老年维持性血液透析病人血镁水平及其临床意义  

Clinical value of blood magnesium levels in elderly patients with maintenance hemodialysis

作　　者：刘虹伶 王暴魁[1] 雷洁[2] 刘钰[2] 李苏童[2] LIU Hong-ling;WANG Bao-kui;LEI Jie;LIU Yu;LI Su-tong(Department of Nephrology,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;Department of Nephrology,Central Hospital of Xi’an,Xi’an 710000,China)

机构地区：[1]北京中医药大学东方医院肾病科,北京市100078 [2]西安市中心医院肾内科,陕西省西安市710000

出　　处：《实用老年医学》2023年第12期1206-1209,1214,共5页Practical Geriatrics

基　　金：陕西省重点研发项目(2017SF-070)。

摘　　要：目的调查老年维持性血液透析(maintenance hemodialysis,MHD)病人血镁水平,分析不同血镁水平病人的血压、全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平及营养状况。方法选择99例透析充分的老年MHD病人,根据透析前血镁水平将病人分为低镁组(<0.75 mmol/L,n=24)、正常组(0.75~1.02 mmol/L,n=45)和高镁组(>1.02 mmol/L,n=30),比较3组透析前血钙、血磷、iPTH、血浆白蛋白、Hb的水平以及透析中和透析间期的血压。结果不同血镁水平病人透析间期血压无明显变化,低镁组透析中SBP明显低于正常组和高镁组(P<0.01),DBP明显低于正常组(P<0.01)。3组间血iPTH、血钙、血磷、Hb水平按低镁组、高镁组、正常组依次升高,且3组间差异均有统计学意义(均P<0.01);正常组血浆白蛋白和Hb水平明显高于低镁组(P<0.05)。结论老年MHD病人血镁水平正常或升高者通常营养指标较好,透析中血压相对稳定,同时iPTH水平偏高。Objective To investigate the blood magnesium levels of the elderly patients undergoing maintenance hemodialysis(MHD),and to analyze the levels of blood pressure,intact parathyroid hormone(iPTH)and nutritional status in the patients with different levels of blood magnesium.Methods A total of 99 elderly MHD patients were enrolled and divided into low-magnesium group(<0.75 mmol/L,n=24),normal-magnesium group(0.75-1.02 mmol/L,n=45)and high-magnesium group(>1.02 mmol/L,n=30)according to the level of blood magnesium before hemodialysis.The levels of calcium,phosphorus,iPTH,plasma albumin,hemoglobin before hemodialysis and the blood pressure during hemodialysis and hemodialysis interval were observed and compared among the three groups.Results There was no significant difference in interdialytic blood pressure among the groups with different magnesium levels.The systolic blood pressure in the low-magnesium group was significantly lower than that in the normal-magnesium group and high-magnesium group(P<0.01),and the diastolic blood pressure in the low-magnesium group was significantly lower than that in the normal-magnesium group(P<0.01).The levels of iPTH,calcium,phosphorus and hemoglobin were significantly increased in the low-magnesium group,followed by the normal-magnesium group and the high-magnesium group(P<0.01).The plasma albumin level in the normal-magnesium group was significantly higher than that in the low-magnesium group(P<0.05).Conclusions Elderly MHD patients with normal or elevated blood magnesium levels usually have relatively normal nutritional status,relatively stable blood pressure and high level of iPTH during dialysis.

关 键 词：维持性血液透析 血镁 全段甲状旁腺激素 血压 营养状况 

分 类 号：R692[医药卫生—泌尿科学]