長期経管栄養施行中の重症心身障害者に対する亜セレン酸ナトリウム内服液投与の有用性

Abstract

Selenium is a component of glutathione peroxidase (GPx), which metabolizes oxygen radicals. Generally, selenium is obtained from such foods as grains and fish. Therefore, for patients with severe motor and intellectual disabilities (SMID) who cannot orally consume meals, a selenium deficiency remains a problem. To overcome this problem, selenium oral solution was administered to SMID patients under long-term total parenteral nutrition, and the usefulness of selenium oral solution was evaluated using the serum selenium concentration and GPx activity as indices.Before selenium oral solution administration, the serum selenium concentration of SMID patients was 3.0 ± 0.7, μg/dL, which is an extremely the low value compared with 11.2 ± 1.2, μg/dL which is the normal value for a healthy adult. Moreover, the GPx activity of 48.5 ± 12.3 n mol/min/mL was also extremely low in comparison to a healthy adult' s value of 112.6 ± 5.6 n mol/min/mL. When a selenium oral solution (6, μg/kg) was administered to SMID patients for two weeks once per day, the serum selenium concentration and the GPx activity increased, and there was no difference from a normal healthy adult' s value. Although the selenium oral solution thereafter decreased to 1.5μg/kg once per day, the serum selenium concentration and the GPx activity were mostly maintained in the normal region. Moreover, a significant positive correlation was observed between the serum selenium concentration and the GPx activity. (p< 0.001)These results suggested that the administration of oral selenium solution to patients with selenium deficiency diseases, such as SMID, and patients under long-term total parenteral nutrition, thus improved the serum selenium concentration and GPx activity.