原发性甲状旁腺功能亢进症患者的血镁特点和临床意义

Characteristics of serum magnesium levels in patients with primary hyperparathyroidism and its clinical significance

目的回顾分析27例原发性甲状旁腺功能亢进症(PHPT)患者的血清镁浓度,了解其特点及临床意义。方法收集1997年～2007年该院收治的PHPT患者27例,利用SPSS软件对血镁等临床资料进行统计分析。结果PHPT患者入院时40.7%存在低镁血症。与血镁正常的PHPT患者相比,低镁者血PTH水平和尿镁/尿钙比值显著增高,尿钙排出减少,骨骼受累明显增多。手术治疗的16例PHPT患者中,术前低镁者术后100%仍有低血镁,且术后血镁水平进一步降低,而术前血镁正常的患者中75%术后发生低镁血症。术前血镁水平不同的2组患者术后血钙磷的变化也存在显著不同。结论PHPT伴发低镁血症并不少见。术前伴发低血镁提示PHPT的病情可能更严重。术后需通过积极监测血钙磷镁水平的变化来指导治疗。

[Objective] To explore the characteristics of serum magnesium levels in patients with primary hyperparathyroidism （PHPT） and its clinical significance through a retrospective study. [Methods] Clinical data including serum magnesium concentration were collected from 27 PHPT patients treated in our hospital during the past ten years, and statistically analyzed using SPSS. [Results] Among 27 PHPT patients, 40.7% had hypomagnesemia at the time of admittance into our hospital. In contrast to the PHPT patients with normal serum magnesium levels, those with hypomagnesemia showed significantly higher circulating PTH and ratio of urinary magnesium to calcium, less urinary calcium excretion and more common bone involvement. 16 of the 27 PHPT patients underwent parathy- roidectomy. Low serum magnesium status in 100% patients with pre-surgery hypomagnesemia did not recover but rather was worsened after operation. Moreover, post-surgery hypomagnesemia was also observed in 75% of the patients with pre-operative normal serum magnesium levels. PHPT patients with pre-operative hypomagnesemia developed significantly different calcium and phosphorus disturbances from those with pre-operative normal serum magne- sium levels after parathyroidectomy. [Conclusions] Hypomagnesemia is not a rare complication of PHPT. It may indicate more severe PHPT expression. After parathyroideetomy, monitoring serum calcium, phosphorus and magnesium levels is necessary for further therapeutic intervention of PHPT patients.