Tsutsui M, Shimokawa H, Yoshihara S, Sobashima A, Hayashida K, Higuchi S, Yamamoto K, Matsuguchi T, Okamatsu S
Department of Cardiology, Iizuka Hospital, Japan.
Jpn Heart J. 1993 Jul;34(4):391-401. doi: 10.1536/ihj.34.391.
It has been hypothesized that intracellular magnesium deficiency is a pathogenetic factor in acute myocardial infarction. This study examined the time course of changes in the erythrocyte magnesium concentration and the correlation between the erythrocyte magnesium concentration and the severity of acute myocardial infarction in 49 consecutive patients with transmural acute myocardial infarction. The data were compared with results from 20 control patients without ischemic heart disease. The erythrocyte magnesium concentration (mg/dl) decreased significantly during the acute phase of the infarction (4.86 +/- 0.09 on day 1, 4.89 +/- 0.10 on day 2 and 4.86 +/- 0.10 on day 3 versus 5.26 +/- 0.19 for controls, all P < 0.05) and then normalized gradually to 5.25 +/- 0.10 on day 28. The serum magnesium concentration (mg/dl) also decreased significantly during the acute phase of the infarction (1.93 +/- 0.04 on day 1 and 2.11 +/- 0.03 on day 2 versus 2.26 +/- 0.08 for controls, all P < 0.05), before recovering to 2.28 +/- 0.06 on day 28. There were significant correlations between the erythrocyte magnesium concentration on day 1 and maximal values of serum cardiac enzymes (r = -0.30 for creatine kinase, r = -0.34 for glutamic oxaloacetic transaminase and r = -0.57 for lactate dehydrogenase, all P < 0.05). Moreover, the erythrocyte magnesium concentration was significantly lower in patients with (4.32 +/- 0.08 mg/dl, n = 13) than in those without (5.06 +/- 0.09 mg/dl, n = 36, P < 0.0001) serious arrhythmias. These data indicate that intracellular magnesium deficiency is involved in the acute phase of myocardial infarction.
据推测，细胞内镁缺乏是急性心肌梗死的发病因素之一。本研究对49例连续性透壁性急性心肌梗死患者红细胞镁浓度的变化时间进程以及红细胞镁浓度与急性心肌梗死严重程度之间的相关性进行了研究。并将数据与20例无缺血性心脏病的对照患者的结果进行了比较。梗死急性期红细胞镁浓度（mg/dl）显著降低（第1天为4.86±0.09，第2天为4.89±0.10，第3天为4.86±0.10，而对照组为5.26±0.19，所有P<0.05），然后逐渐恢复正常，至第28天为5.25±0.10。梗死急性期血清镁浓度（mg/dl）也显著降低（第1天为1.93±0.04，第2天为2.11±0.03，而对照组为2.26±0.08，所有P<0.05），至第28天恢复至2.28±0.06。第1天的红细胞镁浓度与血清心肌酶的最大值之间存在显著相关性（肌酸激酶r=-0.30，谷草转氨酶r=-0.34，乳酸脱氢酶r=-0.57，所有P<0.05）。此外，发生严重心律失常的患者红细胞镁浓度（4.32±0.08mg/dl，n=13）显著低于未发生严重心律失常的患者（5.06±0.09mg/dl，n=36，P<0.0001）。这些数据表明，细胞内镁缺乏参与了心肌梗死的急性期。
