充血性心力衰竭伴室性心律失常时红细胞镁的改变

CHANGES OF ERYTHROCYTE MAGNESIUM IN CONGESTIVE HEART FAILURE WITH VENTRICULAR ARRHYTHMIA AND ITS CLINICAL SIGNIFICANCE

根据心电图监测结果,将91例充血性心力衰竭(CHF)患者分为普通组(30例)和室性心律失常组(61例)。后者又分利尿剂和非利尿剂两个亚组。对照组25例。测定当天红细胞镁、血清镁和尿镁。结果显示:①心律失常组红细胞镁和血清镁明显低于普通组(P<0.05);②利尿剂亚组红细胞镁和血清镁明显低于非利尿剂组(P<0.05);③心律失常组中红细胞镁减低者易发生恶性室性心律失常(P<0.05)。本文提示,CHF伴室性心律失常时缺镁是不容忽视的,应用利尿剂时则更易发生低镁。

Ninety one patients with congestive heart failure (CHF) were monitored electrocardiographically for 24 hours. The patients were classified into general congestive heart failure group (general group) and congestive heart failure with ventrieular arrhythmia group(arrhythmia group). General group consisted of 30 pa- tients who hadn't ventricular arrhythmia (VA) or had only Lown class Ⅰ ventricular premature beat. Arrhythmia group consisted of 61 patients who had over Lown Class Ⅱ ventricular premature beat or ventricular tachycardia and fibrillation. Arrhythmia group was classified again into diuretic and non-diuretic subgroups. Normal control group consisted of 30 subjects. Erythrocyte, serum and urine Mg concentration of all patients were measured on the day with ECG monitoring. The results were shown as follows: 1. Erythrocyte and serum Mg concentrations in the arrhythmia group were lower than the general group (p<0.05) ; 2. Erythrocyte and serum Mg concentrations in the diuretic sub-group were lower than the non-diuretic subgroup; 3. Patients with low erythrocyte Mg in the arrhythmia group had higher incidence of malignant VA than those with normal erythrocyte Mg (p<0.05). It is suggested that the significance of Mg deficiency should be stressed in CHF with VA, especially in using diuretic due to the danger of inducing malignant VA, and supplementation of Mg might be important in the prevention and treatment of CHF with VA.