仰光综合医院和专科医院肝硬化患者血清锌水平

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摘要

肝硬化是临床实践中常见的医学问题之一,也是导致发病和死亡的主要原因之一。锌是人体必需的微量元素,在人体中起着多种生物作用。其中,锌缺乏被认为参与氨的代谢,引起高氨血症,加重肝性脑病。本研究旨在通过Child Turcotte Pugh评分了解肝硬化的严重程度,并探讨血清锌水平与肝硬化严重程度的关系。在仰光综合医院和仰光专科医院的医疗单位,对78名不同病因的肝硬化患者进行了一项基于医院的横断面描述性研究。在研究人群中,儿童A级占28.21%,儿童B级占30.77%,儿童C级占41.03%。血清锌水平低62.8%,正常28.2%,高8.9%。A级血清锌均值为0.68 mg/l, B级血清锌均值为0.54 mg/l, C级血清锌均值为0.48 mg/l (p=0.00)。结果发现,重度肝硬化患者缺锌的发生率较高。与Child-Pugh B和C患者相比,Child-Pugh C患者的锌水平明显最低。肝硬化患者应要求锌缺乏严重程度的补充治疗,以预防肝性脑病、肝细胞癌和肝衰竭等并发症。在这些晚期肝硬化患者中可能需要进行缺锌筛查,因为它似乎是肝病晚期的标志,可以推断,肝硬化患者血清锌水平的认识在临床实践中非常重要。
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Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon
Cirrhosis of liver is one of the common medical problem in daily clinical practice and one of the leading causes of morbidity and mortality. Zinc is an essential trace elements for human and plays in many biological roles in the body. Among them, zinc deficiency is thought to be involved in metabolism of ammonia and causes hyperammonia that worsen hepatic encephalopathy. This study aimed to find out the severity of cirrhosis of liver was by Child Turcotte Pugh score and to investigate the associations between serum zinc level and severity of cirrhosis. A hospital-based cross-sectional descriptive study was performed on 78 patients with different underlying causes of cirrhosis of liver at the Medical Units of Yangon General Hospital and Yangon Specialty Hospital. Among the study population, Child grade A was found to be 28.21%, Child grade B was 30.77% and Child grade C was 41.03%. Regarding result of serum zinc level, 62.8% were low level, 28.2% were within normal level and 8.9% were high level. Mean value of serum zinc level in grade A was 0.68 mg/l, grade B was 0.54 mg/l and grade C was 0.48 mg/l (p=0.00). It was found out that there was a high prevalence of zinc deficiency in severe cirrhotic patients. The zinc level was significantly lowest among patients with Child-Pugh C as compare to those with Child-Pugh B and C. Severity of zinc deficiency should be requested for supplementation therapy in cirrhotic patients as to prevent complications such as hepatic encephalopathy, hepatocellular carcinoma and liver failure. Screening for zinc deficiency may need in these patients with more advanced cirrhosis because it seems to be a marker of advanced liver disease and it can be deducted that awareness of serum zinc level among cirrhotic patients is very important in clinical practice.
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