不明原因肝损害的32例肝组织活检标本的29种微量元素测定  

Determination of 29 Trace Elements in 32 Cases of Liver Biopsy with Unexplained Liver Injury

作　　者：李惠敏 陈刚[2] 李铁汉[3] 冯晓洁[4] 李卫昆 祁燕伟 刘春云 刘立 LI Huimin;CHEN Gang;LI Tiehan;FENG Xiaojie;LI Weikun;QI Yanwei;LIU Chunyun;LIU Li(Dept.of Hepatology,The 3rd People’s Hospital of Kunming,Kunming Yunnan 650041;Dept.of Hepatobiliary and Pancreatic Surgery,The 1st People’s Hospital of Kunming,Kunming Yunnan 650034,China;Dept.of Liver and Gallbladder Surgery,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101;Dept.of Pathology,The 1st People’s Hospital of Kunming,Kunming Yunnan 650034,China)

机构地区：[1]昆明市第三人民医院肝病三科,云南昆明650041 [2]昆明市第一人民医院肝胆胰外科,云南昆明650034 [3]昆明医科大学第二附属医院肝胆外科,云南昆明650101 [4]昆明市第一人民医院病理科,云南昆明650034

出　　处：《昆明医科大学学报》2022年第4期125-131,共7页Journal of Kunming Medical University

基　　金：昆明市科学技术局科研基金资助项目(2019-1-S-25318000001263)。

摘　　要：目的测定肝组织中的微量元素,探讨不明原因肝损害的发生与机体微量元素的关系。方法对不明原因肝损害患者进行肝组织穿刺术取出肝组织,与对照组正常的肝组织,均采用电感耦合等离子体质谱仪测定29种微量元素含量,进行比较分析。结果不明原因肝损害(实验组)与对照组比较,肝组织中的锂7Li、铍9Be、铝27Al、钙44Ca、钛48Ti、钒51V、铬52Cr、钴59Co、镍60Ni、锗73Ge、锶88Sr、钼95Mo、铟115In、锡118Sn、铼185Re、铂195Pt、汞202Hg、铅208Pb、铋209Bi 19种元素均显著增高,差异有统计学意义(P<0.01);砷75As、硒82Se均增高,差异有统计学意义(P<0.05),镉111Cd显著降低,差异有统计学意义(P<0.01),而镁24Mg、锰55Mn、铁57Fe、铜63Cu、锌66Zn、镓71Ga、硒77Se、钡137Ba无显著差异(P>0.05)。实验组中铁蛋白和肝组织活检中铁含量的相关性,采用Spearman相关性分析,P<0.01,铁蛋白与肝组织中铁呈正相关关系。结论不明原因肝损害患者的肝组织中微量元素升高,表明这些微量元素代谢异常可能为不明原因肝损害的原因之一,或在肝病的发生、发展过程中起一定的作用。肝病理检查及肝组织微量元素测定为实验组患者明确找到了肝损害的病因。铁蛋白与肝组织中铁含量呈正相关。Objective To determine trace elements in liver tissue and to explore the relationship between the occurrence of liver injury with unknown causes and trace elements in the body.Methods The liver tissue of patients with liver injury of unknown causes was obtained by liver biopsy.The content of 29 trace elements was determined by inductively coupled plasma mass spectrometry(ICP-MS)and were compared with the normal liver tissue of the control group.Results Compared with the control group,19 elements including lithium,beryllium,aluminum,calcium,titanium,vanadium,chromium,cobalt,nickel,germanium,strontium,molybdenum,indium,tin,rhenium,platinum,mercury,lead,bismuth were significantly increased(P<0.01).Arsenic and selenium increased(P<0.05),and cadmium significantly decreased(P<0.01).However,there were no significant differences in magnesium,manganese,ferrum,copper,zinc,gallium,selenium and barium(P>0.05).Spearman correlation analysis showed ferritin was positively correlated with iron content in liver tissue.Conclusion The increase of trace elements in liver tissue of patients with liver injury of unknown cause indicated that abnormal metabolism of trace elements might be one of the causes of liver injury of unknown causes or play a certain role in the occurrence and development of liver disease.By examination of liver pathology and determination of trace elements in liver tissue,the causes of liver damage in the experimental group were clearly found.Ferritin was positively correlated with iron content in liver tissue.

关 键 词：不明原因肝损害 肝组织活检 微量元素测定 

分 类 号：R575.3[医药卫生—消化系统]