Parikka H, Toivonen L, Pellinen T, Verkkala K, Järvinen A, Nieminen M S
First Department of Medicine, Helsinki University Central Hospital, Finland.
Eur Heart J. 1993 Feb;14(2):251-8. doi: 10.1093/eurheartj/14.2.251.
To examine the influence of magnesium (Mg) on hypomagnesaemia and atrial fibrillation (AF) following coronary artery by-pass surgery, 140 consecutive patients were randomized to receive 70 mmol of magnesium sulphate intravenously (n = 69) or placebo (n = 71). Serum magnesium concentrations fell to 0.77 +/- 0.10 mmol.l-1 in the control group but rose to 1.09 +/- 0.17 mmol.l-1 in the Mg group (P < 0.001). The incidence of AF was 29% in the Mg group and 26% in the placebo group (NS). The AF patients were older, more of them had had prior AF episodes, their sinus rates (SR) were slower (78 +/- 10 vs 86 +/- 12 beats.min-1; P < 0.01) and serum Mg concentrations higher (0.89 +/- 0.21 vs 0.80 +/- 0.11 mmol.l-1; P < 0.05). The incidence of AF was 43% in the highest quartile of serum Mg and 23% among the rest (P = 0.056). In patients experiencing AF during the first three post-operative days, serum Mg concentrations were higher and SR slower on each day compared with non-AF patients. SR increased post-operatively less with high Mg levels (P = 0.044). In the Mg group, serum Mg and SR were the only independent predictors of AF. In conclusion, the incidence of post-operative AF is not decreased with magnesium. High Mg levels are likely to provoke AF probably by mechanisms that modify SR.
为研究镁（Mg）对冠状动脉搭桥术后低镁血症和心房颤动（AF）的影响，140例连续患者被随机分为静脉注射70 mmol硫酸镁组（n = 69）或安慰剂组（n = 71）。对照组血清镁浓度降至0.77±0.10 mmol·l⁻¹，而镁组升至1.09±0.17 mmol·l⁻¹（P < 0.001）。镁组AF发生率为29%，安慰剂组为26%（无统计学差异）。AF患者年龄较大，更多患者有既往AF发作史，其窦性心律（SR）较慢（78±10对86±12次/分钟；P < 0.01）且血清镁浓度较高（0.89±0.21对0.80±0.11 mmol·l⁻¹；P < 0.05）。血清镁最高四分位数组AF发生率为43%，其余组为23%（P = 0.056）。术后前三天发生AF的患者，与未发生AF的患者相比，每天血清镁浓度更高且SR更慢。高镁水平时术后SR升高较少（P = 0.044）。在镁组，血清镁和SR是AF的仅有的独立预测因素。总之，镁不能降低术后AF的发生率。高镁水平可能通过改变SR的机制诱发AF。
