SIGNIFICANCE OF HYPOMAGNESEMIA IN ALCOHOLIC PATIENTS
SIGNIFICANCE OF HYPOMAGNESEMIA IN ALCOHOLIC PATIENTS
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DOI：
10.1016/0002-9343(64)90028-2
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发表时间：
1964-01-01
影响因子：
5.9
通讯作者：
WALLACH, S
中科院分区：
文献类型：
--
作者：
FANKUSHEN, D;RASKIN, D;WALLACH, S
七个慢性酒精中毒患者严重低镁血症的描述，长期的饮食缺乏和胃肠道和肾脏的镁损失的成因强调的低镁血症中发挥的作用。在该组中，除容易归因于肝功能障碍的表现外，神经肌肉易激惹性增加的表现为轻度或不存在。除镁外，细胞外电解质浓度存在显著紊乱，包括低钙血症、低钾血症、低磷血症和水肿。在2例患者中，在纠正低钙血症后，阳性Trousseau体征消失，在3例患者中，尽管持续低镁血症，但随着肝功能改善，震颤和震颤消失。1例肌肉分析证实细胞镁缺乏。在2例患者中进行了放射性镁（Mg28）周转研究，发现尽管细胞外和细胞内总镁耗尽，但细胞可交换镁池扩大。这些数据表明，镁缺乏症是一个复杂的现象，并不一定会导致增加神经肌肉过敏。当低镁血症和增加的神经肌肉易激性同时存在于酒精中毒患者中时，通常通过改善肝功能和纠正电解质紊乱而不是低镁血症的措施来缓解神经功能缺陷。
Seven chronic alcoholic patients with profound hypomagnesemia are described, and the roles played by prolonged dietary deficiency and gastrointestinal and renal losses of Mg in the genesis of the hypomagnesemia stressed. In this group, manifestations of increased neuromuscular irritability other than those readily ascribable to hepatic dysfunction were mild or absent. Significant disturbances in the extracellular concentrations of electrolytes other than Mg were present and included hypocalcemia, hypokalemia, hypophosphatemia and alkalosis. In 2 patients, positive Trousseau signs disappeared upon correction of the hypocalcemia, and in 3 patients tremor and asterixis disappeared as hepatic function improved despite persistent hypomagnesemia. Cellular Mg deficiency was demonstrated in 1 patient by muscle analysis. Radiomagnesium (Mg28) turnover studies were performed in 2 patients and revealed enlarged cellular exchangeable Mg pools despite extracellular and cellular depletion of total Mg. These data indicate that Mg deficiency is a complex phenomenon which does not necessarily lead to increased neuromuscular irritability. When hypomagnesemia and increased neuromuscular irritability coexist in alcoholic patients, the neurologic defect is usually relieved by measures that improve hepatic function and correct electrolyte disturbances other than hypomagnesemia.