Huijgen H J, Sanders R, van Olden R W, Klous M G, Gaffar F R, Sanders G T
Academic Medical Center, University of Amsterdam, Department of Clinical Chemistry, The Netherlands.
Clin Chem. 1998 Mar;44(3):639-48.
To establish the best measure for determining magnesium overload, we measured ionized and total magnesium in serum and mononuclear blood cells and total magnesium in erythrocytes in blood of 23 hemodialysis patients, known for their disturbed magnesium homeostasis. When comparing the mean magnesium values obtained in the patient population with those of a control population, all of these magnesium markers, including the biologically active fractions, were significantly (P < 0.05) increased. Because serum total magnesium was not increased in all dialysis patients studied, the population was divided into two groups, according to total serum magnesium > 1.0 mmol/L or less than that. Results in these two populations showed that ionized serum magnesium and ionized magnesium in mononuclear blood cells might give a better indication about the magnesium status of the tested patients than the currently used total serum magnesium data. However, neither of the two markers, especially ionized serum magnesium, was able to discriminate fully between normal magnesium homeostasis and magnesium excess. We therefore conclude that the two ionized magnesium markers offer minimal advantage for this discrimination, and that the total magnesium concentration in serum remains the measurement of choice.
为确定测定镁过载的最佳方法，我们测定了23例已知镁稳态紊乱的血液透析患者血清和单核血细胞中的离子镁和总镁，以及红细胞中的总镁。将患者群体获得的平均镁值与对照群体的平均镁值进行比较时，所有这些镁标志物，包括生物活性部分，均显著升高（P<0.05）。由于在所有研究的透析患者中血清总镁并未升高，根据血清总镁>1.0 mmol/L或低于该值，将该群体分为两组。这两组人群的结果表明，与目前使用的血清总镁数据相比，血清离子镁和单核血细胞中的离子镁可能能更好地反映受试患者的镁状态。然而，这两种标志物，尤其是血清离子镁，均无法完全区分正常镁稳态和镁过量。因此，我们得出结论，这两种离子镁标志物在这种区分中优势极小，血清总镁浓度仍是首选的测量指标。
