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已有报道称克罗恩病患者血中锌浓度降低。但克罗恩病对青春期患者血中锌代谢的影响仍不甚清楚。本研究的目的是观察病情稳定的克罗恩病患儿锌的吸收、粪便中锌的排泄、尿锌的排泄及锌的平衡情况,并与对照组进行比较。受试者包括15名儿童,年龄范围在8-18 岁,均患有克罗恩病,目前病情平稳。同时有15名健康儿童作为对照组。受试者接受12 mg/d的含锌饮食共2 周,然后进行6 d的代谢研究。通过静脉及口服给予稳定的锌同位素,收集6 d的尿、粪标本,然后通过同位素测定法计算锌的吸收、粪便中锌的排泄以及锌的平衡。患病组与对照组相比,锌吸收(10.9%±6.1% vs 23.4% ±15.8%,P=0.008)和血浆锌浓度(85±0.15 mg/L vs 1.25±0.35 mg/L,P=0.004)显著降低。尽管如此,两组间粪便中锌的排泄(2.0±1.5 mg vs 1.5±1.5 mg,P= 0.34)或尿锌的排泄(0.9±0.7 mg vs 1.0±0.7 mg,P= 0.47)相比没有显著差异。患病组锌平衡(-1.5±1.5 mg) 比对照组(+0.6±3.1 mg,P<0.0001)显著降低。本研究显示:患克罗恩病的青春期儿童对锌的吸收显著减少,而且不能通过减少粪便中锌的排泄来恢复锌的平衡,从而加重了锌代谢的不平衡,与对照组相比,其血浆锌浓度降低。
It has been reported that blood levels of zinc in Crohn’s disease are reduced. However, the effect of Crohn’s disease on zinc metabolism in adolescent blood remains unclear. The purpose of this study was to observe zinc absorption, excretion of zinc, urinary excretion of zinc and zinc balance in children with Crohn’s disease who were stable and compared with those in the control group. Subjects included 15 children aged 8-18 years with Crohn’s disease and were presently stable. At the same time, 15 healthy children served as the control group. Subjects received a 12 mg / d zinc diet for 2 weeks followed by a 6-day metabolic study. By intravenous and oral administration of stable zinc isotopes, urine and fecal specimens were collected for 6 days, and then zinc absorption, fecal zinc excretion and zinc balance were calculated by isotope assays. Compared with control group, zinc absorption (10.9% ± 6.1% vs 23.4% ± 15.8%, P = 0.008) and plasma zinc concentration (85 ± 0.15 mg / L vs 1.25 ± 0.35 mg / L, P = 0.004 ) Significantly reduced. Despite this, there was no significant difference in excretion of zinc (2.0 ± 1.5 mg vs 1.5 ± 1.5 mg, P = 0.34) or urinary excretion of zinc (0.9 ± 0.7 mg vs 1.0 ± 0.7 mg, P = 0.47) between the two groups difference. The zinc balance (-1.5 ± 1.5 mg) in the diseased group was significantly lower than that in the control group (+ 0.6 ± 3.1 mg, P <0.0001). This study shows that adolescent children with Crohn’s disease significantly reduce zinc absorption, and can not restore zinc balance by reducing zinc excretion in feces, thereby aggravating the zinc metabolism imbalance, compared with the control group, its Plasma zinc concentration decreased.