Davis T M, Li G Q, Guo X B, Spencer J L, St John A
University of Western Australia, Department of Medicine, Fremantle Hospital.
Trans R Soc Trop Med Hyg. 1993 Jan-Feb;87(1):49-53. doi: 10.1016/0035-9203(93)90416-n.
Previous studies have shown depressed serum corrected calcium and phosphate concentrations in acute falciparum malaria. To characterize malaria-associated disturbances in mineral homoeostasis further, serum ionized calcium and intracellular phosphate were measured in 18 patients (10 with falciparum malaria, 8 with vivax malaria) and 10 healthy controls. Six patients (4 falciparum, 2 vivax) had admission serum ionized calcium concentrations below the absolute control range (< 1.15 mmol/litre) and a further six (3 falciparum, 3 vivax) developed ionized hypocalcaemia during treatment. The patients with falciparum malaria had the lowest values at presentation (median [95% confidence intervals in brackets]: 1.17 [1.12-1.23] vs. 1.20 [1.18-1.24] mmol/litre in controls, P = 0.035) in the presence of depressed simultaneous serum parathormone concentrations (1.2 [0.6-1.9] vs. 1.6 [1.1-2.6] pmol/litre; P = 0.05). Admission serum phosphate concentrations were lower in the malaria patients (P = 0.007 vs. controls), especially in those with falciparum malaria (0.85 [0.7-1.1] vs. 1.2 [1.1-1.3] mmol/litre in controls; P = 0.002); patients with falciparum malaria also had significantly lower intracellular phosphate than controls (0.74 [0.58-0.90] vs. 0.88 [0.66-1.04] mmol/litre red cells; P = 0.047). There was a weak association between serum corrected and ionized calcium in the malaria patients (rs = 0.31, n = 18, P > 0.1), but serum and intracellular phosphate correlated significantly (rs = 0.71, n = 17, P < 0.001) with a regression line slope of 0.49 and intercept of 0.27 mmol/litre of red cells.(ABSTRACT TRUNCATED AT 250 WORDS)
以往研究表明，急性恶性疟患者血清校正钙和磷酸盐浓度降低。为了进一步明确疟疾相关的矿物质稳态紊乱情况，对18例患者（10例恶性疟，8例间日疟）和10名健康对照者测定了血清离子钙和细胞内磷酸盐。6例患者（4例恶性疟，2例间日疟）入院时血清离子钙浓度低于绝对对照范围（<1.15 mmol/升），另有6例（3例恶性疟，3例间日疟）在治疗期间出现离子钙血症。恶性疟患者就诊时的值最低（中位数[括号内为95%置信区间]：1.17[1.12 - 1.23] vs.对照组1.20[1.18 - 1.24] mmol/升，P = 0.035），同时血清甲状旁腺激素浓度降低（1.2[0.6 - 1.9] vs. 1.6[1.1 - 2.6] pmol/升；P = 0.05）。疟疾患者入院时血清磷酸盐浓度较低（与对照组相比P = 0.007），尤其是恶性疟患者（0.85[0.7 - 1.1] vs.对照组1.2[1.1 - 1.3] mmol/升；P = 0.002）；恶性疟患者的细胞内磷酸盐也显著低于对照组（0.7[0.58 - 0..90] vs.红细胞0.88[0.66 - 1.04] mmol/升；P =..04..7）。疟疾患者血清校正钙和离子钙之间存在弱相关性（rs = 0.31，n = 18，P>0.1），但血清和细胞内磷酸盐显著相关（rs =..071，n = 17，P<.001），回归线斜率为0.49，红细胞截距为0.27 mmol/升。（摘要截短于250字）
