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[心血管病理学与镁]

[Cardiovascular pathology and magnesium].

作者信息

Maurat J P, Kantelip J P, Anguenot T, Platonoff N

机构信息

Laboratoires de Médecine Expérimentale et Pharmacologie Fondamentale, Faculté de Médecine, Besançon.

出版信息

Therapie. 1993 Nov-Dec;48(6):599-607.

PMID:8091345
Abstract

There is no univocal clinical cardiovascular pattern associated with magnesium deficiency. Only an acute hypomagnesaemia gives the evidence of a real magnesium deficiency. Arrhythmias corrected by magnesium are associated with potassium deficiency. Magnesium deficiency appears to be one risk factor of arrhythmias and coronary spasms. The influence of intravenous magnesium salts was clearly evaluated on cardiovascular electrophysiology allowing protocols infusion. The major beneficial effect of magnesium on total incidence of arrhythmias appears to have been due to a reduction in supraventricular tachyarrhythmias and especially in "torsade de pointes". Antiarrhythmic mechanisms still remain to be clarified. It is likely that magnesium influences cardiac conduction and refractoriness by affecting calcium dependent processes as if acting as an indirect inactivator of slow inward calcium current, probably secondary to an inward shift of the background potassium mediated current. Recent studies demonstrated beneficial effect of intravenous magnesium treatment in acute myocardial infraction, both as to mortality and to early cardiac insufficiency. Beside antiarrhythmic and vasodilatator effects, magnesium seems to show cardiac cells protective action against ischaemia.

摘要

镁缺乏症没有单一明确的临床心血管模式。只有急性低镁血症才能证明真正存在镁缺乏。镁纠正的心律失常与钾缺乏有关。镁缺乏似乎是心律失常和冠状动脉痉挛的危险因素之一。静脉注射镁盐对心血管电生理的影响已通过允许进行方案输注的方式得到明确评估。镁对心律失常总发生率的主要有益作用似乎是由于室上性快速心律失常尤其是“尖端扭转型室速”的减少。抗心律失常机制仍有待阐明。镁可能通过影响钙依赖性过程来影响心脏传导和不应期,就好像它作为慢内向钙电流的间接失活剂起作用,这可能继发于背景钾介导电流的内向转移。最近的研究表明,静脉注射镁治疗对急性心肌梗死的死亡率和早期心脏功能不全均有有益作用。除抗心律失常和血管舒张作用外,镁似乎还对心肌细胞具有抗缺血保护作用。

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