儿童边缘性锌缺乏症综合判断的研究  

A Comprehensive Diagnostic Study for Children Suffering from Marginal Zinc Deficiency

作　　者：刘兴旺[1] 贾丽红[1] 张立夫[1] 王怡[1] 

机构地区：[1]中国医科大学营养与食品卫生学教研室,中国医科大学附属第一医院儿科,中国医科大学基础部有机化学教研室

出　　处：《中国公共卫生学报》1995年第5期315-319,共5页

基　　金：卫生部出国归国人员启动基金

摘　　要：对沈阳市某幼儿园９９例３～６岁锌缺乏儿童的营养调查和生物样品（血液、尿液和毛发）的分析发现：同对照组儿童相比，锌缺乏儿童除Ｆｅ、维生素Ａ外，其他主要营养素的摄入明显不足；缺锌儿童的发锌、ＲＢＣ锌水平、血清ＡＬＰ活性、尿锌／尿肌酐比值均明显低于对照组。经补锌治疗后血浆锌水平、血清ＡＬＰ活性、尿锌／尿肌酐比值显著升高。应用临床诊断实验的评价方法分析发现结合血浆锌水平，联合使用发锌，血清ＡＬＰ和尿锌／尿肌酐比值３项指标可以准确判断儿童边缘性锌缺乏，这时并联的灵敏度为９６．１８％，串联的特异度可高达到１００％（血清ＡＬＰ活性＜１０４ＩＵ／Ｌ，同时发锌含量＜１１０ｐｐｍ．尿锌／尿肌酐比值＜０．３μｇ／ｇ）。The results of nutritional investigation, and measurements of biological specimen (blood, urine, and hair)under the condition of artificial control of the influences of several factors such as diet, diseases, infection, and serum albumin level to the plasma zinc levels for 99 marginal zinc deficiency (ZnD) children of 3～6 years old in Shenyang indicated that the intake of nearly all main nutrients except Fe, and vitamin A of the ZnD children is apparently lower compared with those of the control. The zinc levels in the plasma, hair, RBC, serum ALP activity, and urine zinc/creatinine ratio of the ZnD children are also significantly lower than that of control (P<0.05). The plasma zinc level, serum ALP activity, urine zinc/creatinine ratio of the ZnD children were greatly ameliorated after 1. 5 month oral zinc administration(P<0. 05 ). The analysis of these parameters with the method of the evaluation of diagnosis trial revealed that the correct diagnosis for the marginal ZnD can be made according to the levels of three parameters jointly hair Zinc content, serum ALP activity, and urine zinc/creatinine ratio. (<110ppm, <104IU/L, and < 0. 3μg/g, respectively). The diagnostic specificity and positive predictive value of this method are both 100%. Because of the simplicities and accuracy of plasma zine content, we suggest that when this comprehensive method is used to confirmedly diagnose ZnD, the value of plasma Zn level should also be taken into account.

关 键 词：儿童 锌缺乏 血浆锌 血清碱性磷酸酶 诊断 

分 类 号：R725.911[医药卫生—儿科]