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RISS 인기검색어
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- 저자 : 김정용(Jung Lyoung Kim) (검색결과 1 건)
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만성 (慢性) 활동성 (活動性) 간질환에서 (肝疾患) 아연 및 동의 (銅) 혈청 농도와 (濃度) 소변 (小便) 내 (內) 배설양 (批泄量)
이효석(Hyo Suk Lee),김정용(Jung Lyoung Kim) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1
N/A Zinc and copper are two of the most intensively investigated and most metabolically important trace metal nutrients. For this reason, and because of their close chemical similarty and extensive biological interaction, they are often considered together. Copper and zinc are important trace metals involved in several hepatic enzyme systems and are stored in large quantity in the liver. Therefore, it is expected that chronic diseases of the liver have been associated with alterations in serum and urinary levels of zinc. Serum zinc and copper were determined by atomic absorption spectrophotorrictry and serum ceruloplasmin was measured spectrophotometrically from serum oxidase activity using paraphenylene-diamine as the substrate in 10 patients with chronic active liver disease(CALD) including not only 53 patients with liver cirrhosis but also 25 patients with chronic active hepatitis and 32 patients with primary liver cancer, and in 17 patients with a acute viral hepatitis and 20 healthy persons as control. Changes in serum zinc and copper, chekced weekly in three patients with CALD during the cocrse of more than two months of hospitalization were correlated with standard measurements of liver function. Urinary excreticn and clearance of zinc and copper were calculated with each urinary concentration which was directly measured by atomic absorption spectrophotometry in 28 paticnts with CALD and in 6 patients with no history- or current clinical evidence of liver disease and ro other diseae reported to influence zinc metabolism as control. Patients with CALD including liver cirrhosis, chronic active hepatitis and primary liver cancer were found to have significantly decreased serum zinc concentration. There was a linear relationship between albumin and zinc concentration in the serum. But serum zinc levels were only partially related to the levels of serum ceruloplasmin, and not to the SGOT values. Urinary excretion and clearance of zinc increased in CALD. The increment of clearance is statistically significant. The urinary zinc clearance showed a tendency to be inversely related to serum albumin and serum zinc concentration. The change in serum and urine zinc may te related to changes in the manner by which zinc is bound to serum proteins, particularly albumin. Although serum zinc concentration is remarkably decreased in cirrhotic patients with hepatic coma, there was no correlation between serum zinc and blood ammonia concentration. By contrast, serum ceruloplasmin and copper was normal in patients with liver cirrhosis but significantly increased in patients with chronic active hepatitis and primary liver cancer. The levels of serum copper has positive correlation with serum ceruloplaernin but not with serum albumin and SGOT values. The increases of serum copper in chronic active hepatitis and primary liver cancer were accounted for entirely by increase in the concentration of ceruloplasmin. The cirrhotic patients with hepatic coma showed somewhat decreased level of serum ceruloplasmin and copper, which was not statistically significant. But there were 4 cases (about 8%) out of 53 cirrhotic patients who showed definitely decreased serum ceruloplasmin concentration that differs from the mean of the normal control by more twice the standard deviation. Daily urinary copper excretion and clearance were significantly increased in CALD, but its change has not been related to the changes of serurn albumin or serum copper concentrations. The present work revealed markedly altered zinc and copper metabolism in CALD and showed the differences in alteration between the two trace metals. These differences were considered to be derived from the different main serum binding protein, namely albumin for zinc and ceruloplasmin for copper, and from the difference between their main excretory pathways. It is concluded in term of copper metabolism in CALD that chemical test routinely used to assess copper metabolism in Wilsons disease including seru
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