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高镁血症抑制甲状旁腺活动的证据。

Evidence for suppression of parathyroid gland activity by hypermagnesemia.

作者信息

Massry S G, Coburn J W, Kleeman C R

出版信息

J Clin Invest. 1970 Sep;49(9):1619-29. doi: 10.1172/JCI106379.

Abstract

The effect of hypermagnesemia, produced by MgCl(2) infusion, on the activity of parathyroid glands, as assessed by changes in levels of serum calcium (S(Ca)) and in the fraction of filtered phosphate excreted (C(P)/C(Cr)), was studied in 11 intact and 4 thyroparathyroidectomized (T-PTX) dogs. To exclude the effect of diurnal variation in C(P)/C(Cr) on the results, studies were initiated in both morning and afternoon hours and each study with MgCl(2) infusion was paired with a control experiment in the same dog not receiving MgCl(2). During MgCl(2) infusion, serum phosphorus rose progressively. Despite this rise, the levels of C(P)/C(Cr) fell in all experiments and were significantly different from values observed at the same time of the day in the paired control experiments. The concentrations of total S(Ca) fell by 1.0-2.4 mg/100 ml with a proportional decrease in the levels of the diffusible and ionized fractions. The pattern of the fall in C(P)/C(Cr) during MgCl(2) resembled that observed after CaCl(2) infusion (seven dogs) and that which acutely followed thyroparathyroidectomy (seven dogs). When parathyroid extract was given to dogs receiving MgCl(2) infusion both C(P)/C(Cr) and S(Ca) rose, and MgCl(2) infusion did not affect C(P)/C(Cr) and S(Ca) in T-PTX dogs. These results indicate that hypermagnesemia suppresses the activity of the parathyroid glands, probably, by inhibiting production and (or) release of the hormone, without interfering with end-organ response. An increase in serum magnesium of 1.7-2.0 mg/100 ml was capable of producing the suppressive effect. Evaluation of the effect of simultaneous modest hypocalcemia and hypermagnesemia suggests that a decrease in the level of serum calcium is more potent than an increase in the concentration of serum magnesium in the regulation of parathyroid activity.

摘要

通过输注氯化镁产生高镁血症,研究其对甲状旁腺活动的影响,通过血清钙(S(Ca))水平变化以及滤过磷酸盐排泄分数(C(P)/C(Cr))来评估,实验对象为11只未切除甲状腺甲状旁腺的完整犬和4只甲状腺甲状旁腺切除(T-PTX)犬。为排除C(P)/C(Cr)的昼夜变化对结果的影响,实验在上午和下午时段均开展,且每次输注氯化镁的实验都与同一只未接受氯化镁的对照实验配对。在输注氯化镁期间,血清磷逐渐升高。尽管如此,在所有实验中C(P)/C(Cr)水平均下降,且与配对对照实验中同一天同一时间观察到的值有显著差异。总S(Ca)浓度下降1.0 - 2.4 mg/100 ml,可扩散部分和离子化部分的水平也相应下降。氯化镁输注期间C(P)/C(Cr)下降的模式类似于输注氯化钙后观察到的模式(7只犬)以及甲状腺甲状旁腺切除后立即出现的模式(7只犬)。当给接受氯化镁输注的犬注射甲状旁腺提取物时,C(P)/C(Cr)和S(Ca)均升高,且氯化镁输注对T-PTX犬的C(P)/C(Cr)和S(Ca)无影响。这些结果表明,高镁血症可能通过抑制甲状旁腺激素的产生和(或)释放来抑制甲状旁腺的活动,而不干扰终末器官的反应。血清镁升高1.7 - 2.0 mg/100 ml就能产生抑制作用。同时评估适度低钙血症和高镁血症的影响表明,在甲状旁腺活动调节中,血清钙水平降低比血清镁浓度升高更具效力。

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