慢性肾脏病血清镁离子水平与动脉硬化及左心室功能的相关性

The Correlations Between Serum Magnesium Level and Arteriosclerosis,Left Ventricular Function in Patients with Chronic Kidney Disease

目的探究慢性肾脏病患者血清镁离子水平与动脉硬化、左心室功能的相关性。方法将2017年1月至2018年12月我院肾内科住院的200例慢性肾脏病患者分为CKD1期组(12例)、CKD2期组(38例)、CKD3期组(74例)、CKD4期组(55例)、CKD5期组(21例),比较各组患者一般生化指标、动脉硬化指标及左心室功能指标并分析镁离子与不同分期患者指标的相关性。结果(1)随着CKD分期的升高,慢性肾病患者三酰甘油(TG)、低密度脂蛋白(LDL-C)、血清磷、血肌酐(Scr)、尿素氮(BUN)等一般生化指标升高(P<0.05),血清钙逐渐降低(P<0.05);各组患者血清镁离子比较差异具有统计学意义(P<0.05),CKD1~4期患者比较差异无统计学意义(P>0.05),CKD5期患者显著高于其他组别(P<0.05)。(2)各组患者踝臂指数(ABI)、臂踝脉搏波传导速度(baPWV)比较差异具有统计学意义(P<0.05),其他指标比较差异无统计学意义(P>0.05)。(3)CKD1~3期患者血清镁离子水平与动脉硬化指标及心功能指标均无明显相关性(P>0.05);CKD4~5期患者血清镁离子水平与ABI、趾臂指数(TBI)及二尖瓣环舒张早期峰值速度(VE)呈正相关(P<0.05)。结论血清镁离子水平与慢性肾脏病晚期患者动脉硬化、左心功能存在密切关系,临床宜重视镁离子平衡的干预,降低与之相关的并发症发生率。

Objective To explore the correlation between serum magnesium level and arteriosclerosis,left ventricular function in patients with chronic kidney disease(CKD).Methods A total of 200 CKD patients who were hospitalized in the nephrology department of the hospital from January,2017 to December,2018 were divided into the CKD1 group(12 cases),CKD2 group(38 cases),CKD3 group(74 cases),CKD4 group(55 cases)and CKD5 group(21 cases).The general biochemical indexes,arteriosclerosis indexes and left ventricular function indexes were compared among all groups.The correlations between magnesium and indexes of patients in different stages were analyzed.Results(1)With the increase of CKD staging,general biochemical indexes,including triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),serum phosphorus,magnesium,serum creatinine(Scr)and blood urea nitrogen(BUN)were increased in CKD patients,while the serum calcium were decreased.There was a significant difference in the level of serum magnesium ions among patients across groups(P<0.05):there was no significant difference in patients from CKD1 to CKD4 stage(P>0.05),while the patients with CKD5 stage were significantly higher than other groups(P<0.05).(2)The ankle-brachial index(ABI),Brachial-ankle Pulse Wave Velocity(baPWV)of patients across each group was significantly different(P<0.05),and there was no significant difference in other indicators(P>0.05).(3)There was no significant correlation between serum magnesium concentration and arteriosclerosis indexes,cardiac function indexes in CKD patients at stage 1-3(P>0.05).In CKD patients at stage 4-5,serum magnesium concentration was positively correlated with TBI,ABI,VE and VA of mitral valve(P<0.05).Conclusion Serum magnesium level is closely related to arteriosclerosis and left ventricular function in advanced CKD patients.An intervention of magnesium balance should be emphasized in clinical practice to reduce the incidence of related complications.