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研究生:董萃英
研究生(外文):Tsuey-Ing Doong
論文名稱:血液透析患者微量元素(鋅、銅、硒)之營養狀態
論文名稱(外文):Trace Elements (Zn, Cu, Se) Status in Hemodialysis Patients
指導教授:王果行王果行引用關係章樂綺章樂綺引用關係
學位類別:碩士
校院名稱:輔仁大學
系所名稱:食品營養學系
學門:醫藥衛生學門
學類:營養學類
論文種類:學術論文
論文出版年:2003
畢業學年度:91
語文別:中文
論文頁數:62
中文關鍵詞:微量元素血液透析
外文關鍵詞:trace elementshemodialysiszniccopperselenium
相關次數:
  • 被引用被引用:1
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  • 收藏至我的研究室書目清單書目收藏:2
微量元素為人體許多功能所必需之營養素,血液鋅、銅和硒濃度異常與尿毒症患者臨床症狀有關。隨著透析方式的進展,目前血液透析患者體內微量元素的營養狀態可能有所變化。本研究旨在探討血液透析患者血漿和紅血球微量元素(鋅、銅與硒)營養狀態,評估與飲食、體位和生化檢查之相關性。研究對象為台北榮民總醫院五十三位常規接受血液透析治療超過三個月患者,另有三十八位健康人為控制組。結果顯示血液透析患者血漿中鋅、銅、硒與紅血球中銅、硒濃度均顯著低於健康控制組,紅血球鋅濃度則高於健康控制組。血液透析患者飲食熱量攝取量與紅血球鋅濃度有相關性。飲食鋅、蛋白質或熱量攝取量較高者,其乾體重、上臂肌肉圍與肌肉面積均較高。血漿銅濃度隨年齡與透析時間增加而升高,而血漿鋅和硒濃度與年齡呈負相關性。日常習慣飲用茶或咖啡之患者其紅血球鋅濃度低於無飲用習慣者。透析前血漿鋅/銅和血清藍胞漿素濃度、體肌肉量、理想體重百分比及手握力愈高者,於營養評估後一年內住院天數愈少。一年後曾經住院之患者的平均每日熱量攝取量較無住院記錄之患者低。因此,以上之結果可做為幫助改善血液透析患者營養狀況和因微量元素異常所引起的症狀之依據。
For human beings, several trace elements are essential nutrients with many biochemical functions. The abnormal blood levels of zinc (Zn), copper (Cu) and selenium (Se) have been associated with many clinical symptoms in hemodialysis (HD) patients. The trace elements (Zn, Cu, Se) levels of plasma and erythrocyte were measured before and after hemodialysis in 53 HD patients and in a control group of 38 healthy volunteers in this study. The relationship between trace element levels, dietary, anthropometric data and biochemical measurements were also examined. Plasma concentrations of Zn, Cu and Se were significantly lower in HD patients compared to healthy controls. The similar results were observed in the erythrocyte concentrations of Cu and Se. The Zn concentration of erythrocyte was higher in HD patients than that in the controls. There was a positive correlation between the erythrocyte Zn concentrations and caloric intake in HD patients. The dietary Zn, protein and calories intake of HD patients were increased proportional with increasing of the dry body weight, arm muscle circumference and arm muscle area. Plasma Cu level increased as age and dialysis duration increased, however there was a reversely linear correlation between plasma Zn, Se and age. The erythrocyte concentrations of Zn were lower in coffee and tea drinkers as compared to non-drinkers. The lower plasma Zn, Cu and ceruloplasmin levels, lean body mass, ideal body weight percentage and/or hand grip strength, the higher hospitalization days would be within one year after assessment of these subjects. The caloric intake of subjects without hospitalization within one year after assessment were higher than that of the subjects with experience of hospitalization. Therefore, based on above results, the nutrition status and related clinical sign of HD patients may be improved.
頁次
第一章 前言 1
第二章 文獻回顧 2
一、血液透析患者盛行率 2
二、血液透析患者體內微量元素狀態與對血液透析患者 2
可能的臨床意義
(一)鋅(zinc) 2
(二)銅 (copper) 6
(三)硒 (Selenium) 8
三、血液透析前後微量元素(鋅、銅、硒)濃度改變 11
第三章 材料與方法 15
一、實驗設計 15
二、分析項目 15
1.體位測量 15
2.營養相關生化檢查 15
3.飲食評估 18
4.Kt/V、URR 18
三、統計分析 19
第四章 結果 20
一、受試者基本資料 20
二、飲食、生化檢查評估 21
三、血漿與紅血球鋅、銅、硒濃度 22
四、各變數間相關性 22
第五章 討論 24
第六章 結論 32
第七章 未來方向 33
參考文獻 50
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