患者,女性,年龄40岁,体重72 kg,孕2产1,孕26周,因高血压人院.入院时BP 197/135 mm Hg（1 mm Hg=0.133kPa）,双下肢水肿;肾功能检查示：重度蛋白尿;血常规检查示：血小板计数32×109/L;肝功能检查示：总胆红素174μmol/L,直接胆红素3...患者,女性,年龄40岁,体重72 kg,孕2产1,孕26周,因高血压人院.入院时BP 197/135 mm Hg（1 mm Hg=0.133kPa）,双下肢水肿;肾功能检查示：重度蛋白尿;血常规检查示：血小板计数32×109/L;肝功能检查示：总胆红素174μmol/L,直接胆红素31.8μmol/L,ALT 173 U/L,白蛋白28 g/L;电解质未见异常;诊断为HELLP综合征（溶血、肝酶升高及低血小板）.静脉输注1.5%硫酸镁1.2～1.5 g/h,同时给予硝普钠控制血压,并行急诊术前准备.展开更多
Since the early reports nearly a decade ago, proton-pump inhibitor-induced hypomagnesemia （PPIH） has become a well-recognized phenomenon. While many observational studies in the inpatient and outpatient populations ...Since the early reports nearly a decade ago, proton-pump inhibitor-induced hypomagnesemia （PPIH） has become a well-recognized phenomenon. While many observational studies in the inpatient and outpatient populations have confirmed the association of PPI exposure and serum magnesium concentrations, there are no prospective,controlled studies to support causation. Molecular mechanisms of magnesium transporters, including the pH-dependent regulation of transient receptor potential melastatin-6 transporters in the colonic enterocyte, have been proposed to explain the effect of PPIs on magnesium reabsorption, but may be a small part of a more complicated interplay of molecular biology, pharmacology, and genetic predisposition. This review explores the current state of research in the feld of PPIH and the proposed mechanisms of this effect.展开更多
AIM:To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS:We enrolled 120 patients (57 male and 63 fem...AIM:To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS:We enrolled 120 patients (57 male and 63 female) aged 1-14 years old (median:4.7 years) with functional constipation from 13 hospitals and two private clinics.All patients fulfilled the Rome Ⅲ criteria for functional constipation and were treated with daily oral magnesium oxide for at least 1 mo.The median treatment dose was 600 (500-800) mg/d.Patients were assessed by an interview and laboratory examination to determine possible hypermagnesemia.Serum magnesium concentration was also measured in sex-and agematched control subjects (n=38).RESULTS:In the constipation group,serum magnesium concentration [2.4 (2.3-2.5) mg/dL,median and interquartile range] was significantly greater than that of the control group [2.2 (2.0-2.2) mg/dL] (P < 0.001).The highest value was 3.2 mg/dL.Renal magnesium clearance was significantly increased in the constipation group.Serum magnesium concentration in the constipation group decreased significantly with age (P < 0.01).There was no significant correlation between the serum level of magnesium and the duration of treatment with magnesium oxide or the daily dose.None of the patients had side effects associated with hypermagnesemia.CONCLUSION:Serum magnesium concentration increased significantly,but not critically,after daily treatment with magnesium oxide in constipated children with normal renal function.展开更多
文摘Since the early reports nearly a decade ago, proton-pump inhibitor-induced hypomagnesemia （PPIH） has become a well-recognized phenomenon. While many observational studies in the inpatient and outpatient populations have confirmed the association of PPI exposure and serum magnesium concentrations, there are no prospective,controlled studies to support causation. Molecular mechanisms of magnesium transporters, including the pH-dependent regulation of transient receptor potential melastatin-6 transporters in the colonic enterocyte, have been proposed to explain the effect of PPIs on magnesium reabsorption, but may be a small part of a more complicated interplay of molecular biology, pharmacology, and genetic predisposition. This review explores the current state of research in the feld of PPIH and the proposed mechanisms of this effect.
文摘AIM:To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS:We enrolled 120 patients (57 male and 63 female) aged 1-14 years old (median:4.7 years) with functional constipation from 13 hospitals and two private clinics.All patients fulfilled the Rome Ⅲ criteria for functional constipation and were treated with daily oral magnesium oxide for at least 1 mo.The median treatment dose was 600 (500-800) mg/d.Patients were assessed by an interview and laboratory examination to determine possible hypermagnesemia.Serum magnesium concentration was also measured in sex-and agematched control subjects (n=38).RESULTS:In the constipation group,serum magnesium concentration [2.4 (2.3-2.5) mg/dL,median and interquartile range] was significantly greater than that of the control group [2.2 (2.0-2.2) mg/dL] (P < 0.001).The highest value was 3.2 mg/dL.Renal magnesium clearance was significantly increased in the constipation group.Serum magnesium concentration in the constipation group decreased significantly with age (P < 0.01).There was no significant correlation between the serum level of magnesium and the duration of treatment with magnesium oxide or the daily dose.None of the patients had side effects associated with hypermagnesemia.CONCLUSION:Serum magnesium concentration increased significantly,but not critically,after daily treatment with magnesium oxide in constipated children with normal renal function.
