Magnesium and Parathyroid Hormone in Hemodialysis Patients

血液透析病人的鎂與副甲狀腺素

洪崇尹(Chung-Ying Hung) ； 楊垂勳(Chwei-Shiun Yang) ； 陳孟良(Meng-Liang Chen) ； 張旭宏(Hsu-Horng Chang) ； 馬雲虎(Yun-Hu Ma) ； 周家麒(Chia-Chi Chou)

《Acta Nephrologica》 14卷2期 (2000/04) Pp. 60-65

摘要

我們研究163位慢性腎衰竭接受鎂濃度1.0mgq/L的透析液長期血液透析50 ± 48個月的病人。這些病人都沒有接受過副甲狀腺切除或酒精注射，並且在此研究前二個月沒有接受維他命D的治療。這些病人平均血清鎂濃度是2.6 ± 0.4mgq/L。137位病人有高鎂血症（血清鎂濃度大於2.2mgq/L）。104位病人有相對的貑甲狀腺功能低下症（副甲狀腺素小於120pg/ml）。女性比男性有明顯較高的血清副甲狀腺素濃度。血清副甲狀腺素濃度與血清鎂濃度、血清鈣濃度及年紀有明顯的負相關，與接受血液透析的期間有明顯的正相關。多變數回歸分析顯示血清鎂濃度、血清鈣濃度、年紀、性別、及接受血液透析的期間都是血清副甲狀腺素度濃度的預測因子。這顯示高鎂血症可能有抑制副甲狀腺素分泌的效果。

關鍵字

鎂 ； 高鎂血症 ； 副甲狀腺素 ； 血液透析

並列摘要

We studied 163 chronic renal failure patients who had been on maintenance hemodialysis with dialysate content magnesium (Mg) of 1.0 meg/L for 50 ± 48 months (range, 2to 189months). None of them had history of parathyroidectomy or ethanol injection for parathyroid adenoma. They also did not take vitamin D for at least two months before the study. The mean serum Mg concentration was 2.6 ± 0.4mg/dL. Hypermagnesemia (serum Mg＞2.2mg/dL) was found in 137 patients (84%). Relative hypoparathyroidism (intact parathyroid hormone, iPTH＜120pg/mL) was found in 104 patients (63.8%). Women had higher serum iPTH level than men. Serum iPTH level was significantly inversely correlated with serum Mg level (r=-0.19; P＜0.05) and calcium (Ca) level (r=-0.22; P＜0.01), and significantly positively correlated with duration on dialysis (r=0.29; p＜0.001). Stepwise multivariate analysis confirmed that serum mg, Ca, age, duration on dialysis, and gender were predictors of serum iPTH level. It is suggested that hypermagnesemia may have a suppressive effect on parathyroid hormone (PTH) secretion.

並列關鍵字

magnesium ； hypermagnesemia ； parathyroid hormone ； hemodialysis