Kapsner P, Langsdorf L, Marcus R, Kraemer F B, Hoffman A R
Arch Intern Med. 1986 Oct;146(10):1965-8.
Heart and heart-lung transplant recipients at Stanford (Calif) University Medical Center were routinely prescribed long-term calcium carbonate antacid therapy to aid in the prevention of peptic ulcer disease and osteoporosis associated with glucocorticoid immunosuppressive therapy. Patients consumed 4 to more than 10 g/d of elemental calcium. Since calcium carbonate also provides the essential ingredients for the development of the milk-alkali syndrome, the laboratory flow sheets of 297 heart and heart-lung transplant recipients were reviewed to examine the incidence of hypercalcemia. Sixty-five patients developed significant hypercalcemia after transplantation. Thirty-one patients were alkalotic at the time of hypercalcemia; 37 had impairment in renal function. It is likely that most of these patients had the milk-alkali syndrome. While most patients became eucalcemic by discontinuing calcium carbonate therapy, intravenous hydration and forced diuresis were used to treat severe cases. It is possible that the incidence of the milk-alkali syndrome will increase with the current popularity of prescribing calcium carbonate for the prevention and treatment of osteoporosis.
加利福尼亚州斯坦福大学医学中心的心脏及心肺移植受者通常会接受长期碳酸钙抗酸治疗，以预防与糖皮质激素免疫抑制治疗相关的消化性溃疡疾病和骨质疏松症。患者每天摄入4至超过10克元素钙。由于碳酸钙也是导致乳-碱综合征的关键成分，因此对297名心脏及心肺移植受者的实验室流程表进行了审查，以检查高钙血症的发生率。65名患者在移植后出现了明显的高钙血症。31名患者在出现高钙血症时存在碱中毒；37名患者肾功能受损。这些患者中大多数可能患有乳-碱综合征。虽然大多数患者通过停用碳酸钙治疗后血钙恢复正常，但对于严重病例则采用静脉补液和强制利尿进行治疗。随着目前碳酸钙在预防和治疗骨质疏松症方面的广泛应用，乳-碱综合征的发生率可能会增加。
