-stage renal disease undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods Forty-five stable CAPD patients undergoing peritoneal dialysis were enrolled in this study. The dietary zinc intake and serum zinc levels were investigated, and the results were compared with the gender- and age-matched healthy populations (n = 45). The relationship between dietary zinc intake and serum zinc levels and subjective global assessment (SGA) score, blood cell counts, serum albumin (ALB), prealbumin (PA), C-reactive protein (CRP),and lymphocyte subsets were analyzed. Results The percentages of inadequate dietary zinc intake (P= 0. 007)and low blood zinc (P = 0. 036) were significantly higher in CAPD patients than in healthy group. CD8 levels were significantly lower (P = 0. 000) while CD4/CD8 ratio was significantly higher (P = 0. 033) in CAPD patients than in healthy group. In CAPD patients, correlation analysis showed that dietary zinc intake was significantly correlated with serum prealbumin levels (r = 0. 577, P = 0. 000), but was negatively correlated with SGA score (r = - 0.354,P = 0. 015) and CRP (r = - 0.354, P = 0. 015); however, it was not significantly correlated with lymphocyte subsets and CD4/CD8 ratio. Serum zinc level was significantly positively correlated with hemoglobin (r= 0. 411, P=0.005), hematocrit (r=0.345, P=0.023), WBC (r=0.318, P=0.035), SGA score (r=0.417, P=0. 005), and CRP (r=0.342, P = 0. 027), but was not significantly correlated with lymphocyte subsets and CD4/CD8 ratio. Conclusions Zinc deficiency is common among patients with CAPD. Adequate dietary zinc intake can facilitate protein synthesis and improve the overall nutritional status. High serum zinc concentrations are beneficial for the synthesis of hemoglobin and the improvement of anemia.