慢性乙型肝炎、肝硬化与慢加急性肝衰竭患者饮食摄入硒及血清硒水平的对比分析

赵娟; 李娟; 于红卫; 孟庆华

doi:10.3969/j.issn.1001-5256.2015.07.025

慢性乙型肝炎、肝硬化与慢加急性肝衰竭患者饮食摄入硒及血清硒水平的对比分析

DOI: 10.3969/j.issn.1001-5256.2015.07.025

首都医科大学附属北京佑安医院肝病重症医学科

基金项目:

首都卫生发展科研专项项目(首发2011-2018-09)；北京市科技计划重大项目(H020920020890)；国家卫计委2014重点建设专科项目(WJWYA-2014-001)；

详细信息

中图分类号: R575.3
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出版历程
- 出版日期: 2015-07-20

Dietary intake of selenium and serum selenium in patients with chronic hepatitis B,liver cirrhosis and acute- on-chronic liver failure

Research funding:

摘要

摘要:
目的比较不同类型慢性肝病患者饮食摄入硒及血清硒水平,探讨硒与肝损伤程度的相关性。方法收集2008年8月-2014年10月北京佑安医院收治的74例肝病患者,其中慢性肝炎（CH）23例、肝硬化（LC）27例、慢加急性肝衰竭（ACLF）24例,另选取16例健康体检者作为对照组（HC）。应用膳食营养软件计算饮食硒的摄入情况,采用电感耦合等离子体原子发射光谱法同期完成血清硒水平测定。计量资料多组间比较单因素方差分析,进一步两两比较采用LSD-t检验,计数资料组间比较采用χ2检验,采用Pearson进行相关分析。结果与HC组饮食摄入硒（45.45±18.10）μg相比,CH、LC及ACLF患者均存在饮食摄入硒不足,分别为（37.69±11.30）、（32.65±13.55）、（28.95±13.30）μg,差异有统计学意义（F=5.083,P=0.020）,随着肝病严重程度加重而逐渐降低,LC及ACLF组饮食摄入硒明显低于HC组,差异有统计学意义（P值分别为0.004、0.000）;CH、LC及ACLF患者的血清硒水平均降低,分别为（0.12±0.05）、（0.11±0.06）、（0.13±0.0...
- 肝炎,乙型,慢性 /
- 肝硬化 /
- 肝功能衰竭 /
- 硒
Abstract:
Objective To analyse dietary intake of selenium and serum selenium levels in patients with different types of chronic liver diseases,and to explore the relationship between selenium and severity of liver diseases. Methods Seventy- four patients admitted to Beijing You An Hospital from August 2008 to October 2014,as well as 16 healthy persons as healthy control( HC) group,were recruited in this study.Based on liver disease types,these patients were divided into chronic hepatitis( CH) group( n = 23),liver cirrhosis( LC) group( n = 27),and acute- on- chronic liver failure( ACLF) group( n = 24). Dietary intake of selenium was calculated on admission by dietary assessment software,and serum selenium levels were measured by inductively coupled plasma- atomic emission spectroscopy. Comparison of continuous data between groups was made by one- way ANOVA; comparison of categorical data between groups was made by χ2test; the correlation between variables was determined by Pearson correlation analysis. Results The dietary selenium intake in the HC group was 45. 45 ± 18. 10 μg.Compared with the HC group,the CH group,LC group,and ACLF group had insufficient dietary intake of selenium( 37. 69 ± 11. 30 μg,32. 65 ± 13. 55 μg,and 28. 95 ± 13. 30 μg,respectively). Dietary selenium intake gradually decreased with the progression of liver disease.Compared with the HC group,the LC group and ACLF group had significantly lower dietary selenium intake( P = 0. 004 and 0. 000,respectively). Serum selenium in the HC group was 0. 17 ± 0. 04 μg / ml. Compared with the HC group,the CH group,LC group,and ACLF group had significantly lower serum selenium levels( 0. 12 ± 0. 05 μg / ml,P = 0. 007; 0. 11 ± 0. 06 μg / ml,P = 0. 000; 0. 13 ± 0. 05 μg /ml,P = 0. 015). Serum selenium in the LC group was reduced most among these groups. Furthermore,serum selenium was significantly associated with prealbumin level,white blood cell count,and platelet count( r = 0. 229,P = 0. 030; r = 0. 213,P = 0. 044; r = 0. 255,P =0. 015). Conclusion With the progression of liver disease,serum selenium and dietary intake of selenium decrease gradually. It is meaningful to monitor and provide supplementary selenium in patients with chronic liver diseases during clinical practice.
- hepatitis B,chronic /
- liver cirrhosis /
- liver failure /
- selenium