Stroke. 2010 Aug;41(8):1841-4. doi: 10.1161/STROKEAHA.110.585232. Epub 2010 Jun 10.
Conflicting data have been obtained on optimal plasma magnesium concentrations for clinical outcomes in patients with aneurysmal subarachnoid hemorrhage.
Adults (aged 18 years or older) who had acute aneurysmal subarachnoid hemorrhage diagnosed were randomly assigned to receive either an intravenous MgSO(4) infusion (80 mmol in 500 mL normal saline per day) or a placebo (500 mL normal saline per day) for up to 14 days. Post hoc multivariable binary logistic regression analyses were performed by dividing mean plasma magnesium concentrations into 4 quartiles according to treatment group and then comparing with the lowest quartiles.
The worst clinical outcomes at 6 months were seen in MgSO(4) group patients, with mean plasma magnesium concentrations in the fourth quartile, and in placebo group patients, with mean such concentrations in the third and fourth quartiles.
No evidence was found to suggest that a higher mean plasma magnesium concentration improves clinical outcomes. On the contrary, we found an association between high plasma magnesium concentration and worse clinical outcomes.
关于最佳血浆镁浓度对颅内动脉瘤性蛛网膜下腔出血患者临床转归的影响，目前的数据相互矛盾。
将诊断为急性颅内动脉瘤性蛛网膜下腔出血的成年患者（年龄 18 岁或以上）随机分配，接受静脉注射硫酸镁（80mmol 硫酸镁溶于 500mL 生理盐水，每天 1 次）或安慰剂（每天 500mL 生理盐水）治疗，疗程最长达 14 天。采用多变量二项逻辑回归分析，根据治疗组将平均血浆镁浓度分为 4 个四分位数，然后与最低四分位数进行比较。
6 个月时，硫酸镁组患者的最差临床结局与第 4 四分位数的平均血浆镁浓度相关，而安慰剂组患者的最差临床结局与第 3 四分位数和第 4 四分位数的平均血浆镁浓度相关。
没有证据表明较高的平均血浆镁浓度可改善临床结局。相反，我们发现高血浆镁浓度与较差的临床结局之间存在关联。
