Agus Z S, Wasserstein A, Goldfarb S
Am J Med. 1982 Mar;72(3):473-88. doi: 10.1016/0002-9343(82)90519-8.
The components of calcium and magnesium balance and the factors responsible for the maintenance of the serum concentration of these cations are reviewed. Within this framework, the causes and treatment of disturbances of the serum concentration are discussed. Hypercalcemia is usually a reflection of increased bone resorption and/or gut absorption with the kidney playing a secondary role. Hypocalcemia is usually due to either a disturbance in the parathyroid hormone-adenylate cyclase system or a disturbance in vitamin D metabolism. As vitamin D is required for expression of the action of PTH at bone and as PTH is a prime regulator of vitamin D metabolism, the absence of either component results in important disturbances in calcium balance. In contrast to calcium homeostasis, the kidney plays a major role in the determination and regulation of serum magnesium. The major causes of hypermagnesemia therefore are associated with loss of renal function, and hypomagnesemia is frequently due to renal magnesium wasting.
本文综述了钙和镁平衡的组成部分以及维持这些阳离子血清浓度的相关因素。在此框架内，讨论了血清浓度紊乱的原因及治疗方法。高钙血症通常反映骨吸收增加和/或肠道吸收增加，而肾脏起次要作用。低钙血症通常是由于甲状旁腺激素 - 腺苷酸环化酶系统紊乱或维生素D代谢紊乱所致。由于维生素D是甲状旁腺激素在骨骼发挥作用所必需的，且甲状旁腺激素是维生素D代谢的主要调节因子，因此任何一方缺失都会导致钙平衡的重要紊乱。与钙稳态不同，肾脏在血清镁的测定和调节中起主要作用。因此，高镁血症的主要原因与肾功能丧失有关，而低镁血症通常是由于肾脏镁流失所致。
