慢性肾脏病血清镁离子、钙离子水平与周围神经功能的相关性研究  

Correlation between serum magnesium and calcium ions and peripheral nerve function in chronic kidney disease

作　　者：左晓莉 商洪雪 王玉娟[1] Zuo Xiao-li;Shang Hong-xue;Wang Yu-juan(Department of Cardiology&Nephrology,No.961 Hospital,Chinese People's Liberation Army,Qiqihar 161000,China)

机构地区：[1]中国人民解放军联勤保障部队第961医院心肾内科,齐齐哈尔市161000

出　　处：《临床肾脏病杂志》2021年第1期44-48,共5页Journal Of Clinical Nephrology

摘　　要：目的研究慢性肾脏病(chronic kidney disease,CKD)患者血清Ca^(2+)和Mg^(2+)水平及其与周围神经功能的相关性。方法选取2011年10月至2019年10月中国人民解放军联勤保障部队第961医院收治的CKD患者300例为样本进行横断面研究,根据肾小球滤过率分为1~5期,比较各期血清Ca^(2+)和Mg^(2+)水平,同时测量正中神经和腓总神经的感觉及运动传导潜伏期、传导速度和波幅,比较不同血钙和血镁水平患者的神经传导速度、潜伏期和波幅等神经电生理指标的差异,并分析各指标与血清Ca^(2+)、Mg^(2+)水平的相关性。结果CKD 1~3期患者血清Ca^(2+)水平明显高于4~5期(P<0.05),血清Mg^(2+)水平明显低于4~5期(P<0.05),CKD 1~3期低钙血症和高镁血症发生率明显低于4~5期患者(P<0.05)。正常血钙组和高钙血症组正中神经和腓总神经的感觉及运动传导潜伏期低于低钙血症组,神经传导速度及波幅均高于低钙血症组,且高钙血症组正中神经和腓总神经的运动传导波幅高于正常血钙组,差异均有统计学意义(P<0.05);正常血镁组和高镁血症组正中神经和腓总神经的感觉及运动传导潜伏期低于低镁血症组,神经传导速度及波幅高于低镁血症组,且高镁血症组腓总神经的运动传导波幅高于正常血镁组,差异均有统计学意义(P<0.05)。CKD患者正中神经和腓总神经的感觉及运动传导潜伏期与血清Ca^(2+)和Mg^(2+)水平均具有明显负相关性(P<0.05),神经传导速度和波幅均与血清Ca^(2+)和Mg^(2+)水平具有明显正相关性(P<0.05)。结论CKD患者常合并Ca^(2+)和Mg^(2+)代谢紊乱,并可能对周围神经功能造成不利影响。Objective To explore the ionic levels of serum calcium(Ca^2+)and magnesium(Mg^2+)in patients with chronic kidney disease(CKD)and examine their correlations with peripheral nerve functions.Methods From October 2011 to October 2019,a total of 300 CKD patients were selected as subjects for this cross-sectional study.According to the glomerular filtration rate,they were divided into 1~5 stages.The serum levels of Ca^(2+)and Mg^(2+)were compared among different stages.Sensory and motor conduction latencies,conduction velocities,amplitudes of median and common peroneal nerves were measured and the correlations between parameters and serum levels of Ca^(2+)and Mg^(2+)analyzed.Results The serum levels of Ca^(2+)and Mg^(2+)in patients with CKD stage 1~3 were significantly higher than those in those with stage 4~5(P<0.05)and the incidence rates of hypocalcemia and hypermagnesemia in CKD stage 1~3 were significantly lower than those in stage 4~5(P<0.05).The sensory and motor conduction latencies of median and common peroneal nerves in normal blood calcium and hypercalcemia group were lower than those in hypocalcemia group.SNCV and amplitude were higher than those in hypocalcemia group and motor conduction amplitudes of median and common peroneal nerves were higher in hypercalcemia group than those in normal blood calcium group(P<0.05).The sensory and motor conduction latencies of median and common peroneal nerves were significantly lower in normal blood magnesium and hypermagnesemia groups than those in hypomagnesemia group.And sural nerve conduction velocity(SNCV)and amplitude were higher than those in hypomagnesemia group and motor conduction amplitude of common peroneal nerve was higher in hypermagnesemia group than that in normal blood magnesium group(P<0.05).The sensory and motor conduction latencies of median nerve and common peroneal nerve of CKD patients were significantly negatively correlated(P<0.05)while SNCV and amplitude significantly positively correlated with serum levels of Ca^(2+)and Mg^(2+)(P<0.05).Conclus

关 键 词：慢性肾脏病 周围神经 镁离子 钙离子 

分 类 号：R692[医药卫生—泌尿科学]