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[镁稳态。低镁血症的病因、临床诊断与治疗。病例研究]

[Magnesium homeostasis. Etiopathogeny, clinical diagnosis and treatment of hypomagnesaemia. A case study].

作者信息

González E Pérez, Santos F, Coto E

机构信息

Hospital Universitario Virgen Macarena, Sevilla.

出版信息

Nefrologia. 2009;29(6):518-24. doi: 10.3265/Nefrologia.2009.29.6.5534.en.full.

Abstract

Magnesium is the fourth-most abundant cation in the human body and the second-most abundant intracellular cation after potassium. Magnesium is pivotal in the transfer, storage, and utilization of energy as it regulates and catalyzes more than 300 enzyme systems. Hypomagnesemia may thus result in a variety of metabolic abnormalities and clinical consequences. It results from an imbalance between gastrointestinal absorption and renal excretion of magnesium. The main consequence related directly to hypomagnesemia is cardiovascular arrhythmias secondary to hipokaliemia and if this is not recognized and treated it may be fatal. In this article we review the hypomagnesemic disorders in children with emphasis on the molecular mechanisms responsible for abnormalities in magnesium homeostasis, differential diagnosis and appropriate therapy, and we describe the clinical and biochemical manifestations as well as the genetic defect in a family with Gitelman syndrome.

摘要

镁是人体中含量第四丰富的阳离子,是仅次于钾的细胞内第二丰富的阳离子。镁在能量的转移、储存和利用中起着关键作用,因为它调节和催化300多种酶系统。因此,低镁血症可能导致各种代谢异常和临床后果。它是由胃肠道对镁的吸收与肾脏对镁的排泄之间的不平衡引起的。与低镁血症直接相关的主要后果是继发于低钾血症的心血管心律失常,如果不认识到并加以治疗,可能会致命。在本文中,我们回顾了儿童低镁血症性疾病,重点关注镁稳态异常的分子机制、鉴别诊断和适当治疗,并描述了吉特曼综合征家族中的临床和生化表现以及基因缺陷。

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