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低镁血症可预测甲状腺切除术后的生化性低钙血症。

Hypomagnesemia predicts postoperative biochemical hypocalcemia after thyroidectomy.

作者信息

Luo Han, Yang Hongliu, Zhao Wanjun, Wei Tao, Su Anping, Wang Bin, Zhu Jingqiang

机构信息

Department of Thyroid & Parathyroid surgery, West China Hospital, Sichuan University, Guoxue Alley 37#, Chengdu, Sichuan, 610041, People's Republic of China.

Department of Nephrology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

出版信息

BMC Surg. 2017 May 25;17(1):62. doi: 10.1186/s12893-017-0258-2.

Abstract

BACKGROUND

To investigate the role of magnesium in biochemical and symptomatic hypocalcemia, a retrospective study was conducted.

METHODS

Less-than-total thyroidectomy patients were excluded from the final analysis. Identified the risk factors of biochemical and symptomatic hypocalcemia, and investigated the correlation by logistic regression and correlation test respectively.

RESULTS

A total of 304 patients were included in the final analysis. General incidence of hypomagnesemia was 23.36%. Logistic regression showed that gender (female) (OR = 2.238, p = 0.015) and postoperative hypomagnesemia (OR = 2.010, p = 0.017) were independent risk factors for biochemical hypocalcemia. Both Pearson and partial correlation tests indicated there was indeed significant relation between calcium and magnesium. However, relative decreasing of iPTH (>70%) (6.691, p < 0.001) and hypocalcemia (2.222, p = 0.046) were identified as risk factors of symptomatic hypocalcemia. The difference remained significant even in normoparathyroidism patients.

CONCLUSIONS

Postoperative hypomagnesemia was independent risk factor of biochemical hypocalcemia. Relative decline of iPTH was predominating in predicting symptomatic hypocalcemia.

摘要

背景

为研究镁在生化性及症状性低钙血症中的作用,开展了一项回顾性研究。

方法

全甲状腺切除术患者被排除在最终分析之外。确定生化性及症状性低钙血症的危险因素,并分别通过逻辑回归和相关性检验进行研究。

结果

最终分析纳入了304例患者。低镁血症的总体发生率为23.36%。逻辑回归显示,性别(女性)(比值比=2.238,p=0.015)和术后低镁血症(比值比=2.010,p=0.017)是生化性低钙血症的独立危险因素。Pearson相关性检验和偏相关性检验均表明钙与镁之间确实存在显著关系。然而,iPTH相对降低(>70%)(6.691,p<0.001)和低钙血症(2.222,p=0.046)被确定为症状性低钙血症的危险因素。即使在甲状旁腺功能正常的患者中,这种差异仍然显著。

结论

术后低镁血症是生化性低钙血症的独立危险因素。iPTH的相对下降在预测症状性低钙血症中起主要作用。

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