乳糜瀉與微量元素相關性研究進展

摘要 乳糜瀉是一種由遺傳易感個體攝入麩質引起的自身免疫病，主要累及小腸，引起小腸絨毛萎縮。許多乳糜瀉患者因腸道炎癥出現各種營養素吸收障礙，導致體內營養失衡，包括各種微量元素失衡。雖然微量元素在人體中含量很少，但因其特殊生理功能，對人體健康具有重要作用。部分乳糜瀉相關并發癥與不同微量元素失衡有關。此外，研究發現多種微量元素在乳糜瀉發生、發展中發揮作用。本文就乳糜瀉患者中一些重要微量元素水平，以及近年各種微量元素在乳糜瀉發病機制、病情評估和治療中作用的研究進展作一綜述。

關鍵詞 乳糜瀉； 微量元素； 鐵； 鋅； 硒； 銅； 膳食，無麩質

Progress of Research on Correlation Between Celiac Disease and Trace Elements Kailibinuer·NUERMAIMAITI1， LI Ting2，3， GAO Feng2，3. 1Graduate School of Xinjiang Medical University， Urumqi （830054）; 2Department of Gastroenterology， the People′s Hospital of Xinjiang Uygur Autonomous Region， Urumqi; 3Xinjiang Clinical Medical Research Center for Digestive Diseases， Urumqi

Correspondence to： GAO Feng， Email： xjgf@sina.com

Abstract Celiac disease， an autoimmune disease caused by the intake of gluten in genetically susceptible individuals， mainly affects the small intestine， causing villous atrophy of the small intestine. Many celiac disease patients suffer from various nutrient absorption disorders due to intestinal inflammation， leading to nutritional imbalance， including the imbalance of various trace elements. Although the amount of trace elements in human body is very low， all kinds of trace elements are closely related to human health because of their special physiological functions. Some of the complications of celiac disease are thought to be correlated with various trace element imbalances. In addition， many studies have found that various trace elements play roles in the occurrence and development of celiac disease. This article reviewed the levels of some important trace elements in patients with celiac disease， and the progress of research on the roles of various trace elements in the pathogenesis， disease assessment and treatment of celiac disease in recent years.

Key words Celiac Disease; Trace Elements; Iron; Zinc; Selenium; Copper; Diet， Gluten?Free

乳糜瀉（celiac disease）又稱麥膠性腸病，是一種主要累及小腸的多器官自身免疫病。攜帶人類白細胞抗原（HLA）?DQ2或?DQ8的遺傳易感性個體是乳糜瀉的主要發病人群，人群患病率約為1%[1]。乳糜瀉易感個體食用麩質類食物引起腸道黏膜病變而出現一種腸道吸收不良綜合征，通常表現為慢性腹瀉、腹脹等典型的消化道癥狀[2]。目前治療該病的唯一方式為終生無麩質飲食（gluten?free diet， GFD）。由于腸道的慢性炎癥，乳糜瀉患者體內常出現各種營養素的吸收障礙，從而出現貧血、體質量減輕、身材矮小等營養缺乏相關的癥狀[3]。微量元素系指人體中含量低于人體質量0.01%的元素，包括鐵、鋅、硒、銅、鎂、碘、錳、硅等。雖然其含量非常少，但在人體健康中發揮的作用不可忽視。微量元素的攝入過量、不足、不平衡、缺乏均會不同程度地引起生理異常或疾病的發生。……