甲状腺切除术后低镁血症:前瞻性观察-初步研究

A. Abdulkareem
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摘要

背景:镁在钙离子(Ca+2)和钾离子跨细胞膜的主动运输中起作用。大多数Mg+2在细胞内或骨中,<1%在血清中。甲状腺切除术后,甲状旁腺功能减退导致急性低钙血症,导致低镁血症。Ca+2与镁(Mg+2)代谢的关系是复杂的,主要与甲状腺切除术后这些阳离子与甲状旁腺激素(PTH)的相互作用有关。镁是钙离子通量和细胞内钙离子作用的重要调节剂。低镁血症损害低钙诱导的甲状旁腺激素释放,这在镁替代后迅速纠正。试图仅纠正低钙血症可能会延长症状。在甲状腺切除术后监测Ca+2和Mg+2水平对于促进症状的迅速解决是很重要的。目的:强调甲状腺切除术后低镁血症的患病率及其与低钙血症的关系,这需要早期识别和治疗,以防止低钙血症延长和永久性甲状旁腺功能减退。方法:获得机构审查委员会(E20-4615),并发布在ClinicalTrials.gov NCT04351451上。获得所有患者的知情同意。这是一项针对甲状腺切除术患者的前瞻性开放标签观察性先导研究。研究时间为2019年1月至2020年1月。74例患者肾功能正常。术前及术后第一天检查血清钙+2、镁、磷酸盐、维生素D水平。结果:甲状腺切除术后低镁血症发生率为56.8%。59.5.1%的患者存在低钙血症,41.9%的患者存在低钙、低镁血症(P = 0.004)。结论:甲状腺切除术后低钙、低镁血症的病因是多因素的,主要与PTH水平与Ca+2、Mg+2相互作用有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hypomagnesemia following thyroidectomy: Prospective observational - Pilot study
Background: Magnesium plays a role in the active transport of calcium (Ca+2) and potassium ions across cell membranes. Most of Mg+2 is intracellular or in the bone <1% is in the blood serum. Post thyroidectomy, hypoparathyroidism leads to acute hypocalcemia that leads to hypomagnesemia. The relation of Ca+2 and magnesium (Mg+2) metabolism is complex and mainly related to the interaction of these cations with parathyroid hormone (PTH) post thyroidectomy. Magnesium is an essential regulator of Ca+2 flux and intracellular action of Ca+2. Hypomagnesemia impairs hypocalcaemia-induced PTH release, which is corrected rapidly after magnesium replacement. Attempting to correct only hypocalcemia may prolong symptoms. It is important to monitor both Ca+2 and Mg+2 levels following thyroidectomy to facilitate prompt resolution of symptoms. The aim: is to highlight the prevalence of hypomagnesemia following thyroidectomy and its association with hypocalcemia which mandate early recognition and treatment to prevent prolongation of hypocalcemia and permanent hypoparathyroidism. Methods: Institutional review board was obtained (E20-4615) and posted in ClinicalTrials.gov NCT04351451. Informed consent taken from all patients. This is a prospective open Label observational pilot study in patients who underwent thyroidectomy. The study period was from January 2019 to January 2020. A total of 74 patients with normal renal function. Serum Ca+2, magnesium, phosphate level, and Vitamin D level are all checked preoperatively and in the first postoperative day. Results: Post thyroidectomy 56.8% of patients had hypomagnesemia. 59.5.1% had hypocalcemia and 41.9% of had combined low level of Ca+2 and Mg+2 (P = 0.004). Conclusions: Causes of hypocalcemia and hypomagnesemia following thyroidectomy is of multi factorial related mainly to Ca+2, Mg+2 interaction in relation to PTH level.
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