慢性肾脏病3-5D期患者血镁浓度与腹主动脉钙化的关系

Study on the relationship between serum magnesium and abdominal aortic calcification in patients with chronic kidney disease

目的探讨慢性肾脏病(CKD)患者血镁浓度与腹主动脉钙化(AAC)之间的关系及干预钙化的措施。方法选取CKD3-5D期患者共67例,收集患者临床资料,根据是否检出AAC分为钙化组和无钙化组,比较两组间指标差异,分析AAC的高危因素。结果 15例有AAC(22.4%),52例无AAC(77.6%);钙化组年龄、血钙浓度、血磷浓度、钙磷乘积高于无钙化组(P<0.05),钙化组血镁水平低于无钙化组(2.2±0.2 vs 2.4±0.4)mg/dl(P<0.05);性别、体质量、血清白蛋白、碱性磷酸酶、全段甲状旁腺素(i PTH)、25羟维生素D、胆固醇和三酰甘油两组间均未见明显差异;二分类逻辑回归分析结果显示:年龄、血磷浓度、血镁浓度和钙磷乘积均为AAC独立的影响因素,血镁经过年龄、性别、磷、钙磷乘积和i PTH校正后差异有统计学意义(OR=0.072,95%CI:0.006~0.836 mg/dl,P=0.035)。结论高龄、高磷及高钙磷乘积患者易发生AAC,低镁是除年龄、血磷和钙磷乘积外AAC独立危险因素,提高体内血镁浓度可能有利于延缓AAC进展。

Objective To investigate the relationship between magnesium and abdominal aortic calcification （AAC） in patients with chronic kidney disease （ CKD）, and then speculate the intervention measures of vascular calcification. Methods 67 cases with CKD3-5D were enrolled in this study and the clinical data were collected. According to the detection of AAC, the patients were divided into calcification group and no calcification group. The factors between two groups were compared and the risk factors of AAC were analyzed. Results There were 15 cases with AAC （22.4%） ,52 cases without AAC （77.6%） ; The age, calcium, phosphorus and calcium phosphorus product in calcified group were significantly higher than those in non calcified group （ P 〈 0.05 ） ; The level of serum magnesium in calcified group was significantly lower than that in non calcified group （2.2 ±0. 2 vs 2.4± 0. 4） mg./dl（ P 〈 0.05 ） ; Gender, the body weight, serum albumin, alkaline phosphatase, intact parathyroid hormone （ iPTH）, 25 hydroxyvitamin D, cholesterol and triglyceride between the two groups had no significant difference ; Two classification Logistic regression analysis showed that age, serum phosphorus, serum magnesium and calcium phosphorus product were the independent risk factors of AAC. The result of magnesium was statistically significant （ OR = 0. 072,95% CI：0. 006 - 0. 836 mg/dl, P = 0. 035 ） , which were corrected by age, gender, phosphorus, calcium phosphorus product and iPTH. Conclusion Age, high calcium and phosphorus patients prone to abdominal aortic calcification, low magnesium is in addition to age, blood phosphorus and calcium phosphorus products of the abdomi- nal aortic calcification independent risk factors, improving the body＇s blood magnesium concentration may be conducive to delay the progress of abdominal aortic calcification.