Magnesium therapy after aneurysmal subarachnoid haemorrhage a dose-finding study for long term treatment
Magnesium therapy after aneurysmal subarachnoid haemorrhage a dose-finding study for long term treatment
复制标题
DOI：
10.1007/s00701-002-1064-9
复制
发表时间：
2003-03-01
影响因子：
2.4
通讯作者：
Rinkel, GJE
中科院分区：
文献类型：
--
作者：
van den Bergh, WM;Albrecht, KW;Rinkel, GJE
背景。镁是一种可预防或逆转动脉瘤性蛛网膜下腔出血后迟发性脑缺血（DCI）的神经保护剂。虽然短期镁治疗的剂量已经确定，但对镁的长期使用剂量缺乏了解。我们的目的是寻找一个硫酸镁的剂量计划，以维持血清镁水平在1.0-2.0 mmol/L 14天，以覆盖dci期间。我们前瞻性研究了14例动脉瘤性蛛网膜下腔出血（SAH）后48小时内入院的患者。采用3种不同的给药方案，静脉给予硫酸镁14天。A组（3例）先一次性注射硫酸镁16 mmol/d，再持续输注16 mmol/d；B组（n = 6）连续输注30mmol /d；C组（n = 5）连续输注64 mmol/d。至少每2天测定一次血清镁，并在镁治疗期间持续观察所有患者。仅c组测定肾镁排泄量。A组治疗期间血清镁平均水平为1.03 +/- 0.14（范围0.82 ~ 1.34）mmol/L， B组为1.10 +/- 0.15（范围0.87 ~ 1.43）mmol/L， C组为1.38 +/- 0.18（范围1.11 ~ 1.98）mmol/L。C组在治疗开始后48小时内的肾镁排泄量与给药剂量相等。A组所有患者均报告在大剂量注射时有潮红感觉；没有发现其他副作用。连续静脉注射剂量为64 mmol/L /天，血清镁水平维持在1.0-2.0 mmol/L范围内14天。
Background. Magnesium is a neuroprotective agent which might prevent or reverse delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH). Although the dosage for short-term magnesium therapy is well established, there is lack of knowledge on the dosage for extended use of magnesium. Our aim was to find a dosage schedule of magnesium sulphate to maintain a serum magnesium level of 1.0-2.0 mmol/L for 14 days to cover the period of DCI.Methods. We prospectively studied 14 patients admitted within 48 hours after aneurysmal subarachnoid haemorrhage (SAH) to our hospital. Magnesium sulphate was administrated intravenously for 14 days, using 3 different dosage schedules. Group A (= 3) received a bolus injection of 16 mmol magnesium sulphate followed by a continuous infusion of 16 mmol/dayly; group B (n = 6) a continuous infusion of 30 mmol/dayly; and group C (n = 5) a continuous infusion of 64 mmol/dayly. Serum magnesium was measured at least every two days and all patients were under continuous observation during magnesium treatment. Renal magnesium excretion was measured only in group C.Findings. In treatment group A the mean serum magnesium level during treatment was 1.03 +/- 0.14 (range 0.82-1.34) mmol/L, in group B 1.10 +/- 0.15 (range 0.87-1.43) mmol/L, and in group C 1.38 +/- 0.18 (range 1.11-1.98) mmol/L. The renal magnesium excretion in group C was equal to the administrated doses within 48 hours after treatment had started. All patients in group A reported a flushing sensation during the bolus injection; no other side effects were noted.Interpretation. With a continuous intravenous dosage of 64 mmol/L per day, serum magnesium levels maintained within the range of 1.0-2.0 mmol/L for 14 days.