慢性HCV/HIV合并感染对血清锌的影响  

EFFECT OF HCV/HIV CO-INFECTION ON THE CONCENTRATION OF SERUM ZINC

作　　者：刘媛[1] 赵洁[2] 沈弢[3,4] 鲁凤民[3,4] 吕全军[1] 

机构地区：[1]郑州大学公共卫生学院营养与食品卫生学系,郑州450001 [2]北京大学人民医院检验科,北京100044 [3]北京大学基础医学院病原生物学系,北京100191 [4]北京大学感染病研究中心,北京100191

出　　处：《营养学报》2014年第1期40-44,共5页Acta Nutrimenta Sinica

基　　金：国家自然科学基金(No.81271826);十二五国家重大科技专项基金(No.2012ZX10002003;2012ZX10002005)

摘　　要：目的评估与丙型肝炎病毒(HCV)单感染、人免疫缺陷病毒(HIV)单感染相比,HCV/HIV合并感染者体内血清锌的含量变化及意义。方法采用原子吸收分光光度法检测并比较河南某村HCV单感染(129人)、HIV单感染(66人)、HCV/HIV合并感染者(98人)和健康对照者(84人)血清中微量元素锌的含量变化。结果 HCV单感染者、HIV单感染者、HCV/HIV合并感染者和健康对照者血清锌的含量分别为(12.33±1.87)、(11.85±2.79)、(11.70±2.04)、(12.93±2.03)?mol/L。与健康对照者相比,HCV/HIV合并感染者、HCV单感染者、HIV单感染者血清锌的含量均显著降低。HCV/HIV合并感染者与HCV单感染者血清锌相比明显降低。在HCV单感染且ALT≥40(IU/L)者中白蛋白与血清锌呈正相关(r=0.3593,P=0.0052)。在HCV/HIV感染者和HIV感染者中CD4+T细胞数低者(<500/?l)血清锌含量分别为(10.72±1.78)、(10.91±2.27)?mol/L,CD4+T细胞数高者(≥500/?l)血清锌含量分别为(12.01±1.67)、(12.36±2.52)μmol/L。HIV阳性者中,无论HCV合并感染与否,与免疫正常者相比,免疫受损者血清锌含量均明显降低。结论 HCV单感染、HIV单感染均可使血清锌降低,HCV/HIV合并感染加重了锌的缺乏,在HCV单感染且ALT≥40(IU/L)者中血清锌的水平和白蛋白呈正相关,在HCV/HIV合并感染和HIV单感染者血清锌的变化和免疫受损水平有关。[营养学报,2014,36(1):40-44]Objective To explore the changes of serum zinc in patients with hepatitis C virus （HCV）, human immunodeficiency virus （HIV） infection or HCV/HIV co-infection. Methods Serum zinc concentrations of HCV-infected （n=129）, HIV-infected （n=66）, HCV/HIV co-infected （n=98） patients and healthy controls （n=84） all recruited from a village of Henan province were measured by a flame atomic absorption spectrophotometry, and the results of different groups were compared subsequently. Results Serum zinc concentrations were 12.33±1.87, 11.85±2.79, 11.70±2.04 and 12.93±2.03 μmol/L in HCV-infected, HIV-infected, HCV/HIV co-infected patients and healthy controls respectively. Compared with healthy controls, serum zinc concentration in HCV infected, HIV infected or HCV/HIV co-infected patients were all significantly decreased. Additionally, serum zinc concentration in HCV/HIV co-infected patients was significantly lower than that in the HCV infected. There was significant positive correlation between the levels of zinc and albumin in HCV infected patients with alanine aminotransferase （ALT） over 40U. The zinc concentrations were 10.72±1.78 and 10.91±2.27 μmol/L in HCV/HIV co-infected and HIV infected patients with CD4＋ T cell counts 〈500/μl and 12.01±1.67 and 12.36±2.52 μmol/L per liter in these two groups with CD4＋T cell counts ≥500μl respectively. In HIV patients, the zinc concentration in those immunocompromised was significantly lower than those immunocompetent, regardless of HCV co-infected or not.Conclusion Both HCV an HIV infections induce reduction of serum zinc and HCV/HIV co-infection worsens much more. Significant correlation was found between the levels of serum zinc and albumin in HCV infected patients. In addition, the decrease of serum zinc is associated with the immunocompromised condition in HIV infected patients.

关 键 词：HCV HIV合并感染 血清锌 CD4+T细胞数 白蛋白 

分 类 号：R512.91[医药卫生—内科学]