臨牀消化器内科 Vol.23 No.6(7)


特集名 肝疾患の栄養療法
題名 肝硬変に対する亜鉛補充療法
発刊年月 2008年 06月
著者 森山 光彦 日本大学医学部内科学系消化器肝臓内科学分野
著者 松村 寛 日本大学医学部内科学系消化器肝臓内科学分野
著者 田中 直英 日本大学医学部内科学系消化器肝臓内科学分野
著者 荒川 泰行 日本大学医学部内科学系消化器肝臓内科学分野
【 要旨 】 血清亜鉛濃度は肝硬変への進展に伴って有意に低下し,liver damageの程度をよく反映した.また血清亜鉛濃度は,アルブミン,プロトロンビン時間などの肝予備能を示唆する検査所見と有意に相関した.分岐鎖アミノ酸 (BCAA) 製剤投与例では,BTR高値にもかかわらず血中亜鉛濃度の低値群が存在する.亜鉛製剤の補充療法により,血清亜鉛濃度は上昇し,長期予後として血清ASTないしALT値の低下をきたした.結論として,非代償性肝硬変は,血清亜鉛濃度は低値を呈することより,亜鉛製剤の補充が必須である.また特殊アミノ酸製剤や利尿剤の長期にわたる使用例では,血清亜鉛濃度を必ずモニターし,低値例には亜鉛補充療法が必要である.
Theme Nutrition Therapy for Liver Diseases
Title Clinical Significance of Zinc Supplementation for Patients with Type C Hepatitis Related Cirrhosis
Author Mitsuhiko Moriyama Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
Author Hiroshi Matsumura Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
Author Naohide Tanaka Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
Author Yasuyuki Arakawa Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
[ Summary ] Zinc concentrations in patients with the hepatitis C virus (HCV) and RNA-positive chronic liver disease were evaluated. A correlation was then made with the clinical profiles of patients. The median concentration of zinc in patients with liver cirrhosis (LC) was statistically lower than that in healthy control subjects or chronic hepatitis (CH) patients. A significant correlation was observed between the zinc concentrations and prothrombin time and albumin concentrations. Zinc concentrations decreased with the development of Child-Pugh stage. Zinc supplementation therapy reduced AST and ALT levels during as well as after therapy in patients with LC. Zinc supplementation therapy group exhibited significantly reduced platelet counts than the control group. It was concluded that serum concentrations of zinc influenced clinical profiles in patients with LC, and that zinc supplementation improved long term outcomes in LC patients.
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