维持性血液透析患者血镁水平与心脏瓣膜钙化的关系  

Relationship between Blood Magnesium Level and Cardiac Valve Calcification in Maintenance Hemodialysis Patients

作　　者：申抗抗 王景福[1] 张宝红[1] 段书众[1] 吴艳青[1] 

机构地区：[1]承德医学院附属医院肾脏内科,河北承德067000

出　　处：《河北医学》2018年第2期197-201,共5页Hebei Medicine

基　　金：河北省承德市科学技术局计划项目;(编号:20142071)

摘　　要：目的:探讨维持性血液透析(maintenance hemodialysis,MHD)患者血镁与心脏瓣膜钙化(cardiar valve calcification,CVC)的关系。方法:选取年龄≥18岁、MHD≥3个月的患者。收集入选患者临床及血生化资料,采用超声心动图检查CVC情况。采用Logistic回归法分析血镁与CVC的关系。结果:(1)149例MHD患者血镁水平为1.08±0.16mmo L/L,高血镁者100例(67.1%),正常血镁者49例(32.9%);存在CVC者98例(65.8%);高血镁组发生CVC者60例(60.0%)显著低于正常血镁组的38例(77.6%)(P<0.05)。(2)CVC组患者的年龄、透析龄、冠心病、校正钙及血磷水平显著高于无CVC组(均P<0.05),无CVC组血镁水平、高血镁发生率显著高于CVC组(均P<0.05)。(3)多因素Logistic回归分析显示:血镁与CVC呈独立负相关(P=0.001);年龄、透析龄、血磷与CVC呈独立正相关(均P<0.05)。血镁与二尖瓣钙化(mitral valve calcificationotic,MVC)、主动脉瓣钙化(aortic valve calcification,AVC)及两瓣膜同时钙化(MVC+AVC)独立负相关(均P<0.05);血磷与MVC、AVC及MVC+AVC独立正相关(均P<0.05);透析龄与MVC独立正相关(P<0.05),年龄与AVC独立正相关(P<0.001)。结论:MHD患者血镁水平、高血镁及CVC患病率高;高血镁可降低MHD患者CVC发生率;高血磷是CVC的独立危险因素。Objective： To explore the relation between serum magnesium and cardiar valve calcification（CVC） in maintenance hemodialysis（MHD） patients. Methods： Patients with age≥18 years old,maintenance hemodialysis for ≥ 3 months were enrolled in this study.We collected their clinical data and blood biochemical indexes,CVC was measured by echocardiography. Logistic regression was used to analyze the relation between serum magnesium and CVC. Results：（1）Among 149 MHD patients,serum magnesium average was 1.08±0.16 mmol/L and 100 cases were high serum magnesium（67.1%）,49 cases were normal serum magnesium（32.9%）.98 cases were with CVC（65.8%）. There were 60 cases with CVC（60.0%） in the high blood magnesium group,which were significantly lower than those 38 with CVC in the normal serum magnesium.（2）Age,dialysis age,coronary heart disease,correction of calcium and serum scale were significantly higher in CVC group than non-CVC group（P 〈0.05）. Serum magnesium level and the incidence of high serum magnesium were significantly higher in non-CVC group than CVC group（P 〈0.05）.（3）Logistic regression analysis dispaly： Serum magnesium was independent negatively associated with CVC（P = 0. 001）; age,dialysis age,serum phosphorus were independent positively associated with CVC（P 〈 0. 05）. Serum magnesium was independently negatively associated with MVC,AVC,MVC and AVC（P 〈0.05）. Serum phosphorus was independently positively associated with MVC,AVC,MVC and AVC（P 〈0.05）. Dialysis age was independently positively associated with MVC（P 〈 0. 05）. Age was independently positively associated with AVC（P 〈 0.001）. Conclusion： The higher prevalence of serum magnesium,the higher serum magnesium and CVC in MHD patients,high serum magnesium can reduce the incidence of CVC in MHD patients; high serum phosphorus is an independent risk factor for CVC.

关 键 词：血清镁 血液透析 心脏瓣膜 钙化 

分 类 号：R542.5[医药卫生—心血管疾病] R692.5[医药卫生—内科学]