Güllner H G, Gill J R, Bartter F C
Am J Med. 1981 Oct;71(4):578-82. doi: 10.1016/0002-9343(81)90209-6.
The effect of magnesium treatment on serum potassium and potassium balance was examined in three siblings with a recently described syndrome of hypokalemic alkalosis with renal tubulopathy. Oral magnesium supplementation for 11 days in the three siblings increased mean serum potassium from 2.7 +/- 0.1 meq/liter to 3.3 +/- 0.2 meq/liter (p less than 0.05). In addition, urinary and fecal potassium excretion decreased by about 11 meq/day. Magnesium chloride did not affect plasma renin activity while the patients were supine or upright. In contrast, mean supine plasma aldosterone concentration increased from 5.3 +/- 1.5 ng/dl to 13.2 +/- 4.1 ng/dl (p greater than 0.1) and mean upright plasma aldosterone concentration increased from 17.4 +/- 3.8 ng/dl to 66.1 +/- 7.3 ng/dl (p less than 0.01). These findings suggest that hypokalemia and potassium loss in this disorder may be caused by abnormal magnesium metabolism. The increase in plasma aldosterone concentration may have been caused by the positive potassium balance or a direct effect of magnesium on aldosterone secretion from the adrenal gland.
对三名患有最近描述的伴有肾小管病变的低钾性碱中毒综合征的同胞进行了镁治疗对血清钾和钾平衡影响的研究。这三名同胞口服镁补充剂11天，平均血清钾从2.7±0.1毫当量/升升至3.3±0.2毫当量/升（p<0.05）。此外，尿钾和粪钾排泄量每天减少约11毫当量。患者仰卧或直立时，氯化镁不影响血浆肾素活性。相比之下，平均仰卧位血浆醛固酮浓度从5.3±1.5纳克/分升升至13.2±4.1纳克/分升（p>0.1），平均直立位血浆醛固酮浓度从17.4±3.8纳克/分升升至66.1±7.3纳克/分升（p<0.01）。这些发现表明，该疾病中的低钾血症和钾丢失可能由镁代谢异常引起。血浆醛固酮浓度的升高可能是由钾平衡正向改变或镁对肾上腺醛固酮分泌的直接作用所致。
