术后血清镁水平作为全甲状腺切除术后补钙需求的预测指标：一项前瞻性研究。
Postoperative serum magnesium levels as a predictor for the need for calcium replacement after total thyroidectomy: a prospective study.
机构信息
Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, SP, Brasil.
Departamento de Anatomia Patológica, A.C.Camargo Cancer Center, São Paulo, SP, Brasil.
出版信息
Arch Endocrinol Metab. 2023 Mar 30;67(3):355-360. doi: 10.20945/2359-3997000000581. Epub 2023 Jan 17.
OBJECTIVE
Our aim was to assess the ability of serum magnesium (Mg), measured on the first postoperative day (Mg1PO), to predict the need for calcium (Ca) replacement in patients undergoing total thyroidectomy (TT).
SUBJECTS AND METHODS
Eighty patients undergoing TT, with Mg1PO and PTH dosage in the first (PTH1h) and eighth (PTH8h) hours after TT, were evaluated for the need for Ca replacement. Data were evaluated by uni/multivariate logistic regression and Receiver Operating Characteristic (ROC) curve.
RESULTS
32 patients (40%) required Ca replacement. Median PTH1h, PTH8h and Mg1PO were higher in the no replacement group: 17 versus (vs) 3 pg/mL (p < 0.001), 18.2 vs 3.0 pg/mL (p < 0.001) and 2 vs 1.6 mg/dL (p < 0.001), respectively. Mg1PO was the isolated predictor for this replacement (odds ratio = 0.0004, 95% confidence interval: 0.000003-0.04; p = 0.001), with the cut-off value of 1.8 mg/dL showing sensitivity and specificity of 78.1% and 87.5%, respectively.
CONCLUSION
In this group of patients, serum Mg1PO was the isolated predictor for the need for Ca replacement.
目的
评估术后第 1 天（Mg1PO）的血清镁（Mg）水平预测行甲状腺全切除术（TT）患者是否需要补钙的能力。
对象和方法
对 80 例行 TT 术的患者进行评估，检测其 Mg1PO 及 TT 后第 1 小时（PTH1h）及第 8 小时（PTH8h）的甲状旁腺激素（PTH）水平，以评估是否需要补钙。通过单变量/多变量逻辑回归和受试者工作特征（ROC）曲线对数据进行评估。
结果
32 例（40%）患者需要补钙。不补钙组的 PTH1h、PTH8h 和 Mg1PO 中位数更高：17 比（vs）3 pg/mL（p < 0.001）、18.2 比 3.0 pg/mL（p < 0.001）和 2 比 1.6 mg/dL（p < 0.001）。Mg1PO 是唯一预测该替代治疗的因素（优势比=0.0004，95%置信区间：0.000003-0.04；p = 0.001），截断值为 1.8 mg/dL 时的灵敏度和特异性分别为 78.1%和 87.5%。
结论
在该组患者中，血清 Mg1PO 是预测是否需要补钙的唯一因素。
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